Negative self-focused cognitions mediate the effect of trait social anxiety on state anxiety

The cognitive model of social anxiety predicts that negative self-focused cognitions increase anxiety when anticipating social threat. To test this prediction, 36 individuals were asked to anticipate and perform a public-speaking task. During anticipation, negative self-focused cognitions or relaxation were experimentally induced while self-reported anxiety, autonomic arousal (heart rate, heart rate variability, skin conductance level), and acoustic eye-blink startle response were assessed. As predicted, negative self-focused cognitions mediated the effects of trait social anxiety on self-reported anxiety and heart rate variability during negative anticipation. Furthermore, trait social anxiety predicted increased startle amplitudes. These findings support a central assumption of the cognitive model of social anxiety.

Here is looking at you: emotional faces predominate in binocular rivalry

Two incompatible pictures compete for perceptual dominance when they are presented to one eye each. This so-called binocular rivalry results in an alternation of dominant and suppressed percepts. In accordance with current theories of emotion processing, the authors' previous research has suggested that emotionally arousing pictures predominate in this perceptual process. Three experiments were run with pictures of emotional facial expressions that are known to induce emotions while being well controlled in terms of physical characteristics. In Experiment 1, photographs of emotional and neutral facial expressions were presented of the same actor to minimize physical differences. In Experiment 2, schematic emotional expressions were presented to further eliminate low-level differences. In Experiment 3, a probe-detection task was conducted to control for possible response-biases. Together, these data clearly demonstrate that emotional facial expressions predominate over neutral expressions; they are more often the first percept and they are perceived for longer durations. This is not caused by physical stimulus properties or by response-biases. This novel approach supports that emotionally significant visual stimuli are preferentially perceived.

Affective pain modulation in fibromyalgia, somatoform pain disorder, back pain, and healthy controls

Previous research suggested that patients with fibromyalgia (FM) experience a higher pain intensity (clinical pain) than do patients with musculoskeletal pain after negative emotional priming compared to positive priming. To further examine affective pain modulation in FM, we applied an experimental pain induction to compare 30 patients with FM with 30 healthy (pain-free) participants (HC), and 30 patients with back pain (BP). For another group of 30 patients with somatoform pain disorder (SF), we predicted the same pain modulation as for FM. As primes we presented positive, neutral, negative, and pain-related pictures and assessed pain intensity in response to a fixed pressure weight. Overall, picture valence modulated pain intensities (in the order of pain-related > negative pictures > neutral), but the pain intensities between neutral and positive pictures did not differ significantly. SF reported significantly higher pain intensities than did BP and HC; FM were in between, but did not differ significantly from the three other groups. There was no interaction of priming and group. Affective modulation of pain was not specifically altered in FM and SF, but SF were more sensitive to pressure pain than BP and HC.

Validierung der deutschen Übersetzung des Psychopathy Personality Inventory (PPI)

Zusammenfassung. Theoretischer Hintergrund: Psychopathie ist ein Persönlichkeitskonstrukt, für dessen Messung noch kein deutschsprachiges Selbstbeurteilungsmaß vorliegt. Das Psychopathy Personality Inventory ( Lilienfeld & Andrews, 1996 ) ist ein reliables und valides Maß, das im englischen Sprachraum breite Verwendung findet. Fragestellung: Entspricht die deutsche Übersetzung des PPI den üblichen Gütekriterien? Methode: Unsere deutsche Übersetzung wurde an einer studentischen Stichprobe (n = 352) zum einen durch einen Vergleich der Faktorenstrukturen und zum anderen durch Reliabilitäts- und Trennschärfenanalysen auf Messgenauigkeit untersucht. Ergebnisse: Die Faktorenstruktur des Originals konnte fast vollständig repliziert werden. Demnach ergaben sich neun Faktoren entsprechend der Originalskalen: Schuld-Externalisierung, Rebellische Risikofreude, Stressimmunität, Sozialer Einfluss, Kaltherzigkeit, Machiavellistischer Egoismus, Sorglose Planlosigkeit, Furchtlosigkeit und Unaufrichtige Beantwortung. Die Reliabilitäts- und Trennschärfenanalysen ergaben für fast alle Items eine hohe Testgüte und eine hohe Gesamtreliabilität. Darüber hinaus zeigte sich die konkurrente Validität anhand signifikanter Unterschiede zwischen einer forensischen Stichprobe (n = 57) und der studentischen Stichprobe. Schlussfolgerungen: Damit stellt die deutsche Version des PPI eine valide und reliable Möglichkeit dar, Psychopathie mit Hilfe eines Selbstbeurteilungsmaßes zu messen.

Musically induced arousal affects pain perception in females but not in males: A psychophysiological examination

The present study investigated affective and physiological responses to changes of tempo and mode in classical music and their effects on heat pain perception. Thirty-eight healthy non-musicians (17 female) listened to sequences of 24 music stimuli which were variations of 4 pieces of classical music. Tempo (46, 60, and 95 beats/min) and mode (major and minor) were manipulated digitally, all other musical elements were held constant. Participants rated valence, arousal, happiness and sadness of the musical stimuli as well as the intensity and the unpleasantness of heat pain stimuli which were applied during music listening. Heart rate, respiratory rate and end-tidal PCO(2) were recorded. Pain ratings were highest for the fastest tempo. Also, participants' arousal ratings, their respiratory rate and heart rate were accelerated by the fastest tempo. The modulation of pain perception by the tempo of music seems to be mediated by the listener's arousal.

Two facets of being bothered by bodily sensations: anxiety sensitivity and alexithymia in psychosomatic patients

OBJECTIVE

Anxiety sensitivity (AS) and alexithymia have common characteristics with regard to somatic sensations. The purpose of the present study is to investigate if both constructs are distinct or overlapping in a sample of psychosomatic inpatients.

METHODS

We analyzed the alexithymia scores of extreme groups who are high and low in AS and the correlations between both constructs in 204 patients.

RESULTS

As predicted, groups with high and low AS differed significantly in their Toronto Alexithymia Scale (TAS-20) scores. The correlations between the Anxiety Sensitivity Index and the TAS-20 were moderately high and were not significantly reduced if conceptually redundant items were removed from the TAS-20. A common factor analysis of the combined items of the Anxiety Sensitivity Index and the TAS-20 yielded no item overlap between the extracted factors of both measures.

CONCLUSION

Results suggest that AS and alexithymia are related, but they are also distinct constructs. Therefore, it is important to assess AS and alexithymia separately.

Dissociation of rated emotional valence and Stroop interference in observer-rated alexithymia

OBJECTIVE

The objective of this study was to investigate a theoretically predicted deficit in the capacity to process emotions in alexithymia. The performance of patients high and that of patients low in alexithymia was tested in a computerized emotional Stroop task.

METHODS

Reaction times of high and low self- and observer-rated alexithymia groups of 45 psychosomatic inpatients were compared. The task was to name the color of emotionally neutral, positive, negative, and bodily-symptom words as quickly as possible.

RESULTS

As expected, patients rated high versus those rated low in alexithymia by observers (but not by self-rating) showed a significantly lesser emotional bias for emotionally negative words and bodily-symptom words but did not differ in their explicit rating of the emotional valence of the words.

CONCLUSION

This dissociation between explicit and implicit reactions to the emotional valence of word stimuli suggests that patients high in alexithymia spontaneously allocate less processing resources to negative information.

Another Look at “Look-Alikes”

Popular belief and recent findings suggest that dogs look like their owner - but are such pairs necessarily look-alikes or do we recognize their affiliation based on other information? We asked judges to match automobiles with their owners. They were able to identify the pairs above chance. The correlational analyses of actual information about owners' and automobiles' characteristics and their estimations suggest that stereotypes with respect to external clues about the owner and the automobiles were available to judges. People's appearance and certain characteristics of their possessions apparently carry information beyond physiognomic resemblance and these clues help to make inferences about their affiliation. The different mechanisms that judges might use to make connections between people and their cars are discussed.

Emotion processing in Parkinson's disease: Dissociation between early neuronal processing and explicit ratings

OBJECTIVE

Patients suffering from Parkinson's disease (PD) have a diminished ability to discriminate facial expressions of emotion. We investigated early emotion discrimination deficits in PD by means of event-related potentials (ERPs).

METHODS

Emotional pictures were presented to 14 PD patients and 14 healthy controls in a rapid serial visual presentation paradigm (three frames per second) while EEG was recorded. In addition, valence and arousal ratings were obtained for a representative subsample of 54 pictures.

RESULTS

PD patients rated pictures of highly arousing content as less exciting than did healthy controls. Pictures of high compared to low emotional arousal were associated with a pronounced relative negative shift in the ERP waveform over parietal and occipital sites developing about 220 ms after picture onset. This early posterior negativity (EPN) did not differ between PD and control group.

CONCLUSIONS

This dissociation of affective ratings and early ERP components supports the view that PD is associated with blunted emotional responses, but there is no evidence for a deteriorated early visual processing of emotional stimuli.

SIGNIFICANCE

Frequently reported deficits in emotion discrimination are likely not due to deficits in early emotion processing.

Binocular rivalry between emotional and neutral stimuli: a validation using fear conditioning and EEG

When two incompatible pictures are projected to the two eyes, they compete for perceptual dominance. Previous research has claimed that meaningful and emotionally valenced pictures predominate over neutral pictures in this rivalry. This may be interpreted as evidence for preferential processing of emotionally significant stimuli in the visual system but it is difficult to dismiss that the physical characteristics of the different pictures or response biases influenced the results of these studies. Thus, we set out to examine the influence of emotion using methods eliminating the influence of physical characteristics and minimizing response biases. We used simple visual patterns and induced emotional valence by fear conditioning. In Experiment 1 the aversive CS+ predominated over the CS-. In Experiment 2 we extended previous findings by showing that participants' self-reported perception is validated by corresponding steady-state visually evoked potentials in the EEG in the context of such a conditioning experiment. This was accomplished by frequency coding the rivalling stimuli with a stimulus specific pattern reversal and extracting the corresponding frequency from the occipital lobe EEG. Taken together, these studies provide further evidence that picture valence can influence perception in binocular rivalry. This is discussed in terms of subcortical mechanisms supporting the efficient processing of threatening information.

Psychophysiological assessment during exposure in driving phobic patients

A comprehensive assessment of fear or anxiety requires measurement of both self-report and physiological responses. Respiratory abnormalities have been rarely examined during real-life exposure, although they are an integral part of fear. Twenty-one women with a specific driving phobia and 17 nonphobic women were psychophysiologically monitored during 2 highway-driving sessions; phobic women completed an additional session. Respiratory movements, end-tidal partial pressure of carbon dioxide, an electrocardiogram, skin conductance, and skin temperature were recorded. Phobic patients differed from control participants both physiologically and experientially before, during, and after exposure. Effect size during exposure was large for the authors' measure of hyperventilation. Discriminant analysis indicated that multiple physiological measures contributed nonredundant information and correctly classified 95% of phobic and control participants. Thus, selected respiratory and autonomic measures are valid diagnostic and therapeutic outcome criteria for this situational phobia.

Energy and macronutrient intake in bulimia nervosa

Energy deprivation and malnutrition are often thought to be key factors in the maintenance of bulimia nervosa (BN). Our review shows that it is unclear how much energy is actually available to BN patients' metabolism because the contribution of food consumed during binge eating is generally neglected. Also, there is little evidence for another key hypothesis that binge-eating episodes are triggered by carbohydrate craving. This study examined energy consumption and macronutrient composition of meals and binge-eating episodes in food diaries. Forty female BN patients, 40 female panic disorder (PD) patients, and 40 healthy women recorded their food intake while in their natural environment during two consecutive days. We did not find the expected evidence for chronic energy deprivation and malnutrition in BN patients. Also, there was no evidence that carbohydrate craving drives binge eating. The implications for models of BN and for treatments targeting eating behavior are discussed.

Negative feelings and the desire to eat in bulimia nervosa

This study examines a broad range of negative feelings as possible antecedents of binge eating in bulimia nervosa (BN). Another goal is to explore the connection between negative feelings and the desire to eat as recorded continuously during two consecutive days. This is the first study comparing data from BN patients with a relevant clinical control group. Forty female BN patients, 40 female panic disorder (PD) patients, and 40 healthy women continuously recorded their feelings and the desire to eat while in their natural environment. Both patient groups reported more negative feelings than the healthy controls. BN patients had higher within-subject correlations between most negative feelings and the desire to eat than the two control groups. BN patients rated most feelings more negatively in the hour prior to binge eating than during the rest of the day. BN patients' general mood state worsened after binge eating but returned to prebinge levels after purging. The study provides additional evidence that unspecific negative feelings play an important role in the context of binge-eating behavior in BN.

Salivary cortisol response during exposure treatment in driving phobics

OBJECTIVE

Extensive research on the hypothalamic-pituitary-adrenal (HPA) axis response to stress has not clarified whether that axis is activated by phobic anxiety. We addressed this issue by measuring cortisol in situational phobics during exposure treatment.

METHODS

Salivary cortisol was measured in 11 driving phobics before and during three exposure sessions involving driving on crowded limited-access highways and compared with levels measured in 13 healthy controls before and during two sessions of driving on the same highways. For each subject, data collected in the same time period on a comparison nondriving day served as an individual baseline from which cortisol response scores were calculated.

RESULTS

Cortisol levels of driving phobics and controls did not differ on the comparison day. Phobics also had normal cortisol response scores on awakening on the mornings of the exposures but these were already increased 1 hour before coming to the treatment sessions. Phobics had significantly greater cortisol response scores during driving exposure and during quiet sitting periods before and afterward. These greater responses generally paralleled increases in self-reported anxiety. At the first exposure session, effect sizes for differences in cortisol response scores between the two groups were large. Initial exposure to driving in the first session evoked the largest responses.

CONCLUSION

The data demonstrate that the HPA axis can be strongly activated by exposure to, and anticipation of, a phobic situation.

Evaluation of an internet support group for women with primary breast cancer

BACKGROUND

Women with breast carcinoma commonly experience psychologic distress following their diagnosis. Women who participate in breast cancer support groups have reported significant reduction in their psychologic distress and pain and improvement in the quality of their lives. Web-based breast cancer social support groups are widely used, but little is known of their effectiveness. Preliminary evidence suggests that women benefit from their participation in web-based support groups.

METHODS

Seventy-two women with primary breast carcinoma were assigned randomly to a 12-week, web-based, social support group (Bosom Buddies). The group was semistructured, moderated by a health care professional, and delivered in an asynchronous newsgroup format.

RESULTS

The results indicate that a web-based support group can be useful in reducing depression and cancer-related trauma, as well as perceived stress, among women with primary breast carcinoma. The effect sizes ranged from 0.38 to 0.54. Participants perceived a variety of benefits and high satisfaction from their participation in the intervention

CONCLUSIONS

This study demonstrated that the web-based program, Bosom Buddies, was effective in reducing participants' scores on depression, perceived stress, and cancer-related trauma measures. The effect size of the intervention was in the moderate range. Although web-based social support groups offer many advantages, this delivery mechanism presents a number of ethical issues that need to be addressed.

High altitudes, anxiety, and panic attacks: is there a relationship?

People exposed to high altitudes often experience somatic symptoms triggered by hypoxia, such as breathlessness, palpitations, dizziness, headache, and insomnia. Most of the symptoms are identical to those reported in panic attacks or severe anxiety. Potential causal links between adaptation to altitude and anxiety are apparent in all three leading models of panic, namely, hyperventilation (hypoxia leads to hypocapnia), suffocation false alarms (hypoxia counteracted to some extent by hypocapnia), and cognitive misinterpretations (symptoms from hypoxia and hypocapnia interpreted as dangerous). Furthermore, exposure to high altitudes produces respiratory disturbances during sleep in normals similar to those in panic disorder at low altitudes. In spite of these connections and their clinical importance, evidence for precipitation of panic attacks or more gradual increases in anxiety during altitude exposure is meager. We suggest some improvements that could be made in the design of future studies, possible tests of some of the theoretical causal links, and possible treatment applications, such as systematic exposure of panic patients to high altitude.

Memory bias in patients with hypochondriasis and somatoform pain disorder

OBJECTIVE

A memory bias enhances memory for disorder congruent information. The experimental evaluation of such biases in somatoform disorders may improve our understanding of these disorders.

METHOD

Immediate and delayed free recall as well as recognition for positive, negative, pain, and neutral word stimuli were studied in 28 patients with somatoform disorders (hypochondriasis and/or pain disorder patients) and 14 patients without somatoform disorders.

RESULTS

Somatoform patients recalled fewer positive words and their criteria for recognition of negative and pain words were less conservative than in patients without somatoform disorders. In addition, patients with comorbid hypochondriasis and somatoform pain disorder showed an enhanced immediate recall of pain words.

CONCLUSION

The memory biases found in this study support cognitive theories of somatoform disorders. They may contribute to the development and maintenance of somatoform disorders.