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Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related to the trajectory of change in a variety of panic-relevant outcomes. Method: Participants had a primary diagnosis of panic disorder (N = 43; 70% female; mean age = 40.14 years). Race or ethnicity was reported as 91% Caucasian, 5% African American, 2.3% biracial, and 2.3% 'other.' Change in catastrophic misinterpretations (assessed with the Brief Body Sensations Interpretation Questionnaire; Clark et al., 1997) was used to predict a variety of treatment outcomes, including overall panic symptom severity (assessed with the Panic Disorder Severity Scale [PDSS]; Shear et al., 1997), panic attack frequency (assessed with the relevant PDSS item), panic-related distress/apprehension (assessed by a latent factor, including peak anxiety in response to a panic-relevant stressor--a straw breathing task), and avoidance (assessed by a latent factor, which included the Fear Questionnaire--Agoraphobic Avoidance subscale; Marks & Mathews, 1979). Results: Bivariate latent difference score modeling indicated that, as expected, change in catastrophic misinterpretations predicted subsequent reductions in overall symptom severity, panic attack frequency, distress/apprehension, and avoidance behavior. However, change in the various symptom domains was not typically a significant predictor of later interpretation change (except for the distress/apprehension factor). Conclusions: These results provide considerable support for the cognitive model of panic and speak to the temporal sequence of change processes during therapy. Keywords: panic disorder, catastrophic misinterpretations, cognitive behavior therapy, avoidance Supplemental materials: http://dx.doi.org/10.1037/a0021067.supp DOI: 10.1037/a0021067

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.beth.2008.04.002 Byline: Bunmi O. Olatunji (a), Carol M. Woods (b), Peter J. de Jong (c), Bethany A. Teachman (d), Craig N. Sawchuk (e), Bieke David (f) 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. Author Affiliation: (a) Vanderbilt University (b) Washington University in St. Louis (c) University of Groningen (d) University of Virginia (e) University of Washington (f) Vanderbilt University Article History: Received 29 November 2007; Revised 14 March 2008; Accepted 17 April 2008

Previous research has demonstrated that induced sad mood is associated with increased accuracy of recall in certain memory tasks: the effects of clinical depression, however, are likely to be quite different. The authors used the Deese-Roediger-McDermott paradigm to examine the impact of clinical depression on erroneous recall of neutral and/or emotional stimuli. Specifically, they presented Deese-Roediger-McDermott lists that were highly associated with negative, neutral, of positive lures and compared participants diagnosed with major depressive disorder and nondepressed control participants on the accuracy of their recall of presented material and their false recall of never-presented lures. Compared with control participants, major depressive disorder participants recalled fewer words that had been previously presented but were more likely to falsely recall negative lures; there were no differences between major depressive disorder and control participants in false recall of positive or neutral lures. These findings indicate that depression is associated with false memories of negative material. Keywords: depression, memory, cognition, emotion, bias

Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tested these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over a 12-week course of cognitive behavior therapy (CBT) is related to the trajectory of change in panic symptoms. Individuals with panic disorder (N = 43) completed a measure of automatic panic associations--the Implicit Association Test (A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998), which reflects elements of the schema construct--every 3 weeks over the course of therapy and measures of panic symptoms each week. Dynamic bivariate latent difference score modeling not only indicated that automatic panic associations changed over the course of CBT for panic disorder but showed these changes were correlated with symptom reduction. Moreover, change in automatic panic associations was a significant predictor of change in panic symptom severity. These findings permit inferences about the temporality of change, suggesting that cognitive change does in fact precede and contribute to symptom change. Keywords: panic disorder, implicit associations, schema, cognitive behavior therapy

The current study investigates sudden gains (rapid symptom reduction) in group cognitive-behavioral therapy for panic disorder. Sudden gains occurring after session 2 of treatment predicted overall symptom reduction at treatment termination and some changes in cognitive biases. Meanwhile, sudden gains occurring immediately following session 1 were not associated with symptom reduction or cognitive change. Together, this research points to the importance of examining sudden gains across the entire span of treatment, as well as the potential role of sudden gains in recovery from panic disorder. Keywords: Sudden gains Anxiety Panic disorder Cognitive bias

Ethnic group differences in affective, behavioral, and cognitive measures of anxiety were examined to better characterize the unique triggers and modes of anxious responding across different groups. Using an ethnically diverse sample (N = 112; 39 African Americans, 34 Asian Americans, and 39 European Americans), the study examined differences in anxious responding following three anxiety provocations (physical, social interpersonal, and social performance), each hypothesized to be a primary anxiety trigger for one of the groups. African Americans and European Americans demonstrated greater behavioral avoidance during a physical provocation designed to elicit shortness of breath sensations relative to Asian Americans. Asian Americans reported a higher number of anxious cognitions than African Americans during a social provocation designed to trigger performance concerns. These findings suggest ethnicity should be carefully considered when assessing the predominant triggers of anxiety and modes of anxious responding. Keywords: anxiety; ethnicity; African Americans; Asian Americans; self construal

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.brat.2007.07.014 Byline: Joshua C. Magee, Bethany A. Teachman Keywords: Thought suppression; Obsessive-compulsive disorder; Unwanted thoughts; Attributions; Obsessions Abstract: The current study examined the nature and consequences of attributions about unsuccessful thought suppression. Undergraduate students with either high (n=67) or low (n=59) levels of obsessive-compulsive symptoms rated attributions to explain their unsuccessful thought suppression attempts. We expected that self-blaming attributions and attributions ascribing importance to unwanted thoughts would predict more distress and greater recurrence of thoughts during time spent monitoring or suppressing unwanted thoughts. Further, we expected that these attributions would mediate the relationship between obsessive-compulsive symptom levels and the negative thought suppression outcomes (distress and thought recurrence). Structural equation models largely confirmed the hypotheses, suggesting that attributions may be an important factor in explaining the consequences of thought suppression. Implications are discussed for cognitive theories of obsessive-compulsive disorder and thought suppression. Author Affiliation: Department of Psychology, University of Virginia, P.O. Box 400400, 102 Gilmer Hall, Charlottesville, VA 22904-4400, USA Article History: Received 14 April 2007; Revised 29 July 2007; Accepted 31 July 2007

The current study examined the nature and consequences of attributions about unsuccessful thought suppression. Undergraduate students with either high (n = 67) or low (n = 59) levels of obsessive-compulsive symptoms rated attributions to explain their unsuccessful thought suppression attempts. We expected that self-blaming attributions and attributions ascribing importance to unwanted thoughts would predict more distress and greater recurrence of thoughts during time spent monitoring or suppressing unwanted thoughts. Further, we expected that these attributions would mediate the relationship between obsessive-compulsive symptom levels and the negative thought suppression outcomes (distress and thought recurrence). Structural equation models largely confirmed the hypotheses, suggesting that attributions may be an important factor in explaining the consequences of thought suppression. Implications are discussed for cognitive theories of obsessive-compulsive disorder and thought suppression. Keyword: Thought suppression; Obsessive-compulsive disorder: Unwanted thoughts; Attributions; Obsessions

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.brat.2007.01.009 Byline: Bethany A. Teachman, Shannan B. Smith-Janik, Jena Saporito Keywords: Information processing; Panic disorder; Interpretation; Attention; Implicit associations; Automatic Abstract: To test cognitive models of panic disorder, a range of information processing biases were examined among persons with panic disorder (N=43) and healthy control participants (N=38). Evidence for automatic associations in memory was assessed using the Implicit Association Test, interference effects related to attention biases were assessed using a modified supraliminal Stroop task, and interpretation biases were assessed using the Brief Body Sensations Interpretation Questionnaire. In addition, the relationship between information processing biases and clinical markers of panic (including affective, behavioral, and cognitive symptom measures) was investigated, along with the relationships among biases. Results indicated more threat biases among the panic (relative to control) group on each of the information processing measures, providing some of the first evidence for an implicit measure of panic associations. Further, structural equation modeling indicated that the information processing bias measures were each unique predictors of panic symptoms, but that the bias indicators did not relate to one another. These findings suggest that cognitive factors may independently predict panic symptoms, but not covary. Results are discussed in terms of their support for cognitive models of panic and the potential for automatic versus strategic processing differences across the tasks to explain the low relationships across the biases. Author Affiliation: Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400, USA Article History: Received 24 September 2006; Revised 13 January 2007; Accepted 23 January 2007

To test cognitive models of panic disorder, a range of information processing biases were examined among persons with panic disorder (N = 43) and healthy control participants (N = 38). Evidence for automatic associations in memory was assessed using the Implicit Association Test, interference effects related to attention biases were assessed using a modified supraliminal Stroop task, and interpretation biases were assessed using the Brief Body Sensations Interpretation Questionnaire. In addition, the relationship between information processing biases and clinical markers of panic (including affective, behavioral, and cognitive symptom measures) was investigated, along with the relationships among biases. Results indicated more threat biases among the panic (relative to control) group on each of the information processing measures, providing some of the first evidence for an implicit measure of panic associations. Further, structural equation modeling indicated that the information processing bias measures were each unique predictors of panic symptoms, but that the bias indicators did not relate to one another. These findings suggest that cognitive factors may independently predict panic symptoms, but not covary. Results are discussed in terms of their support for cognitive models of panic and the potential for automatic versus strategic processing differences across the tasks to explain the low relationships across the biases. Keywords: Information processing; Panic disorder; Interpretation; Attention; Implicit associations; Automatic

In a large, community-based sample of women (N = 750), the authors examined the nature of associations between dysfunctional attitudes and depression. Dysfunctional attitudes were evaluated both as a vulnerability factor for depression and as a consequence of depression. A link was found between past depression and baseline elevations in dysfunctional attitudes that was independent of current subsyndromal symptoms, but intensification of dysfunctional attitudes following prospectively evaluated episodes of depression (depressive 'scarring') was not observed. Although baseline dysfunctional attitudes predicted an episode of major depression over 3 years of prospective study, this prediction, considered alone or in interaction with negative life events, was redundant with that offered by history of past depression. Further, no significant prediction was evident for the Dysfunctional Attitude Scale (A. N. Weissman & A. T. Beck, 1978) when the formerly depressed and never-depressed cohorts were considered separately. Implications for cognitive theories are discussed. Keywords: depression, dysfunctional attitudes, cognitive vulnerability, depressive scarring

Two studies were conducted to test a dual-process theory of cognitive vulnerability to depression. According to this theory, implicit and explicit cognitive processes have differential effects on depressive reactions to stressful life events. Implicit processes are hypothesized to be critical in determining an individual's immediate affective reaction to stress whereas explicit cognitions are thought to be more involved in long-term depressive reactions. Consistent with hypotheses, the results of study 1 (cross-sectional; N = 237) showed that implicit, but not explicit, cognitions predicted immediate affective reactions to a lab stressor. Study 2 (longitudinal; N = 251) also supported the dual-process model of cognitive vulnerability to depression. Results showed that both the implicit and explicit measures interacted with life stress to predict prospective changes in depressive symptoms, respectively. However, when both implicit and explicit predictors were entered into a regression equation simultaneously, only the explicit measure interacted with stress to remain a unique predictor of depressive symptoms over the five-week prospective interval. Keywords: Cognitive vulnerability; Depression; Implicit; Explicit; Dual-process

The structural variance of anxiety and depression symptoms across adulthood is examined in a cross-sectional sample using three nested models. Results suggest that the tripartite model incorporating the structure of negative affect, anxious arousal and low positive affect is remarkably invariant across adulthood.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.brat.2005.05.005 Byline: Bethany A. Teachman (a), Sheila R. Woody (b), Joshua C. Magee (a) Keywords: Obsessions; Appraisals; Implicit associations; OCD; Intrusive thoughts Abstract: To evaluate cognitive theories of obsessions, the current study experimentally manipulated appraisals of the importance of intrusive thoughts. Undergraduate students (N=156) completed measures of obsessive-compulsive disorder (OCD) symptoms and beliefs and were primed with a list of commonly reported unwanted thoughts. Participants were then informed that unwanted thoughts are either (1) significant and indicative of their personal values, or (2) meaningless, or participants (3) received no instructions about unwanted thoughts. Participants then completed implicit and explicit measures of self-evaluation and interpretations of their unwanted thoughts. Results indicated that the manipulation shifted implicit appraisals of unwanted thoughts in the expected direction, but not self-evaluations of morality or dangerousness. Interestingly, explicit self-esteem and beliefs about the significance of unwanted thoughts were associated with measures of OCD beliefs, whereas implicit self-evaluations of dangerousness were better predicted by the interaction of pre-existing OCD beliefs with the manipulation. Results are discussed in terms of divergent predictors of implicit and explicit responses to unwanted thoughts. Author Affiliation: (a) Department of Psychology, University of Virginia, P.O. Box 400400, Charlottesville, VA 22904-4400, USA (b) Department of Psychology, University of British Columbia, Canada Article History: Received 27 September 2004; Revised 28 April 2005; Accepted 20 May 2005

To evaluate cognitive theories of obsessions, the current study experimentally manipulated appraisals of the importance of intrusive thoughts. Undergraduate students (N = 156) completed measures of obsessive--compulsive disorder (OCD) symptoms and beliefs and were primed with a list of commonly reported unwanted thoughts. Participants were then informed that unwanted thoughts are either (1) significant and indicative of their personal values, or (2) meaningless, or participants (3) received no instructions about unwanted thoughts. Participants then completed implicit and explicit measures of self-evaluation and interpretations of their unwanted thoughts. Results indicated that the manipulation shifted implicit appraisals of unwanted thoughts in the expected direction, but not self-evaluations of morality or dangerousness. Interestingly, explicit self-esteem and beliefs about the significance of unwanted thoughts were associated with measures of OCD beliefs, whereas implicit self-evaluations of dangerousness were better predicted by the interaction of pre-existing OCD beliefs with the manipulation. Results are discussed in terms of divergent predictors of implicit and explicit responses to unwanted thoughts. Keywords: Obsessions; Appraisals; Implicit associations; OCD; Intrusive thoughts

This study evaluates the cognitive model of anxiety by investigating treatment-related changes in automatic associations to evaluate schematic processing. Spider-phobic participants (n = 31) and healthy controls (n = 30) completed fear-based Implicit Association Tests (IATs), which are reaction-time measures that tap implicit associations without requiring conscious introspection. The specific tasks involved classifying pictures of snakes and spiders along with semantic categorizations (good vs. bad, afraid vs. unafraid, danger vs. safety, and disgusting vs. appealing). Phobic individuals were assessed before and after group-based exposure treatment and 2 months later; controls were assessed at matched time points. Results supported clinical applications for implicit fear associations, including prediction of phobic avoidance, and treatment sensitivity of the fear- and disgust-specific automatic associations.

The measures of neuroticism, anxiety, and depression symptoms in a cross-sectional, community sample were examined to evaluate a nonlinear model of the relationship between aging and negative affect. The results indicated a curvilinear relationship, with mean symptom levels increasing during early adulthood and then showing a small decline until older adulthood, when symptoms again increase with age.

The purpose of this research was to develop a dependable self-reporting tool for young people to assess obsessive-compulsive disorder. Good internal consistency was discovered between the children's version of the Obsessional Compulsive Inventory and the Children's Yale-Brown Obsessive Compulsive Scale.

Three studies on implicit biases, and their modifiability, against overweight persons is investigated. The results showed that diminished implicit bias among overweight participants was seen suggesting an in-group bias.

This study investigated an implicit measure of cognitive processing, the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998), as a measure of fear-related automatic associations. Sixty-seven students with snake or spider fears completed 4 IAT tasks in which they classified pictures of snakes and spiders along with descriptive words indicating valence, fear, danger, or disgust. Results indicated that all 4 tasks discriminated between fear groups in terms of their implicit associations, and fear-specific effects were significant even after controlling for the impact of valence evaluation. Findings are discussed in terms of applications of the IAT methodology to examine cognitive processing and schemata in anxiety and potential uses for assessing anxiety disorders.