RESUMEN
BACKGROUND: Reassurance seeking has been hypothesized to be a key factor in the maintenance of anxiety and obsessive-compulsive disorders according to contemporary cognitive-behavioural therapy (CBT) approaches. The present study sought to examine the structure, clinical correlates, and malleability of reassurance seeking in the context of CBT treatment. METHODS: Treatment-seeking participants (Nâ¯=â¯738) with DSM-IV-TR (American Psychiatric Association, 2000) panic disorder with agoraphobia (PD/A), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) completed the Reassurance Seeking Scale (RSS) with other symptom measures prior to and following CBT treatment. RESULTS: A confirmatory factor analysis supported a three factor solution: the need to seek excessive reassurance regarding decisions, attachment and the security of relationships, and perceived general threat and anxiety. The RSS was moderately correlated with general measures of anxiety and depression as well as disorder-specific symptom scales. Further, CBT was found to produce changes in reassurance seeking across CBT treatments and these reductions were significantly associated with disorder-specific clinical improvement. CONCLUSION: Reassurance seeking appears to be a common factor across anxiety disorders and its reduction in CBT treatment is associated with improved clinical outcomes.
Asunto(s)
Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual , Trastorno Obsesivo Compulsivo/psicología , Trastorno Obsesivo Compulsivo/terapia , Adolescente , Adulto , Anciano , Agorafobia/psicología , Agorafobia/terapia , Ansiedad/psicología , Ansiedad/terapia , Trastornos de Ansiedad/complicaciones , Depresión/complicaciones , Depresión/psicología , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastorno de Pánico/psicología , Trastorno de Pánico/terapia , Fobia Social/psicología , Fobia Social/terapia , Resultado del Tratamiento , Adulto JovenRESUMEN
There is a growing interest in the role of distress tolerance (i.e., the capacity to withstand negative emotions) in the onset and maintenance of anxiety. However, both empirical and theoretical knowledge regarding the role of distress tolerance in the anxiety disorders is relatively under examined. Accumulating evidence supports the relationship between difficulties tolerating distress and anxiety in nonclinical populations; however, very few studies have investigated distress tolerance in participants with diagnosed anxiety disorders. Individuals with social anxiety disorder (SAD), generalized anxiety disorder (GAD), panic disorder with and without agoraphobia (PD/A) and obsessive-compulsive disorder (OCD) completed measures of distress tolerance (DT), conceptually related measures (i.e., anxiety sensitivity (AS), intolerance of uncertainty (IU)), and anxiety symptom severity. Results showed that DT was negatively associated with AS and IU. DT was correlated with GAD, SAD and OCD symptoms, but not PD/A symptoms, in individuals with those respective anxiety disorders. DT was no longer a significant predictor of OCD or anxiety disorder symptom severity when AS and IU were also taken into account. There were no between group differences on DT across OCD and the anxiety disorder groups. Implications for the role of distress tolerance in anxiety pathology are discussed.
Asunto(s)
Trastornos de Ansiedad/psicología , Trastorno Obsesivo Compulsivo/psicología , Estrés Psicológico/psicología , Incertidumbre , Adulto , Análisis de Varianza , Ansiedad/psicología , Femenino , Humanos , Masculino , Trastornos Fóbicos/psicología , Escalas de Valoración PsiquiátricaRESUMEN
BACKGROUND: Research on post-event processing (PEP), where individuals conduct a post-mortem evaluation of a social situation, has focused primarily on its relationship with social anxiety. AIMS: The current study examined: 1) levels of PEP for a standardized event in different anxiety disorders; 2) the relationship between peak anxiety levels during this event and subsequent PEP; and 3) the relationship between PEP and disorder-specific symptom severity. METHOD: Participants with primary DSM-IV diagnoses of social anxiety disorder (SAD), obsessive compulsive disorder (OCD), panic disorder with/without agoraphobia (PD/A), or generalized anxiety disorder (GAD) completed diagnosis specific symptom measures before attending group cognitive behavioural therapy (CBT) specific to their diagnosis. Participants rated their peak anxiety level during the first group therapy session, and one week later rated PEP in the context of CBT. RESULTS: The results indicated that all anxiety disorder groups showed heightened and equivalent PEP ratings. Peak state anxiety during the first CBT session predicted subsequent level of PEP, irrespective of diagnostic group. PEP ratings were found to be associated with disorder-specific symptom severity in SAD, GAD, and PD/A, but not in OCD. CONCLUSIONS: PEP may be a transdiagnostic process with relevance to a broad range of anxiety disorders, not just SAD.
Asunto(s)
Trastornos de Ansiedad/psicología , Juicio , Trastornos Fóbicos/psicología , Percepción Social , Adulto , Agorafobia/clasificación , Agorafobia/diagnóstico , Agorafobia/psicología , Agorafobia/terapia , Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual , Femenino , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/clasificación , Trastorno Obsesivo Compulsivo/diagnóstico , Trastorno Obsesivo Compulsivo/psicología , Trastorno Obsesivo Compulsivo/terapia , Trastorno de Pánico/clasificación , Trastorno de Pánico/diagnóstico , Trastorno de Pánico/psicología , Trastorno de Pánico/terapia , Trastornos Fóbicos/clasificación , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/terapia , Psicoterapia de Grupo , Encuestas y CuestionariosRESUMEN
There is accumulating evidence suggesting that anxiety sensitivity (AS) may play a role in social anxiety disorder (SAD; e.g., Ball, Otto, Pollack, Uccello, & Rosenbaum, 1995). Precedent research has demonstrated the role of AS in panic disorder and posttraumatic stress disorder, and subsequently, treatment techniques aimed at reducing AS (i.e., interoceptive exposure (IE)) have been studied in these populations (Schmidt & Trakowski, 2004; Wald & Taylor, 2008). The purpose of this study was to examine the types of responses elicited during IE exercises among individuals with SAD. This study describes the responses of individuals with SAD (n = 37) and nonclinical control participants (n = 28) to six IE exercises. Significant differences in responses to the IE exercises were found between participants with SAD and nonclinical controls. However, there were no significant differences in responses to the exercises among persons with SAD, depending on whether the exercises were completed in private versus group settings. Similarity to symptoms during naturally occurring anxiety significantly predicted fearful responding across all exercises in persons with SAD. Implications and directions for future research are discussed.
Asunto(s)
Ansiedad/psicología , Miedo , Trastornos Fóbicos/psicología , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
The association between anxiety sensitivity (AS) and posttraumatic stress disorder (PTSD) has been established in contemporary literature; however, research is divided over the nature of specific relationships between AS dimensions and PTSD symptoms clusters. Further, a paucity of research has examined the AS and PTSD relationship while accounting for theoretically relevant variables, such as negative (NA) and positive affect (PA). The purpose of the current study was twofold: first, to clarify divergent findings regarding the contribution of AS dimensions to PTSD symptom clusters, and, second, to further assess the relevance of NA and PA within the AS/PTSD relationship. Hierarchal regression analyses showed that, beyond shared variance attributable to NA and PA, AS somatic concerns were significantly associated with three of four PTSD symptom (i.e., reexperiencing, numbing, hyperarousal), AS cognitive concerns were only associated with hyperarousal, and AS socially observable symptoms were not significantly associated with any PTSD symptom clusters. These findings suggest that AS somatic concerns are the most robust predictor of variance within the AS/PTSD relationship and further clarify the theoretical importance of NA and PA within this relationship. Comprehensive results, implication, and directions for future research are discussed.
Asunto(s)
Síntomas Afectivos/psicología , Ansiedad/psicología , Trastornos por Estrés Postraumático/psicología , Adulto , Síntomas Afectivos/complicaciones , Ansiedad/complicaciones , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Análisis de Regresión , Trastornos por Estrés Postraumático/complicacionesRESUMEN
The fear of negative evaluation (FNE) represents a fundamental component of social anxiety and social anxiety disorder (SAD) within modern cognitive-behavioral models (Clark & Wells, 1995; Rapee & Heimberg, 1997). As such, access to comprehensive psychometrics for measures of FNE is an important component of thorough clinical and research efforts. Among the most popular measures of FNE have been variations of the 12-item Brief Fear of Negative Evaluation (BFNE) scale (Leary, 1983). There are currently three versions of the BFNE based on two psychometric studies (i.e., two 8-item variants and a 12-item variant). There is still substantial debate regarding which of the three alternatives should be used by researchers and clinicians. Normative data for each of the three alternatives are not available across samples of individuals with diagnosed anxiety and mood disorders; moreover, there has been no comparative assessment of responses for such samples. The present investigation was to provide more definitive recommendations about the three alternatives, to provide normative clinical data, and to explore differences in FNE endorsement across anxiety and mood disorders. Clinical participants included 381 individuals (60% women; age M=35.61, SD=12.49) from an established anxiety treatment and research center. Diagnoses included those with a principal diagnosis of SAD (32%), those with a diagnosis of SAD as an additional disorder (24%), those without a diagnosis of SAD (41%), and those with features of SAD (3%). Results of descriptive analyses, factor analyses, analysis of variance, and receiver operating curves demonstrated that the 12-item variant of the BFNE was inferior or comparable to the two 8-item variants. FNE scores were consistently higher among all participants with a diagnosis of SAD (either principal or additional) relative to all other diagnostic groups (p<.05). Accordingly, the current evidence, as well as parsimony and previous research, supports the utility of the 8-item variant that includes only the original straightforwardly worded items from the BFNE. Comprehensive findings, implications, and future research directions are discussed.
Asunto(s)
Trastornos de Ansiedad/psicología , Miedo/psicología , Trastornos del Humor/psicología , Adulto , Trastornos de Ansiedad/diagnóstico , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Humor/diagnóstico , Escalas de Valoración Psiquiátrica , Psicometría , Curva ROC , Encuestas y CuestionariosRESUMEN
Recent evidence supports the notion that relatively common social events, such as public humiliation and teasing, may precipitate or exacerbate symptoms of social anxiety disorder (SAD; Erwin et al., 2006; McCabe et al., 2010). In addition, individuals with SAD often report event-specific hallmark symptoms of posttraumatic stress (PTSS; e.g., intrusive memories, avoidance, hyperarousal) following significant negative social events. Although intriguing, there is a paucity of research data to date exploring the relationships between negative social events, social anxiety, and PTSS. The present study (1) assessed endorsement rates of negative social events; (2) compared patterns of social anxiety and PTSS reporting among persons reporting negative social events relative to persons reporting the Criterion A1 events associated with posttraumatic stress disorder; and (3) evaluated the interrelationships between social anxiety and PTSS, and common constructs including fear of negative evaluation, anxiety sensitivity, and depression. Participants included community members (n = 601; 74% women; M(age) = 25.8, SD = 9.8) who endorsed experiencing a significantly negative social event. Approximately 55% of all participants reported experiencing a negative social event, with one-third of those indicating it was worse than the Criterion A events they had experienced. Participants reporting negative social events scored higher on measures of social anxiety and PTSS than those reporting only Criterion A events. Trauma symptoms only predicted social anxiety symptoms for participants who reported a negative social event. Comprehensive results and directions for future research are discussed.
Asunto(s)
Trastornos Fóbicos/psicología , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/psicología , Adolescente , Adulto , Análisis de Varianza , Depresión/psicología , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Autoinforme , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) are frequently comorbid among veteran and community samples. Several studies have demonstrated significant comorbidity between trauma, PTSD, and social anxiety (SA), and a growing number of studies have explored the nature of this association. Although a diagnosis of either PTSD or SAD alone can result in significant impairment in social and occupational functioning, these difficulties are often magnified in persons suffering from both disorders. This review describes the current state-of-the-art regarding the co-occurrence of trauma, PTSD, and SA. First, we provide an overview of empirical data on the prevalence of co-occurring trauma, PTSD, and SAD. Second, we describe possible explanatory models of the co-occurrence, with a specific focus on the shared vulnerability model. Third, we review the available empirical data addressing the postulates of this model, including both genetic and psychological vulnerabilities. Fourth, we describe additional factors-guilt, shame, and depressive symptoms-that may help to explain the co-occurrence of PTSD and SA. A better understanding of this complex relationship will improve the efficacy of treatment for individuals suffering from both disorders. We conclude with key areas for future research.
Asunto(s)
Miedo , Relaciones Interpersonales , Acontecimientos que Cambian la Vida , Trastornos Fóbicos/psicología , Trastornos por Estrés Postraumático/psicología , Comorbilidad , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Trastorno Depresivo/psicología , Culpa , Humanos , Modelos Psicológicos , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/epidemiología , Factores de Riesgo , Vergüenza , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiologíaRESUMEN
The Social Phobia Inventory (SPIN) was designed to assess three dimensions of social anxiety (i.e., fear, avoidance, and physiological arousal) as posited by the scale authors (Connor et al., 2000). Despite expectations of a 3-factor solution, analyses of the SPIN to date have provided support for 3- and 5-factor solutions (Radomsky et al., 2006). Moreover, a 3-item version, the Mini-SPIN (Connor et al., 2001), has good sensitivity and specificity for generalized social anxiety disorder (SAD), implying some item redundancy. Another recent psychometric analysis of the SPIN was performed in a diagnostically diverse clinical sample (Antony et al., 2006); however, the study did not include a comprehensive evaluation of the factor structure. The current study was designed to comprehensively assess the SPIN factor structure using exploratory (EFA) and confirmatory (CFA) factor analyses in undergraduate (N=227) and clinical samples (N=355) using current recommendations for factor analyses (Osborne et al., 2008). Results suggest a 10-item 3-factor solution may be an ideal fit for clinical samples; however, using the undergraduate sample, the same solution was significantly better than precedent solutions but nonetheless not ideal. Implications and recommendations for future research are discussed.
Asunto(s)
Ansiedad/diagnóstico , Trastornos Fóbicos/diagnóstico , Conducta Social , Adolescente , Adulto , Afecto , Anciano , Distribución de Chi-Cuadrado , Análisis Factorial , Miedo/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Escalas de Valoración Psiquiátrica , Psicometría , Curva ROC , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Interest in the role of intolerance of uncertainty (IU) - the tendency for a person to consider the possibility of a negative event occurring as unacceptable and threatening irrespective of the probability of its occurrence - in anxiety disorders has been increasing in recent research. IU has been implicated as an important construct associated with generalized anxiety disorder (GAD); however, a growing body of research suggests that levels of IU are also high among individuals with other anxiety disorders. Despite the increasing interest, few studies have examined the relationship between IU and social anxiety (SA). The purpose of the present investigation was to further investigate the relationship between IU and SA. Participants included 286 community members (71% women) from Canada who completed measures of IU, SA, anxiety sensitivity, and fear of negative evaluation (FNE). Regression analyses revealed that the inhibitory anxiety dimension of IU, the fear of socially observable anxiety symptoms dimension of anxiety sensitivity, and the FNE were consistently significant predictors of SA symptoms. Unexpectedly, IU and FNE were often comparable predictors of SA variance. Moreover, participants with SA symptoms consistent with SAD exhibited levels of IU comparable to those reported by participants with worry symptoms consistent with GAD. Comprehensive findings, implications, and directions for future research are discussed.
Asunto(s)
Trastornos de Ansiedad/psicología , Percepción Social , Incertidumbre , Adolescente , Adulto , Canadá , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Fóbicos/psicología , Análisis de RegresiónRESUMEN
BACKGROUND: The Social Interaction Anxiety Scale and Social Phobia Scale are companion measures for assessing symptoms of social anxiety and social phobia. The scales have good reliability and validity across several samples, however, exploratory and confirmatory factor analyses have yielded solutions comprising substantially different item content and factor structures. These discrepancies are likely the result of analyzing items from each scale separately or simultaneously. The current investigation sets out to assess items from those scales, both simultaneously and separately, using exploratory and confirmatory factor analyses in an effort to resolve the factor structure. METHODS: Participants consisted of a clinical sample (n 5353; 54% women) and an undergraduate sample (n 5317; 75% women) who completed the Social Interaction Anxiety Scale and Social Phobia Scale, along with additional fear-related measures to assess convergent and discriminant validity. RESULTS: A three-factor solution with a reduced set of items was found to be most stable, irrespective of whether the items from each scale are assessed together or separately. Items from the Social Interaction Anxiety Scale represented one factor, whereas items from the Social Phobia Scale represented two other factors. CONCLUSION: Initial support for scale and factor validity, along with implications and recommendations for future research, is provided.
Asunto(s)
Relaciones Interpersonales , Inventario de Personalidad/estadística & datos numéricos , Trastornos Fóbicos/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Fóbicos/psicología , Psicometría/estadística & datos numéricos , Valores de Referencia , Reproducibilidad de los Resultados , Estudiantes/psicología , Adulto JovenRESUMEN
Few studies have examined why socially related fears and posttraumatic stress commonly, but not invariably, co-occur. It may be that only traumata of human agency (e.g., sexual assault), for which there is an interpersonal component, give rise to co-occurring socially related fears. These symptoms might also co-occur because of shared genetic factors. We investigated these issues using a sample of 882 monozygotic and dizygotic twins. No significant differences in socially related fear (i.e., fear of negative evaluation, fear of socially observable arousal symptoms) were found between participants reporting assaultive or nonassaultive trauma. However, significant differences in socially related fear were found when participants were grouped into probable PTSD and no PTSD groups. Participants with probable PTSD exhibited greater socially related fear (i.e., fear of negative evaluation) than those without PTSD. Using biometric structural equation modeling, trauma exposure was best explained by shared and nonshared environmental influences. The fear of socially observable arousal symptoms was influenced by genetic and nonshared environmental influences. Implications and directions for future research are discussed.
Asunto(s)
Miedo , Acontecimientos que Cambian la Vida , Medio Social , Trastornos por Estrés Postraumático/genética , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Víctimas de Crimen , Enfermedades en Gemelos/genética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Trastornos por Estrés Postraumático/diagnóstico , Gemelos/genética , Adulto JovenRESUMEN
The present investigation examined the impact of anxiety sensitivity (AS) and media exposure on posttraumatic stress disorder (PTSD) symptoms. Reactions from 143 undergraduate students in Hamilton, Ontario were assessed in the Fall of 2003 to gather information on anxiety, media coverage, and PTSD symptoms related to exposure to a remote traumatic event (September 11th). Regression analyses revealed that the Anxiety Sensitivity Index (ASI; [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual, 2nd ed. Worthington, Ohio: International Diagnostic Systems]) and State-Trait Anxiety Inventory trait form (STAI-T; [Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). State-trait anxiety inventory. Palo Alto, California: Consulting Psychologists Press]) total scores were significant predictors of PTSD symptoms in general. The ASI total score was also a significant predictor of hyperarousal and avoidance symptoms. Subsequent analyses further demonstrated differential relationships based on subscales and symptom clusters. Specifically, media exposure and trait anxiety predicted hyperarousal and re-experiencing symptoms, whereas the ASI fear of somatic sensations subscale significantly predicted avoidance and overall PTSD symptoms. Implications and directions for future research are discussed.
Asunto(s)
Trastornos de Ansiedad/psicología , Acontecimientos que Cambian la Vida , Medios de Comunicación de Masas , Inventario de Personalidad/estadística & datos numéricos , Trastornos por Estrés Postraumático/diagnóstico , Adolescente , Adulto , Nivel de Alerta/fisiología , Análisis por Conglomerados , Miedo/psicología , Femenino , Humanos , Masculino , Modelos Psicológicos , Valor Predictivo de las Pruebas , Escalas de Valoración Psiquiátrica , Sensación/fisiología , Ataques Terroristas del 11 de Septiembre/psicología , Trastornos por Estrés Postraumático/psicología , Estudiantes/psicología , Encuestas y Cuestionarios , TelevisiónRESUMEN
UNLABELLED: Elevated fear of pain is believed to denote a potential mechanism through which pain is maintained over time; however, our knowledge about fear of pain, its measurement, and its conceptualization is far from complete. It has been assumed that the latent structure of fear of pain is multidimensional and continuous. Although there is factor analytic evidence that it is multidimensional, there have been no empiric efforts to establish whether fear of pain is continuous or discontinuous (ie, taxonic or dichotomous latent class variable) in nature. Using taxometric methods in a sample of 650 patients seeking treatment for musculoskeletal or headache pain, we evaluated the latent structure of fear of pain as indexed by the Pain Anxiety Symptoms Scale. Results from analyses of simulated Monte Carlo data, MAXEIG-HITMAX, and MAMBAC and L-mode external consistency tests indicated that the latent structure of fear of pain was nontaxonic, characterized by latent continuity. Results are discussed in relation to the conceptual understanding of fear of pain, implications for treatment, and future directions for research on issues pertinent to pain-related fear. PERSPECTIVE: This article presents an analysis designed to establish whether fear of pain is continuous or discontinuous in clinical samples. The findings, indicating that fear of pain is continuous, are important for understanding the nature of fear of pain and to designing appropriately targeted interventions.
Asunto(s)
Trastornos de Ansiedad/etiología , Miedo , Dolor/complicaciones , Dolor/psicología , Adulto , Trastornos de Ansiedad/clasificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor/métodos , Inventario de Personalidad , Psicometría/métodos , Reproducibilidad de los ResultadosRESUMEN
The Brief Fear of Negative Evaluation Scale [BFNE; Leary, M. R. (1983). A brief version of the Fear of Negative Evaluation Scale. Personality and Social Psychology Bulletin, 9, 371-375] is a self-report measure designed to assess fear of negative evaluation, a characteristic feature of social anxiety disorders [Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741-756]. Recent psychometric assessments have suggested that a 2-factor model is most appropriate, with the first factor comprising the straightforwardly worded items and the second factor comprising the reverse-worded items [Carleton, R. N., McCreary, D., Norton, P. J., & Asmundson, G. J. G. (in press-a). The Brief Fear of Negative Evaluation Scale, Revised. Depression & Anxiety; Rodebaugh, T. L., Woods, C. M., Thissen, D. M., Heimberg, R. G., Chambless, D. L., & Rapee, R. M. (2004). More information from fewer questions: the factor structure and item properties of the original and brief fear of negative evaluation scale. Psychological Assessment, 2, 169-181; Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., et al. (2005). Empirical validation and psychometric evaluation of the Brief Fear of Negative Evaluation Scale in patients with social anxiety disorder. Psychological Assessment, 17, 179-190]. Some researchers recommend the reverse-worded items be removed from scoring [e.g., Rodebaugh, T. L., Woods, C. M., Thissen, D. M., Heimberg, R. G., Chambless, D. L., & Rapee, R. M. (2004). More information from fewer questions: the factor structure and item properties of the original and brief fear of negative evaluation scale. Psychological Assessment, 2, 169-181; Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., et al. (2005). Empirical validation and psychometric evaluation of the Brief Fear of Negative Evaluation Scale in patients with social anxiety disorder. Psychological Assessment, 17, 179-190]; however [Carleton, R. N., McCreary, D., Norton, P. J., & Asmundson, G. J. G. (in press-a). The Brief Fear of Negative Evaluation Scale, Revised. Depression & Anxiety; Collins, K. A., Westra, H. A., Dozois, D. J. A., & Stewart, S. H. (2005). The validity of the brief version of the fear of negative evaluation scale. Journal of Anxiety Disorders, 19, 345-359] recommend that these items be reworded to maintain scale sensitivity. The present study examined the reliability and validity of the BFNE-II, a version of the BFNE evaluating revisions of the reverse-worded items in a community sample. A unitary model of the BFNE-II resulted in excellent confirmatory factor analysis fit indices. Moderate convergent and discriminant validity were found when BFNE-II items were correlated with additional independent measures of social anxiety [i.e., Social Interaction Anxiety & Social Phobia Scales; Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470], and fear [i.e., Anxiety Sensitivity Index; Reiss, S., & McNally, R. J. (1985). The expectancy model of fear. In S. Reiss, R. R. Bootzin (Eds.), Theoretical issues in behaviour therapy (pp. 107--121). New York: Academic Press. and the Illness/Injury Sensitivity Index; Carleton, R. N., Park, I., & Asmundson, G. J. G. (in press-b). The Illness/Injury Sensitivity Index: an examination of construct validity. Depression & Anxiety). These findings support the utility of the revised items and the validity of the BFNE-II as a measure of the fear of negative evaluation. Implications and future research directions are discussed.
Asunto(s)
Afecto , Miedo , Trastornos Fóbicos/diagnóstico , Encuestas y Cuestionarios , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Fóbicos/psicología , Reproducibilidad de los ResultadosRESUMEN
Attentional bias research with chronic pain samples has yielded conflicting results. In the present investigation the startle paradigm was used to test the postulate that fear-based mechanisms play an important role in attentional biases for pain-related threat in chronic pain. Participants, including 31 individuals with chronic musculoskeletal pain and 20 healthy controls, completed a startle task designed to measure attention to different types of words (neutral vs sensory pain vs affective pain vs health catastrophe) presented at different levels of cognitive processing (strategic vs automatic). Measures of fear-based individual difference variables, including anxiety sensitivity and fear of pain, were also completed. Startle amplitudes and latencies to acoustic startle probes that followed word presentations were recorded. Data were analyzed with repeated measures ANOVAs and correlational analysis. Significant between-group differences were found indicating that, relative to chronic pain participants, healthy controls had higher startle amplitude index scores for health catastrophe words. There was also a trend among patients with chronic pain for greater startle amplitude index scores for strategic presentations of sensory pain words. In the automatic condition, all participants demonstrated a lower startle latency index for sensory words relative to both affect and health catastrophe words, suggesting participants had more difficulty disengaging from affect and health catastrophe words or were more avoidant of sensory words. Correlational analyses indicated that startle response indices for words related to health catastrophe became more pronounced for chronic pain patients as anxiety sensitivity and fear of pain increased. Implications and directions for future research are discussed.
Asunto(s)
Nivel de Alerta , Automatismo/psicología , Dolor de Espalda/psicología , Dolor de Cuello/psicología , Reflejo de Sobresalto , Estimulación Acústica , Adolescente , Adulto , Atención , Reacción de Prevención , Miedo , Femenino , Humanos , Individualidad , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Inventario de Personalidad , Lectura , Semántica , Encuestas y CuestionariosRESUMEN
The purpose of this article is to summarize strategies for effectively managing the symptoms of anxiety. The distinction between the cognitive, physiological and behavioral components of fear and anxiety is explained and various treatment targets are outlined. Empirically-supported strategies that are effective in alleviating common symptoms of anxiety are reviewed. These include various forms of psychosocial intervention (i.e., cognitive and behavioral therapies), pharmacotherapy, in addition combined treatment approaches. Expert consensus guidelines, prognostic factors, patient preferences and accessibility issues are discussed with regard to treatment selection in addition to emerging challenges in the field and future research directions.