Looming Cognitive Style and Its Associations with Anxiety and Depression: A Meta-analysis

The association between looming cognitive style and posttraumatic stress symptoms: The case of older Holocaust survivors

The looming cognitive style (LCS) refers to a tendency to produce mental illustrations and images of adverse events and potentially threatening situations with perceived accumulating threat and danger. LCS is a well-known cognitive vulnerability for anxiety, nevertheless few studies examined the relationship between LCS and posttraumatic reactions. Among the existing studies, a higher LCS was reported in Holocaust survivors relative to matched comparisons, and directly associated with posttraumatic stress symptoms (PTSS) in older Holocaust survivors. The current study aimed to expand the understanding of the relationship between LCS with PTSS in general, and among older Holocaust survivors in particular. Moreover, whether the number of Holocaust experiences encountered by Holocaust survivors moderated this relationship. The sample consisted of 153 older Holocaust survivors (Mage = 82.42, SD = 5.75). Participants were interviewed regarding their background characteristics, PTSS, LCS, and number of Holocaust experiences. Participants reporting higher LCS showed higher PTSS. There was an interaction between LCS and number of Holocaust experiences for predicting PTSS, suggesting that LCS was associated with higher PTSS to a stronger degree among Holocaust survivors who experienced a smaller number of Holocaust experiences. The findings indicate that Holocaust trauma may have influenced the LCS of Holocaust survivors throughout their lives and into old age. The results provide insight for mental health practitioners treating older Holocaust survivors in focusing on reducing schematic processing biases for threat information and anxiety to enhance better mental health for those suffering from posttraumatic stress symptoms.

COVID-19 pandemic and mental health problems of adults in United States: mediating roles of cognitive concerns and behavioral changes

OBJECTIVES

We examined the associations of statewide COVID-19 conditions (i.e., state-level case and death rates) with individual-level Generalized Anxiety Disorder (GAD) and Major Depression Disorder (MDD) focusing on the salient mediating roles of individual-level cognitive concerns and behavioral changes.

METHODS

Using a national representative sample of adults in the United States (n = 585,073), we fitted logistic regressions to examine the overall associations between the COVID-19 pandemic and GAD/MDD. We employed a causal mediation analysis with two mediators: cognitive concerns (i.e., concerns on going to the public, loss of income, food insufficiency, housing payment, and the economy) and behavioral changes (i.e., taking fewer trips, avoiding eating-out, more online-purchase, more curbside pick-up, and cancelling doctor's appointments).

RESULTS

We found relationships of statewide COVID-19 cases with GAD (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.05, 1.07) and MDD (OR = 1.08; 95% CI = 1.07, 1.09). The ORs were mediated by cognitive concerns for GAD (OR = 1.02, proportion mediated: 29%) and MDD (OR = 1.01, 17%). Another salient mediator was behavioral changes for GAD (OR = 1.02, 31%) and MDD (OR = 1.01, 15%). Similar associations were found with statewide COVID-19 death.

CONCLUSIONS

Our mediation analyses suggest that cognitive concerns and behavioral changes are important mediators of the relationships between statewide COVID-19 case/death rates and GAD/MDD. COVID-19 pandemic may involve individual-level concerns and behavior changes, and such experiences are likely to affect mental health outcomes. Public health approaches to alleviate adverse mental health consequences should take into account the mediating factors.

When the UPPS-P Model of Impulsivity Meets a Revised Approach: The Development and Validation of the TRUE Multidimensional Impulsivity Scale

There is inconsistency in the measurement of impulsivity resulting from the diversity in its conceptualization. We aimed to develop a revised measure based on the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking - Positive Urgency (UPPS-P) model (i.e., TRUE Multidimensional Impulsivity Scale; TRUE-MIS) considering the limitations and strengths of the existing measures. We conceptualized impulsivity as a personality trait referring to the inability to restrain one's urges without thinking about the future consequences in various contexts. A total of 535 adults (262 females, M = 34.1, SD = 12.7) participated in Study 1. Principal component analyses indicated a four-factor structure (internal urgency, social urgency, lack of premeditation, and lack of perseverance) with satisfactory internal consistency and validity evidence by significant relations with self-control. Confirmatory factor analysis in Study 2 confirmed the factor structure obtained in Study 1. Hierarchical linear regression analyses provided further validity evidence through establishing differential links between the subscales and Big Five personality traits, emotion regulation, depression, anxiety, and smartphone addiction in a sample of 556 adults (368 females, M = 24.0, SD = 7.4). Overall, TRUE-MIS is a valid and reliable measure of impulsivity addressing the arguments regarding the conceptual structure of the construct.

Anxiety, depression, and related factors in hemodialysis patients during the lockdown period of COVID- 19 in China: a multicenter study

The outbreak of coronavirus disease 2019 (COVID-19) made a huge impact on hemodialysis (HD) patients. The aim of the study was to survey the anxiety, depression and related factors of HD patients during the lockdown and to explore the factors that affect their anxiety and depression. From February 1 to 15, 2020, an online survey was conducted in HD patients; the survey collected information on demographic data, epidemic perception, travel status and Zung's Self-rating Anxiety Scale (SAS) and Zung's Self-rating Depression Scale (SDS). The original SAS and SDS data from 96 HD patients gathered between May and August 2018 were retained as data for the control group. A total of 506 HD patients were recruited, and the prevalence of anxiety and depression was 22.33% and 45.45%, respectively. They had significantly higher SAS and SDS scores than the HD patients before the epidemic (p < 0.01; p < 0.05). It was found that self-threat perception, trouble related to transportation and skipping dialysis sessions were factors related to anxiety in HD patients during the lockdown (p ˂ 0.05). Education level, trouble related to transportation and the awareness of the seriousness of the epidemic were factors related to depression (p ˂ 0.05). During the COVID-19 lockdown period, HD patients reported higher levels of psychological distress than HD patients before the pandemic. Psychological support and transport policies should be provided to them.

Intolerance of Uncertainty, Looming Cognitive Style, and Avoidant Coping as Predictors of Anxiety and Depression During COVID-19: a Longitudinal Study

The COVID-19 pandemic has resulted in increased distress and uncertainty. Understanding the progression of mental health and factors underlying the perpetuation of distress during the pandemic is pivotal in informing interventions and public health messaging. This current study examined longitudinal effects of two cognitive vulnerabilities, looming cognitive style, and intolerance of uncertainty, as well as coping styles on anxiety and depression through online questionnaires at two time points in the pandemic, May 2020 (N = 1520) and August 2020 (N = 545). Depression, but not anxiety, significantly increased across time, which was moderated by coping style. Serial mediation modeling using path analysis demonstrated a significant pathway illustrating increased looming cognitive style in the beginning of the pandemic leads to increased intolerance of uncertainty, avoidant coping, and anxiety later in the pandemic. Results suggest a novel model in conceptualizing anxiety during the pandemic, namely highlighting looming cognitive style as an underlying cognitive vulnerability factor and antecedent of intolerance of uncertainty and illuminating the temporal directionality between looming cognitive style and intolerance of uncertainty. These findings provide important implications regarding intervention and public health messaging with modifiable behavioral and cognitive factors to improve mental health during a pandemic.

A Perfect Storm? Health Anxiety, Contamination Fears, and COVID-19: Lessons Learned from Past Pandemics and Current Challenges

The novel coronavirus disease 2019 (COVID-19) rapidly spread, becoming a global pandemic with significant health, economic, and social impacts. COVID-19 has caused widespread anxiety, which at healthy levels leads to adaptive, protective behavioral changes. For some individuals, a pandemic outbreak can lead to excessive, maladaptive levels of anxiety, particularly among those with obsessive-compulsive disorder (OCD) and health anxiety. In the present paper, we review past research studies that examined anxiety in response to other disease outbreaks (including Swine Flu, Zika, and Ebola) to serve as a guide for expectable responses to COVID-19. Our review focused on the role of belief-based cognitive variables (obsessive beliefs, contamination cognitions), transdiagnostic processes (disgust sensitivity, anxiety sensitivity, an intolerance of uncertainty), social factors, and environmental/situational variables as contributing factors to excessive concerns about past pandemics. These factors in combination with unique characteristics of the virus (disease, behavioral, social and economic factors) and media consumption might enhance vulnerability to excessive anxiety about COVID-19, in line with a diathesis-stress model. COVID-19 is also unique from past pandemics due to its severity, easy transmissibility, and the nature of prescribed behavioral responses (i.e., hand washing and social distancing). We therefore discuss the ways in which COVID-19 may disproportionately affect individuals with OCD and health anxiety. We conclude with important topics for clinical and research attention to help mental health professionals respond in this time of crisis.