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Zhou J, Zou F, Gong X. The Reciprocal Relations between Parental Psychological Control and Social Anxiety and the Mediating Role of Self-Concept Clarity Among Chinese Early Adolescents. J Youth Adolesc 2024; 53:2363-2377. [PMID: 38811479 DOI: 10.1007/s10964-024-02015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/13/2024] [Indexed: 05/31/2024]
Abstract
Although parental psychological control has been well-documented as a significant predictor of social anxiety among adolescents, few studies examine how changes in parental psychological control and adolescent social anxiety are reciprocally related at the within-person level, especially in Chinese culture. This longitudinal study examined reciprocal relations between parental psychological control and social anxiety, and the potential mediating role of self-concept clarity, by disentangling between- and within-person effects. A total of 4731 students (44.9% girls; Mage = 10.91 years, SD = 0.72) participated in a four-wave longitudinal study with 6-month intervals. Results from random intercept cross-lagged panel modeling indicated that parental psychological control directly predicted social anxiety, and vice versa. Parental psychological control indirectly predicted social anxiety via self-concept clarity, and social anxiety also indirectly predicted parental psychological control via self-concept clarity. These findings reveal a vicious cycle of mutual influence between parental psychological control and adolescent social anxiety in Chinese youth, and highlight the crucial role of self-concept clarity in the interplay between parenting and adolescent social functioning.
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Affiliation(s)
- Jianhua Zhou
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Fan Zou
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Xue Gong
- Department of Psychology, Normal College, Qingdao University, Qingdao, China.
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Malivoire BL, Rowa K, Milosevic I, McCabe RE. Partner symptom accommodation in generalized anxiety disorder: a preliminary examination of correlates with symptoms and cognitive behavioural therapy outcome. Behav Cogn Psychother 2024; 52:478-494. [PMID: 38712614 DOI: 10.1017/s1352465824000213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
BACKGROUND Symptom accommodation is suggested to maintain anxiety pathology and interfere with treatment effectiveness for anxiety and related disorders. However, little is known about symptom accommodation in generalized anxiety disorder (GAD). AIM This study investigated the associations between romantic partner symptom accommodation, GAD symptoms, intolerance of uncertainty (IU), relationship satisfaction, and cognitive behavioural therapy (CBT) outcomes from the perspective of the person with GAD. METHOD One hundred and twelve people with GAD participated in group CBT and completed measures at pre- and post-treatment. RESULTS All participants endorsed that their partner engaged in symptom accommodation to some extent, and the most commonly endorsed type was providing reassurance. Greater self-reported partner symptom accommodation was associated with greater GAD symptoms, chronic worry severity, IU, and relationship satisfaction at baseline. Partner symptom accommodation was found to significantly decrease over treatment; however, less improvement in symptom accommodation from pre- to post-treatment was associated with worse treatment outcomes. DISCUSSION This study is the first to show that partner symptom accommodation is prevalent in adults with GAD and to elucidate the presentation and frequency of behaviours. The findings provide preliminary evidence that targeting partner symptom accommodation in treatment may improve CBT outcomes.
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Affiliation(s)
- B L Malivoire
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
- Anxiety Treatment and Research Clinic, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - K Rowa
- Anxiety Treatment and Research Clinic, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - I Milosevic
- Anxiety Treatment and Research Clinic, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - R E McCabe
- Anxiety Treatment and Research Clinic, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Azoulay R, Gilboa-Schechtman E. Specificity of cost and probability biases in social anxiety: Comparing status and belongingness threats. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:273-280. [PMID: 38717962 DOI: 10.1111/bjc.12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/24/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Social anxiety (SA) is characterized by concerns about the expected occurrence (probability) and anticipated distress (cost) of social threats. Unclear is whether SA correlates specifically with biased expectations of belongingness or status threats. AIMS We aimed to discern if SA is uniquely tied to biased expectancies of either belongingness or status threats. MATERIALS AND METHODS We assessed 757 participants' perceptions of exclusion and put-down scenarios, analysing associations between SA and threat perceptions. DISCUSSION Our findings support the status-sensitivity hypothesis, suggesting individuals with high SA are particularly attuned to the perceived cost of status threats, potentially informing treatment approaches. CONCLUSION Understanding SA's link to status concerns enhances therapeutic strategies, emphasizing the need to address status-related situations, cognitions, and emotions in interventions.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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Lang JC, Peters BJ, Tudder A, Gresham AM, Zoccola PM, Allan NP. Conflicting patterns of cardiovascular reactivity, self-report, and behavior associated with social anxiety during a conversation with a close friend. Psychophysiology 2024:e14629. [PMID: 38886908 DOI: 10.1111/psyp.14629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/26/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
Social anxiety (SA) is characterized by anxious symptomology and fear during social situations, but recent work suggests that SA may not necessarily be associated with negative interpersonal and intrapersonal outcomes in support contexts. The current research investigates the discrepancies between self-perceptions, behavior, and physiological responses associated with SA in social support conversations with close friends. Specifically, we examined the associations between SA and positive and negative affect, perceptions of demands and resources, and responsiveness. Additionally, we used the biopsychosocial model of challenge and threat to understand the physiological responses associated with SA. Participants (79.9% White, 9.8% Black or African American, 10.3% Multiple races or other; 78.7% Female), totaling 172 undergraduate friend dyads, completed self-report measures and had physiological responses recorded while they discussed a problem unrelated to the friendship. Trained coders rated responsive behaviors exhibited during the conversation. Results revealed that greater SA was associated with greater negative perceptions of social interactions (greater negative affect, fewer perceived resources, and greater perceived demands). However, cardiovascular reactivity and behavioral responses within the conversation, as well as perceptions of partners' behavior after the conversation, contrasted with these negative perceptions. Indeed, greater SA was associated with greater sympathetic arousal (indicative of greater task engagement), but not with greater challenge or threat, and SA was not associated with perceived partner responsiveness or responsive behaviors. These results add to the growing body of research that suggests people with greater SA show inconsistencies between their conscious appraisals of social situations and their physiological responses.
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Affiliation(s)
- Jessica C Lang
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Brett J Peters
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Ashley Tudder
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Peggy M Zoccola
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Nicholas P Allan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
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Wu J, Wang H, Li X, Van IK, Xie X, Pang CH. Social anxiety mediates between victimization experiences and internet addiction among adolescents: results from propensity score matching. Front Psychol 2024; 15:1378428. [PMID: 38860039 PMCID: PMC11164189 DOI: 10.3389/fpsyg.2024.1378428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Background Previous research has indicated that Victimization Experiences (VE) may be linked to a heightened likelihood of developing psychological symptoms and Internet Addiction (IA) among adolescents. However, the precise mechanism through which VE contributes to IA in adolescents remains uncertain. This study aimed to investigate whether Social Anxiety (SA) serves as a mediation between VE and IA, utilizing the framework of General Strain Theory. Methods A cross-sectional survey among 11 middle schools or high schools in Macao was conducted from October to December 2022. Respondents in the victimized group and non-victimized group were 1:1 paired using Propensity Score Matching (PSM) to control the potential confounding factors. Results A total of 1,089 questionnaires were valid for analysis and 311 pairs were generated through PSM. Respondents in the victimized group reported significantly higher IA than those in non-victimized group (23.5% vs. 12.5%, p < 0.001) after PSM treatment. Multivariate logistic regression analysis showed that VE (p = 0.015, OR = 1.750, 95% CI = 1.115 to 2.746, E-value = 2.90) and SA (p < 0.001, OR = 1.052, 95% CI = 1.030 to 1.074, E-value = 1.29) were the predictors of IA. The model successfully classified 81.7% of cases overall (R 2 N = 0.133). Further analysis indicated that SA mediates between VE and IA (Z = 3.644, p < 0.001). Conclusion This study revealed the potential mediation effect of SA on the link between VE and IA. By acknowledging the mediating influence of SA, researchers and practitioners can develop more accurate and effective strategies to mitigate Internet Addiction among adolescents.
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Affiliation(s)
- Jianwei Wu
- Kiang Wu Nursing College of Macau, Complexo de Cuidados de Saúde das Ilhas – Edifício do Instituto de Enfermagem Kiang Wu de Macau, Avenida do Hospital das Ilhas no. 447, Macao, Macao SAR, China
| | - Hui Wang
- Kiang Wu Nursing College of Macau, Complexo de Cuidados de Saúde das Ilhas – Edifício do Instituto de Enfermagem Kiang Wu de Macau, Avenida do Hospital das Ilhas no. 447, Macao, Macao SAR, China
| | - Xiang Li
- Kiang Wu Nursing College of Macau, Complexo de Cuidados de Saúde das Ilhas – Edifício do Instituto de Enfermagem Kiang Wu de Macau, Avenida do Hospital das Ilhas no. 447, Macao, Macao SAR, China
| | - Iat Kio Van
- Kiang Wu Nursing College of Macau, Complexo de Cuidados de Saúde das Ilhas – Edifício do Instituto de Enfermagem Kiang Wu de Macau, Avenida do Hospital das Ilhas no. 447, Macao, Macao SAR, China
| | - Xuebin Xie
- Kiang Wu Hospital, Macau, Macao SAR, China
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Liu Y, Hopwood CJ, Pincus AL, Zhou B, Yang J, Bai S, Yang B. Interpersonal Problem Profiles of Personality and Psychopathology Constructs in Chinese Undergraduates and Offenders. Assessment 2024:10731911241241495. [PMID: 38606887 DOI: 10.1177/10731911241241495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The interpersonal problem circumplex is extensively used in the field as an assessment framework for understanding the interpersonal implications of a range of personality and psychopathology constructs. The vast majority of this large literature has been conducted in Western convenience and clinical samples. We computed interpersonal problem structural summary parameters for a range of personality and psychopathology variables in two Chinese offender samples (N = 424 and N = 555) and one undergraduate sample (N = 511) to test how well findings from Western samples generalize to Chinese undergraduates and offenders. The results showed that findings in Western samples generalized reasonably well to Chinese young adult and forensic contexts, although the interpersonal profiles of external variables were less specific in Chinese samples. Compared with undergraduates, interpersonal distress has stronger associations with the mental health of offenders. This study further elaborates the interpersonal correlates of individual differences in personality and psychopathology across cultures and assessment contexts, and it also extends the literature examining interpersonal problems in forensic settings.
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Affiliation(s)
| | | | | | - Bingtao Zhou
- China University of Political Science and Law, Beijing, China
| | - Jiali Yang
- China University of Political Science and Law, Beijing, China
| | | | - Bo Yang
- China University of Political Science and Law, Beijing, China
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Przeworski A, Newman MG. The Contrast Avoidance Model: Conclusion and synthesis of new research in the special issue. J Anxiety Disord 2024; 102:102830. [PMID: 38232491 PMCID: PMC10923164 DOI: 10.1016/j.janxdis.2024.102830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/06/2024] [Accepted: 01/07/2024] [Indexed: 01/19/2024]
Abstract
In this special series, new research on the Contrast Avoidance Model (CAM) was presented, including studies on the role of CAM in the maintenance of chronic worry, the incremental validity of CAM, CAM as a mediator of the association between generalized anxiety disorder (GAD) and other variables, CAM as transdiagnostic, and interpersonal behaviors as a means to avoid negative emotional contrasts (NECs). Furthermore, the role of perseverative thought in relation to positive emotional contrasts (PECs) was explored. Studies indicated that higher worry was positively and negatively reinforced, a factor that is likely to contribute to the maintenance of GAD. Further, research demonstrated that CAM contributed unique variance to understanding GAD above and beyond other variables associated with GAD, such as intolerance of uncertainty and negative problem orientation. Additional research revealed the transdiagnostic nature of contrast avoidance, as well as the association between contrast avoidance and problem-solving deficits. In addition, both worry and rumination increased the likelihood of PECs. Further, data suggested that anxious individuals may use interpersonal strategies to avoid NECs. Finally, savoring positive emotions was found to reduce contrast avoidance, providing a novel intervention strategy to address contrast avoidance in individuals with GAD.
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Bock RC, Baker LD, Kalantar EA, Berghoff CR, Stroman JC, Gratz KL, Tull MT. Clarifying relations of emotion regulation, emotional avoidance and anxiety symptoms in a community-based treatment-seeking sample. Psychol Psychother 2024. [PMID: 38411316 DOI: 10.1111/papt.12523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/13/2024] [Accepted: 02/08/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Anxiety is a global problem that is readily treatable with psychosocial interventions, though many individuals do not benefit following participation in extant treatment protocols. Accordingly, clarification of process-related variables that may be leveraged to enhance outcomes appears warranted. Emotion regulation (ER) is a robust correlate of anxiety symptoms and is often targeted in behavioural treatments applied to anxiety-related problems. Yet, some evidence suggests ER difficulties may be a proxy variable for emotional avoidance (EA). Clarifying the relative influence of ER and EA on anxiety symptom severity may improve specificity in targeting behavioural processes within psychosocial treatments designed to alleviate anxiety-related suffering. Accordingly, we examined relations of ER and EA to anxiety symptom severity after accounting for anxiety sensitivity and anxiolytic medication use in a community-based treatment-seeking sample. DESIGN A four-step hierarchical linear regression analysis of cross-sectional data provided by a community-based treatment-seeking sample. METHODS Totally, 120 participants (Mage = 39.18; Female = 58.3%) completed a questionnaire packet upon intake to an anxiety disorders clinic. RESULTS EA and ER were strongly correlated, and each accounted for significant variance over and above model covariates. EA was a dominant risk factor for anxiety symptom severity, as ER was not a significant predictor (p = .073) following the inclusion of EA in the model (p = .006). CONCLUSIONS EA appears to be a dominant risk factor, and ER a proxy risk factor, for anxiety symptom severity. EA may be an avenue for greater treatment specificity for those with anxiety symptoms.
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Affiliation(s)
- Rachel C Bock
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Lucas D Baker
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Emily A Kalantar
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | | | - Joel C Stroman
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Kim L Gratz
- Lyra Health, Burlingame, California, USA
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Matthew T Tull
- Lyra Health, Burlingame, California, USA
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
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Tiraboschi GA, Garon-Carrier G, Smith J, Fitzpatrick C. Adolescent internet use predicts higher levels of generalized and social anxiety symptoms for girls but not boys. Prev Med Rep 2023; 36:102471. [PMID: 37881178 PMCID: PMC10594560 DOI: 10.1016/j.pmedr.2023.102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/07/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Past research suggests that internet use can increase the risks of internalizing symptoms in adolescents. However, bidirectional relationships between adolescent internet use and anxiety symptoms have received very little attention. Furthermore, few studies have examined these links according to sex. The present study attempts to fill this gap by investigating longitudinal associations between Canadian boys' and girls' internet use and symptoms of generalized anxiety and social anxiety using data from the Quebec longitudinal Study of Child Development. A sample of 1324 adolescents (698 girls, 626 boys) self-reported the number of hours per week they spent on the internet and their symptoms of generalized and social anxiety at ages 15 and 17. We estimated two cross-lagged panel models with social or generalized anxiety symptoms and internet use at age 15 predicting those same variables at age 17. Sex was used as a grouping variable and socioeconomic status was included as a control variable. Internet use at 15 predicted generalized and social anxiety symptoms at age 17 in girls, but not boys. Social and generalized anxiety symptoms at age 15 did not predict internet use at age 17 for both boys and girls. These results suggest that internet use can be a significant risk factor for the development of anxiety symptoms in adolescent girls. Girls may be more vulnerable to the negative effects of internet use due to increased sensitivity to social comparisons. Thus, helping girls develop healthier internet use habits should be a target for promoting their mental health.
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Affiliation(s)
- Gabriel A. Tiraboschi
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
- Département de psychoéducation, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Gabrielle Garon-Carrier
- Département de psychoéducation, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Jonathan Smith
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Caroline Fitzpatrick
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
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Levendosky AA, Turchan JE, Luo X, Good E. A re-introduction of the psychodynamic approach to the standard clinical psychology curriculum. J Clin Psychol 2023; 79:2439-2451. [PMID: 37310149 DOI: 10.1002/jclp.23551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 05/02/2023] [Accepted: 05/28/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE There is a strong evidence-base for a psychodynamic approach, supporting primary theoretical tenets as well as the treatment effectiveness. Additionally, there are increasing calls from the field for more individualized treatment for clients, and the lack of training in multiple orientations limits the ability of students in clinical psychology Ph.D. programs in the United States to personalize their treatments. The accumulated evidence-base for contemporary relational psychodynamic theory and therapy places it in good standing to return to the standard clinical psychology curriculum, along with other evidence-based approaches. METHODS We use data from the Insider's Guide (which describes clinical Ph.D. programs in the United States) from three time points over 20 years to document the waning psychodynamic approach in clinical psychology programs. We review the scientific evidence for four primary tenets of a contemporary psychodynamic approach: three related to development-from healthy to psychopathological: (1) unconscious processes; (2) internal representations of self and other; (3) dimensional model of psychopathology, and a fourth tenet that builds on these three and is the foundation for a contemporary psychodynamic approach to psychotherapy: (4) therapeutic relationship as a primary mechanism of change. RESULTS/CONCLUSIONS Based on the review of the evidence, we make specific recommendations for clinical psychology training programs about how to include a psychodynamic approach in the curriculum.
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Affiliation(s)
- Alytia A Levendosky
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Joshua E Turchan
- Counseling and Psychiatric Services, Michigan State University, East Lansing, Michigan, USA
| | - Xiaochen Luo
- Department of Counseling Psychology, Santa Clara University, Santa Clara, California, USA
| | - Evan Good
- Austen Riggs Center, Stockbridge, Massachusetts, USA
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Patel TA, Abber SR, Cougle JR. Do treatments for mental disorders affect relationship satisfaction? A systematic review and meta-analysis. Psychother Res 2023:1-12. [PMID: 37611199 DOI: 10.1080/10503307.2023.2249215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
Objective: Psychiatric disorders have been linked to poor social functioning, including deficits in relationship satisfaction. Treatments have shown strong effectiveness in reducing clinical symptoms for a range of disorders, though less is known of the effects disorder-focused treatments have on relationship satisfaction. Methods: The present study describes a systematic review that was conducted to determine the efficacy of treatments for specific psychiatric disorders in improving relationship satisfaction. Surprisingly, only seventeen studies were identified and included in the review. Results: We found that a majority of these studies reported modest improvement in relationship satisfaction among people who completed treatment. However, studies were severely hampered by methodological limitations, and all therapy-related improvements could be attributable to placebo effects or the passage of time. Conclusion: Important gaps in the literature were found that future research should seek to address to maximize treatment outcomes and psychosocial functioning.
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Affiliation(s)
- Tapan A Patel
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Sophie R Abber
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Kamhout S, Olivier JM, Morris J, Brimhall HR, Black BL, Gabrielsen TP, South M, Lundwall RA, Nielsen JA. Binocular rivalry in autistic and socially anxious adults. Front Psychiatry 2023; 14:1181797. [PMID: 37547197 PMCID: PMC10400451 DOI: 10.3389/fpsyt.2023.1181797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background Social anxiousness is a pervasive symptom in both social anxiety disorder and autism spectrum conditions. Binocular rivalry, which occurs when different images are presented to each eye, has been used to explore how visual and cognitive processing differs across various clinical diagnoses. Previous studies have separately explored whether individuals with autism or anxiety experience binocular rivalry in ways that are different from neurotypical individuals. Methods We applied rivalry paradigms that are similar to those used in previous studies of autism and general anxiety to individuals experiencing symptoms of social anxiousness at clinical or subclinical levels. We also incorporated rivalrous stimuli featuring neutral and emotional facial valances to explore potential overlap of social processing components in social anxiety and autism. Results We hypothesized that higher levels of social anxiousness would increase binocular rivalry switch rates and that higher levels of autistic traits would decrease switch rates. However, stimulus condition did not affect switch rates in either diagnostic group, and switch rate was not significantly predictive of dimensional measures of either autism or social anxiety. Discussion This may suggest a common mechanism for atypical visual cognition styles previously associated with social anxiety and autism. Alternatively, differences in switch rates may only emerge at higher trait levels than reported by the participants in our studies. Furthermore, these findings may be influenced by sex differences in our unique sample.
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Affiliation(s)
- Sarah Kamhout
- Neuroscience Center, Brigham Young University, Provo, UT, United States
| | - Joshua M. Olivier
- Department of Psychology, Brigham Young University, Provo, UT, United States
| | - Jarom Morris
- Neuroscience Center, Brigham Young University, Provo, UT, United States
| | | | - Braeden L. Black
- Neuroscience Center, Brigham Young University, Provo, UT, United States
| | - Terisa P. Gabrielsen
- Department of Counseling Psychology and Special Education, Brigham Young University, Provo, UT, United States
| | - Mikle South
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Rebecca A. Lundwall
- Neuroscience Center, Brigham Young University, Provo, UT, United States
- Department of Psychology, Brigham Young University, Provo, UT, United States
| | - Jared A. Nielsen
- Neuroscience Center, Brigham Young University, Provo, UT, United States
- Department of Psychology, Brigham Young University, Provo, UT, United States
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Rosen FN, LaFreniere LS. Savoring, worry, and positive emotion duration in generalized anxiety disorder: Assessment and interventional experiment. J Anxiety Disord 2023; 97:102724. [PMID: 37207556 DOI: 10.1016/j.janxdis.2023.102724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 04/14/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Intentional attempts to savor positive emotions may be infrequent in Generalized Anxiety Disorder (GAD) due to avoidance of emotional contrasts. Yet purposeful enjoyment may help reduce worry and increase wellbeing in GAD. We sought to explore 1) the frequency, intensity, and duration of positive emotions from savoring in GAD and 2) its effect on pre-existing worry. METHOD The same 139 participants participated in two studies. They first took baseline measures. After, they were explicitly taught about savoring practices. In study 1, all participants were instructed to savor a photograph and video, timing and rating their emotion. Then in study 2, participants underwent a worry induction followed by an interventional experiment. In a savoring condition, participants were instructed to savor a personally-chosen enjoyable video. In a control condition, participants watched an emotionally neutral video. RESULTS Participants who met DSM-5 criteria for GAD had significantly lower scores on naturalistic savoring via self-report than those without GAD. Yet when explicitly taught and directed to savor in study 1, there were no differences between those with and without GAD in positive emotion duration and intensity. In study 2, longitudinal linear mixed models demonstrated that savoring after a worry induction significantly decreased worry, decreased anxiety, and increased positive emotions to greater degrees than the control task. These changes did not differ between diagnostic groups. All analyses controlled for depression symptoms. CONCLUSION Although persons with GAD tend to savor less in daily life than those without GAD, intentional savoring may decrease worry and increase positive emotion for both groups.
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Affiliation(s)
- Felicia N Rosen
- Skidmore College, 151 Tisch Learning Center, 815 N. Broadway, Saratoga Springs, NY 12866, USA
| | - Lucas S LaFreniere
- Skidmore College, 151 Tisch Learning Center, 815 N. Broadway, Saratoga Springs, NY 12866, USA.
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Nakajima S, Kaneko Y, Fujii N, Kizuki J, Saitoh K, Nagao K, Kawamura A, Yoshiike T, Kadotani H, Yamada N, Uchiyama M, Kuriyama K, Suzuki M. Transdiagnostic association between subjective insomnia and depressive symptoms in major psychiatric disorders. Front Psychiatry 2023; 14:1114945. [PMID: 37168089 PMCID: PMC10165079 DOI: 10.3389/fpsyt.2023.1114945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/27/2023] [Indexed: 05/13/2023] Open
Abstract
In psychiatric disorders, comorbid depressive symptoms are associated with clinically important issues such as reduced quality of life, a poor prognosis, and increased suicide risk. Previous studies have found a close relationship between insomnia and depressive symptoms in major depressive disorder (MDD), and that actively improving insomnia heightens the improvement of depressive symptoms. This study aimed to investigate whether the association between insomnia and depressive symptoms is also found in other psychiatric disorders besides MDD. The subjects were 144 patients with MDD (n = 71), schizophrenia (n = 25), bipolar disorder (n = 22), or anxiety disorders (n = 26). Sleep status was assessed subjectively and objectively using the Athens Insomnia Scale (AIS) and sleep electroencephalography (EEG), respectively. Sleep EEG was performed using a portable EEG device. Depressive symptoms were assessed using the Beck Depression Inventory. Subjective insomnia, as defined by the AIS, was associated with depressive symptoms in all disorders. Moreover, in schizophrenia, a relation between depressive symptoms and insomnia was also found by objective sleep assessment methods using sleep EEG. Our findings suggest that the association between subjective insomnia and depressive symptoms is a transdiagnostic feature in major psychiatric disorders. Further studies are needed to clarify whether therapeutic interventions for comorbid insomnia can improve depressive symptoms in major psychiatric disorders, similar to MDD.
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Affiliation(s)
- Suguru Nakajima
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Kaneko
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Nobukuni Fujii
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Jun Kizuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Kaori Saitoh
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Aoi Kawamura
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | | | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
- Tokyo Adachi Hospital, Tokyo, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
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15
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Goodman ML, Temple JR, Elliott AJ, Seidel SE, Gitari S, Raimer-Goodman LA. Child maltreatment, social capital, maternal mental health and duration of program involvement: Assessment from a community-based empowerment program in Kenya. JOURNAL OF FAMILY VIOLENCE 2023; 38:407-417. [PMID: 37197413 PMCID: PMC10187605 DOI: 10.1007/s10896-022-00391-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 05/19/2023]
Abstract
Multisystem, multi-level interventions are required to enable resilient, nurturing environments for children facing adversity. This study assesses parenting behavior associated with participation in a community-based, adapted microfinance program, and mediated by program-affiliated social capital, maternal depression and self-esteem among Kenyan women. Participants in the intervention, Kuja Pamoja kwa Jamii (KPJ, Swahili for "Come Together to Belong"), gather weekly to engage in trainings and group-based microfinance. Groups selected for the study had participated in the program for 0-15 months at the time of the first interview. Women (n = 400) completed surveys in June 2018 and June 2019. Measures included duration of program exposure, group-affiliated social capital (i.e. trust, belonging, cohesion, and expectation of mutual benefit), depression, self-esteem, and conflict tactics. We used regression analyses and generalized structural equation models to explore associations between program exposure, social capital, psychosocial variables and child maltreatment. Each standard deviation increase in duration of program exposure decreased odds of child physical abuse by 40% and child neglect by 35%. Each standard deviation in the social capital index predicted a significant reduction in odds of child physical abuse (aOR: 0.67), and child neglect (aOR: 0.71). Self-esteem and depression fully mediated observed associations between social capital and child maltreatment. Findings recommend further investigation of the potential for adapted microfinance programs to deliver parenting interventions, improve mental health and foster resilience-enabling social capital. A randomized control trial is required to validate the potential of the assessed intervention to improve parenting behaviors and supportive social conditions.
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Affiliation(s)
- Michael L. Goodman
- University of Texas Medical Branch, Galveston, TX, USA
- Sodzo International, Houston, TX, USA
| | | | - Aleisha J. Elliott
- University of Texas Medical Branch, Galveston, TX, USA
- Sodzo International, Houston, TX, USA
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16
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Barber KE, Zainal NH, Newman MG. Positive relations mediate the bidirectional connections between depression and anxiety symptoms. J Affect Disord 2023; 324:387-394. [PMID: 36584704 PMCID: PMC9893796 DOI: 10.1016/j.jad.2022.12.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/14/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Major depressive disorder (MDD) and generalized anxiety disorder (GAD) co-occur at high rates, often preceding and predicting one another over long durations. Interpersonal theories propose that relationships with others may contribute to the longitudinal connections between MDD and GAD. Therefore, the current study examined the mediational effect of positive relations with others in these connections over 18 years. METHODS Community-dwelling adults (n = 3294) participated in data collection at three time-points (Time 1 [T1], Time 2 [T2], and Time 3 [T3]) spaced about nine years apart. MDD and GAD symptoms were assessed using the Composite International Diagnostic Interview-Short Form. Positive relations was measured with the Psychological Well-Being Scale-Positive Relations with Others subscale. Structural equation mediation modeling was used for data analysis. RESULTS Results indicated that lower T2 positive relations significantly mediated the relationship between higher T1 MDD severity predicting more severe T3 GAD symptoms (d = 0.375) and explained 10.7% of the variance. T2 positive relations also had a significant mediational effect in the association between T1 GAD symptoms positively predicting T3 MDD severity (d = 0.360), accounting for 12.2% of the variance of this connection. These mediational effects were significant after adjusting for age, gender, education, and T1 symptoms (d = 0.277-0.677). CONCLUSIONS Supporting interpersonal theories, lack of positive relations with others mediated the bidirectional connections between MDD and GAD symptoms across 18 years. Future research should continue to explore the influence of positive relations on mental health and whether treatments that enhance interpersonal functioning could improve treatment for depression and anxiety.
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Affiliation(s)
- Kathryn E Barber
- Marquette University, Department of Psychology, Milwaukee, WI, USA; The Pennsylvania State University, Department of Psychology, University Park, PA, USA.
| | - Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, Boston, MA, USA
| | - Michelle G Newman
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
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17
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Erickson TM, Lewis JA, Crouch TA, Singh NB, Cummings MH. Interpersonal contrast avoidance as a mechanism for the maintenance of worry. J Anxiety Disord 2023; 94:102678. [PMID: 36773485 DOI: 10.1016/j.janxdis.2023.102678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
Despite consistent links between interpersonal problems and worry, mechanisms explaining this relationship remain unknown. The Contrast Avoidance Model (CAM; Newman & Llera, 2011) posits that individuals at risk for chronic worry and generalized anxiety disorder (GAD) fear sudden negative mood shifts, using worry to perpetuate negative moods and avoid these negative emotional contrasts. We propose interpersonal (IP) contrast avoidance (e.g., acting friendly to prevent others from causing mood shifts) as a novel explanation for interpersonal dysfunction in worriers. This study investigated IP contrast avoidance and worry in two samples. A nonclinical sample ranging in GAD symptoms (Study 1; N = 92) reported IP problems at baseline then IP contrast avoidance and worry over eight weeks (637 diaries). As expected, baseline IP problems prospectively predicted worry indirectly through chronic IP contrast avoidance. Affiliative, submissive, cold, and total IP contrast avoidance strategies predicted same-week and lagged next-week worry increases; affiliative, submissive, and total strategies also predicted maintenance of worry over eight weeks in growth models. Lastly, Study 2 showed the relevance of IP contrast avoidance strategies in a treatment-seeking clinical sample (N = 40), correlating with interpersonal problems and worry. Overall, results provide proof-of-concept for extending the CAM to the interpersonal domain.
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Affiliation(s)
- Thane M Erickson
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA 98119, USA.
| | - Jamie A Lewis
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA 98119, USA
| | - Tara A Crouch
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA 98119, USA
| | - Narayan B Singh
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA 98119, USA
| | - Mackenzie H Cummings
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA 98119, USA
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18
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Ringwald WR, Pilkonis PA, Wright AGC. Filling gaps in the nomological networks for dominance and affiliation by examining self-informant agreement on momentary interpersonal behavior. EUROPEAN JOURNAL OF PERSONALITY 2023. [DOI: 10.1177/08902070221145766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Interpersonal functioning involves an interplay of subjective perceptions and overt behavior. This study examines alignment between self and informant perceptions of momentary behavior to enrich the nomological networks for the domains of dominance and affiliation. We studied a sample of romantic couples ( N = 210 individuals) who rated their own and their partner’s interpersonal behavior during a 21-day ambulatory assessment (AA) protocol. We used multi-level structural equation modeling to estimate self-informant agreement on averages and variability of dominance and affiliation (between-person level) and on situational shifts in behavior (within-person level). We also examined convergence between self- and informant reported behavior measured by AA with cross-sectional self-report trait dominance, affiliation, and interpersonal problems. Results showed no self-informant agreement on dominance measured by AA, but moderate to strong agreement on affiliation at the between- and within-person levels. Self- and informant reported average affiliation measured by AA correlated with self-reports of trait affiliation, but only AA self-reports correlated with affiliation problems. Both self- and informant report dominance variability, and informant report affiliation variability, correlated with self-report interpersonal distress. Evidence for (mis)alignment in how dominance and affiliation are perceived by self and others have important implications for the role of these behaviors in everyday interpersonal functioning.
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Affiliation(s)
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
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19
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Patel TA, Cougle JR. Submissive behavior as a transdiagnostic construct: Associations with internalizing symptoms and distress intolerance. J Clin Psychol 2023; 79:1314-1327. [PMID: 36603203 DOI: 10.1002/jclp.23478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 11/03/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Submissive behavior is associated with significant impairment and negative life outcomes. The goal of the present study was to determine the transdiagnostic nature of submissive behavior by observing its association with internalizing symptoms (i.e., social anxiety, depression, and worry) and distress intolerance. Additionally, we sought to determine the moderating role of gender in these relationships. METHOD We used a community sample (N = 208) to evaluate the hypothesized relationships between submissive behavior and internalizing symptoms. RESULTS All three internalizing symptoms were uniquely associated with greater submissive behavior when covarying for each other. Distress intolerance was also uniquely positively related to submissive behavior respective of general distress. Moderation analyses revealed that the associations between social anxiety, worry, and distress intolerance with submissive behavior were stronger in men rather than women. CONCLUSION The present study provides novel evidence for the relevance of submissive behavior to internalizing symptoms and distress intolerance. We discuss clinical implications and directions for future research.
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Affiliation(s)
- Tapan A Patel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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20
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Constantino MJ, Castonguay LG, Coyne AE, Boswell JF, Newman MG. Baseline overly accommodating interpersonal problems in relation to parsed alliance-outcome associations in cognitive behavioral therapy for generalized anxiety disorder. Psychother Res 2023; 33:3-15. [PMID: 35696653 PMCID: PMC9744962 DOI: 10.1080/10503307.2022.2086836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Given its interpersonal underpinnings, relational factors may be salient in psychotherapy for generalized anxiety disorder (GAD). Supporting this point, research has indicated a positive total alliance-improvement correlation in cognitive behavioral therapy (CBT) for GAD. However, less research has disaggregated this correlation into within- and between-patient components, or examined theory-informed ways in which patient characteristics influence to these components. Thus, we first investigated parsed alliance-outcome associations in CBT for GAD. Second, consistent with theory that alliance may represent a direct interpersonal change correlate, we tested whether within-patient alliance improvements were especially therapeutic for patients with higher levels of an interpersonal problem prototypical of GAD-over accommodation. Also, consistent with theory that between-patient differences in overall alliance may be influenced by patients' preexisting relational characteristics, we tested whether more overly accommodating patients reported poorer average alliances that, in turn, related to worse outcomes. Sixty-nine patients received variants of CBT. Patients rated over accommodation at baseline, and alliance and outcome across treatment. As hypothesized, within-patient alliance improvements correlated with subsequent anxiety reduction, and this association was stronger for more overly accommodating patients. All between-patient associations were nonsignificant. Results help clarify the nuanced role of alliance in CBT for GAD.
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Affiliation(s)
| | | | - Alice E Coyne
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - James F Boswell
- Department of Psychology, University at Albany, State University of New York
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21
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Niu G, Jin S, Xu F, Lin S, Zhou Z, Longobardi C. Relational Victimization and Video Game Addiction among Female College Students during COVID-19 Pandemic: The Roles of Social Anxiety and Parasocial Relationship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416909. [PMID: 36554792 PMCID: PMC9779800 DOI: 10.3390/ijerph192416909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 05/31/2023]
Abstract
Video game addiction, a common behavioral problem among college students, has been more prominent during the COVID-19 pandemic; at the same time, females' video game usage has also attracted considerable research attention. Against this background and under the perspective of social interaction, this study aimed to examine the relationship between relational victimization and video game addiction among female college students, as well as its underlying mechanism-the mediating roles of social anxiety and parasocial relationships with virtual characters. Female college students (N = 437) were recruited to complete a set of questionnaires voluntarily in June 2022. Through the mediating effect analysis, the results found that (1) relational victimization was positively associated with female college students' video game addiction; (2) social anxiety and parasocial relationships with virtual characters could independently mediate this relation; (3) social anxiety and parasocial relationships with virtual characters were also the serial mediators in this association. These findings not only expand previous studies by revealing the social motivation of video game usage and the underlying mechanism accounting for video game addiction, but also provide basis and guidance for the prevention and intervention of video game addiction in the current context of the COVID-19 pandemic.
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Affiliation(s)
- Gengfeng Niu
- Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan 430079, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
- Center for Research on Internet Literacy and Behavior, Central China Normal University, Wuhan 430079, China
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Central China Normal University Branch, Wuhan 430079, China
| | - Siyu Jin
- Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan 430079, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - Fang Xu
- Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan 430079, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - Shanyan Lin
- Department of Psychology, University of Turin, 10124 Torino, Italy
| | - Zongkui Zhou
- Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan 430079, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
- Center for Research on Internet Literacy and Behavior, Central China Normal University, Wuhan 430079, China
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Central China Normal University Branch, Wuhan 430079, China
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22
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Newman MG, Schwob JT, Rackoff GN, Doren NV, Shin KE, Kim H. The naturalistic reinforcement of worry from positive and negative emotional contrasts: Results from a momentary assessment study within social interactions. J Anxiety Disord 2022; 92:102634. [PMID: 36182690 PMCID: PMC10187062 DOI: 10.1016/j.janxdis.2022.102634] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND The Contrast Avoidance Model (Newman & Llera, 2011) proposes that worry is reinforced by avoiding a negative contrast and increasing the likelihood of a positive contrast. OBJECTIVE To determine if reinforcement of worry occurs naturalistically via contrasts in both negative and positive emotion. METHOD Using event-contingent momentary assessment we assessed social interactions, pre-interaction state worry and pre-post interaction positive and negative emotion. Participants with generalized anxiety disorder (GAD; N = 83) completed an online questionnaire after social interactions lasting at least 1 min for 8 days. Three-level multilevel models were conducted. RESULTS Higher worry was concurrently associated with increased negative emotion and decreased positive emotion. Regardless of pre-interaction worry level, negative emotion decreased, and positive emotion increased from before to after interactions, suggesting that most interactions were benign or positive. At lower levels of pre-interaction worry, participants experienced increased negative emotion and decreased positive emotion from before to after interactions. At higher levels of pre-interaction worry, participants experienced decreased negative emotion and increased positive emotion from before to after interactions. CONCLUSION Among persons with GAD, worrying before social interactions may be both negatively and positively reinforced; furthermore, not worrying before social interactions may be both negatively and positively punished.
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23
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Liu Q, Zhao X, Liu W, Liu Q. Empathy and depression among a Chinese sample: The moderating role of rumination and attentional shift. Front Psychol 2022; 13:1027298. [PMID: 36507000 PMCID: PMC9729700 DOI: 10.3389/fpsyg.2022.1027298] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Although previous studies have explored the moderating role of emotional regulation strategies in the relationship between empathy and depression, no studies have studied the moderating role of attentional control in the relationship between empathy and depression. To address this research gap, the present study investigated the moderating roles of rumination and attentional control in the relationship between empathy and depression. Methods 423 participants filled out questionnaires anonymously, including Interpersonal Reactivity Index, Attention Control Scale, Self-rating Depression Scale, and Rumination Response Scale. PROCESS macro for SPSS was used for moderating effect analysis. Results Rumination and attentional shift moderated the relationship between emotional empathy and depression. Specifically, the lower rumination or the higher attentional shift, the stronger the negative association between emotional empathy and depression. Attentional shift moderated the relationship between cognitive empathy and depression, and cognitive empathy was significantly associated with depression only among participants whose attentional shift is high. Conclusion The study showed that rumination and attentional shift play important roles in the relationship between empathy and depression. The findings implicated that the positive role of good emotional regulation strategies and executive function for individuals in the relationship between empathy and depression.
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Affiliation(s)
- Qipeng Liu
- School of Education, Huaibei Normal University, Huaibei, China
| | - Xiaoyun Zhao
- School of Education, Huaibei Normal University, Huaibei, China,Anhui Engineering Research Center for Intelligent Computing and Application on Cognitive Behavior, Huaibei, China,*Correspondence: Xiaoyun Zhao,
| | - Weidi Liu
- School of Education, Huaibei Normal University, Huaibei, China
| | - Qianchen Liu
- School of Education, Huaibei Normal University, Huaibei, China
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24
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Newman MG, Basterfield C, Erickson TM, Caulley E, Przeworski A, Llera SJ. Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts. Expert Rev Neurother 2022; 22:751-770. [PMID: 36107159 PMCID: PMC9754763 DOI: 10.1080/14737175.2022.2125800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/14/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Generalized anxiety disorder (GAD) is common and disabling. Different versions of cognitive behavioral therapy (CBT) have been tested, but no treatment works for everyone. Therefore, researchers have attempted approaches to enhance CBT. AREAS COVERED The current narrative review examines meta-analyses and individual trials of CBT-based treatments for GAD. We focus on CBT and its cognitive and behavioral components as well as efforts to enhance CBT and its dissemination and generalizability. Enhancement efforts included interpersonal and emotional processing therapy, mindfulness-based CBT, emotion regulation therapy, intolerance of uncertainty therapy, the unified protocol, metacognitive therapy, motivational interviewing, and contrast avoidance targeted treatment. Emerging strategies to enhance dissemination have focused on technologically based treatments. Attempts at generalizability have included examination of efficacy within diverse racial and ethnic groups. EXPERT OPINION We conclude that CBT is efficacious, and a number of enhancement efforts have shown some promise in improving upon CBT in single trials. However, more research is needed, particularly efforts to determine which enhancements work best for which individuals and what are the mechanisms of change. Furthermore, few technological interventions have been compared to active treatments. Finally, much more attention needs to be paid to ethnic and racial diversity in randomized controlled trials.
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Affiliation(s)
- Michelle G Newman
- Department of Psychology, The Pennsylvania State University, Park, PA, USA
| | | | - Thane M Erickson
- Department of Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Evan Caulley
- Department of Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Amy Przeworski
- Department of Psychology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sandra J Llera
- Department of Psychology, Towson University, Baltimore, Maryland, USA
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25
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Zhang X, Yue H, Sun J, Liu M, Li C, Bao H. Regulatory emotional self-efficacy and psychological distress among medical students: multiple mediating roles of interpersonal adaptation and self-acceptance. BMC MEDICAL EDUCATION 2022; 22:283. [PMID: 35421953 PMCID: PMC9011952 DOI: 10.1186/s12909-022-03338-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychological distress (depression, anxiety and stress) is more common among medical students than in the general population, and is an important cause of insomnia, internet addiction, substance abuse, decreased academic performance and increased suicidality in medical students. METHODS To examine the mechanism by which regulatory emotional self-efficacy affects medical students' psychological distress, a questionnaire of 539 medical students using an interpersonal adaptability scale, regulatory emotional self-efficacy scale, self-acceptance scale and depression-anxiety-stress scale was conducted. RESULTS ① Regulatory emotional self-efficacy, interpersonal adaptability and self-acceptance are positively correlated, but they are negatively correlated with psychological distress. ② The mediation model shows that interpersonal adaptation and self-acceptance are the mediation variables of the effect of regulatory emotional self-efficacy on psychological distress, and the total mediation effect value is -0.37, accounting for 86.05% of the total effect (-0.43). Specifically, the effect involves three paths: first, regulatory emotional self-efficacy indirectly affects psychological distress through interpersonal adaptation (effect value-0.24); second, regulatory emotional self-efficacy indirectly affects psychological distress through interpersonal adaptation and self-acceptance (effect value-0.08); and third, regulatory emotional self-efficacy indirectly affects psychological distress through self-acceptance (effect value -0.05). CONCLUSIONS Interpersonal adaptation and self-acceptance have a significant mediating effect between regulatory emotional self-efficacy and psychological distress, and the chain mediating effect of interpersonal adaptation and self-acceptance is also significant.
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Affiliation(s)
- Xuemin Zhang
- School of Psychology, Inner Mongolia Normal University, 81 Zhaowuda Road, Saihan District, Hohhot, 010022, China
- School of Humanity, Baotou Medical College, No.31 Jianshe Road, East District, Baotou, 014040, China
| | - Heng Yue
- School of Psychology, Inner Mongolia Normal University, 81 Zhaowuda Road, Saihan District, Hohhot, 010022, China
| | - Junfang Sun
- School of Psychology, Inner Mongolia Normal University, 81 Zhaowuda Road, Saihan District, Hohhot, 010022, China
| | - Min Liu
- School of Psychology, Inner Mongolia Normal University, 81 Zhaowuda Road, Saihan District, Hohhot, 010022, China
| | - Cuiyun Li
- School of Psychology, Inner Mongolia Normal University, 81 Zhaowuda Road, Saihan District, Hohhot, 010022, China
| | - Hugejiletu Bao
- School of Physical Education, Inner Mongolia Normal University, 81 Zhaowuda Road, Saihan District, Hohhot010022, China.
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26
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Marr NS, Zainal NH, Newman MG. Focus on and venting of negative emotion mediates the 18-year bi-directional relations between major depressive disorder and generalized anxiety disorder diagnoses. J Affect Disord 2022; 303:10-17. [PMID: 35065091 PMCID: PMC8917061 DOI: 10.1016/j.jad.2022.01.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Myriad emotion regulation and coping theories have proposed that avoidant/emotion-oriented coping is a cause and consequence of anxiety and depression. However, few studies have investigated potential mechanisms underlying the prospective anxiety-depression disorder relation. The current study examined various coping strategies (i.e., denial, focus on and venting of emotion (FOAVE), and behavioral disengagement) as potential longitudinal mediators between generalized anxiety disorder (GAD) and major depressive disorder (MDD). METHODS In a nationally representative sample of adults (N = 3,294), MDD and GAD were assessed at Time 1 (T1) and Time 3 (T3) (Composite International Diagnostic Interview - Short-Form), and avoidant coping strategies (denial, behavioral disengagement, and FOAVE) were measured at Time 2 (T2) (Coping Questionnaire). Assessments occurred over 18 years, each spaced approximately 9 years apart. Structural equation modeling mediation analyses examined whether T1 MDD predicted T3 GAD (and vice versa), and if T2 avoidant coping mediated these relations, above and beyond baseline comorbidity. RESULTS FOAVE mediated the T1 MDD-T3 GAD association, and vice versa. Presence of T1 MDD and GAD predicted more T2 FOAVE, and greater T2 FOAVE forecasted T3 MDD and GAD, accounting for 16-21% of the longitudinal MDD-GAD relations. However, behavioral disengagement and denial did not mediate the prospective MDD-GAD relations. Also, T1 MDD and GAD forecasted greater T2 behavioral disengagement. CONCLUSIONS The use of FOAVE, may be a mechanism by which MDD earlier in life may lead to GAD 18 years later, and vice versa. Theoretical and potential clinical implications are discussed.
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Wang TC, Tsai CL, Tang TW. Visual responses of patients with generalized anxiety disorder who cycling in the virtual sportscapes with different tree cover densities. Front Psychiatry 2022; 13:880586. [PMID: 36051546 PMCID: PMC9424623 DOI: 10.3389/fpsyt.2022.880586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
The tree density of virtual sportscape is the main factor that determines the benefits that generalized anxiety disorder (GAD) patients can obtain when they exercise with virtual environment. By using pupil size, fixation count and time as metrics, this research aimed to clarify the relationship between tree cover density and stress in the virtual environment. Ninety GAD patients were randomly grouped into the 36-60% tree density (high tree density, HTDS), 20-35% tree density (medium tree density, MTDS), or control groups (n = 30). Researchers used eye-tracking technology to analyze fixation time, fixation count and changes in pupil size to evaluate the stress changes of participants after 20 min of aerobic exercise in a virtual environment. The results showed that pupil size expanded in GAD patients after exercising in the virtual environment. Furthermore, GAD patient cycling in the MTDS group can show smaller pupil size than those in HTDS. Those results suggest that GAD patient cycling 20 min in the MTDS group can perceived lower stress. The results of eye tracking analysis showed that GAD patients spend more time and counts observing tree elements in HTDS and MTDS sportscapes. Specifically, they spent more 48% and 27% time on tree and green plants in the HTDS condition and MTDS condition, respectively, than in non-natural sportsscapes. Although 36-60% tree density of virtual natural sportscape can get more visual attention from GAD patients, 20-35% tree density of virtual natural sportscape is more capable of reducing their stress.
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Affiliation(s)
- Tsai-Chiao Wang
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| | - Ta-Wei Tang
- Department of Leisure and Recreation Management, Asia University, Taichung, Taiwan
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Oltmanns JR, Ruggero C, Miao J, Waszczuk M, Yang Y, Clouston SAP, Bromet EJ, Luft BJ, Kotov R. The Role of Personality in the Mental and Physical Health of World Trade Center Responders: Self- versus Informant-Reports. Clin Psychol Sci 2022; 1:10.31234/osf.io/c4gbf. [PMID: 36407479 PMCID: PMC9670015 DOI: 10.31234/osf.io/c4gbf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Personality is linked to important health outcomes, but most prior studies have relied on self-reports, making it possible that shared-method variance explains the associations. The present study examined self- versus informant-reports of personality and multi-method outcomes. World Trade Center (WTC) responders and informants, 283 pairs, completed five-factor model personality measures and multi-method assessments of stressful events, functioning, mental disorders, 9/11-related treatment costs, BMI, and daily activity across three years. Self-reports were uniquely related to stressful events and functioning. Both self-reports and informant-reports showed incremental validity over one another for mental disorder diagnoses and treatment costs. For objective outcomes daily activity and BMI, informant-reports showed incremental validity over self-reports, accounting for all self-report variance and more. The findings suggest that informant-reports of personality provide better validity for objective health outcomes, which has implications for understanding personality and its role in mental and physical health.
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O'Brien K, Sukovieff A, Johnson EA. Evidence of Delayed, Recursive Benefits of Self-Affirmation on Anxiety in Socially Anxious University Students. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2021. [DOI: 10.1521/jscp.2021.40.6.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Persons with social anxiety disorder (SAD) often experience social interactions as threatening and commonly avoid them or perform poorly in them (Asher et al., 2017). Self-affirmation is an intervention shown to help individuals engage effectively in situations they perceive as threatening (Sherman & Hartson, 2011). We hypothesized that self-affirmation would allow socially anxious individuals to participate in more social activities, do so more effectively, and with less stress and anxiety. Methods: Following completion of baseline measures, 75 socially anxious university students were randomly assigned to complete a self-affirming or control writing task. They subsequently completed the Trier Social Stress Test for Groups (TSST-G), and received SAD psychoeducation designed to promote social engagement over the coming month, after which they were reassessed on baseline measures of social anxiety. Results Self-affirmation demonstrated no benefit at the time of engagement in the TSST-G. However, at follow-up, self-affirmed students reported significantly less discomfort, anxiety, and distress related to a variety of social behaviors as well as more engagement in those behaviors, relative to baseline, compared with non-affirmed students. Moreover, significantly more affirmed than non-affirmed participants reported clinically significant reductions in symptoms of SAD at follow-up. Discussion These results help to broaden our conceptualization of self-affirmation and provide support for its potential utility in treatment for those with SAD.
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Interpersonal dysfunction in individuals high in chronic worry: relations with interpersonal problem-solving. Behav Cogn Psychother 2021; 50:142-157. [PMID: 34789349 DOI: 10.1017/s1352465821000436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Interpersonal dysfunction has been proposed as an important maintenance factor in chronic worry and generalized anxiety disorder (GAD). Perceptions of problems and the problem-solving process as threatening, and unhelpful (e.g. avoidant, impulsive) problem-solving styles are implicated in worry and have also been suggested to be associated with dysfunctional interpersonal styles. AIMS The present study assessed the relationships between interpersonal dysfunction and problem-solving orientation, approach, and effectiveness in a sample of individuals high in chronic worry and investigated the indirect effect of interpersonal dysfunction on GAD symptom severity through negative problem-solving beliefs and approaches. METHOD Fifty-nine community participants completed questionnaires and an interpersonal problem-solving task. RESULTS Greater interpersonal dysfunction was significantly associated with greater negative problem-solving orientation and greater habitual avoidant and impulsive/careless problem-solving styles. Greater interpersonal dysfunction was associated with poorer effectiveness of solutions when the task problem involved conflict with a romantic partner. Negative problem-solving orientation fully mediated the relationship between interpersonal dysfunction and GAD symptoms. CONCLUSIONS These findings support that problem-solving processes are implicated in interpersonal dysfunction and that negative beliefs about problem-solving account for the relationship between interpersonal dysfunction and GAD symptoms. Theoretical implications are discussed.
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Psychometric Evaluation of a Controlled Social Affiliation Paradigm: Findings From Anxiety, Depressive Disorder, and Healthy Samples. Behav Ther 2021; 52:1464-1476. [PMID: 34656199 PMCID: PMC8812488 DOI: 10.1016/j.beth.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
Social impairments are common across many psychiatric conditions. Standardized dyadic assessments intended to elicit social affiliation between unacquainted partners are used to elucidate mechanisms that disrupt relationship formation and inform possible treatment targets; however, the psychometric properties of such paradigms remain poorly understood. This study evaluated the psychometric properties of a controlled social affiliation paradigm intended to induce connectedness between a target participant and trained confederate. Individuals with an anxiety or depressive disorder diagnosis (clinical group; n = 132) and those without (control group; n = 35) interacted face-to-face with a trained confederate; partners took turns answering a series of increasingly intimate questions about themselves. Social connectedness, affect, and affiliative behavior measures were collected during the interaction. Participant symptom and social functioning measures were collected to examine validity. The paradigm elicited escalating social connectedness throughout the task for both participants and confederates. Parallel forms (i.e., different question sets) elicited similar affiliation outcomes. Self-reported (but not behavioral) affiliation differed across some demographic variables (e.g., participant gender, Hispanic ethnicity). Within-task affiliation measures were associated with one another and with global social connectedness and social anxiety symptom measures, but not with somatic anxiety measures. Clinical participants reported lower social affiliation and positive affect reactivity and higher negative affect reactivity than healthy participants. These findings provide initial psychometric support for a standardized and controlled dyadic affiliation paradigm that could be used to reliably probe social disconnection mechanisms across psychopathology.
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Nordahl H, Hjemdal O, Wells A. Metacognitive Beliefs Uniquely Contribute to Interpersonal Problems: A Test Controlling for Adult Attachment, Big-5 Personality Traits, Anxiety, and Depression. Front Psychol 2021; 12:694565. [PMID: 34539491 PMCID: PMC8440874 DOI: 10.3389/fpsyg.2021.694565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Interpersonal difficulties are common across psychological disorders and are a legitimate target of treatment. Psychotherapeutic models differ in their understanding of interpersonal problems and how these problems are formulated and treated. It has been suggested that they are both the cause and effect of emotional distress symptoms, that they result from early attachment experiences, and that they are related to personality dimensions. However, the metacognitive model of psychopathology predicts that emotion disorder symptoms and interpersonal problems are linked to a common set of factors involving dysfunctional metacognition. In support of this view, metacognitive therapy has substantially reduced interpersonal problems in patients with anxiety and depression even though interpersonal problems are not directly targeted, indicating a role for metacognitive change. Nevertheless, the relationship between interpersonal problems and metacognitive beliefs remains underexplored, and the statistical control of emotion symptoms, personality, and attachment is important in substantiating any metacognition effects. The aim of the present study was therefore to test metacognitive beliefs as statistical predictors of interpersonal problems while controlling for anxiety/depression, adult attachment, and the Big-5 personality dimensions. In a cross-sectional study, 296 participants completed a battery of self-report questionnaires. We found that positive- and negative-metacognitive beliefs, cognitive confidence, and cognitive self-consciousness accounted for significant and unique variance in interpersonal problems together with avoidant attachment and conscientiousness when the overlap between all predictors was controlled. These findings support the notion that metacognitive beliefs are relevant to interpersonal problems with the potential implication that metacognitive therapy could have particularly broad effects on both emotion disorder symptoms and interpersonal problems.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Adrian Wells
- School of Psychological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Hasina SN, Noventi I, Livana P, Hartono D. Mindfulness Meditation Based on Spiritual Care to Reduce Community Anxiety due to the Impact of Pandemic Coronavirus Disease. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: The spread of coronavirus disease (COVID-19) has spread throughout the world and has created a level of fear, uncertainty that has an impact on several aspects of life including mental health. The rapid spread of the Corona Virus or COVID-19 throughout the world has damaged the order of life starting from the economy, social, politics, education, culture, religion and health. Various efforts have been made by the Indonesian government with social distancing or physical distancing, washing hands with soap and staying active at home. Conditions that change suddenly will make people unprepared to deal with it, especially in the psychological condition of the Indonesian people who experience a lot of anxiety.
AIM: The purpose of this study was to analyze the effect of mindfulness meditation based on spiritual care on the level of community anxiety due to the COVID-19 pandemic.
METHODS: This type of research uses experimental quantitative research using a randomized controlled trial research design. This research was conducted for 4 weeks in January-February 2021. The population of this study is the Surabaya community. The sampling technique used consecutive sampling technique and was divided into two groups, namely the intervention group as many as 61 respondents and the control group as many as 61 respondents. Data analysis used paired t test and independent t test with a significance value of p < 0.05. This research questionnaire uses the DASS 42 questionnaire has reliability 0.82 and the validity test gets the Cronbach alpha value is 0.85.
RESULTS: The average level of anxiety before doing the spiritual care-based mindfulness meditation intervention in the intervention group was 17.28 (severe anxiety) and 17.18 in the control group (severe anxiety) with p = 1.000 which means there is no difference in the average level of anxiety whereas After being given the intervention, the average level of anxiety in the intervention group was 6.03 (normal anxiety) and 18.06 in the control group (severe anxiety) with p = 0.000, which means that there is a difference in the average level of anxiety in the intervention group and the control group after being given the intervention.
CONCLUSION: Mindfulness meditation based on spiritual care can reduce people’s anxiety levels during the COVID-19 pandemic.
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Malivoire BL, Mutschler C, Monson CM. Interpersonal dysfunction and treatment outcome in GAD: A systematic review. J Anxiety Disord 2020; 76:102310. [PMID: 33002755 DOI: 10.1016/j.janxdis.2020.102310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/01/2020] [Accepted: 09/08/2020] [Indexed: 01/06/2023]
Abstract
Interpersonal dysfunction is posited to maintain worry and generalized anxiety disorder (GAD). It has been suggested that the low remission rates in psychotherapy for GAD may be attributable, in part, to inadequately addressing interpersonal dysfunction. This paper systematically reviewed the literature examining the moderating role of interpersonal dysfunction on GAD psychotherapy outcomes and change in interpersonal dysfunction over the course of GAD treatment. Thirteen studies were identified, seven of which examined the relationship between interpersonal dysfunction or distress and treatment outcome and nine investigated change in interpersonal dysfunction over the course of psychotherapy. The majority of studies indicated that interpersonal dysfunction improves following psychotherapy. However, there is preliminary evidence that not all subscales of interpersonal dysfunction improve, including subscales relevant to GAD pathology such as overly-nurturant dysfunction. Further, greater interpersonal dysfunction predicted worse treatment outcomes. As such, interpersonal dysfunction may hinder treatment success and further research is needed to delineate for whom additional or integrated interpersonal interventions may be needed. Approaches to target interpersonal dysfunction in GAD are discussed.
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Affiliation(s)
- Bailee L Malivoire
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada.
| | - Christina Mutschler
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada
| | - Candice M Monson
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada
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Tonge NA, Lim MH, Piccirillo ML, Fernandez KC, Langer JK, Rodebaugh TL. Interpersonal problems in social anxiety disorder across different relational contexts. J Anxiety Disord 2020; 75:102275. [PMID: 32891027 PMCID: PMC7755155 DOI: 10.1016/j.janxdis.2020.102275] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/18/2020] [Accepted: 07/27/2020] [Indexed: 11/28/2022]
Abstract
People with social anxiety disorder (SAD) frequently report interpersonal problems across various domains; however, it is unclear whether these problems are observable by others or represent negatively biased self-report. We assessed the interpersonal problems of people with and without SAD using self-report, friend, and romantic partner report. We hypothesized that SAD diagnosis would predict self-reported problems across multiple interpersonal domains, but restricted domains of informant report. Additionally, we hypothesized that diagnosis would predict discrepancy between self and informant report either in the form of a bias toward reporting more problems or in the form of lack of concordance between self and informant reporters. Using structural equation and multilevel models, we found evidence for differences between people with and without SAD in terms of domains of impairment observed by self and informants as well as differences in correspondence across relationship types. Results highlight the utility of multi-informant assessment of SAD.
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Affiliation(s)
| | - Michelle H. Lim
- Department of Psychology, Washington University in St. Louis
| | | | | | - Julia K. Langer
- Department of Psychology, Washington University in St. Louis
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Wang TC, Sit CHP, Tang TW, Tsai CL. Psychological and Physiological Responses in Patients with Generalized Anxiety Disorder: The Use of Acute Exercise and Virtual Reality Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4855. [PMID: 32640554 PMCID: PMC7370051 DOI: 10.3390/ijerph17134855] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 01/20/2023]
Abstract
Virtual exercise therapy is considered a useful method by which to encourage patients with generalized anxiety disorder (GAD) to engage in aerobic exercise in order to reduce stress. This study was intended to explore the psychological and physiological responses of patients with GAD after cycling in a virtual environment containing natural images. Seventy-seven participants with GAD were recruited in the present study and randomly assigned to a virtual nature (VN) or a virtual abstract painting (VAP) group. Their electroencephalogram alpha activity, perceived stress, and levels of restorative quality and satisfaction were assessed at baseline and after an acute bout of 20 min of moderate-intensity aerobic exercise. The results showed that both the VN and VAP groups showed significantly higher alpha activity post-exercise as compared to pre-exercise. The VN group relative to the VAP group exhibited higher levels of stress-relief, restorative quality, and personal satisfaction. These findings imply that a virtual exercise environment is an effective way to induce a relaxing effect in patients with GAD. However, they exhibited more positive psychological responses when exercising in such an environment with natural landscapes.
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Affiliation(s)
- Tsai-Chiao Wang
- Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, Tainan 701, Taiwan;
| | - Cindy Hui-Ping Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong;
| | - Ta-Wei Tang
- Department of Leisure and Recreation Management, Asia University, Taichung 413, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung 413, Taiwan
- Institute of Innovation and Circular Economy, Asia University, Taichung 413, Taiwan
| | - Chia-Liang Tsai
- Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, Tainan 701, Taiwan;
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