The integration of dual-systems processing and cognitive bias in cognitive vulnerability to anxiety: Investigations of spider fear

A recent model of cognitive vulnerability to anxiety proposes that discrepant findings related to the time-course of attentional responding to threat in anxious samples may be explained by individual differences in associative and rule-based processing. Specifically, stronger fear-relevant associations and maladaptive rule-based processing are hypothesized to contribute jointly to impaired disengagement from threat. The current program of research was designed as a test of this model within the context of spider fear/phobia. In Study 1, unselected participants completed measures of spider-fear associations (Go/No-go Association Task; GNAT), attention bias (Visual Search Task; VST), and self-reported spider fear and avoidance (Fear of Spiders Questionnaire; FSQ; & Spider Phobia Questionnaire; SPQ). Results demonstrated that participants were slower on disengagement trials of the VST compared to engagement trials. Surprisingly, higher levels of spider fear/avoidance were related to faster engagement with and disengagement from threat; stronger spider-fear associations were related to reduced disengagement accuracy. Moreover, an indirect relationship between spider-fear associations and reported spider fear/avoidance via disengagement accuracy was observed, such that stronger spider-fear associations predicted reduced disengagement accuracy, which subsequently predicted higher scores on the FSQ and SPQ. In Study 2, participants were randomly assigned into 1 of 2 conditions, wherein they either repeatedly negated the threat value of spiders or repeatedly reappraised spider stimuli as safe. As in Study 1, they completed the VST, FSQ, and SPQ. Again, all participants were slower on disengagement trials of the VST than on engagement trials. Attentional responding was unrelated to condition or to reported spider fear/avoidance. Moreover, there was no effect of condition on FSQ/SPQ scores. Exploratory analyses conducted within a restricted subsample of participants who obtained reasonable accuracy rates on the VST demonstrated that assignment to the negate condition predicted increased reported spider fear/avoidance. This relationship, however, was not mediated by attentional bias, contrary to hypotheses. For both studies, methodological limitations were noted, particularly with respect to the use of the VST. The utility of assessing fear with both indirect and direct measures is discussed, as well as theoretical and clinical implications for cognitive models of anxiety disorders and their associated treatments

Cognitive vulnerability to anxiety: A review and an integrative model.

Consistent research evidence supports the existence of threat-relevant cognitive bias in anxiety, but there remains controversy about which stages of information processing are most important in the conferral of cognitive vulnerability to anxiety. To account for both theoretical and empirical discrepancies in the literature, an integrative multi-process model is proposed wherein core assumptions of dual-systems theories from social and cognitive psychology are adapted to explain attentional and interpretive biases in the anxiety disorders. According to the model, individual differences in associative and rule-based processing jointly influence orientation, engagement, disengagement, and avoidance of threat-relevant stimuli, as well as negatively-biased interpretation of ambiguous stimuli in anxious populations. By linking anxiety-related symptoms to basic principles of information processing, the model parsimoniously integrates different kinds of cognitive biases in anxiety, providing a useful framework for future research and clinical intervention

A meta-analysis of CBT for pathological worry among clients with GAD.

Previous meta-analyses assessing the effectiveness of Cognitive Behavioural Therapy (CBT) for Generalized Anxiety Disorder (GAD) used general measures of anxiety to assess symptom severity and improvement (e.g., Hamilton Anxiety Ratings Scale or a composite measure of anxiety). While informative, these studies do not provide sufficient evidence as to whether CBT significantly reduces the cardinal symptom of GAD: pathological worry. The current meta-analysis employed stringent inclusion criteria to evaluate relevant outcome studies, including the use of the Penn State Worry Questionnaire as the main outcome variable. Results showed a large overall effect size (ES) that was moderated by age and modality of treatment. Specifically, the largest gains were found for younger adults and for individual treatment. Analyses also revealed overall maintenance of gains at 6- and 12-month follow-up. Clinical implications of different treatment packages are discussed, as well as potential explanations for the differential effectiveness of CBT

Looking for interaction: quantitative measurement of research utilization by Dutch local health officials

Background: In the Netherlands, local authorities are required by law to develop local health memoranda, based on epidemiological analyses. The purpose of this study was to assess the actual use of these epidemiological reports by municipal health officials and associated factors that affect this use.Method: Based on a conceptual framework, we designed a questionnaire in which we operationalized instrumental, conceptual, and symbolic use, the interaction between researchers and local health officials, and four clusters of barriers in this interaction process. We conducted an internet survey among 155 Dutch local health officials representing 35% of all Dutch municipalities. By means of multiple regression analyses, we gained insight into the related factors for each of the three types of research utilization.Results: The results show that local health officials use epidemiological research more often in a conceptual than an instrumental or symbolic way. This can be explained by the complexity of the local policy process which is often linked to policies in other areas, and the various policy actors involved. Conceptual use was statistically associated with a presentation given by the epidemiologist during the policy process, the presence of obstructions regarding the report's accessibility, and the local official's personal belief systems and interests originating from different professional values and responsibilities. Instrumental and symbolic use increased with the involvement of local officials in the research process.Conclusions: The results of this study provide a partial solution to understanding and influencing research utilization. The quantitative approach underpins earlier qualitative findings on this topic. The outcomes suggest that RPHS epidemiologists can use different strategies to improve research utilization. 'Blurring the boundaries', and the enhancement of interfaces between epidemiologists and local health officials, like direct interactions into each other's work processes, is expected to create better possibilities for optimizing research use

Supplemental Material - Does evaluating oneself cause evaluations of others while observing a social interaction? An experimental investigation of the cognitive and emotional consequences following a false-feedback task

Supplemental Material for Does evaluating oneself cause evaluations of others while observing a social interaction? An experimental investigation of the cognitive and emotional consequences following a false-feedback task by Ryan J Ferguson and Allison J Ouimet in Journal of Experimental Psychopathology.</p

Fear of anxiety or fear of emotions? Anxiety sensitivity is indirectly related to anxiety and depressive symptoms via emotion regulation

Background and objectives: Both anxiety sensitivity (AS) and maladaptive emotion regulation (ER) may contribute to anxious and depressive symptoms. Given the overlap between ER and AS—They both pertain to maladaptive beliefs about emotions (BE)—We tested whether AS would demonstrate an indirect relationship with anxiety and depressive symptoms via BE and ER. Design: Participants were 150 undergraduate students who completed an online survey. Methodology: Participants completed the Anxiety Sensitivity Index-3, difficulties with emotion regulation scale, Beliefs about Emotions Questionnaire, and Depression Anxiety Stress scales. Results: Bootstrapped serial mediation analyses demonstrated that the relationship between AS and anxiety symptoms was partially attributable to BE and ER, but not to BE alone. Similarly, the relationship between AS and depressive symptoms was completely attributable to BE and ER, but not to BE alone. Supplemental analyses suggested that beliefs about the controllability of emotions/anxiety were particularly important in the indirect nature of the relationship between AS and anxiety and depressive symptoms. Conclusions: AS and ER play an important role in the maintenance of anxiety and depressive symptoms. These results highlight the uncontrollability of emotions as a potentially important construct in cognitive-behavioural models of anxiety and emotion regulation. The cross-sectional design and non-clinical sample limit the generalizability of our findings; replication and extension in other samples and via experimental designs is warranted

A New Italian Questionnaire to Assess Caregivers of Cancer Patients' Satisfaction With Palliative Care: Multicenter Validation of the Post Mortem Questionnaire-Short Form

CONTEXT: Caregiver satisfaction with palliative care is a crucial indicator of its effectiveness. In light of the lack of validated or reliable Italian instruments, the Post Mortem Questionnaire-Short Form (QPM-SF), a self-report questionnaire, has been developed to assess home and inpatient hospice care. OBJECTIVES: The present study was designed to evaluate the psychometric properties of QPM-SF and assess for differences in quality of palliative care between hospice and home care settings. METHODS: A total of 584 caregivers of terminal cancer patients completed QPM-SF one month after the death of the care recipient. To assess test-retest reliability, a subgroup of 50 caregivers completed the questionnaire a second time, one month later. RESULTS: QPM-SF showed good internal consistency and temporal stability and a four-factor structure: "Integrated home care," "Hospice," "Physical care-Information-Global evaluation," and "Needs." CONCLUSION: QPM-SF may be considered a valid, reliable, and well-accepted self-report instrument for examining and implementing palliative care interventions