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Miller ML, Jiang LJ, O'Hara MW. Experiential avoidance as a mediator of risk factors for higher order internalizing psychopathology in the perinatal period. J Clin Psychol 2024; 80:625-645. [PMID: 38265296 DOI: 10.1002/jclp.23644] [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: 04/09/2023] [Revised: 11/09/2023] [Accepted: 01/07/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Perinatal psychopathology can be damaging. This study examined the strength of the associations between risk factors and all perinatal mood and anxiety disorder symptoms while assessing the mediating effect of experiential avoidance. METHOD Participants (N = 246) completed assessments during pregnancy (28-32 weeks) and the postpartum (6-8 weeks). Structural equation modeling (SEM) was used to examine associations between risk factors and latent factors: distress (composed of depression, generalized anxiety, irritability, and panic symptoms); fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive); and bipolar (mania and obsessive-compulsive). RESULTS During pregnancy, past psychiatric history, anxiety sensitivity, maladaptive coping, and age were significant risk factors. In the postpartum, negative maternal attitudes and past psychiatric history were only risk factors for symptoms that composed distress. Experiential avoidance mediated the relation between maladaptive coping and symptoms that composed fear. CONCLUSION It is important to assess for psychological risk factors starting in pregnancy. This study identified critical risk factors that are associated with the underlying commonality among perinatal mood and anxiety symptoms. Some of the risk factors as well as the mediator are malleable (negative maternal attitudes, experiential avoidance), creating new possibilities for prevention and treatment of perinatal mood and anxiety disorder symptoms.
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Affiliation(s)
- Michelle L Miller
- University of Iowa, Iowa City, Iowa, USA
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lily J Jiang
- Indiana University-Bloomington, Bloomington, Indiana, USA
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2
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Robinson A, Weitzner DS, Calamia M. Factor structure of the anxiety sensitivity index-3 in a sample of older adults. Eur J Ageing 2022; 19:1543-1548. [PMID: 36692783 PMCID: PMC9729492 DOI: 10.1007/s10433-022-00736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 01/26/2023] Open
Abstract
Anxiety sensitivity is a transdiagnostic risk factor for internalizing psychopathology in children and adults. Several factor analytic studies have examined the factor structure of anxiety sensitivity in children, adolescents, and adults. However, to date, no studies have specifically examined the factor structure of the Anxiety Sensitivity Index-3 in older adults. The purpose of the current study was to compare the fit of a correlated three-factor, higher-order, and bifactor model of the Anxiety Sensitivity Index-3 (ASI-3) in a sample of older adults. Participants were 856 older adults aged 60-94 recruited through Qualtrics Panels. Confirmatory factor analyses demonstrated good model fit for the bifactor model and the higher-order model and adequate fit for the correlated three-factor model. These results suggests that the ASI-3 is a valid tool assessing anxiety sensitivity in older adults. Limitations and future directions are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-022-00736-9.
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Affiliation(s)
- Anthony Robinson
- Department of Psychology, Louisiana State University, Baton Rouge, LA USA
| | - Daniel S Weitzner
- Department of Psychology, Louisiana State University, Baton Rouge, LA USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA USA
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3
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Yılmaz Koğar E. Examining the Factor Structure of the Anxiety Sensitivity Index-3 in a Turkish Sample: The Factor Structure of the Anxiety Sensitivity Index-3. Psychol Rep 2021; 125:3289-3312. [PMID: 34412544 DOI: 10.1177/00332941211040427] [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: 11/17/2022]
Abstract
The purpose of the current study was to investigate the factor structure of the Anxiety Sensitivity Index-3 (ASI-3) in a Turkey sample and to determine measurement invariance of the ASI-3 across gender and age groups. Confirmatory factor analysis was performed on four different models to determine the best fit model for the structure. After the best structure was determined, different models were tested for measurement invariance across gender and age groups. To determine the reliability of the ASI-3, the hierarchical omega coefficient and correlations between the scores obtained from different scales for convergent validity were calculated. It has been determined that the bifactor model is the model that best fits the data, and this model shows invariance across gender and age groups. Besides, evidence regarding the reliability and convergent validity of the ASI-3 was also provided in the study. Current findings show that anxiety sensitivity consists of a general factor (anxiety sensitivity) and three independent specific factors (physical, cognitive, and social concerns). It was concluded that the general factor of anxiety sensitivity constitutes a dominant factor and special factors have a relatively low effect on explaining the structure. Considering the dominance of the general factor, it is recommended to use the ASI-3 total score as a measure of general anxiety sensitivity.
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Affiliation(s)
- Esin Yılmaz Koğar
- Department of Education Science, Omer Halisdemir University, Niğde, Turkey
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4
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Baek IC, Lee EH, Kim JH. Differences in anxiety sensitivity factors between anxiety and depressive disorders. Depress Anxiety 2019; 36:968-974. [PMID: 31344315 DOI: 10.1002/da.22948] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/27/2019] [Accepted: 07/04/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Anxiety sensitivity (AS) refers to the tendency to fear physical sensations associated with anxiety due to concerns about potential physical, social, or cognitive consequences. Many previous studies were limited by the use of the anxiety sensitivity index (ASI) or the ASI-revised (ASI-R), which are both measurements with unitary or unstable structures. No recent study that has utilized the ASI-3 examined the relations between AS dimensions and depression. Thus, we examined multiple relationships between AS and anxiety disorders and depression using the ASI-3. METHODS The total sample consisted of 667 outpatients, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders fourth text revision as assessed by a structured clinical interview. There were eight patient groups: multiple anxiety disorder, major depressive disorder (MDD), panic disorder (PD), social phobia (SP), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and anxiety disorder not otherwise specified (AD NOS). We conducted one-way analysis of variances and post hoc tests to compare the ASI-3 total and subscale scores across the groups. RESULTS The physical concern score was higher in patients with PD than patients with MDD, SP, OCD, or GAD. The social concern score was higher in the SP group than those with MDD, PD, GAD, and AD NOS. Patients with GAD and PTSD showed higher cognitive concern scores than the patients with PD. CONCLUSION Results partially replicated the relationship between PD and physical concern, between SP and social concern, and between GAD and cognitive concern examining the relationships between AS dimensions and anxiety disorders.
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Affiliation(s)
- In-Chul Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun-Ho Lee
- Depression Center, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Hae Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Wauthia E, Lefebvre L, Huet K, Blekic W, El Bouragui K, Rossignol M. Examining the Hierarchical Influences of the Big-Five Dimensions and Anxiety Sensitivity on Anxiety Symptoms in Children. Front Psychol 2019; 10:1185. [PMID: 31231271 PMCID: PMC6558314 DOI: 10.3389/fpsyg.2019.01185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/06/2019] [Indexed: 01/04/2023] Open
Abstract
Anxiety sensitivity (AS), namely the fear of anxiety symptoms, has been described as a precursor of sub-threshold anxiety levels. Sexton et al. (2003) posited that increased AS would arise from an elevated neuroticism and that both would act as vulnerability factors for panic disorder (PD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) symptoms. Accordingly, this study aimed to (1) evaluate the applicability of this model to a pediatric population and (2) examine the influences of the other Big-Five personality dimensions on the four lower-order dimensions of AS (cognitive, physical, control, and physical) and on social phobia (SP), separation anxiety disorder (SAD) and depression symptoms. 200 children (104 girls) aged between 8 and 12 years old (mean age = 132.52 months, SD = 14.5) completed the Childhood Anxiety Sensitivity Index (Silverman et al., 1991), the Big Five Questionnaire for Children (Barbaranelli et al., 2003), and the Revised’s Children Anxiety and Depression Scale (Chorpita et al., 2000). Regression analyses confirmed that AS and neuroticism together significantly predicted the presence of PD, OCD, and GAD symptoms but also SP, SAD, and depression symptoms. Moreover, neuroticism interacted with extraversion, conscientiousness and agreeableness to significantly predict SP, GAD, and depression. Surprisingly, the global AS score was only predicted by agreeableness, while AS dimensions also specifically related to openness. Finally, AS dimensions did not predict the presence of specific anxiety symptoms. To conclude, the predicting model of anxiety symptoms in children sets neuroticism and AS on the same level, with an unexpected influence of agreeableness on AS, raising the importance of other trait-like factors in the definition of such models. Moreover, AS should be considered as a unitary construct when predicting the presence of anxiety symptoms in children. Future interventions must consider these associations to help children detect and recognize the symptoms of their anxiety and help them to interpret them correctly.
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Affiliation(s)
- Erika Wauthia
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,National Fund for Human Research (FRESH), National Fund for Scientific Research, Brussels, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
| | - Laurent Lefebvre
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
| | - Kathy Huet
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium.,Laboratory of Phonetics, Research Institute for Language Sciences and Technology, Faculty of Psychology and Education, University of Mons, Mons, Belgium
| | - Wivine Blekic
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,National Fund for Human Research (FRESH), National Fund for Scientific Research, Brussels, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
| | - Khira El Bouragui
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium.,Laboratory C2S, University of Reims Champagne-Ardenne, Reims, France
| | - Mandy Rossignol
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
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Abstract
OBJECTIVE While past research found family conflict, disordered eating, body image concerns and anxious self-doubts may affect adolescent diabetic glucose control, available measures of adherence mainly focus on management tasks. The current study aimed to combine measures of emotional distress and beliefs with decisions concerning management in a new measure of resistance to treatment adherence: the 12-item Glucose Control Resistance Scale (GCRS). METHODS Participants included 135 adolescents and their parents from a pediatric diabetes clinic. Family conflict, body image concerns, anxious self-doubts and glucose control resistance were assessed. RESULTS Factor analysis identified 12 items, with loadings of ≥0.40, which were used to form the GCRS. The scale had adequate reliability and there was a significant correlation between child and parent GCRS scores. One factor, family conflict, was significantly related to hemoglobin A1c (HbA1c) levels, but a set of four factors explained a total of 12% of the variance in HbA1c levels. Of the demographic variables considered (gender, number of parents at home, age, body mass index z-score), only gender was significantly associated with adolescent perceptions of family conflict. CONCLUSION The GCRS may allow diabetic care teams to better understand the origin of family conflict perceptions and the motivational beliefs that modify behavior and contribute to independent self-management and glucose control. Each question was designed to be meaningful in interventions by addressing common items of resistance to adherence and impulsive management decisions. The GCRS may be used by providers as an initial short screening survey on an annual or semi-annual basis.
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Affiliation(s)
| | - Helen M. Hendy
- Penn State University, Schuylkill Campus, Department of Psychology, Pennsylvania, United States
| | - Keith E. Williams
- Penn State Hershey Medical Center, Department of Pediatrics, Pennsylvania, United States,* Address for Correspondence: Penn State Hershey Medical Center, Department of Pediatrics, Pennsylvania, United States Phone: +7175317117 E-mail:
| | - Paul L. Mueller
- Penn State Hershey Medical Center, Department of Pediatrics, Pennsylvania, United States
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Lim JA, Lee YI, Jang JH, Choi SH. Investigating effective treatment factors in brief cognitive behavioral therapy for panic disorder. Medicine (Baltimore) 2018; 97:e12422. [PMID: 30235717 PMCID: PMC6160091 DOI: 10.1097/md.0000000000012422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Numerous studies have provided evidence for the effectiveness of cognitive behavioral therapy (CBT) on panic disorders (PDs). There has also been growing attention on brief CBT with regard to delivering intensive treatment efficiently. This study investigated the essential parts of mindfulness-based brief CBT to optimize treatment benefits.A total of 37 patients were retrospectively enrolled in this study. They were recruited from the anxiety/panic/fear clinic of Seoul National University Hospital. The patients participated in group CBT once a week for a total of 4 sessions over a 4-week period, when they were assessed using the Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after brief CBT. Twenty-nine patients completed the 1-month follow-up.There were significant reductions in PDSS (P < .001), ASI-R-fear of respiratory symptoms (P = .006), ASI-R-fear of publicly observable anxiety reaction (P = .002), ASI-R-fear of cardiovascular symptoms (P < .001), ASI-R-fear of cognitive dyscontrol (P = .001), ASI-R-Total (P < .001), APPQ-Agoraphobia (P = .003), APPQ-Total (P = .028), STAI-State anxiety (P < .001), STAI-Trait anxiety (P = .002), BAI (P = .003), and BDI (P < .001) scores. We also found significant associations between ASI-R-fear of cardiovascular symptoms, ASI-R-Total, and changes in PDSS scores. A stepwise multiple linear regression analysis indicated that anxiety sensitivity for fear of cardiovascular symptoms predicted an improvement in panic severity (β = 0.513, P = .004).Our findings suggested that behavioral aspects, especially physiological symptom control, needed to be considered in brief, intensive CBT for PD. The results also suggested that a mindfulness-based brief CBT approach might be particularly helpful for patients with PD who have severe cardiovascular symptoms.
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Affiliation(s)
- Jae-A Lim
- Department of Psychiatry, Seoul National University Hospital
| | | | - Joon Hwan Jang
- Department of Psychiatry, Seoul National University Hospital
- Department of Medicine, Seoul National University College of Medicine
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital
- Department of Psychiatry and Institute of Human Behavioral Medicine in SNU-MRC, Seoul National University College of Medicine, Seoul, Republic of Korea
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8
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Examining predictors of help-seeking behaviours in patients with mood and anxiety symptoms. Psychiatry Res 2018; 265:190-197. [PMID: 29729499 DOI: 10.1016/j.psychres.2018.04.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 11/23/2022]
Abstract
Relatively little is known about individual characteristics that factor into the decision to seek help for mood and anxiety symptoms. The current study was undertaken in order to examine factors that predict the likelihood of seeking help for mood and anxiety symptoms amongst a clinical population. Patients (N = 278) referred to a tertiary care clinic in Toronto, Canada were asked about their help-seeking behaviours (HSB) through initial intake assessments and self-administered questionnaires, including the Beck Anxiety Inventory, Anxiety Sensitivity Index, Intolerance of Uncertainty Scale, and Beck Depression Inventory-II. Correlates of anxiety and depression were examined to determine whether they could predict HSB amongst individuals with Generalized Anxiety Disorder with or without comorbid Major Depressive Disorder, as well as Panic Disorder and Social Anxiety Disorder. Psychiatric diagnoses were then examined to determine whether comorbidity and demographic factors impacted HSB. Results indicated that there were significant differences in anxiety and depression correlating mainly with anxiety sensitivity, as a predictor of HSB, and that there is a complex relationship between disorder type and demographic variables. The implications of these findings and suggested targeted interventions are discussed.
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Hou R, Garner M, Holmes C, Osmond C, Teeling J, Lau L, Baldwin DS. Peripheral inflammatory cytokines and immune balance in Generalised Anxiety Disorder: Case-controlled study. Brain Behav Immun 2017; 62:212-218. [PMID: 28161475 PMCID: PMC5373436 DOI: 10.1016/j.bbi.2017.01.021] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/24/2017] [Accepted: 01/30/2017] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Previous investigations have demonstrated that major depression is associated with particular patterns of cytokine signalling. The primary aim of this study was to examine peripheral pro-inflammatory and anti-inflammatory cytokines and immune balance in Generalised Anxiety Disorder (GAD). METHODS A case-controlled cross-sectional study design was employed: 54 patients with GAD and 64 healthy controls were recruited. Participants completed self-report measures of anxiety and depression. Two pro-inflammatory and two anti-inflammatory cytokines were measured using multiplex technology. RESULTS Case-control logistic regression analyses revealed significant differences in serum levels of IL-10, TNF-α, and IFN-γ between GAD and control groups after adjusting for age, gender, body mass index, smoking and alcohol consumption: these group differences were independent of the presence or degree of depression. Comparison of pro-inflammatory to anti-inflammatory cytokine ratios indicated that there were significantly higher ratios of TNF-α/IL10, TNF-α/IL4, IFN-γ/IL10, and IFN-γ/IL4 in the GAD group compared to the control group. CONCLUSIONS This study is the first to investigate both pro- and anti-inflammatory cytokines and their balance in patients with GAD in comparison to healthy controls. The findings indicate a relatively increased pro-inflammatory response and decreased anti-inflammatory response and provide the first demonstration of an altered cytokine balance in GAD. Serum cytokine levels in GAD were independent of the presence of depression.
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Affiliation(s)
- Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom.
| | - Matthew Garner
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton,Department of Psychology, University of Southampton
| | - Clive Holmes
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton
| | - Clive Osmond
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton
| | | | - Laurie Lau
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton
| | - David S. Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton,University Department of Psychiatry and Mental Health, University of Cape Town
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Panayiotou G, Michaelides MP, Theodorou M, Neophytou K. Identifying sub-categories of social fears using an alternative factor analytic structure of the Social Phobia and Anxiety Inventory. Psychiatry Res 2017; 251:304-311. [PMID: 28236783 DOI: 10.1016/j.psychres.2017.02.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/31/2017] [Accepted: 02/18/2017] [Indexed: 10/20/2022]
Abstract
AIMS This study evaluates an alternative factor structure of the Social Phobia and Anxiety Inventory (Turner et al., 1989), a widely used measure of social anxiety. Existing models ignore variance due to the different social contexts where social fears are expressed. METHOD Taking a different approach to scoring than previous studies, this investigation proposes a new model, which, in addition to 4-5 symptom dimensions, is able to capture the situations (strangers, authority figures, members of the opposite sex and people in general) that are of concern to the examinee. To test this model, all 96 items of the Social Phobia scale, rather than the average of the sub-items of its 23 questions were subjected to confirmatory factor analysis. RESULTS The model shows good fit and is superior to models ignoring the "situation" factors, which show good predictive validity in respect to real life demographics. CONCLUSION Utilization of all single questions of the SPAI can capture a wider range of social fears related to social anxiety than using the average of the items, which has implications for the understanding and clinical assessment of social anxiety.
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11
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Kröner-Herwig B, Gorbunova A, Maas J. Predicting the occurrence of headache and back pain in young adults by biopsychological characteristics assessed at childhood or adolescence. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2017; 8:31-39. [PMID: 28405174 PMCID: PMC5378444 DOI: 10.2147/ahmt.s127501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the current study was to identify predictors of recurrent headache and back pain in young adults (aged 18–27 years) from data assessed in childhood or adolescence, i.e., 9 years before the final survey. Our interest was whether psychological characteristics contribute to the risk of pain prevalence in adult age when controlling for already empirically supported risk factors such as parental pain, pediatric pain and sex. The study was part of a five-wave epidemiological investigation of >5000 families with children aged between 7 and 14 years when addressed first. In a multiple hierarchical regression analysis, the abovementioned three variables (Block-I variables) were entered first followed by five psychological trait variables (Block-II variables: internalizing, anxiety sensitivity, somatosensory amplification, catastrophizing and dysfunctional stress coping) to find out the extent of model improvement. The multivariable hierarchical regression analysis confirmed the hypothesis that the Block-I variables significantly enhance the risk of future pain at young adult age. None of the psychological variables did so. Thus, the hypothesis of a significant surplus predictive effect was not confirmed. The amount of total explained variance differed strongly between headache and back pain. In particular, a valid prediction of back pain was not possible. When analyzed separately in simple regression analysis, psychological variables turned out to be significant predictors, however, of very low effect size. The inclusion of Block-I variables in the model clearly reduced the impact of the psychological variables. This risk profile is discussed in the context of the different trajectories of headache and back pain from childhood to adult age, which were proposed by various studies. We propose that a biopsychological characteristic denoted as emotional negativity, especially regarding self-reference, might be a common factor behind all selected variables. Risk research in recurrent pain is a field where much more multidisciplinary research is needed before progress can be expected.
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Affiliation(s)
- Birgit Kröner-Herwig
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Anastasia Gorbunova
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Jennifer Maas
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany
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12
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Helmes E, Ward BG. Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care. Aging Ment Health 2017; 21:272-278. [PMID: 26565928 DOI: 10.1080/13607863.2015.1111862] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Anxiety in older people is under-diagnosed and poorly treated despite significant impairments that arise from anxiety. Mindfulness-based cognitive therapy (MBCT) has been shown to be a promising treatment for anxiety. The aim of this study was to determine the effect of an MBCT program on anxiety symptoms in older people living in residential care. METHOD Fifty-two participants (34 females) were randomly allocated into therapy and control groups using a 2 × 3 mixed design. The average age of participants was 83 years. RESULTS The group effect showed significant improvements on all measures at the end of the seven-week program in the therapy group, while the control group did not show significant changes. CONCLUSION This study represents one of the first studies of the effectiveness of an MBCT program on anxiety symptoms for older people using a randomized controlled trial. The study has implications for future research that include the effectiveness of MBCT for the treatment of anxiety symptoms in older people, the utility of group therapy programs in residential care and the benefits of using specialized instruments for older populations.
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Affiliation(s)
- Edward Helmes
- a Department of Psychology , College of Healthcare Sciences, James Cook University , Townsville , Australia
| | - Bradley G Ward
- a Department of Psychology , College of Healthcare Sciences, James Cook University , Townsville , Australia
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Abstract
The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among college students, the authors replicated the vulnerability effect of AS on panic onset. By measuring AS according to its hierarchical structure, the authors found an AS subfactor—AS-Mental Incapacitation Concerns—to be a significant predictor of panic onset. The authors also demonstrate that AS is not only statistically significant but also clinically/pragmatically important for the onset of panic. The association between panic and increased AS was confirmed in this study, although it remains for future research to conclude whether this association should be attributed to a “scar effect” of panic. Theoretical and methodological issues regarding tests of the scar effect hypothesis are discussed.
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Affiliation(s)
- Wen Li
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA
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Ghisi M, Bottesi G, Altoè G, Razzetti E, Melli G, Sica C. Factor Structure and Psychometric Properties of the Anxiety Sensitivity Index-3 in an Italian Community Sample. Front Psychol 2016; 7:160. [PMID: 26909057 PMCID: PMC4754426 DOI: 10.3389/fpsyg.2016.00160] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/28/2016] [Indexed: 11/30/2022] Open
Abstract
Anxiety Sensitivity (AS) is defined as the fear of anxiety and of arousal-related bodily sensations, arising from erroneous beliefs that these sensations will have adverse consequences. AS plays a key role both in the onset and in the maintenance of several disorders, particularly anxiety disorders. To date, only two studies on American samples have examined the bifactor structure of the Anxiety Sensitivity Index-3 (ASI-3); therefore, findings on different cultures are needed. The main purpose of the present study was to assess the factor structure and psychometric properties of the ASI-3 in an Italian community sample. Participants were recruited from the general population (N = 1507). The results of a series of confirmatory factor analyses indicated that the bifactor structure fitted the data better than the most commonly accepted structure for the measure and that it was invariant across gender. Moreover, the current study provided evidence regarding the ASI-3’s reliability and its convergent and divergent validity. Lastly, results pertaining incremental validity of the ASI-3 Physical and Cognitive Concerns subscales above and beyond the total showed that the former was not associated with a measure of physiological anxiety, whereas the latter was weakly associated with a measure of worry. Findings suggest that the ASI-3 is comprised of a dominant general factor and three specific independent factors; given the dominance of the general factor, the use of the ASI-3 total score as a measure of the general fear of anxiety is recommended in both clinical and research settings.
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Affiliation(s)
- Marta Ghisi
- Department of General Psychology, University of Padova Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova Padova, Italy
| | - Gianmarco Altoè
- Department of Developmental and Social Psychology, University of Padova Padova, Italy
| | - Enrico Razzetti
- Department of General Psychology, University of Padova Padova, Italy
| | - Gabriele Melli
- Institute of Behavioral and Cognitive Psychology and Psychotherapy (IPSICO) Firenze, Italy
| | - Claudio Sica
- Department of Health Sciences, University of Florence Firenze, Italy
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Psychological inflexibility mediates the effects of self-efficacy and anxiety sensitivity on worry. SPANISH JOURNAL OF PSYCHOLOGY 2015; 17:E3. [PMID: 25012484 DOI: 10.1017/sjp.2014.3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Recent research has found low levels of general self-efficacy (GSE: beliefs about the ability to appropriately handle a wide range of stressors) and high levels of anxiety sensitivity (AS: fear of the negative consequences of experiencing anxiety) to be relevant predictors of pathological worry. This study examined the role of psychological inflexibility (PI: the dominance of private experiences over chosen values and contingencies in guiding action), the central component of the acceptance and commitment therapy model of psychopathology, in the effect of GSE and AS on worry. A total of 132 nonclinical participants completed questionnaires assessing the constructs of interest. Partial correlations and regression analyses showed that both GSE and AS were independent predictors of pathological worry after controlling for each other. However, mediation analyses revealed that psychological inflexibility completely mediated the independent effects of both GSE and AS on pathological worry. Theoretical and treatment implications of the results are discussed.
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Talkovsky AM, Norton PJ. The Indirect Effect of Anxiety Sensitivity in the Relationship Between Panic Symptoms and Panic Severity. J Cogn Psychother 2015; 29:123-133. [PMID: 32759163 DOI: 10.1891/0889-8391.29.2.123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The cognitive model of panic (Clark, 1988) suggests that panic attacks result from the catastrophic misinterpretation of bodily sensations rather than the sensations themselves. Anxiety sensitivity (AS) is fear of anxious bodily sensations (Reiss, 1991) and has implications in panic development, maintenance, and severity. Although previous work has demonstrated that AS amplifies symptoms in response to provocations, few have analyzed the role of AS in the relationship between panic symptoms and panic disorder severity. The purpose of this investigation was to determine if AS, a cognitive risk for panic, has an indirect effect on the association between self-reported panic symptoms and panic severity, both self-reported and clinician-assessed, among 67 treatment-seeking individuals with a primary diagnosis of panic disorder with or without agoraphobia. Data were analyzed using the bootstrapped conditional process indirect effects model. Results indicated that the overall total mediational effect on Panic Disorder Severity Scale (PDSS) was significant with evidence of partial mediation. The direct effect of Beck Anxiety Inventory (BAI) on PDSS remained significant although there was also a significant indirect effect of BAI via AS. Results showed a similar relationship when Clinician Severity Rating was the outcome. Moderation analyses were not significant. Therefore, AS was a significant partial mediator of the relationship between symptom intensity and panic severity, whether clinician-rated or self-reported. This investigation provides support for the importance of AS in panic, highlighting its importance but suggesting that it is not sufficient to explain panic disorder.
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Talkovsky AM, Norton PJ. Anxiety sensitivity across four ethnoracial groups in an undergraduate sample. Cogn Behav Ther 2014; 44:33-43. [PMID: 25243807 DOI: 10.1080/16506073.2014.953568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Anxiety sensitivity (AS), the fear of anxious cognitive and physiological experiences, is multidimensional and adds incrementally to the prediction of relationships of panic and relevant phenomenology. Many agree upon the content of the dimensions, but there is less agreement about the factor structure of the anxiety sensitivity index (ASI), a widely used measure of AS, across cultural groups. Anxiety disorders vary in their epidemiology and phenomenology across ethnoracial groups. This investigation adds clarity to research in the psychometric properties of the ASI across four cultural groups. Results from a confirmatory factor analysis support invariance across groups with the exception of three psychometrically questionable items assessing fear of gastrointestinal symptoms. The convergent and divergent validity are consistent with cross-group invariance as well. Clinical implications are discussed.
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Lechner WV, Shadur JM, Banducci AN, Grant DM, Morse M, Lejuez CW. The mediating role of depression in the relationship between anxiety sensitivity and alcohol dependence. Addict Behav 2014; 39:1243-8. [PMID: 24813550 DOI: 10.1016/j.addbeh.2014.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/06/2014] [Accepted: 04/02/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many studies have reported that Anxiety Sensitivity (AS) is positively associated with alcohol use or other alcohol-related variables. More recent mediator and moderator models have shown promise in elucidating mechanisms within this relationship; the literature to date suggests that the relationship between AS and alcohol is likely mediated by problematic coping motives. However, few studies have considered the effects of depression within the AS-alcohol use relationship, despite a strong body of evidence linking AS to subsequent depression and depression to subsequent alcohol use problems, independently. Therefore, the current study assessed depression as a potential mediator of this relationship. METHOD Participants were 418 sequential admissions to a substance abuse treatment facility. A mediation analysis using bootstrapping was utilized in order to estimate indirect effects of AS on alcohol dependence through depression. RESULTS Results reveal an indirect effect suggesting that the effects of anxiety sensitivity on alcohol dependence are mediated by symptoms of depression. More specifically, the effects of AS total score and AS somatic sensations on alcohol dependence were mediated by symptoms of depression. Lastly, a dual mediator model demonstrated that both depression and problematic coping uniquely mediate the relationship between AS and alcohol dependence. CONCLUSIONS While preliminary in nature, the current study provides evidence supporting the hypothesis that depression is an important factor to consider when examining the relationship between AS and alcohol dependence.
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Affiliation(s)
- William V Lechner
- Oklahoma State University, 118 North Murray Hall, Stillwater, OK 74075, United States; Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, MD 20742, United States.
| | - Julia M Shadur
- Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, MD 20742, United States
| | - Anne N Banducci
- Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, MD 20742, United States
| | - DeMond M Grant
- Oklahoma State University, 118 North Murray Hall, Stillwater, OK 74075, United States
| | - Melanie Morse
- Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, MD 20742, United States
| | - C W Lejuez
- Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, MD 20742, United States
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Barke A, Gaßmann J, Kröner-Herwig B. Cognitive processing styles of children and adolescents with headache and back pain: a longitudinal epidemiological study. J Pain Res 2014; 7:405-14. [PMID: 25031545 PMCID: PMC4096452 DOI: 10.2147/jpr.s64334] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous research has shown positive relationships between dysfunctional cognitive styles and different aspects of pain (eg, pain frequency). One goal of our longitudinal study was to investigate potential risk factors for the incidence of headache (HA) and back pain (BP). METHODS In the first wave (2003), questionnaires were sent to 6,400 children between the ages of 9 and 14 years. Those who answered in wave 1 were contacted again every year (four survey waves in total: 2003-2006). The data presented are based on the children's self-reports in the second wave (2004) and third wave (2005). Potential risk factors (dysfunctional stress coping, pain catastrophizing, anxiety sensitivity, and somatosensory amplification) were collected in wave 2. Binary logistic regression analyses - for boys and girls - were performed to assess the predictive value of the risk factors for HA and BP in wave 3. RESULTS In the comprehensive model, none of the examined variables predicted the incidence of HA. Anxiety sensitivity increased the risk that boys would report BP after 1 year by 50% and dysfunctional stress coping increased the risk by 40%. For girls, somatosensory amplification increased the risk of the incidence of BP 1 year later by 80%, whereas pain catastrophizing reduced the risk by 50%. CONCLUSION In this incidence sample, the amount of variance explained by the psychological variables investigated was very small. Integrating this result with existing findings from cross-sectional studies suggests that dysfunctional cognitive processing styles may develop more as a consequence or a concomitant feature of BP or HA, but play a less important role in its initial development.
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Affiliation(s)
- Antonia Barke
- Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Georg-August-Universität Göttingen, Göttingen, Germany ; Department of Clinical Psychology and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Jennifer Gaßmann
- Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Birgit Kröner-Herwig
- Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Georg-August-Universität Göttingen, Göttingen, Germany
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Abstract
A combination of exposure therapy techniques and Acceptance and Commitment Therapy (ACT) strategies were used to treat a 23-year-old pregnant female who was housebound due to symptoms of agoraphobia. The client in this case study had not left her family home in 10 months when she sought treatment for her anxiety. The client was successfully treated over a year, such that she was able to receive prenatal care at an obstetrician’s office and to deliver her infant at a hospital. Neither the client nor her fetus suffered any complications due to treatment. Post-treatment and 1-year follow-up data indicated that the client continued to show significant functional improvements following the birth of her child. Recommendations for integrating ACT strategies into exposure therapy for severe agoraphobia and for anxious pregnant women are provided.
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Abstract
CONTEXT Relation of three dimensions of anxiety sensitivity (AS) (physical concerns [PC], cognitive concerns [CC] and social concerns [SC]) with anxiety or depression has been inconsistently reported. One possible explanation on the mixed findings is the lack of reliable measurement that assesses AS dimensions. AIMS This study was aimed to examine the specificity of dimensions of AS to anxiety and depression in a sample of Korean adults. SETTINGS AND DESIGN Participants included 426 Korean adults who were recruited by means of advertisements requesting volunteers for the psychological assessments. MATERIALS AND METHODS Participants completed measures of AS, anxious symptoms and depressive symptoms. STATISTICAL ANALYSIS Linear regression equations were constructed. RESULTS It was found that PC and SC showed specificity to anxiety after adjusting for depression, while CC showed specificity to depression after controlling for anxiety. CONCLUSIONS The findings suggest specificity of PC and SC to anxiety and of CC to depression when their relationship was explored with the more reliable measurement. The present findings clarify the nature of dimensions of AS in Korean adults.
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Affiliation(s)
- Young-Jin Lim
- Department of Psychology, Daegu University, Gyengbuk, Korea
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Allan NP, Capron DW, Raines AM, Schmidt NB. Unique relations among anxiety sensitivity factors and anxiety, depression, and suicidal ideation. J Anxiety Disord 2014; 28:266-75. [PMID: 24534564 DOI: 10.1016/j.janxdis.2013.12.004] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
Abstract
Anxiety sensitivity (AS) is composed of three lower-order dimensions, cognitive concerns, physical concerns, and social concerns. We examined the relations between AS dimensions using a more adequate assessment of subscales (ASI-3) than has previously been used, and measures of anxiety and mood disorders as well as suicidal ideation in a sample of 256 (M age = 37.10 years, SD = 16.40) treatment-seeking individuals using structural equation modeling. AS cognitive concerns was uniquely associated with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and suicidal ideation. AS physical concerns was uniquely associated with OCD, social anxiety disorder (SAD), panic disorder (PD), and specific phobia. AS social concerns was uniquely associated with SAD, GAD, OCD, and MDD. These results highlight the importance of considering the lower-order AS dimensions when examining the relations between AS and psychopathology.
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Affiliation(s)
- Nicholas P Allan
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA.
| | - Daniel W Capron
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Amanda M Raines
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA.
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Klauke B, Deckert J, Zwanzger P, Baumann C, Arolt V, Pauli P, Reif A, Domschke K. Neuropeptide S receptor gene (NPSR) and life events: G × E effects on anxiety sensitivity and its subdimensions. World J Biol Psychiatry 2014; 15:17-25. [PMID: 22404660 DOI: 10.3109/15622975.2011.646302] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The pathogenesis of anxiety is assumed to be interactively influenced by genetic and environmental factors. Thus, a gene-environment interaction (G × E) study of the neuropeptide S receptor gene (NPSR) A/T polymorphism (rs324981) and life events was conducted with respect to anxiety sensitivity (AS) as an intermediate phenotype of anxiety disorders. METHODS A sample of 475 healthy German subjects was genotyped for NPSR and assessed for AS, childhood maltreatment (CTQ) and recent life events (LTE). Influences on AS and its subdimensions were determined by a step-wise hierarchical regression and a multiple indicator multiple cause (MIMIC) model. RESULTS Significant main effects of NPSR and CTQ as well as significant G × E were observed, with T/T homozygosity and a high CTQ score resulting in increased anxiety sensitivity. MIMIC modelling yielded association of AS subfactor "concern about mental/cognitive incapacitation" and the basal somatic subdimension "concern about physical sensations" to be associated with CTQ and its interaction with NPSR, while the acute somatic subfactor "concern about heart/lung failure" was associated with NPSR and its interaction with LTE. CONCLUSIONS Results indicate G × E effects of the more active NPSR rs324981 T allele and life events on AS with differential effects of temporally proximal and distal factors on specific AS subdimensions.
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Affiliation(s)
- Benedikt Klauke
- Department of Psychiatry and Psychotherapy , University of Muenster , Germany
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A Bifactor Model of Anxiety Sensitivity: Analysis of the Anxiety Sensitivity Index-3. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2013. [DOI: 10.1007/s10862-013-9400-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Baumann C, Klauke B, Domschke K, Fassbinder F, Gartmann N, Kalisch R, Reif A, Deckert J, Pauli P. Die gemeinsamen und spezifischen Komponenten von Depression und Angst. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2013. [DOI: 10.1026/1616-3443/a000225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Theoretischer Hintergrund: Mit Fragebögen erfasste Depressions- und Angstwerte sind häufig hoch korreliert. Nach dem Tripartite Modell von Clark und Watson (1991) ist diese Kovariation auf die gemeinsame Komponente negativer Affekt zurückzuführen. Eine bessere Differenzierung depressiver und ängstlicher Symptome sei über den depressionsspezifischen geringen positiven Affekt und das angstspezifische physiologische Hyperarousal möglich. Fragestellung: Ziel dieser Studie ist die Überprüfung dieses Modells und die Bestimmung übergeordneter angst- und depressionsspezifischer Faktoren. Methode: Die Evaluation des Modells erfolgte anhand von Fragebögen zu Depression, Angst und Affekt an einer Stichprobe von 1 110 gesunden Erwachsenen (48 % weiblich; Alter: M = 25.43; SD = 6.07). Ergebnisse: Eine Hauptachsenanalyse erbrachte eine zweifaktorielle Lösung, welche sich ebenfalls in den Strukturgleichungsmodellen abbildete und die Konstrukte Depression und Angst repräsentiert. Beide Faktoren waren mit negativem Affekt assoziiert, nur die Komponente Depression war durch das Fehlen von positivem Affekt gekennzeichnet. Die angstspezifische Komponente Hyperarousal konnte nicht nachgewiesen werden. Schlussfolgerungen: Implikationen für weiterführende Studien, insbesondere hinsichtlich der Weiterentwicklung des Modells, werden diskutiert.
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Affiliation(s)
- Christian Baumann
- Institut für Psychologie, Lehrstuhl für Biologische Psychologie, Klinische Psychologie und Psychotherapie, Universität Würzburg
| | - Benedikt Klauke
- Klinik für Psychiatrie und Psychotherapie, Universität Münster
| | | | - Frauke Fassbinder
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf
| | - Nina Gartmann
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf
| | - Raffael Kalisch
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf
| | - Andreas Reif
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universität Würzburg
| | - Jürgen Deckert
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universität Würzburg
| | - Paul Pauli
- Institut für Psychologie, Lehrstuhl für Biologische Psychologie, Klinische Psychologie und Psychotherapie, Universität Würzburg
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Kröner-Herwig B, Maas J. The German Pain Catastrophizing Scale for Children (PCS-C) - psychometric analysis and evaluation of the construct. PSYCHO-SOCIAL MEDICINE 2013; 10:Doc07. [PMID: 23922617 PMCID: PMC3734764 DOI: 10.3205/psm000097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: The Pain Catastrophizing Scale, adapted for children (PCS-C) by Crombez et al. (2003), was translated into German (SKS-D) and evaluated regarding its factorial structure, its reliability and validity. The association of catastrophizing with various pain characteristics and disability measures was examined as well as its association to neighboring constructs. Method: The paper-and-pencil version of the SKS-D was used in two different samples of children and adolescents. Analyses were conducted on a subgroup of participants from an epidemiological sample [n=898; age: M=12.9 (SD=1.4)] who had experienced monthly headaches in the 6-months period before and a clinical sample [n=60; age: M=12.6 (SD=0.8)] seeking treatment for recurrent headaches. Results: Exploratory factor analysis (PCA) suggested a one-factor model in contrast to the 3-factor model suggested by Crombez et al. (2003). The unidimensional scale showed distinct homogeneity and satisfying reliability. The clinical sample showed significantly higher scores than the epidemiological group. Also girls scored higher than boys. The catastrophizing explained a considerable amount of variance in pain and disability parameters in both samples thus underlining its validity. The psychological variables internalising, anxiety sensitivity and somatosensory amplification showed significant small to moderate associations with pain catastrophizing and also with pain and disability. After controlling for the above mentioned psychological variables, catastrophizing still yielded an independent contribution to the explanation of variance in pain and disability parameters. Conclusions: The PCS-C in its German form is a valid and reliable instrument for assessing catastrophizing in children with recurrent pain, in particular headache, in the age of 10–16 years. Pain catastrophizing is suggested to be assessed especially in pediatric pain patients as it is a significant moderator of pain and disability. In children with a distinct tendency to catastrophize cognitive restructuring should become a target of pediatric pain therapy, as a reduction of catastrophizing cognitions may indirectly help to ameliorate pain and disability.
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Affiliation(s)
- Birgit Kröner-Herwig
- Georg-Elias-Müller-Institute, University of Göttingen, Dept. of Clinical Psychology and Psychotherapy, Göttingen, Germany
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Fischer MJ, Scharloo M, Abbink J, van 't Hul A, van Ranst D, Rudolphus A, Weinman J, Rabe KF, Kaptein AA. Concerns about exercise are related to walk test results in pulmonary rehabilitation for patients with COPD. Int J Behav Med 2012; 19:39-47. [PMID: 21080250 PMCID: PMC3277820 DOI: 10.1007/s12529-010-9130-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Although international guidelines on pulmonary rehabilitation acknowledge that psychological factors contribute to exercise intolerance in patients with chronic obstructive pulmonary disease (COPD), the few empirical studies investigating this association have found inconsistent results. Purpose The purpose of this study is to investigate whether negative affect and beliefs about exercise of patients with COPD would be related to baseline 6-min walk (6-MW) test results in a pulmonary rehabilitation setting, after correction for physical variables (sex, age, height, weight, and lung function). A second aim was to examine whether patients' beliefs are associated with treatment outcomes, as measured by an improvement in 6-MW distance. Method A 12-week pulmonary rehabilitation program was completed by 166 patients. Beliefs (perceived necessity and concerns) about exercise and negative affect were assessed by a questionnaire. Clinical data were obtained from medical records. Results Baseline 6-MW distance was positively related to younger age, male gender, better pulmonary function, and having fewer concerns about exercise. After rehabilitation, patients had increased their walk distance by 12% (32 m), on average. Baseline physiological and psychological variables were unrelated to patients' response to treatment (increase in walk distance). However, subgroup analysis showed that for patients with mild to moderate airflow obstruction, concerns about exercise were negatively related to response to treatment. Conclusion We conclude that patients' beliefs about the negative consequences of exercise are associated with baseline 6-MW test performance and response to treatment for patients with mild to moderate COPD. We recommend that patients' concerns about exercise are discussed and, if necessary, corrected during the intake phase.
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Affiliation(s)
- Maarten J Fischer
- Medical Psychology, Leiden University Medical Center (LUMC), P.O. Box 9555, 2300, RB, Leiden, the Netherlands.
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Kröner-Herwig B, Gassmann J. Headache disorders in children and adolescents: their association with psychological, behavioral, and socio-environmental factors. Headache 2012; 52:1387-401. [PMID: 22789010 DOI: 10.1111/j.1526-4610.2012.02210.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This cross-sectional study on a randomly drawn population sample of children and adolescents (n = 3399; aged 9 to 15) aimed at the assessment of patterns of associations between psychosocial variables and primary headache disorders like migraine (MIG) or tension-type headache. A headache-free group served as a control. METHODS Data on headache and psychological trait variables (eg, internalizing symptoms), behavioral factors (eg, physical activities), and socio-environmental factors (eg, life events) were gathered by questionnaire. Logistic regression analyses were conducted with headache types (MIG, tension-type, and non-classifiable headache) as dependent variables. RESULTS The pattern of correlations was largely congruent between the headache disorders. Associations were closest regarding maladaptive psychological traits (in particular internalizing symptoms with an odds ratio > 4 regarding MIG) compared with socio-environmental factors and particularly the behavioral factors. Unfavorable psychological traits and socio-environmental strains demonstrated distinctly stronger associations with MIG than tension-type headache and explained more variance in the occurrence of pediatric headache disorders than parental headache. Sex-specific analyses showed similarities as well as differences regarding the correlations, and in general, the associations were stronger in girls than boys. CONCLUSIONS A common path model as posited by several researchers in the field may explain the parallelism in biopsychosocial vulnerability regarding the different headache disorders.
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Affiliation(s)
- Birgit Kröner-Herwig
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller Institute of Psychology, University of Göttingen, Göttingen, Germany.
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Wheaton MG, Deacon BJ, McGrath PB, Berman NC, Abramowitz JS. Dimensions of anxiety sensitivity in the anxiety disorders: evaluation of the ASI-3. J Anxiety Disord 2012; 26:401-8. [PMID: 22306133 DOI: 10.1016/j.janxdis.2012.01.002] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 10/14/2011] [Accepted: 01/05/2012] [Indexed: 11/25/2022]
Abstract
Anxiety sensitivity (AS), the fear of sensations of anxious arousal based on beliefs about their harmful consequences, is increasingly recognized as a multidimensional construct. The recently developed Anxiety Sensitivity Index-3 [ASI-3; Taylor, S., Zvolensky, M., Cox, B., Deacon, B., Heimberg, R., Ledley, D. R., et al. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3 (ASI-3). Psychological Assessment, 19, 176-188] measures three dimensions of AS: physical concerns, social concerns, and cognitive concerns. The ASI-3 shows promise, although further evaluation of its psychometric properties and validity in independent samples is needed. We evaluated the ASI-3 in a mixed sample of anxiety disorder patients (N=506) and undergraduate student controls (N=315). The measure demonstrated a stable 3-factor structure and sound psychometric properties, with the three factors showing theoretically consistent patterns of associations with anxiety symptoms and diagnoses. ASI-3 total scores were less discriminative. Implications for conceptual models of anxiety are discussed.
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Affiliation(s)
- Michael G Wheaton
- Department of Psychology, University of North Carolina at Chapel Hill, NC 27599, United States
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Lim YJ, Kim JH. Korean Anxiety Sensitivity Index-3: its factor structure, reliability, and validity in non-clinical samples. Psychiatry Investig 2012; 9:45-53. [PMID: 22396684 PMCID: PMC3285740 DOI: 10.4306/pi.2012.9.1.45] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 08/29/2011] [Accepted: 09/30/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim here is to examine the factorial structure, internal consistency, and concurrent validity of the Korean version of the Anxiety Sensitivity Index-3 (K-ASI-3) in student samples in Korea. Also, we investigated the cross-cultural differences in the Social Concerns factor. METHODS K-ASI-3 was administered to non clinical samples in Korea. Internal consistency, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were undertaken to examine the factorial structure and reliability of the K-ASI-3. RESULTS Results from CFA comparing our data to factor solutions commonly reported as representative of European-American samples indicated an adequate fit. The K-ASI-3 showed good performance on the indices of internal consistency and concurrent validity. In addition, using regression analyses, we found the Social Concerns factor is most strongly related to life satisfaction and worry. However, we found no evidence that Korean college students express more Social Concerns than their European Caucasian counterparts. CONCLUSION The authors demonstrate that the K-ASI-3 has highly internally consistent and psychometrically sound items, and that it reliably measures three lower-order domains assessing Physical, Social, and Cognitive Concerns.
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Affiliation(s)
- Young-Jin Lim
- Department of Psychology, Daegu University, Gyeongsan, Korea
| | - Ji-Hae Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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31
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Klauke B, Deckert J, Reif A, Pauli P, Zwanzger P, Baumann C, Arolt V, Glöckner-Rist A, Domschke K. Serotonin transporter gene and childhood trauma--a G × E effect on anxiety sensitivity. Depress Anxiety 2011; 28:1048-57. [PMID: 21681867 DOI: 10.1002/da.20840] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 04/27/2011] [Accepted: 04/27/2011] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Genetic factors and environmental factors are assumed to interactively influence the pathogenesis of anxiety disorders. Thus, a gene-environment interaction (G × E) study was conducted with respect to anxiety sensitivity (AS) as a promising intermediate phenotype of anxiety disorders. METHOD Healthy subjects (N = 363) were assessed for AS, childhood maltreatment (Childhood Trauma Questionnaire), and genotyped for functional serotonin transporter gene variants (5-HTTLPR/5-HTT rs25531). The influence of genetic and environmental variables on AS and its subdimensions was determined by a step-wise hierarchical regression and a multiple indicator multiple cause (MIMIC) model. RESULTS A significant G × E effect of the more active 5-HTT genotypes and childhood maltreatment on AS was observed. Furthermore, genotype (LL)-childhood trauma interaction particularly influenced somatic AS subdimensions, whereas cognitive subdimensions were affected by childhood maltreatment only. CONCLUSIONS Results indicate a G × E effect of the more active 5-HTT genotypes and childhood maltreatment on AS, with particular impact on its somatic subcomponent.
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Affiliation(s)
- Benedikt Klauke
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
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Sensitivity to pain traumatization: a higher-order factor underlying pain-related anxiety, pain catastrophizing and anxiety sensitivity among patients scheduled for major surgery. Pain Res Manag 2011; 16:169-77. [PMID: 21766066 DOI: 10.1155/2011/932590] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The present article addresses two related developments in the psychology of pain, and integrates them into a coherent framework to better understand the relationship between pain and trauma. The first is an emerging conceptualization regarding the nature of the hierarchical organization of major pain-related anxiety constructs. The second is the theoretical rationale and empirical evidence linking pain and symptoms of post-traumatic stress disorder. OBJECTIVES To explore the underlying hierarchical factor structure of commonly used pain-related anxiety measures including the Pain Anxiety Symptoms Scale (PASS-20), the Pain Catastrophizing Scale (PCS), and the Anxiety Sensitivity Index (ASI); and to relate this structure to post-traumatic stress disorder in patients scheduled for major surgery. METHODS Measures were completed by 444 patients scheduled to undergo major surgery. Exploratory factor analysis and subsequent higherorder analysis using the Schmid-Leiman transformation were conducted to investigate the underlying factor structure of the ASI, the PCS and the PASS-20. RESULTS Twenty items from the ASI, the PASS-20 and the PCS loaded exclusively on one higher-order factor. The authors suggest the term 'sensitivity to pain traumatization' (SPT) for the underlying construct based in part on the strong, significant positive correlation between SPT scores and scores on the Post-traumatic Stress Disorder Checklist - Civilian Version. Finally, the total SPT score was significantly higher for patients with a history of pain than for those without a history of pain, both before surgery and one year after surgery. SPT describes the propensity to develop anxiety-related somatic, cognitive, emotional and behavioural responses to pain that resemble features of a traumatic stress reaction. Together, the results of the present study provide preliminary evidence for the construct validity of SPT.
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Jurin T, Jokic-Begic N, Korajlija AL. Factor Structure and Psychometric Properties of the Anxiety Sensitivity Index in a Sample of Croatian Adults. Assessment 2011; 19:31-41. [DOI: 10.1177/1073191111402459] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that these symptoms may have harmful consequences. The most widely used operationalization of AS in adults is the Anxiety Sensitivity Index (ASI). The factor structure, gender stability, and psychometric properties of the ASI in a sample of Croatian adults ( N = 984) were evaluated. Results confirm the multidimensional and hierarchical structure of the ASI, which consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor, AS. Furthermore, the achievement of normative scores for the ASI in a Croatian adult sample demonstrates the cross-national stability of the ASI. Reliability coefficients for the ASI, Physical Concerns, and Psychological Concerns are high and satisfactory in the total sample and for both genders. Overall, the results confirmed the cross-national stability, gender stability, reliability, and validity of the ASI in a sample of Croatian adults.
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Kroner-Herwig B, Gassmann J, van Gessel H, Vath N. Multiple Pains in Children and Adolescents: A Risk Factor Analysis in a Longitudinal Study. J Pediatr Psychol 2011; 36:420-32. [DOI: 10.1093/jpepsy/jsq099] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Norman SB, Campbell-Sills L, Hitchcock CA, Sullivan S, Rochlin A, Wilkins KC, Stein MB. Psychometrics of a brief measure of anxiety to detect severity and impairment: the Overall Anxiety Severity and Impairment Scale (OASIS). J Psychiatr Res 2011; 45:262-8. [PMID: 20609450 PMCID: PMC2970755 DOI: 10.1016/j.jpsychires.2010.06.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 06/15/2010] [Accepted: 06/15/2010] [Indexed: 10/19/2022]
Abstract
Brief measures of anxiety-related severity and impairment that can be used across anxiety disorders and with subsyndromal anxiety are lacking. The Overall Anxiety Severity and Impairment Scale (OASIS) have shown strong psychometric properties with college students and primary care patients. This study examines sensitivity, specificity, and efficiency of an abbreviated version of the OASIS that takes only 2-3 min to complete using a non-clinical (college student) sample. 48 participants completed the OASIS and SCID for anxiety disorders, 21 had a diagnosis of ≥1 anxiety disorder, and 4 additional participants had a subthreshold diagnosis. A cut-score of 8 best discriminated those with anxiety disorders from those without, successfully classifying 78% of the sample with 69% sensitivity and 74% specificity. Results from a larger sample (n = 171) showed a single factor structure and excellent convergent and divergent validity. The availability of cut-scores for a non-clinical sample furthers the utility of this measure for settings where screening or brief assessment of anxiety is needed.
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Affiliation(s)
- Sonya B. Norman
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 0603 La Jolla, CA 92037-0603, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA, VA Center of Excellence for Stress and Mental Health, San Diego, CA 92161, USA
| | - Laura Campbell-Sills
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 0603 La Jolla, CA 92037-0603
| | - Carla A. Hitchcock
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 0603 La Jolla, CA 92037-0603, Alliant International University, 10455 Pamerado Road, San Diego, CA 92131-1799, USA
| | - Sarah Sullivan
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 0603 La Jolla, CA 92037-0603
| | | | - Kendall C. Wilkins
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite, 103, San Diego, CA 92120-4919
| | - Murray B. Stein
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 0603 La Jolla, CA 92037-0603, Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive Mail Code 0628 La Jolla, CA 92093-0628
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Lewis AR, Zinbarg RE, Mineka S, Craske MG, Epstein A, Griffith JW. The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach. Behav Res Ther 2010; 48:761-9. [PMID: 20510917 DOI: 10.1016/j.brat.2010.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Revised: 04/19/2010] [Accepted: 05/02/2010] [Indexed: 10/19/2022]
Abstract
A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.
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Affiliation(s)
- Alison R Lewis
- Northwestern University, Department of Psychology, 2029 Sheridan Road, Swift Hall 102, Evanston, IL 60208, USA.
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Measurement invariance of alcohol use motivations in junior military personnel at risk for depression or anxiety. Addict Behav 2010; 35:444-51. [PMID: 20097012 DOI: 10.1016/j.addbeh.2009.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 10/23/2009] [Accepted: 12/10/2009] [Indexed: 11/21/2022]
Abstract
Measurement invariance is typically assumed when assessing drinking-related constructs across distinct groups of respondents. However, measurement properties of motivations related to mood maintenance and stress relief may differ in those experiencing symptoms of depression or anxiety. Invariance of social and coping drinking motives were explored with a sample of 4133 junior enlisted Air Force and Navy personnel. Measurement did not differ in those with depression symptoms. In contrast, those with anxiety symptoms differed in measurement of both motives. The impact of non-equivalence was demonstrated with a mediation model in which anxiety and depression predicted drinking motives, which in turn predicted heavy drinking. Incorporation of the partial invariance of the social motives factor attenuated the estimate of the mediated effect of social drinking motives by almost half compared to the estimate with invariance assumed. These results suggest that lack of measurement invariance could seriously bias or alter conclusions from tests of theoretical models and highlight the need for researchers to carefully consider the measurement properties of their constructs prior to model estimation.
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Kröner-Herwig B, Heinrich M, Vath N. The assessment of disability in children and adolescents with headache: adopting PedMIDAS in an epidemiological study. Eur J Pain 2010; 14:951-8. [PMID: 20346716 DOI: 10.1016/j.ejpain.2010.02.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 01/15/2010] [Accepted: 02/28/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The study aimed at the assessment of disability in children with headache (n=1585, 11-14 yrs) from a randomly drawn population based sample. We explored the suitability of the PedMIDAS in epidemiological research by various indicators of response quality. Furthermore, predictors of disability were examined, as well as its association with measures of health care behaviour. METHODS The PedMIDAS measures functional interference in different domains of life by asking the children for the number of days that their headache partially or totally interfered with their activities. RESULTS The examination of response behaviour revealed a marked attrition of responses (missing, invalid) in two items. As a consequence, the total score for disability could not be obtained for about 25% of the children. Analysis of homogeneity of the PedMIDAS items revealed low item/total correlations in two items. The grading of disability resulted in 81.2% of all children with headache showing no or low disability. Only 1.4% was "severely" disabled. Disability was predicted by frequency, type and intensity of headache. From all psychological variables only dysfunctional stress coping was significantly associated with disability. Disability itself was significantly associated with medical consultation. CONCLUSIONS Suitability of the PedMIDAS for epidemiological research was supported, however with a caveat and recommendations for item revision. Severe disability due to headache was rare in the studied unselected sample when defined by behavioural interference. It is suggested to explore the construct of disability by a multi-method approach, including further instruments assessing headache related distress, (respectively) quality of life.
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Affiliation(s)
- Birgit Kröner-Herwig
- Georg-Elias-Müller-Institute of Psychology, Dept. of Clinical Psychology and Psychotherapy, University of Göttingen, Göttingen, Germany.
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Osman A, Gutierrez PM, Smith K, Fang Q, Lozano G, Devine A. The Anxiety Sensitivity Index–3: Analyses of Dimensions, Reliability Estimates, and Correlates in Nonclinical Samples. J Pers Assess 2010; 92:45-52. [PMID: 20013455 DOI: 10.1080/00223890903379332] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kemper CJ, Ziegler M, Taylor S. Überprüfung der psychometrischen Qualität der deutschen Version des Angstsensitivitätsindex-3. DIAGNOSTICA 2009. [DOI: 10.1026/0012-1924.55.4.223] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Angstsensitivität ist ein Konstrukt, das bei der Ätiologie von Angststörungen relevant ist und sich in der internationalen Forschung zunehmender Beliebtheit erfreut. Bisher existiert jedoch kein aktuelles deutschsprachiges Instrument mit einer robusten faktoriellen Validität zur Erfassung von Angstsensitivität. Daher zielte diese Studie darauf ab, die psychometrische Qualität einer deutschsprachigen Version des Anxiety Sensitivity Index-3 ( Taylor et al., 2007 ) zu überprüfen. In die Auswertung gingen Daten von insgesamt N = 5477 Personen aus drei Ländern ein. Die Ergebnisse belegen eine zufriedenstellende Messgenauigkeit, faktorielle Validität und Konstruktvalidität der Übersetzung. Zudem konnte die Messinvarianz mit der englischsprachigen Originalversion gezeigt werden. Die praktischen und theoretischen Implikationen der Ergebnisse werden diskutiert.
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Hesser H, Andersson G. The role of anxiety sensitivity and behavioral avoidance in tinnitus disability. Int J Audiol 2009; 48:295-9. [DOI: 10.1080/14992020802635325] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Belcher J, Peters L. Relationship between Anxiety Sensitivity subscales and social fears. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2009. [DOI: 10.1080/00049530802239318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jessica Belcher
- Department of Psychology, Division of Linguistics and Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Lorna Peters
- Department of Psychology, Division of Linguistics and Psychology, Macquarie University, Sydney, New South Wales, Australia
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Johansson M, Andersson G. Prevalence of dizziness in relation to psychological factors and general health in older adults. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/16513860600997483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Olatunji BO, Woods CM, de Jong PJ, Teachman BA, Sawchuk CN, David B. Development and initial validation of an abbreviated Spider Phobia Questionnaire using item response theory. Behav Ther 2009; 40:114-30. [PMID: 19433143 DOI: 10.1016/j.beth.2008.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Revised: 03/14/2008] [Accepted: 04/17/2008] [Indexed: 11/18/2022]
Abstract
An abbreviated Spider Phobia Questionnaire (SPQ) was developed using methods based in item response theory. Fifteen of the 31 SPQ items that demonstrated good to excellent discrimination along the spider fear continuum were retained in Study 1 that consisted of 1,555 nonclinical and clinical participants. The SPQ-15 demonstrated good internal consistency and correlated highly with the full SPQ. Structural equation modeling revealed that the SPQ-15 demonstrated excellent convergent validity, with strong associations with small animal disgust and other phobic symptoms. Supportive evidence was also found for divergent validity in relation to panic-related symptoms. The SPQ-15 was uniquely predictive of avoidance behavior and fear and disgust responding towards spiders in nonclinical, analogue, and treatment-seeking samples in Studies 2, 3, and 4. Lastly, in Study 5, the SPQ-15 was sensitive to the effects of exposure-based treatment. These findings suggest that the SPQ-15 has considerable strengths, including decreased assessment and scoring time while retaining high reliability, validity, and sensitivity.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 111 21st Avenue South, Nashville, TN 37203, USA.
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Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clin Psychol Rev 2009; 29:87-100. [DOI: 10.1016/j.cpr.2008.10.002] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2007] [Revised: 10/07/2008] [Accepted: 10/13/2008] [Indexed: 11/22/2022]
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Benítez CIP, Shea MT, Raffa S, Rende R, Dyck IR, Ramsawh HJ, Edelen MO, Keller MB. Anxiety sensitivity as a predictor of the clinical course of panic disorder: a 1-year follow-up study. Depress Anxiety 2009; 26:335-42. [PMID: 19133700 PMCID: PMC3675878 DOI: 10.1002/da.20423] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is evidence that negative affect (NA) and anxiety sensitivity (AS) predict the development of anxiety disorders, particularly panic disorder (PD). The main purpose of this study was to examine whether NA and AS will also predict the clinical course of PD. METHODS Participants were 136 individuals with a DSM-III-R diagnosis of PD (with or without agoraphobia) enrolled in a naturalistic and longitudinal study of anxiety disorders, the Harvard/Brown Anxiety Research Project (HARP). Participants were administered the Anxiety Sensitivity Index and the Negative Affect Scales of the Positive and Negative Affect Schedule-Expanded Form (PANAS-X-NA) and their percentage of time in PD episode was followed for 1 year after the administration of the measures. RESULTS Multiple regression analyses indicated that AS, but not NA, was a significant predictor of percentage of time in PD episode after controlling for previous time in PD episodes, comorbid depression, other anxiety disorders, and exposure to psychopharmacological and behavioral treatments. As expected, the Physical Concerns subscale of the Anxiety Sensitivity Index had a significant independent contribution in predicting the course of the disorder. CONCLUSIONS Overall, these findings suggest that AS, as a unique construct, may be predictive of the amount of time patients are in episode of PD.
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Affiliation(s)
| | | | - Susan Raffa
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Richard Rende
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Ingrid R. Dyck
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Holly J. Ramsawh
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Maria Orlando Edelen
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Martin B. Keller
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
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Escocard MRPG, Fioravanti-Bastos ACM, Landeira-Fernandez J. Anxiety Sensitivity Factor Structure Among Brazilian Patients with Anxiety Disorders. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2008. [DOI: 10.1007/s10862-008-9103-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vancleef LMG, Peters ML. Examining content specificity of negative interpretation biases with the Body Sensations Interpretation Questionnaire (BSIQ). J Anxiety Disord 2008; 22:401-15. [PMID: 17606361 DOI: 10.1016/j.janxdis.2007.05.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 05/15/2007] [Accepted: 05/17/2007] [Indexed: 11/22/2022]
Abstract
Cognitive biases have been suggested to act as latent vulnerability factors for the onset and maintenance of affective and emotional disorders. Additionally, several global and specific personality constructs are known to influence the course of psychopathology (e.g., trait anxiety, optimism, anxiety sensitivity (AS), injury/illness sensitivity (IS), fear of negative evaluation (FNE)). The current study examined the specificity of the relation between these constructs and a negative interpretation bias. One hundred and fifty-four healthy participants completed the Body Sensations Interpretation Questionnaire (BSIQ) [Clark, D. A., Salkovskis, P. M., Breitholtz, E., Westling, B. E., Ost, L.-G., Koehler, K. A., et al. (1997). Misinterpretation of body sensations in panic disorder. Journal of Consulting and Clinical Psychology, 65, 203-213], measuring negative interpretations on four domains. A confirmatory factor analysis offered support for four factors in the BSIQ. Multiple linear regression analyses demonstrated that optimism is predictive of less negative interpretations. AS, IS, and FNE are specifically predictive of negative interpretations on the panic, other bodily symptoms, and social situations subscale, respectively. In addition, specific pain-related constructs were found most predictive of the other bodily sensations subscale. It is concluded that individual variability in global and specific psychological constructs is associated with a content-specific negative interpretation bias.
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Affiliation(s)
- Linda M G Vancleef
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
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Kröner-Herwig B, Morris L, Heinrich M. Biopsychosocial Correlates of Headache: What Predicts Pediatric Headache Occurrence? Headache 2008; 48:529-44. [DOI: 10.1111/j.1526-4610.2007.00945.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ochsner KN, Zaki J, Hanelin J, Ludlow DH, Knierim K, Ramachandran T, Glover GH, Mackey SC. Your pain or mine? Common and distinct neural systems supporting the perception of pain in self and other. Soc Cogn Affect Neurosci 2008; 3:144-60. [PMID: 19015105 DOI: 10.1093/scan/nsn006] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Humans possess a remarkable capacity to understand the suffering of others. Cognitive neuroscience theories of empathy suggest that this capacity is supported by 'shared representations' of self and other. Consistent with this notion, a number of studies have found that perceiving others in pain and experiencing pain oneself recruit overlapping neural systems. Perception of pain in each of these conditions, however, may also cause unique patterns of activation, that may reveal more about the processing steps involved in each type of pain. To address this issue, we examined neural activity while participants experienced heat pain and watched videos of other individuals experiencing injuries. Results demonstrated (i) that both tasks activated anterior cingulate cortex and anterior insula, consistent with prior work; (ii) whereas self-pain activated anterior and mid insula regions implicated in interoception and nociception, other pain activated frontal, premotor, parietal and amygdala regions implicated in emotional learning and processing social cues; and (iii) that levels of trait anxiety correlated with activity in rostral lateral prefrontal cortex during perception of other pain but not during self-pain. Taken together, these data support the hypothesis that perception of pain in self and other, while sharing some neural commonalities, differ in their recruitment of systems specifically associated with decoding and learning about internal or external cues.
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Affiliation(s)
- Kevin N Ochsner
- Department of Psychology, Columbia University, Schermerhorn Hall, 1190 Amsterdam Ave, New York, NY 10027, USA.
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