Search

Background: Efforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertainty (IU), a transdiagnostic risk factor for anxiety, may be a particularly relevant vulnerability factor., Method: N = 641 adults with pre-pandemic anxiety data reported their anxiety, IU, and other pandemic and mental health-related variables at least once and up to four times during the COVID-19 pandemic, with assessments beginning in May 2020 through March 2021., Results: In preregistered analyses using latent growth models, higher IU at the first pandemic timepoint predicted more severe anxiety, but also a sharper decline in anxiety, across timepoints. This finding was robust to the addition of pre-pandemic anxiety and demographic predictors as covariates (in the full sample) as well as pre-pandemic depression severity (in participants for whom pre-pandemic depression data were available). Younger age, lower self/parent education, and self-reported history of COVID-19 illness at the first pandemic timepoint predicted more severe anxiety across timepoints with strong model fit, but did not predict anxiety trajectory., Conclusions: IU prospectively predicted more severe anxiety but a sharper decrease in anxiety over time during the pandemic, including after adjustment for covariates. IU therefore appears to have unique and specific predictive utility with respect to anxiety in the context of the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest Lauren S. Hallion and Gordon J. G. Asmundson are Associate Editor and Editor-in-Chief at Journal of Anxiety Disorders, respectively, and receive financial support through payments for their editorial work on the journal. Neither author was involved in the review of the manuscript or the decision regarding its acceptance. We have no additional conflicts of interest to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background and Objectives: Reinforcement learning biases have been empirically linked to anhedonia in depression and theoretically linked to social anhedonia in social anxiety disorder, but little work has directly assessed how socially anxious individuals learn from social reward and punishment., Methods: N = 157 individuals high and low in social anxiety symptoms completed a social probabilistic selection task that involved selecting between pairs of neutral faces with varying probabilities of changing to a happy or angry face. Computational modeling was performed to estimate learning rates. Accuracy in choosing the more rewarding face was also analyzed., Results: No significant group differences were found for learning rates. Contrary to hypotheses, participants high in social anxiety showed impaired punishment learning accuracy; they were more accurate at choosing the most rewarding face than they were at avoiding the most punishing face, and their punishment learning accuracy was lower than that of participants low in social anxiety. Secondary analyses found that high (vs. low) social anxiety participants were less accurate at selecting the more rewarding face on more (vs. less) punishing face pairs., Limitations: Stimuli were static, White, facial images, which lack important social cues (e.g., movement, sound) and diversity, and participants were largely non-Hispanic, White undergraduates, whose social reinforcement learning may differ from individuals at different developmental stages and those holding more marginalized identities., Conclusions: Socially anxious individuals may be less accurate at learning to avoid social punishment, which may maintain negative beliefs through an interpersonal stress generation process., Competing Interests: Declaration of competing interest The authors have no conflicts of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Technology-delivered interventions have the potential to help address the treatment gap in mental health care but are plagued by high attrition. Adding coaching, or minimal contact with a nonspecialist provider, may encourage engagement and decrease dropout, while remaining scalable. Coaching has been studied in interventions for various mental health conditions but has not yet been tested with anxious samples. This study describes the development of and reactions to a low-intensity coaching protocol administered to N = 282 anxious adults identified as high risk to drop out of a web-based cognitive bias modification for interpretation intervention. Undergraduate research assistants were trained as coaches and communicated with participants via phone calls and synchronous text messaging. About half of the sample never responded to coaches' attempts to schedule an initial phone call or did not answer the call, though about 30% completed the full intervention with their coach. Some anxious adults may choose technology-delivered interventions specifically for their lack of human contact and may fear talking to strangers on the phone; future recommendations include taking a more intensive user-centered design approach to creating and implementing a coaching protocol, allowing coaching support to be optional, and providing users with more information about how and why the intervention works., (Copyright © 2022. Published by Elsevier Ltd.)

Background and Objectives: Intolerance of uncertainty (IU) is an individual difference factor that reflects difficulty tolerating emotional distress in the context of uncertainty and is a robust transdiagnostic risk factor for emotional disorders. A limitation of prior research on IU is the heavy reliance on self-report measures to assess this construct. The aim of the present study was to examine the validity of a brief, computerized anagram task modified to assess IU (the PACT Anagram Task; PAT)., Methods: Participants were 221 unselected undergraduate students (71% female; M age  = 19; 89% Caucasian) who completed the PAT and a series of self-report measures of convergent, discriminant, and incremental validity, and measures of anxiety and depression symptoms online for course credit., Results: Greater PAT-Distress was positively correlated measures of convergent validity and demonstrated incremental validity in relation to self-reported IU above and beyond attentional control. None of the PAT indicators were associated with compassion or empathic concern, evidencing discriminant validity. PAT-Distress and PAT-Answers were each associated with greater worry above and beyond self-reported IU., Limitations: Study limitations include the cross-sectional design and lack of diversity in terms of sample demographics. Furthermore, we did not examine convergence between this task and other behavioral measures of IU., Conclusion: Subjective distress following completion of the PAT may serve as one indicator of IU. Further research is needed in order to replicate these results and validate the use of the PAT in clinical samples., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

This study aimed to investigate the effect of acute psychological stress on autonomic function and arterial stiffness, and to test a mediating role of changes in autonomic function between acute stress and arterial stiffness. Eighty-five healthy female adults were randomized into either an experimental or control group. The Trier Social Stress Test (TSST) was used to induce acute psychological stress. Autonomic function (measured by pre-ejection period [PEP] from cardiac impedance and high frequency [HF] of heart rate variability [HRV]) and arterial stiffness (measured by carotid and femoral pulse wave velocity [cfPWV] and augmentation index [AIx]) were assessed before and after the TSST. The mean age of the participants was 28.78 (±9.84) years old. Experimental group participants had a significant increase in cfPWV (p = .025) and AIx (p = .017) following the stressor, compared with those in the control group, after controlling for age, body mass index, and systolic blood pressure. However, no significant group differences were observed in changes in PEP (p = .181) and HF (p = .058). Changes in PEP and HF were neither associated with changes in cfPWV (p = .975 and p = .654, respectively), nor in AIx (p = .376 and p = .323, respectively). The results suggest that even a brief period of mild to moderate stress, which does not cause sustainable changes in autonomic function, may still exert significant adverse effects on arterial stiffness. The changes in arterial stiffness were not related to changes in autonomic function. Future experimental studies with several measurement points are recommended to identify distinct effects of stress on autonomic function and arterial stiffness., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Cognitive control is central to the phenomenon of intrusive thinking in obsessive-compulsive and related disorders. The current study tested how attempts at cognitive control are impacted by self- vs. other-generated distractor thoughts. Participants ( N =1913) were randomly assigned to suppress or monitor an intrusive thought and also randomly assigned to: a) self-generate a distractor, b) receive a distractor, or c) receive no distractor guidance. Participants reported subsequent thought recurrences, perceived success and effort keeping the thought out of mind, and positive and negative affect during a one-minute thinking period and a one-minute monitoring period. During the first thinking period only, self-generated distractors resulted in greater perceived control ( p <.001; during monitoring instructions only) relative to no guidance, and less effort ( p s<.001) relative to both other conditions. Interestingly, self-generated distractors led to longer duration of recurrences relative to both other conditions ( p s≤.007). Finally, there were no distractor differences in trajectories of positive and negative affect ( p s>.10). These findings suggest that the source of distractors may inform when attempts to control intrusive thinking will be helpful versus harmful., Competing Interests: Conflict of Interest: B. A. T. has a significant financial interest in Project Implicit, Inc., which provided services in support of this project under contract with the University of Virginia.

Background and Objectives: Dieters are likely primed to think about their diet throughout the day (e.g., as they feel hungry). However, prior research has not tested whether and how thinking about dieting might have negative effects, like poor self-esteem and body shape concerns., Methods: We experimentally primed dieters' thoughts about their diets and tested whether: 1) dieting thoughts are related to poor state self-esteem through body shape concerns; and 2) dieting thoughts are related to body shape concerns through poor state self-esteem. Dieting participants (N = 225) were randomly assigned to complete a dieting or neutral prime., Results: Unexpectedly, there was a different pattern of results across male (n = 72) and female (n = 144) dieters. When accounting for body shape concerns, males primed to think about dieting (vs. neutral condition) reported greater state self-esteem. Further, the dieting prime indirectly led to lower body shape concerns through greater state global self-esteem. However, for females, the dieting prime indirectly led to poorer state self-esteem through its effects on body shape concerns., Limitations: The sample was collected online and was predominantly female and Caucasian. Other limitations include self-report of dieting status and body mass index., Conclusions: The findings suggest that for males, thoughts about dieting may actually be associated with greater state self-esteem, which may indirectly predict lower body shape concerns. In contrast, for females, when thoughts about dieting activate body shape concerns, poorer state self-esteem may follow. These results highlight important, potentially gender-specific relationships between thoughts about dieting, body shape concerns, and state self-esteem., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background and Objectives: People who are afraid of heights may have a perceptual bias, such that they see heights as higher than they truly are. The current study tested if there is a causal relationship between treatments for height fear and changes in perceptual bias., Methods: Specifically, the effects on perceptual bias following three height fear interventions (exposure, cognitive bias modification for interpretations, and a combination of exposure and cognitive bias modification) and a control condition were examined in individuals with an extreme fear of heights (N = 107)., Results: Results provided preliminary evidence that some height fear interventions reduce perceptual bias. Specifically, participants that completed exposure had a significant decrease in perceptual bias, and participants in the cognitive bias modification and combination conditions had decreases in perceptual bias at the level of non-significant trends, while no reduction occurred for the control condition., Limitations: Limitations of this study include that the hypothesis was largely informed by data from a parent study and that the effect sizes were small; thus, replicating these results is warranted., Conclusions: These findings suggest that there may be a causal relationship between height fear treatments and altered perception of heights., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Socially anxious and depressed individuals tend to evaluate their social interactions negatively, but little is known about the specific real-time contributors to these negative perceptions. The current study examined how affect ratings during social interactions predict later perceptions of those interactions, and whether this differs by social anxiety and depression severity. Undergraduate participants (N = 60) responded to a smartphone application that prompted participants to answer short questions about their current affect and social context up to 6 times a day for 2 weeks. At the end of each day, participants answered questions about their perceptions of their social interactions from that day. Results indicated that the link between negative affective experiences reported during social interactions and the end-of-day report of enjoyment (but not effectiveness) of those experiences was more negative when social anxiety was more severe. The link between negative affective experiences rated during social interactions and the end-of-day report of effectiveness (but not enjoyment) during those social encounters was more negative when depression was more severe. These findings demonstrate the importance of examining self-perceptions of social interactions based both on the extent to which individuals think that they met the objective demands of an interaction (i.e., effectiveness, mastery) and the extent to which they liked or disliked that interaction (i.e., enjoyment, pleasure). These findings also highlight how real-time assessments of daily social interactions may reveal the key experiences that contribute to negative self-evaluations across disorders, potentially identifying critical targets for therapy., (Copyright © 2018. Published by Elsevier Ltd.)

Background: In spite of the significant burden associated with substance use disorders, especially among persons who inject drugs (PWIDs), most affected individuals do not engage with any type of formal or informal treatment. Addiction stigma, which is represented by negative social attitudes toward individuals who use alcohol and/or other drugs, is one of the barriers to care that is poorly understood. The current study: a) assessed implicit (indirect and difficult to consciously control) and explicit (consciously controlled) beliefs about PWIDs among visitors to a public web site; and b) experimentally investigated the effects of ethnicity/race and gender on those implicit and explicit beliefs., Methods: N=899 predominantly White (70%) and women (62%) were randomly assigned to one of six target PWIDs conditions: gender (man/woman) x race/ethnicity (White, Black, Latino/a). Participants completed an Implicit Association Test and explicit assessment of addiction stigma., Results: Participants implicitly associated PWIDs (especially Latino/a vs. White PWIDs) with deserving punishment as opposed to help (p=0.003, d=0.31), indicating presence of addiction stigma-related implicit beliefs. However, this bias was not evident on the explicit measure (p=0.89). Gender did not predict differential implicit or explicit addiction stigma (p=0.18)., Conclusions: Contrary to explicit egalitarian views towards PWIDs, participants' implicit beliefs were more in line with addiction stigma. If replicated and clearer ties to behavior are established, results suggest the potential importance of identifying conditions under which implicit bias might influence behavior (even despite explicit egalitarian views) and increase the likelihood of discrimination towards PWIDs., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background and Objectives: Implicit associations are relatively uncontrollable associations between concepts in memory. The current investigation focuses on implicit associations in four mental health domains (alcohol use, anxiety, depression, and eating disorders) and how these implicit associations: a) relate to explicit associations and b) self-reported clinical symptoms within the same domains, and c) vary based on demographic characteristics (age, gender, race, ethnicity, and education)., Methods: Participants (volunteers over age 18 to a research website) completed implicit association (Implicit Association Tests), explicit association (self + psychopathology or attitudes toward food, using semantic differential items), and symptom measures at the Project Implicit Mental Health website tied to: alcohol use (N = 12,387), anxiety (N = 21,304), depression (N = 24,126), or eating disorders (N = 10,115)., Results: Within each domain, implicit associations showed small to moderate associations with explicit associations and symptoms, and predicted self-reported symptoms beyond explicit associations. In general, implicit association strength varied little by race and ethnicity, but showed small ties to age, gender, and education., Limitations: This research was conducted on a public research and education website, where participants could take more than one of the studies., Conclusions: Among a large and diverse sample, implicit associations in the four domains are congruent with explicit associations and self-reported symptoms, and also add to our prediction of self-reported symptoms over and above explicit associations, pointing to the potential future clinical utility and validity of using implicit association measures with diverse populations., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background and Objectives: Cognitive Bias Modification to reduce threat interpretations (CBM-I) trains individuals to resolve ambiguous scenarios via completion of word fragments that assign benign meanings to scenarios. The current study tested: 1) whether Internet-based CBM-I can shift interpretations to be more positive/less negative, and 2) whether varying the number of letters missing in the word fragments (assumed to increase task difficulty) moderates CBM-I's effects., Methods: Participants (N = 350) completed a brief online version of CBM-I, followed by assessments of interpretation bias, fear of negative evaluation, and anticipatory anxiety. Participants were randomly assigned to 1 of 5 conditions: control (half of scenarios ended positively, half negatively), or 4 positive conditions (all scenarios ended positively, but word fragments varied on number of letters missing, from 0 to 3)., Results: Relative to the control condition, all positive conditions led to more positive/less negative interpretations. When analyses were re-run with only a highly socially anxious subset of the sample (n = 100), conditions in which the final word of scenarios was missing 0, 1, or 2 letters led to more positive/less negative interpretations compared to the control condition, but the condition missing 3 letters did not differ from the control condition. There were no differences between conditions on other outcome measures., Limitations: Training was brief, and an unselected sample was used., Conclusions: Results suggest a brief Internet-based CBM-I paradigm can shift interpretation bias, but not necessarily other anxiety-relevant outcomes. Making the task too difficult may blunt effects for highly socially anxious individuals., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The current study brings together two typically distinct lines of research. First, social anxiety is inconsistently associated with behavioral deficits in social performance, and the factors accounting for these deficits remain poorly understood. Second, research on selective processing of threat cues, termed cognitive biases, suggests these biases typically predict negative outcomes, but may sometimes be adaptive, depending on the context. Integrating these research areas, the current study examined whether conscious and/or unconscious threat interference biases (indexed by the unmasked and masked emotional Stroop) can explain unique variance, beyond self-reported anxiety measures, in behavioral avoidance and observer-rated anxious behavior during a public speaking task. Minute of speech and general inhibitory control (indexed by the color-word Stroop) were examined as within-subject and between-subject moderators, respectively. Highly socially anxious participants (N=135) completed the emotional and color-word Stroop blocks prior to completing a 4-minute videotaped speech task, which was later coded for anxious behaviors (e.g., speech dysfluency). Mixed-effects regression analyses revealed that general inhibitory control moderated the relationship between both conscious and unconscious threat interference bias and anxious behavior (though not avoidance), such that lower threat interference predicted higher levels of anxious behavior, but only among those with relatively weaker (versus stronger) inhibitory control. Minute of speech further moderated this relationship for unconscious (but not conscious) social-threat interference, such that lower social-threat interference predicted a steeper increase in anxious behaviors over the course of the speech (but only among those with weaker inhibitory control). Thus, both trait and state differences in inhibitory control resources may influence the behavioral impact of threat biases in social anxiety., (Copyright © 2015. Published by Elsevier Ltd.)

Background and Objectives: Carbon dioxide (CO2) hypersensitivity is hypothesized to be a robust endophenotypic marker of panic spectrum vulnerability. The goal of the current study was to explore the latent class trajectories of three primary response systems theoretically associated with CO2 hypersensitivity: subjective anxiety, panic symptoms, and respiratory rate (fR)., Methods: Participants (n = 376; 56% female) underwent a maintained 7.5% CO2 breathing task that included three phases: baseline, CO2 air breathing, and recovery. Growth mixture modeling was used to compare response classes (1…n) to identify the best-fit model for each marker. Panic correlates also were examined to determine class differences in panic vulnerability., Results: For subjective anxiety ratings, a three-class model was selected, with individuals in one class reporting an acute increase in anxiety during 7.5% CO2 breathing and a return to pre-CO2 levels during recovery. A second, smaller latent class was distinguished by elevated anxiety across all three phases. The third class reported low anxiety reported during room air, a mild increase in anxiety during 7.5% CO2 breathing, and a return to baseline during recovery. Latent class trajectories for fR yielded one class whereas panic symptom response yielded two classes., Limitations: This study examined CO2 hypersensitivity in one of the largest samples to date, but did not ascertain a general population sample thereby limiting generalizability. Moreover, a true resting baseline measure of fR was not measured., Conclusions: Two classes potentially representing different risk pathways were observed. Implications of results will be discussed in the context of panic risk research., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents' maladaptive beliefs regarding social situations, and with parents' intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10-15; N=18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents' cognitive biases related to social anxiety (Child-only condition); the second targeted parents' biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents' biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Some studies have found that trying to suppress thoughts increases their long-term recurrence, a phenomenon associated with psychopathology, particularly obsessive-compulsive disorder. However, effect sizes in thought suppression studies have often been small and inconsistent. The present study sought to improve thought suppression conceptualization and measurement by examining two distinct dimensions of thought recurrence - frequency and duration of a thought's return - and how they evolve over time. After a thought focus period, 100 adults were assigned to either suppress or monitor the recurrence of an unpleasant thought for 4 min. Then, during a second four-minute period, all participants were asked to monitor the thought's recurrence. Hierarchical linear modeling indicated that thought frequency declined across time and the rate of decline slowed as time went on. Initially, the extent of thought duration remained short and stable for those asked to suppress, and increased linearly over time for those asked to monitor. Later, this pattern reversed. Duration increased linearly for those initially asked to suppress but was short and stable for those who initially monitored. Accounting for change over time and means of measuring recurrence (frequency vs. duration) may help elucidate past mixed findings, and improve thought suppression research methodology.

Background and Objectives: Prominent theories suggest that explicit and implicit cognitive biases are critical in the development and maintenance of posttraumatic stress disorder (PTSD). However, studies evaluating implicit PTSD-related cognitive biases are rare, and findings are mixed. We developed two adaptions of the Implicit Association Test (IAT), the "traumatized self" IAT (evaluations of the self as traumatized vs. healthy) and the "dangerous memory" IAT (evaluations of remembering as dangerous vs. safe), and investigated their psychometric properties and relations to PTSD symptoms and trauma exposure., Methods: Participants were visitors to the Project Implicit research website (Study 1: N = 347, Study 2: N = 501). They completed the IATs (Study 1: both IATs; Study 2: traumatized self IAT only), a trauma exposure measure, a PTSD symptom inventory, and explicit cognitive bias measures (Study 2 only)., Results: Both IATs had good internal consistency, but only the traumatized self IAT was correlated with PSTD symptoms and identified participants meeting clinical cutoffs for PTSD symptoms. Study 2 focused on the traumatized self IAT and included explicit cognitive bias measures. The IAT correlated with PTSD symptoms and explicit cognitions, and predicted variance in PSTD symptoms above and beyond trauma exposure and explicit cognitions., Limitations: Study designs were cross-sectional; samples were unselected; and PTSD symptoms were self-reported., Conclusions: Despite these limitations, these studies provide preliminary validation of an implicit measure of PTSD-related cognitive bias - the traumatized self IAT - that is consistent with PTSD theories and may ultimately improve the identification and treatment of individuals with PTSD., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Understanding differences in responses following attempts to suppress versus simply monitor intrusive thoughts is important given the established relationship between intrusive thinking and numerous forms of psychopathology. Moreover, these differences may vary as a function of age. Because of the links between aging and both enhancement in emotion regulation skills and decline in inhibition skills, older and younger adults were expected to differ in their responses (e.g., experience of negative affect and thought recurrence) to attempts at suppressing intrusive thoughts. This study examined whether efforts to suppress thought content that varied in valence and age-relevance differentially affected older (N=40, aged 66-92) and younger (N=42, aged 16-25) adults' ability to inhibit intrusive thought recurrence and their resulting negative affect. Interestingly, older adults experienced less recurrence for most thoughts than younger adults. Also, for several dependent variables (negative affect and perceived difficulty suppressing intrusive thoughts), older adults showed less decline in their magnitude of response across thinking periods (i.e., from suppression to monitoring) than did younger adults. These age effects were not generally moderated by level of trait anxiety, though higher anxiety did predict intrusive thought responding in expected directions, such as greater negative affect. These findings point to independent influences of age and anxiety, and suggest a complex mix of risk and protective factors for older adults' responses to intrusive thoughts., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background and Objectives: Cognitive-behavioral therapies are currently the gold standard for panic disorder treatment, with well-documented treatment response. However, following interventions, some individuals continue to improve, while others experience a return of symptoms. The field lacks reliable ways to predict follow-up symptomatology. In the current study, a cluster analysis with a repeated measures design was conducted to examine change patterns over 12 weeks of cognitive behavioral group therapy for panic disorder. The central aim of the study was to evaluate if change patterns predict level of panic symptom severity at a six month follow-up in this sample., Methods: Individuals with panic disorder (N = 36) completed a measure of panic symptoms (Panic Disorder Severity Scale) at the outset of every therapy session and at a six month follow-up., Results: Results revealed three patterns of change in this specific trial, which significantly predicted level of panic symptoms six months post-treatment, beyond initial or final level of panic symptoms, and beyond total symptom change., Limitations: Given the relatively small, lab-based sample, replications in other settings and samples will be important., Conclusions: Overall, results provide initial evidence that change patterns are meaningful predictors of panic symptom severity well after the final session of treatment., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

We examined the predictive validity of explicit and implicit measures of threat overestimation in relation to contamination-fear outcomes using structural equation modeling. Undergraduate students high in contamination fear ( N = 56) completed explicit measures of contamination threat likelihood and severity, as well as looming vulnerability cognitions, in addition to an implicit measure of danger associations with potential contaminants. Participants also completed measures of contamination-fear symptoms, as well as subjective distress and avoidance during a behavioral avoidance task, and state looming vulnerability cognitions during an exposure task. The latent explicit (but not implicit) threat overestimation variable was a significant and unique predictor of contamination fear symptoms and self-reported affective and cognitive facets of contamination fear. On the contrary, the implicit (but not explicit) latent measure predicted behavioral avoidance (at the level of a trend). Results are discussed in terms of differential predictive validity of implicit versus explicit markers of threat processing and multiple fear response systems.

Differences in the relative use of global and local information (seeing the forest vs. the trees) may explain why people with social anxiety often do not benefit from corrective feedback, even though they pay close attention to details in social situations. In the current study, participants high (n=43) or low (n=47) in social anxiety symptoms gave a series of brief speeches, and then self-rated their speaking performance on items reflecting global and local performance indicators (self-assessment) and also received standardized performance feedback from an experimenter. Participants then completed a questionnaire asking how they thought the experimenter would rate their performance based on the feedback provided (experimenter assessment). Participants completed the self- and experimenter assessments again after 3 days, in addition to a measure of postevent processing (repetitive negative thinking) about their speech performance. Results showed that, as hypothesized, the High SA group rated their performance more negatively than the Low SA group. Moreover, the High SA group's ratings of global aspects of their performance became relatively more negative over time, compared to their ratings of local aspects and the Low SA group's ratings. As expected, postevent processing mediated the relationship between social anxiety group status and worsening global performance evaluations. These findings point to a pattern of progressively more negative global evaluations over time for persons high in social anxiety., (Copyright © 2011. Published by Elsevier Ltd.)

Three studies were conducted to examine the psychometric properties of a new scale: the Heights Interpretation Questionnaire (HIQ). This scale was designed to measure height fear-relevant interpretation bias to help assess the relationship between biased interpretations and acrophobia symptoms. Studies 1 (N=553) and 2 (N=308) established the scale's factor structure and convergent and discriminant validity among two large undergraduate samples. Study 3 (N=48) evaluated the predictive validity of the HIQ by examining how well the scale predicted subjective distress and avoidance on actual heights. Factor analysis resulted in four distinct factors, and results suggest that each of the factors, along with the full HIQ, have good reliability and validity. Additionally, the scale predicts subjective distress and avoidance on heights beyond self-reported acrophobia symptoms. Overall, the HIQ shows promise as a new tool to investigate cognitive processing biases in acrophobia., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The current study tested the causal premise underlying cognitive models of obsessive compulsive disorder (OCD) that negative interpretations of intrusive thoughts lead to the distress and impairment associated with symptoms of OCD. Specifically, we sought to determine: (a) whether it was possible to train healthier (defined as more benign/less threatening) interpretations regarding the significance of intrusive thoughts; and (b) whether there was a link between modifying negative interpretations and subsequent emotional vulnerability to an OC stressor. A nonclinical sample of students high in OC symptoms completed either a Positive (n = 50) or Neutral (n = 50) interpretation training procedure designed to alter OC-relevant interpretations and beliefs. As expected, participants in the Positive (versus Neutral) training condition endorsed healthier OC-relevant interpretations and beliefs following training. Additionally, when controlling for baseline affect, participants in the Positive (versus Neutral) training condition reported less negative affect during the OC-stressor task (at the level of a non-significant trend) and reported less desire to perform neutralizing activities. In general, results provide some support for cognitive models of obsessions and suggest that negative interpretations of intrusive thoughts may be causally related to symptoms of OCD., (Published by Elsevier Ltd.)

Cognitive-behavioral models of body dysmorphic disorder (BDD) suggest the disorder is characterized by exaggerated beliefs about the significance of appearance. However, previous studies assessing automatic associations regarding the importance of attractiveness failed to find any differences between individuals with BDD and healthy control participants using the Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998). An open question is whether the BDD and control groups indeed implicitly evaluate attractiveness comparably, or whether methodological factors (e.g., the IAT design requirement of a relative comparison category for attractiveness) made it difficult to observe group differences. To address this question, we evaluated explicit and implicit attractiveness beliefs among individuals with BDD (n = 36), individuals with a dermatological condition (n = 36), and psychiatrically healthy control participants (n = 36) using the single target category Go/No-go Association Task (GNAT; Nosek, & Banaji, 2001). Indeed, BDD participants had significantly stronger implicit associations between attractive and important, relative to the other groups, whereas there was no difference between the dermatology and control groups. Further, the GNAT was effective at classifying individuals with BDD above and beyond the prediction offered by an explicit measure of attractiveness beliefs. The GNAT may be a useful tool for assessing implicit associations in clinical populations because it does not require an explicit comparison target category, which is a restriction of many implicit measures., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Despite predictions following from cognitive theories of anxiety, evidence for memory biases in social anxiety has been mixed. This study extends previous research by using stimuli relevant to participants' concerns and allowing time for post-event processing. Participants high (n=42) or low (n=39) in social anxiety symptoms gave speeches and received standardized feedback on their and a confederate's performance. Participants then took recognition and recall tests for the feedback immediately after it was given and after a two-day delay. Results showed no recall biases. However, the hypothesized recognition biases were found: the high social anxiety group remembered the confederate's feedback more positively than their own, remembered their negative feedback as worse than the low group, and diminished positive feedback over time. Moreover, post-event processing mediated the relationship between social anxiety and memory for negative feedback. Results suggest that biased recognition of social feedback is linked to social anxiety., (Copyright 2010 Elsevier Ltd. All rights reserved.)

The current study investigates an experimental anxiety reduction intervention among a highly socially anxious sample (N=108; n=36 per Condition; 80 women). Using a conditioning paradigm, our goal was to modify implicit social anxiety associations to directly test the premise from cognitive models that biased cognitive processing may be causally related to anxious responding. Participants were trained to preferentially process non-threatening information through repeated pairings of self-relevant stimuli and faces indicating positive social feedback. As expected, participants in this positive training condition (relative to our two control conditions) displayed less negative implicit associations following training, and were more likely to complete an impromptu speech (though they did not report less anxiety during the speech). These findings offer partial support for cognitive models and indicate that implicit associations are not only correlated with social anxiety, they may be causally related to anxiety reduction as well., ((c) 2010 Elsevier Ltd. All rights reserved.)

To examine the causal relationship between cognitive biases and anxiety, a bias modification paradigm was used to reduce negative interpretation biases in participants with high anxiety sensitivity (AS). Participants (N=75) were assigned to a Positive training condition or to one of two Control conditions (Neutral or No training). During training, participants imagined themselves in ambiguous scenarios related to AS. Positive training required participants to resolve the scenarios' ambiguity positively and was hypothesized to result in more positive and less negative subsequent interpretations related to AS, fewer self-reported AS symptoms, and less emotional vulnerability on AS stressors (compared to the Control conditions). As expected, Positive training shifted interpretations of novel scenarios and self-reported AS symptoms in the anticipated direction. Evidence was mixed for the effect of Positive training on emotional vulnerability (small effect for less fear, but not for avoidance). Findings support the causal premise underlying cognitive models of anxiety.

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.

Body dysmorphic disorder (BDD) is characterized by imagined or slight defects in one's appearance. We evaluated implicit and explicit biases among individuals diagnosed with BDD (n=21), individuals with subclinical BDD symptoms (n=21), and healthy control participants (n=21). Specifically, we used the Implicit Association Test [IAT; Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: the implicit association test. Journal of Personality and Social Psychology, 74, 1464-1480] to examine automatic associations related to self-esteem, associations between attractive and important, and a physical attractiveness stereotype (associations between attractive and competent). BDD participants had significantly lower implicit self-esteem, relative to control participants, and the subclinical BDD participants were intermediate between these groups. Although no group differences were observed on the implicit Attractive Important IAT; as predicted, BDD participants had significantly stronger implicit associations between attractive and competent than the other groups, in line with a common stereotype about physical attractiveness. Both the Attractive Competent IAT and Self-Esteem IAT were significant predictors of BDD symptom severity, and distress and avoidance during a mirror exposure task. Findings are discussed in light of cognitive-behavioral models of BDD.

The current study tested whether height overestimation is related to height fear and influenced by images of falling. To assess perceptual biases, participants high (n=65) versus low (n=64) in height fear estimated the vertical extents of two balconies using a visual matching task. On one of the balconies, participants engaged in an imagery exercise designed to enhance the subjective sense that they were acting in a dangerous environment by picturing themselves falling. As expected, we found that individuals overestimated the balcony's height more after they imagined themselves falling, particularly if they were already afraid of heights. These findings suggest that height fear may serve as a vulnerability factor that leads to perceptual biases when triggered by a stressor (in this case, images of falling).

The Go/No-go association task (GNAT) [Nosek, B.A., & Banaji, M.R. (2001). The Go/No-go Association Task. Social Cognition, 19, 625-666], which measures automatic associations in memory, was administered to participants who were high (N=17) versus low (N=17) in spider fear along with other established fear measures to validate the tool as a proxy measure for fear schemata. The GNAT involves participants classifying stimuli into superordinate categories and looking at speed of categorization when categories match, versus contradict, participants' hypothesized implicit fear associations. Results showed that the GNAT successfully differentiated the fear groups, indicating its convergent validity, and there was no group difference on a GNAT control fear task, supporting its discriminant validity. In addition, the GNAT spider fear task was associated with questionnaire measures of spider fear, self-reported anxiety during a behavioral avoidance test (approaching a live spider), and whether or not participants touched the spider during the behavioral test, supporting the task's predictive validity. Findings suggest the GNAT provides an effective, single-target measure of involuntary fear associations.

The aim of this study was to develop a reliable self-report instrument to assess obsessive-compulsive disorder (OCD) in young people. The children's Obsessional Compulsive Inventory (CHOCI) had good internal consistency, criterion validity and was significantly correlated with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). This preliminary new measure could serve to provide a more efficient and accessible way of assessing OCD in young people.