Phobic dimensions: III. factor analytic approaches to the study of common phobic fears; An updated review of findings obtained with adult subjects

Aging-related fears and their associations with ideal life expectancy

Fears regarding various aspects tend to stimulate individuals to escape or to avoid the sources of the threat. We concluded that fears associated with the future aging process, like the fear of aging-related diseases, the fear of loneliness in old age, and the fear of death, would stimulate patterns of avoidance when it comes to ideal life expectancy. We expected fear of aging-related diseases and fear of loneliness in old age to be related to lower ideal life expectancies. We expected fear of death to be related to higher ideal life expectancies. In two adult lifespan samples [N₁ = 1065 and N₂ = 591; ages ranging from 18 to 95 years, M (SD)₁ = 58.1 (17.2) years, M (SD)₂ = 52.6 (18.1) years], we were able to support our hypothesis regarding fear of death. We furthermore found significant interactions among the fears, indicating that individuals fearing diseases or loneliness but being unafraid of death opted for the shortest lives. Our results indicate that fears regarding life in very old age might be associated with the wish to avoid this age period; the fear of death was however associated with the wish for particularly long lives, and thus, with distancing oneself from the dreaded event of death. We conclude that fears seem to be associated with how individuals approach old age and with what they wish for in their own future as aged people.

Something Scary is Out There II: the Interplay of Childhood Experiences, Relict Sexual Dinichism, and Cross-cultural Differences in Spatial Fears

Children’s nighttime fear is hypothesized as a cognitive relict reflecting a long history of natural selection for anticipating the direction of nighttime predatory attacks on the presumed human ancestor, Australopithecus afarensis, whose small-bodied females nesting in trees would have anticipated predatory attacks from below. Heavier males nesting on the ground would have anticipated nighttime predatory attacks from their sides. Previous research on preschool children and adults supports this cognitive-relict hypothesis by showing developmental consistencies in their remembrances of the location of a “scary thing” relative to their beds. The current study expands this research by investigating whether nighttime fear in childhood, including the effect of parental threats to behave, influenced adult spatial fears in different biotic and abiotic situations. A 25-item questionnaire employing ordinal scales was given to 474 foreign-born Vietnamese and ethnic Chinese adults living in the USA. Univariate analyses of adult remembrances of childhood indicated that females were more fearful of something scary below their beds than males. To examine the influence of childhood nighttime fear on adult fears, exploratory factor analyses supported three factors: (1) indeterminate agents, indicated something scary under the bed, the difficulty locating unspecific threats, and the brief appearances of large apparitions; (2) environmental uncertainty, indicated by potential encounters with unseen animate threats; (3) predictable animals, as the relative comfort of viewing animals in zoo exhibits. Using structural equation modeling, the results suggest that childhood nighttime fear influenced only the latent variable, indeterminate agents, in both groups via the mediating variable, parental threats.

Confirming the factor structure and improving the screening function of the Medical Fear Survey - short in a Hungarian community sample

Medical Fear Survey (MFS) was designed to assess the fear of medical treatments and related factors through five dimensions including fears of injections and blood draws, sharp objects, blood, mutilation, medical examination and physical symptoms. We analysed the factor structure and validity of a short version of MFS in Hungarian, on a large sample (2631 participants; 558 men, 2067 women) focusing on possible age and gender differences (aged Mean = 30.4, SD = 13.4), which were not reported for the original version. Furthermore, using discriminant analysis, potential screening function of the MFS-short was examined. Results supported construct and convergent validity and scale-reliability for the five-factor structure of the MFS-short. Further analyses demonstrated excellent discriminatory power for four subscales, while one subscale had acceptable power. Our findings provide implications for the utility of MFS-short as a screening measure in assessing the severity of medical fears controlling for gender differences and age-biases.

Kinematic dataset of actors expressing emotions

Human body movements can convey a variety of emotions and even create advantages in some special life situations. However, how emotion is encoded in body movements has remained unclear. One reason is that there is a lack of public human body kinematic dataset regarding the expressing of various emotions. Therefore, we aimed to produce a comprehensive dataset to assist in recognizing cues from all parts of the body that indicate six basic emotions (happiness, sadness, anger, fear, disgust, surprise) and neutral expression. The present dataset was created using a portable wireless motion capture system. Twenty-two semi-professional actors (half male) completed performances according to the standardized guidance and preferred daily events. A total of 1402 recordings at 125 Hz were collected, consisting of the position and rotation data of 72 anatomical nodes. To our knowledge, this is now the largest emotional kinematic dataset of the human body. We hope this dataset will contribute to multiple fields of research and practice, including social neuroscience, psychiatry, computer vision, and biometric and information forensics.

Faster detection of snake and spider phobia: revisited

Snake and spider phobia are one of the most prevalent anxiety disorders, yet quick and reliable measures are rather scarce. Recently, attempts have been made to shorten two widespread measures of snake and spider fear, the Snake Questionnaire (SNAQ) and Spider Questionnaire (SPQ). The new 12-item scales demonstrate very good psychometric qualities in terms of internal consistency and discriminatory power. Using the same approach on a bigger sample from another cultural background, we aimed to verify psychometric properties of the short scales. In total, 2 644 Czechs completed the SNAQ, 1 816 of which also completed the SPQ. The item response theory revealed that nine and seven items on the shorter SNAQ and SPQ, respectively, were identical with the Hungarian study. The 12-item scales show excellent reliability (α = 0.84 and 0.91) and highly correlate with scores on the full versions (r = 0.81 and 0.89) as well as with fear and disgust ratings of snake and spider images. Thus, despite slight discrepancies in the selected items, we confirm that the shorter SNAQ and SPQ keep considerable diagnostic strengths and can be used in the clinical practice as reliable, easy-to- administer, and fast screening tools for snake and spider phobia.

Fear of Crime: The Influence of General Fear, Risk, and Time Perspective

Prior research on fear of crime has focused less on psychological causes than on sociological and demographic factors. This study, however, introduces time perspective (TP) as an important psychological variable in the understanding of fear of crime. Specifically, the article assesses the relationship between TP as a stable personality factor and the mediation of risk and general fear on fear of crime levels. Data were collected using the survey method from a sample of 375 respondents utilizing the following scales: Zimbardo Time Perspective Inventory (ZTPI) consisting of five TP subscales, Ferraro's perceived risk of victimization and fear of crime scales, and a general (non-crime) fear scale measuring pragmatic and abstract fear. Path analysis shows no significant direct relationships between the five TP subscales and fear of crime. However, indirect effects are observed for Past Negative TP and Present Fatalistic TP, with general fear (pragmatic and abstract) and risk of victimization mediating the relationship, and pragmatic fear having the greatest significant effect size. Results are discussed in the context of risk and general fear sensitivity and construal level theory. We conclude with recommendations for future research.

Psychosocial impact of Parkinson's disease-associated dysarthria: Cross-cultural adaptation and validation of the Dysarthria Impact Profile into European Portuguese

AIM

The present study sought to make a cross-cultural adaptation of the Dysarthria Impact Profile (DIP) for European Portuguese (EP) and validate it for use in Parkinson's disease (PD) patients.

METHODS

The cross-cultural adaptation was carried out in accordance with the guidelines. The EP version of the DIP was administered to 80 people with PD, and 30 sex- and age-matched control participants. Psychometric properties, acceptability, feasibility reliability (internal consistency and intrarater agreement) and validity (construct, convergent and known-groups validity) were assessed using other assessment tools (motor disability and impairment, and voice impact).

RESULTS

Overall, the EP-DIP final version has the same conceptual meaning, semantics, idiomatic and score equivalences as the original version. Statistical analyses showed adequate feasibility (missing data <5%), good acceptability (ceiling or floor effects <15%; high requests of assistance to complete the questionnaire), satisfactory internal consistency (Cronbach's α = 0.9), weak-to-moderate intrarater reliability, good construct validity, strong convergent validity (with the Voice Handicap Index; Spearman's P = -0.8) and good known-groups validity (between those with PD and control participants).

CONCLUSIONS

The EP-DIP version displays the salient features of a valid patient-based assessment tool used to measure the psychosocial impact of slight-to-mild dysarthria in people with PD. Geriatr Gerontol Int 2018; 18: 767-774.

The Set of Fear Inducing Pictures (SFIP): Development and validation in fearful and nonfearful individuals

Emotionally charged pictorial materials are frequently used in phobia research, but no existing standardized picture database is dedicated to the study of different phobias. The present work describes the results of two independent studies through which we sought to develop and validate this type of database—a Set of Fear Inducing Pictures (SFIP). In Study 1, 270 fear-relevant and 130 neutral stimuli were rated for fear, arousal, and valence by four groups of participants; small-animal (N = 34), blood/injection (N = 26), social-fearful (N = 35), and nonfearful participants (N = 22). The results from Study 1 were employed to develop the final version of the SFIP, which includes fear-relevant images of social exposure (N = 40), blood/injection (N = 80), spiders/bugs (N = 80), and angry faces (N = 30), as well as 726 neutral photographs. In Study 2, we aimed to validate the SFIP in a sample of spider, blood/injection, social-fearful, and control individuals (N = 66). The fear-relevant images were rated as being more unpleasant and led to greater fear and arousal in fearful than in nonfearful individuals. The fear images differentiated between the three fear groups in the expected directions. Overall, the present findings provide evidence for the high validity of the SFIP and confirm that the set may be successfully used in phobia research.

PTSD symptom severity and sensitivity to blood, injury, and mutilation in U.S. army special operations soldiers

Sensitivity to blood, injury, and mutilation (SBIM) may increase risk for posttraumatic stress disorder (PTSD), given that traumatic events often involve actual or perceived threat of bodily harm to oneself and/or others, including exposure to blood and other mutilation-related stimuli. A self-report questionnaire was administered to male, active duty, U.S. Army Special Operations Command soldiers who had deployed to Iraq and Afghanistan (n =694 males). We first used exploratory factor analysis to examine whether the 30-item Mutilation Questionnaire (Klorman et al., 1974) comprised a unitary measure of SBIM, finding that 10 of the items form a cohesive SBIM factor. Summed, those 10 SBIM items had a significant bivariate correlation with PTSD symptom severity. In a multiple regression analysis that included demographic characteristics and lifetime trauma exposure, SBIM was positively associated with PTSD symptom severity. Other significant multivariate predictors were high lifetime trauma exposure and junior enlisted rank. When trait neuroticism was added to the model to test the robustness of these findings, the association of SBIM with PTSD symptom severity remained significant. The results suggest that SBIM may be a risk factor for PTSD in male soldiers. Further research is warranted to improve measurement and understanding of SBIM.

The Interface Between Emotion and Attention: A Review of Evidence from Psychology and Neuroscience

This review addresses the interconnections between emotional and attentional processing, with an emphasis on both behavioral and neuroscientific findings. Are emotional stimuli encoded automatically, and what does that mean? How are emotional stimuli selected for enhanced processing within a limited capacity system? Evidence suggests a two-stage process: First, emotional significance is evaluated preattentively by a subcortical circuit involving the amygdala; and second, stimuli deemed emotionally significant are given priority in the competition for access to selective attention. This process involves bottom-up inputs from the amygdala as well as top-down influences from frontal lobe regions involved in goal setting and maintaining representations in working memory. The review highlights limitations in the current literature, directions for fruitful future research, and the need to move beyond simple dichotomies such as “cognition” versus “emotion.”

Developmental Psychopathology and Normal Fear

This paper reviews the extensive research examining developmental patterns in normal fear. Areas of focus include age, gender, and socioeconomic status differences in fear content, prevalence, and intensity. The structure and stability/duration of normal fears are also discussed. Finally, the crosscultural research in this area is reviewed. Cross-sectional and longitudinal studies indicate that fear decreases in prevalence and intensity with age. There are also major changes in the content of normal fear over the course of development. Such changes are characterised by a transition from infant fears which are related to immediate, concrete, and prepotent stimuli, and which are largely noncognitive, to fears of late childhood and adolescence which are related to anticipatory, abstract, and more global stimuli and events. Fears of late childhood and adolescence are also more cognitive. One of the prominent themes during these years is social evaluation. It is noteworthy that fears have been demonstrated to be largely transitory in nature, decreasing significantly in number and intensity over time and with maturation. Future research into normal fear should more closely examine the validity of current assessment techniques. There is also a need for research into the developmental correlates of fear, including individual differences and affective environmental experiences. In particular, research examining the correlates of normal fear within a developmental psychopathology framework is recommended.

Surf & Turf: Effects of Ground Substrate on Perceived Threat, Enclosure, and Perceived Walkability

Permeability theory suggests that perceived enclosure should be mitigated by the walkability of the surface underneath a person. This prediction was tested by obtaining ratings of perceived threat, perceived walkability, and perceived enclosure for five types of surfaces: pavement, grass, sand, water, and rocks. There were three experiments, 20 stimuli, and 112 participants. Perceived threat and perceived enclosure were highly correlated, as were perceived walkability and type of surface underfoot. Environments in which the surface underneath were difficult to walk over were perceived as being more enclosing and more threatening than surfaces that were easy to walk over. The findings all supported a priori hypotheses generated from the permeability theory of environmental perception and preference.

Authoritarianism and fear responses to pictures: the role of social differences

Authoritarianism can be defined as the covariation of authoritarian submission, authoritarian aggression, and conventionalism (Altemeyer, 1981). All three of these tendencies involve adherence to specific standards of behavior: standards that could be exposed to threat and disruption. This study is an investigation of the self-reported fear of authoritarians in response to threats. A sample of 126 university students was exposed to a series of pictures of potentially threatening people and situations. In general, participants with high scores on authoritarianism were more fearful than participants with low scores. This result was found for both social threats (i.e., social differences, social disorder) and personal threats (i.e., animals, dangerous situations). The strongest association between authoritarianism and fear involved cases of social differences, defined as elements of a person's appearance or behavior that involve diversity or deviance from common social norms. Regression analyses also indicated that variation in authoritarianism could be best predicted by fear of social differences. Thus, these data suggest that authoritarians are relatively sensitive to threat, and particularly to threats involving the "outsider" who does not fit authoritarian standards of uniformity and order. The data are also consistent with recent research and theory that right-wing ideology is at least partly motivated by threat and fear.

Development and validation of new anxiety and bipolar symptom scales for an expanded version of the IDAS (the IDAS-II)

The original Inventory of Depression and Anxiety Symptoms (IDAS) contains 11 nonoverlapping scales assessing specific depression and anxiety symptoms. In creating the expanded version of the IDAS (the IDAS-II), our goal was to create new scales assessing other important aspects of the anxiety disorders as well as key symptoms of bipolar disorder. Factor analyses of the IDAS-II item pool led to the creation of seven new scales (Traumatic Avoidance, Checking, Ordering, Cleaning, Claustrophobia, Mania, Euphoria) plus an expanded version of Social Anxiety. These scales are internally consistent and show strong convergent and significant discriminant validity in relation to other self-report and interview-based measures of anxiety, depression, and mania. Furthermore, the scales demonstrate substantial criterion and incremental validity in relation to interview-based measures of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) symptoms and disorders. Thus, the expanded IDAS-II now assesses a broad range of depression, anxiety, and bipolar symptoms.

Disgust: the disease-avoidance emotion and its dysfunctions

This review analyses the accumulating evidence from psychological, psychophysiological, neurobiological and cognitive studies suggesting that the disease-avoidance emotion of disgust is a predominant emotion experienced in a number of psychopathologies. Current evidence suggests that disgust is significantly related to small animal phobias (particularly spider phobia), blood-injection-injury phobia and obsessive-compulsive disorder contamination fears, and these are all disorders that have primary disgust elicitors as a significant component of their psychopathology. Disgust propensity and sensitivity are also significantly associated with measures of a number of other psychopathologies, including eating disorders, sexual dysfunctions, hypochondriasis, height phobia, claustrophobia, separation anxiety, agoraphobia and symptoms of schizophrenia--even though many of these psychopathologies do not share the disease-avoidance functionality that characterizes disgust. There is accumulating evidence that disgust does represent an important vulnerability factor for many of these psychopathologies, but when disgust-relevant psychopathologies do meet the criteria required for clinical diagnosis, they are characterized by significant levels of both disgust and fear/anxiety. Finally, it has been argued that disgust may also facilitate anxiety and distress across a broad range of psychopathologies through its involvement in more complex human emotions such as shame and guilt, and through its effect as a negative affect emotion generating threat-interpretation biases.

Development and Initial Validation of the Medical Fear Survey–Short Version

The present investigation employs item response theory (IRT) to develop an abbreviated Medical Fear Survey (MFS). Application of IRT analyses in Study 1 ( n = 931) to the original 50-item MFS resulted in a 25-item shortened version. Examination of the location parameters also resulted in a reduction of the Likert-type scaling of the MFS by removing the last response category (“Terror”). The five subscales of the original MFS were highly correlated with those of the MFS–short version. The short version also displayed comparable convergent and discriminant validity with the original MFS in relation to measures of fear, disgust, and anxiety. Confirmatory factor analysis in Study 2 revealed that the five-factor structure of the MFS–short form fit the data well in U.S. ( n = 283) and Dutch ( n = 258) samples. The short form also had comparable convergent and discriminant validity with the original MFS in relation to domains of disgust in both samples. Receiver operating characteristic (ROC) analysis in Study 3 demonstrated that the subscales of the short version were comparable with the original MFS in classifying participants high ( n = 40) and low ( n = 40) in blood/injection phobia. Last, structural equation modeling in Study 4 ( n = 113) revealed that the MFS–short form demonstrated excellent convergent/discriminant validity with strong associations with injection fear and no association with spider fear. These findings suggest that the MFS–short form has considerable strengths, including decreased assessment time, while retaining sound psychometric properties.

Fear factors: cross validation of specific phobia domains in a community-based sample of African American adults

The current study attempted a cross-validation of specific phobia domains in a community-based sample of African American adults based on a previous model of phobia domains in a college student sample of African Americans. Subjects were 100 African American community-dwelling adults who completed the Fear Survey Schedule-Second Edition (FSS-II). Domains of fear were created using a similar procedure as the original, college sample of African American adults. A model including all of the phobia domains from the FSS-II was initially tested and resulted in poor model fit. Cross-validation was subsequently attempted through examining the original factor pattern of specific phobia domains from the college sample (Chapman, Kertz, Zurlage, & Woodruff-Borden, 2008). Data from the current, community based sample of African American adults provided poor fit to this model. The trimmed model for the current sample included the animal and social anxiety factors as in the original model. The natural environment-type specific phobia factor did not provide adequate fit for the community-based sample of African Americans. Results indicated that although different factor loading patterns of fear may exist among community-based African Americans as compared to African American college students, both animal and social fears are nearly identical in both groups, indicating a possible cultural homogeneity for phobias in African Americans. Potential explanations of these findings and future directions are discussed.

Development and initial validation of an abbreviated Spider Phobia Questionnaire using item response theory

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.

Trait anxiety, disgust sensitivity, and the hierarchic structure of fears

This paper describes an evaluation of Taylor's (1998) hierarchic model of fears and its relationship to trait anxiety and disgust sensitivity (DS). In Study 1 (N=420), a confirmatory factor analysis supported a hierarchic structure of fears. Next, an analysis using structural equation modeling indicated that trait anxiety is associated with claustrophobic and social fears, whereas DS is associated with all four fear subtypes examined (claustrophobic, social, blood-injection-injury and animal). However, trait anxiety and DS did not account for all variance shared by fear subtypes. The addition of a generalized "fear factor" accounted for significant residual shared variance between the four fear subtypes, beyond that accounted for by trait anxiety and DS. Study 2 (N=213) generally replicated these results. Findings suggest that the hierarchic structural model of fears would benefit from inclusion of trait anxiety and DS as higher-order contributors to fearfulness.

The structure of disgust: domain specificity in relation to contamination ideation and excessive washing

The primary goal of the present study was to employ confirmatory factor analysis to compare two theoretical models regarding the factor structure of disgust (N=307). The two-factor model of Animal Reminder and Core disgust proposed by Rozin et al. (2000) demonstrated superior model fit over a one-factor model that has been implicated in prior research. However, contrary to theoretical predictions, categorizing Hygiene disgust as Core disgust rather than Animal Reminder disgust provided an overall better fit for the two-factor model. The second aim of the study was to investigate the relationship between the empirically derived two-factor model and contamination ideation and excessive washing using structural equation modeling. Findings indicated that the Contamination Ideation and Excessive Washing latent factor was specifically related to Core disgust (domain specific) and negatively related to Animal Reminder disgust. The relevance of these findings in the context of future research investigating the role of disgust in specific anxiety disorders is discussed.

Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." There are now sufficient data to eliminate this rational system and replace it with an empirically based structure that reflects the actual similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching class of emotional disorders, which can be decomposed into 3 subclasses: the bipolar disorders (bipolar I, bipolar II, cyclothymia), the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), and the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia). The optimal placement of other syndromes (e.g., obsessive-compulsive disorder) needs to be clarified in future research.

Mind the gap: interhemispheric communication about emotional faces

This study tested the hypothesis that interhemispheric communication about emotional stimuli is influenced by situational factors that alter emotional relevance. Under evaluative or nonevaluative conditions, participants matched angry and happy faces within a single visual field or across opposite visual fields. An overall across-field advantage (AFA) reflected the benefit of sharing information between the hemispheres. The AFA was greater for angry than for happy faces in the evaluation condition but did not differ for angry and happy faces in the no-evaluation condition. Examination of individual differences indicated that high trait evaluation levels of worry were associated with poorer interhemispheric communication of angry faces, supporting a threat-avoidance conception of worry. Thus, both situational factors and individual differences affected interhemispheric communication about emotional faces.

Specific phobia of illness: search for a new subtype

Specific phobia of illness makes its appearance in DSM-IV as a new diagnostic subtype, separate from hypochondriasis. A review of the literature indicates that, while there is some support for this new category, studies have not as yet been done that could provide validation. Illness phobia appears to be a significant problem; it is prevalent in the general population and is associated with distress and impairment, including interference with medical care. It appears to be associated with older age, physical illness, and female gender. Group comparisons are needed showing that persons with this phobia can be distinguished from hypochondriasis on the basis of these and other demographic and illness features. We outline a research agenda for demonstrating this separation.

Normative development of fears in Greece: self-reports on the Hellenic Fear Survey Schedule for Children

This study assessed the psychometric properties of self-reports on the Hellenic Fear Survey Schedule for Children (FSSC-GR), a Greek-language version of Ollendick's FSSC-R [Behav. Res. Ther. 21 (1983) 685-692], and explored the factor structure, intensity, prevalence, and content of fears of Hellenic children aged 7-12 years. Internal consistency and temporal stability assessments of responding on the FSSC-GR were comparable to those obtained on the FSSC-R. A seven-factor solution provided the best conceptual fit for the structure of children's fears in Greece, including five components similar to factors previously obtained for the FSSC-R, plus two unique components, "Travel and Agoraphobic Fears" and "School Performance Fears." Fear intensity and prevalence scores of Hellenic children were higher than scores observed in most countries. Self-reported fear scores were higher for Hellenic girls than for boys. The relation between age and self-reported fears in Greece was complex and interpreted in relation to age-related changes in environmental demands.

Cognitive causes of social phobia: A critical appraisal

This review examined critically studies issuing from the cognitive therapy (CT) model claiming to have unveiled cognitive causal factors of social phobia. Additionally, it examined outcome studies of CT-inspired interventions and other treatments having included measurements of cognitive constructs. Overall, we found no evidence consistently supporting the claim that social phobics are characterized by typical cognitive processes. Moreover, we found neither corroborating evidence for a controlling effect of such cognitive processes on social phobic conduct, nor consistent indications that cognitive therapies or techniques effect cognitive changes differently than other approaches. The evidence suggests rather, that cognitive factors change concurrently with other features of psychopathology as part of an overall improvement during or after effective therapy, regardless of therapeutic approach.

Genetic and environmental causes of the interrelationships between self-reported fears. A study of a non-clinical sample of Norwegian identical twins and their families

The present study reports results from a study of the self-reported fears of identical twins and their spouses and offspring. Factor analysis with oblique rotation of questionnaire responses yielded four correlated fear dimensions: situational fears, illness-injury fears, social fears, and fear of small animals. Models allowing for genetic and cultural transmission, together with specially correlated environments for twins, were fitted, both for separate fears and across fears. Simple models with only genetic and uncorrelated environments were sufficient to account for each the fear dimensions considered separately. The cross-dimensional analyses revealed a genetic and an environmental factor common to the four fear dimensions, together with fear-specific genetic and environmental factors. The impact of the common genetic and common environmental factor varied across dimensions. No evidence of cultural transmission or specially correlated twin environments of the cross-dimensional environments was detected. It is concluded that both common and fear-specific genes and (individual-specific) common and fear-specific environments are necessary to account for the data. The results are discussed in terms of the prepared learning hypothesis and the expectancy bias hypothesis.

Phobic anxiety in 11 nations. Part I: Dimensional constancy of the five-factor model

The Fear Survey Schedule-III (FSS-III) was administered to a total of 5491 students in Australia, East Germany, Great Britain, Greece, Guatemala, Hungary, Italy, Japan, Spain, Sweden, and Venezuela, and submitted to the multiple group method of confirmatory analysis (MGM) in order to determine the cross-national dimensional constancy of the five-factor model of self-assessed fears originally established in Dutch, British, and Canadian samples. The model comprises fears of bodily injury-illness-death, agoraphobic fears, social fears, fears of sexual and aggressive scenes, and harmless animals fears. Close correspondence between the factors was demonstrated across national samples. In each country, the corresponding scales were internally consistent, were intercorrelated at magnitudes comparable to those yielded in the original samples, and yielded (in 93% of the total number of 55 comparisons) sex differences in line with the usual finding (higher scores for females). In each country, the relatively largest sex differences were obtained on harmless animals fears. The organization of self-assessed fears is sufficiently similar across nations to warrant the use of the same weight matrix (scoring key) for the FSS-III in the different countries and to make cross-national comparisons feasible. This opens the way to further studies that attempt to predict (on an a priori basis) cross-national variations in fear levels with dimensions of national cultures.

Fears, phobias, and preparedness: toward an evolved module of fear and fear learning

An evolved module for fear elicitation and fear learning with 4 characteristics is proposed. (a) The fear module is preferentially activated in aversive contexts by stimuli that are fear relevant in an evolutionary perspective. (b) Its activation to such stimuli is automatic. (c) It is relatively impenetrable to cognitive control. (d) It originates in a dedicated neural circuitry, centered on the amygdala. Evidence supporting these propositions is reviewed from conditioning studies, both in humans and in monkeys; illusory correlation studies; studies using unreportable stimuli; and studies from animal neuroscience. The fear module is assumed to mediate an emotional level of fear learning that is relatively independent and dissociable from cognitive learning of stimulus relationships.

Beware and be aware: capture of spatial attention by fear-related stimuli in neglect

Stimuli with threat significance may be privileged in summoning attention, allowing fast detection even outside the field of attention. We studied patients with unilateral neglect and visual extinction, who usually remain unaware of contralesional stimuli presented together with concurrent ipsilesional stimuli, to learn whether emotional stimuli might differentially be affected by contralesional extinction. Pictures of spiders or flowers with similar features were presented in right, left, or both fields. On bilateral trials, the patients detected emotional stimuli (spiders) on the left side much more often than neutral pictures (flowers). While mechanisms of spatial attention are impaired after parietal damage in neglect patients, intact visual pathways to the ventral temporal lobe and amygdala might still mediate distinct mechanisms of emotional attention.

The development of normal fear: a century of research

This paper reviews over a century's research into the developmental patterns of normal fear. Normal fear has been defined as a normal reaction to a real or imagined threat and is considered to be an integral and adaptive aspect of development with the primary function of promoting survival. Across a wide range of methodologies and assessment instruments researchers have been particularly focussed on investigating whether fear content, prevalence and intensity differ depending upon age, gender, socio-economic status, and culture. The structure and continuity of normal fears have also received much attention. The most consistently documented findings include that fear decreases in prevalence and intensity with age and that specific fears are transitory in nature. There are also predictable changes in the content of normal fear over the course of development. Such changes are characterized by a transition from infant fears which are related to immediate, concrete and prepotent stimuli, and which are largely non-cognitive, to fears of late childhood and adolescence which are related to anticipatory, abstract, and more global stimuli and events. Recent research into normal fear has more closely examined the validity of the more frequently used current assessment technique (i.e., the fear survey schedule). This research has provided some encouraging results as well as directions for future investigation.

Illness fears in the general population

OBJECTIVES

Because relatively little is known about illness fears, we sought to estimate the prevalence, risk factors, and morbidity associated with such fears in the community.

METHODS

We conducted a brief telephone survey of persons aged 40 to 65 years from randomly selected households in the Johnson County, Iowa, area. Respondents were asked whether a series of illness and medical care items made them no more nervous, somewhat more nervous, or much more nervous than other people. Those who reported more discomfort were asked to what extent this interfered with medical care or caused impairment or distress. Information about demographic and health characteristics was also obtained.

RESULTS

Five hundred persons, 62% of those contacted, responded to the survey. A factor analysis revealed four fear dimensions: illness/injury, medical care, blood/needle, and aging/death. Five percent of respondents reported much more nervousness in relation to at least four of six illness/injury items, 4% indicated that such fears interfered with their medical care, and 5% reported some negative effect on their life. Similarly, 5% of respondents reported much more nervousness in relation to at least two of four medical care items. Illness/injury fears were somewhat more common in persons with lower income and education and in those with medical conditions.

CONCLUSIONS

This survey shows that fears of illness and medical care are common in the general population and indicates that lower socioeconomic status and experience with illness are associated with these fears. The findings also suggest that interference with care occurs among those with the strongest fears.

Phobic dimensions: IV. The structure of animal fears

Research designed to determine the number and kind of dimensions underlying self-reports of animal fears is relatively rare. To contribute further knowledge to this area of study, Davey's methodology [Davey, G. C. L. (1994a). Self-reported fears to common indigenous animals in an adult UK population: the role of disgust sensitivity. British Journal of Psychology, 85, 541-554.] was improved. Principal components analysis with Varimax rotation of the self-ratings to items of Davey's Animal Fears Questionnaire returned by Ss from a Dutch community sample (N = 214) revealed four reliable, relatively independent dimensions: (1) fear-relevant animals, (2) dry or non-slimy invertebrates, (3) slimy or wet looking animals and (4) farm animals. Replicating Davey (1994a), females, relative to males, reported higher levels on most fear items. Principal components analysis with Oblimin rotation involving animal fears scales (derived from the dimensions identified in the present study), dimensions of non-animal fears, disgust sensitivity, sex-role orientation and the major dimensions of personality from the Eysenckian system revealed 4 higher-order factors, namely specific animals fears, positive affectivity, toughmindedness and negative affectivity. At an even higher level, these 4 higher-order factors merged into two factors: (1) a bipolar positive affectivity versus neuroticism/general emotionality/negative affectivity factor and (2) a toughmindedness dimension. Studies such as these contribute in helping provide the elements of the hierarchical model of fears proposed by Taylor [Taylor, S. (1998). The hierarchic structure of fears. Behaviour Research and Therapy, 36, 205-214.]. Findings across different studies suggest that there are at least 5 first-order dimensions of animal fears, the above 4 and predatory (fierce) animals, that may be included in such a model.

The utility of the Fear Survey Schedule-III: an extended replication

This investigation examined the factor structure of the Fear Survey Schedule-III in patients with specific anxiety disorders, including patients with panic disorder, agoraphobia without panic, generalized anxiety disorder, social phobia, specific phobia, obsessive compulsive disorder, post traumatic stress disorder, and anxiety disorder NOS. Four factors were obtained, reflecting a similar structure as has been noted in other studies. However, the ability of the obtained factors to discriminate among patients with panic disorder, social phobia, and specific phobia was not high. Future directions are highlighted.

The hierarchic structure of fears

Contemporary theories of fears (and phobias) suggest two kinds of etiologic factors; those common to all fears (factors influencing fear-proneness) and factors specific to particular fears (e.g. specific learning experiences). There also may be etiologic factors of intermediate specificity; factors common to some but not all fears. The present article describes this hierarchic model of fears, which proposes that fears (and phobias) arise from a hierarchy of causal factors, ranging from specific to general. The model is supported by factor-analytic studies of fear inventories and behavioural-genetic studies of twins. However, further research is needed to clarify the number of levels, and to identify environmental, psychobiological, and genetic factors at each level of the causal hierarchy. The hierarchic model of fears represents a call for research. It encourages researchers to take a broad view of etiology by considering factors at various levels of causal specificity.

The Blood-Injection Symptom Scale (BISS): assessing a structure of phobic symptoms elicited by blood and injections

Assessments for blood-injury-injection phobia measure feared stimuli and overt behaviours, but they have not systematically addressed the symptoms of fear and faintness. The Blood-Injection Symptom Scale (BISS) was developed to overcome this omission. An exploratory factor analysis grouped symptoms triggered by blood and injections into three internally consistent factors (faintness, anxiety and tension). A confirmatory factor analysis replicated the factor structure in a new sample. To test the construct validity of the BISS, an attempt was made to reproduce Ost's (1992, Journal of Abnormal Psychology, 101, 68-74) finding that fear was stronger among people with concerns about injections, while faintness was stronger among people with concerns about blood. A community sample of 80 individuals with concerns (i.e. fear or fainting) about blood or injections completed the BISS. Controlling faintness, individuals with concerns about injections reported more fear than people with concerns about blood. In contrast, controlling for fear, the latter reported more symptoms of faintness. These data suggest that the BISS generates stable and internally consistent subscales useful in the measurement of symptoms elicited by blood and injections.

The Fear Survey Schedule for Children--II: a psychometric investigation with American data

The Fear Survey Schedule for Children and Adolescents (FSSC-II) was introduced in 1992 as a revised and updated self-report fear scale by the Australian researchers Gullone and King. The present study examines the factor structure as well as age and gender differences using the FSSC-II with an American sample of youth. Two phases of data collection were completed. During phase I (the pilot study), an adapted American version of the FSCC-II was administered to 239 subjects. Following revisions of the adapted FSSC-II, phase II was completed. The second phase of the study involved a sample of 720 children and adolescents ranging from grades 2-12. Results were found to be very similar across the two countries. The FSSC-II factor structure with American youth was found to be almost identical to that reported for Australian youth. Eight of the 10 most common fears were the same across countries. Moreover, age and gender differences consistent with the Australian data were found with females and younger respondents reporting higher levels of fear.

Fear of water in children and adults: etiology and familial effects

Water-fearful children (non-swimmers. 5-8 yrs and adults (non-swimmers or late learners, 23-73 yr) were compared with non-fearful controls of similar swimming ability. Parallel assessments were carried out with children and adults to investigate water-related experiences, water fear and competence in parents and siblings, and the relationship of water fear to other fear dimensions. Children were assessed behaviorally and by self and mother's report, adults by self-report. In neither children nor adults was there clear evidence that fearful and non-fearful groups differed in incidence of aversive water-related experience before fear onset. Parents usually believed that children's fear was present at first contact. In both samples, we found parent-offspring and sibling resemblances in fear. Analysis of details of children's contact with parents suggested that social learning within the family decreased water fear rather than increasing it; when both child and parent showed fear, that was as likely to reflect genetic influences as modeling. Young children's water fear forms part of a generic cluster, fear of the Unknown or Danger, while in adults it becomes independent of generic fears.

Encountering the Dead Body: Experiences of Medical Students in their Anatomy, and Pathology Training

With the aim to deepen the understanding of reactions to procedures involving the dead body, medical students were interviewed after their anatomy and pathology training. The intensity of their reactions was estimated, and their attitudes toward having anatomic dissection, autopsy, and organ taking performed on themselves were explored. In the qualitative analysis, the material was integrated into themes and interpreted in terms of why the students reacted the way they did. Five themes emerged: 1) unlimited empathy, 2) the horrifying dead, 3) contra-instinctivity, 4) the superstructure of reverence, 5) and philosophy of life. They emanate from socio-cultural, psychological, and biological components, intertwined in an intricate interplay. Thus, the students' encounter with a cadaver became loaded because of these deeply rooted emotions. However, some of these reactions are of transient character, fading when more cognitively based processes start working. We must expect that the public's attitudes are influenced by the same components.

Anxiety sensitivity: theoretical perspectives and recent findings

Anxiety sensitivity (AS) is the fear of anxiety-related sensations, which arises from beliefs that these sensations have harmful somatic, psychological or social consequences. According to Reiss (1991), AS is one of three fundamental fears that amplify or cause many common fears. AS also is thought to play an important role in causing panic attacks. The purpose of the present article is to review recent findings concerning the construct of AS and its place in the nomological network outlined by Reiss. Although the weight of evidence supports a unifactorial model of AS, recent findings suggest AS is multifactorial at the level of first-order factors, and these factors load on a single higher-order factor. People with elevated AS, compared to those with low AS, are more likely to have histories of panic attacks. AS is factorially distinct from other fundamental fears, and is more strongly related to agoraphobia than other common fears. AS can be regarded as a subfactor of trait anxiety, and is more strongly related to agoraphobia than other common fears. AS can be regarded as a subfactor of trait anxiety, although the question arises as to whether AS is a cause of trait anxiety. Important questions for further investigation concern the etiology of AS and whether it can be reduced to still more basic fears.

Men are innocent until proven guilty: a comment on the examination of sex differences by Pierce and Kirkpatrick (1992)

Pierce and Kirkpatrick (1992, Behaviour Research and Therapy, 30, 415-418) addressed the finding that men reported lower levels of fear than women in response to specific fear items and concluded on the basis of their experiment that this was because the men were lying. Their conclusion is questioned on various grounds, including inappropriate statistical analyses, inadequate treatment of physiological data, failure to address the possibility of sample selection bias (signalled by the high drop-out rate) and the inadequacy of self-assessed fear measures based on a small number of single items. An alternative interpretation of their data is offered, based on the inverse correlation between initial response level and size of increment, demonstrable in their study in males but not in females. It is argued here that the increments may have been due to anticipatory arousal, a mediating factor that would also account for the facilitation of generalization between certain specific items. It is further suggested that, if this explanation is correct, the men were acting with more rather than less honesty, and it may on the other hand be the reports of the females that were affected by their sex-role stereotype. Another possible explanation of the findings is discussed. If men relatively high in masculinity had a greater tendency to drop out, the experimental sample at the second testing would be biased towards men relatively low in masculinity and reporting higher fear levels.