Sensitivity to punishment and low maternal care account for the link between bulimic and social anxiety symptomology

Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation

OBJECTIVE

Reinforcement Sensitivity Theory (RST) provides a theoretical foundation associated with various approach and avoidance behaviors and individual personality differences. Sensitivity to reward and punishment, two neural systems within the RST have been significantly associated with bingeing and purging behaviors. However, inconsistent findings are observed and specific factors mediating these relationships are not well understood. Deficits in emotion regulation may account for these relationships, as both negative urgency and distress tolerance have been independently associated with bulimia behaviors. Thus, this is an area that requires further investigation.

METHOD

The current study utilized various self-report inventories, including the Eating Disorder Inventory-3rd Edition to measure bulimia symptoms, as well as measures of negative affect, sensitivity to reward and punishment, distress tolerance, and negative urgency. These measures were used to assess whether distress tolerance and negative urgency mediated associations between sensitivity to reward and punishment and bulimia symptoms in a community sample of 394 young adults ranging from the ages of 18 to 25.

RESULTS

As expected, sensitivity to reward and punishment were significantly associated with decreased distress tolerance. Distress tolerance was also directly associated with greater negative urgency, which was significantly associated with increased bulimia symptoms. Consistent with hypotheses, indirect associations between sensitivity to reward and sensitivity to punishment to bulimia symptoms via distress tolerance and negative urgency were observed, controlling for gender and negative affect.

DISCUSSION

Results contribute to understanding specific contributions of risk factors within the relationship of sensitivity to reward and punishment and bulimia symptoms, measured by the EDI-3. Novel to existing literature, results indicate that reinforcement sensitivity significantly contributes to emotion regulation deficits. Thus, these findings may have important implications for understanding the development and treatment of bulimia symptoms.

LEVEL OF EVIDENCE

Level V, based on descriptive, cross-sectional data.

The Psychometric Properties of the Spanish Reinforcement Sensitivity Theory - Personality Questionnaire (RST-PQ) and its Relationship with Everyday Behaviors

This study aimed to adapt and validate the Spanish version of the Reinforcement Sensitivity Theory-Personality Questionnaire (RST-PQ; Corr & Cooper, 2016) and to demonstrate how RST constructs are associated with a variety of everyday behaviors. To achieve this goal, three studies have been conducted. In Study 1, a direct translation of the items from English to Spanish was pilot-tested in a sample of 139 students and a descriptive analysis of items was conducted. Moreover, a reverse translation and comparison between the two English versions were carried out by the lead author of the original questionnaire and the items were refined accordingly. In Study 2, the questionnaire's internal structure was assessed using exploratory and confirmatory factor analyses and the predictive validity was assessed using the Criterion Set of Act Clusters in a sample of 1,281 participants. Finally, a study of convergent validity with other measures of personality was performed in Study 3 with 190 participants. The obtained results suggested that the RST-PQ has adequate psychometric properties and the convergent validity results with other personality measures replicate findings from previous research. Having a Spanish language version of the RST-PQ is important, not only to advance RST research but also to demonstrate that this theoretical approach contributes to the prediction and explanation of different behaviors whether they are healthy or pathological ones.

Social anxiety and rumination in the context of the revised reinforcement sensitivity theory and the mediation model of social anxiety

The aim of this study was to examine the relationship between temperament, ruminative thought style and social anxiety using latent variable modeling. Before examining the integrated model that specifies the relations between the constructs, relevant measurement issues were examined. The study was conducted on a heterogeneous sample from the general population that included 1,029 participants (62.1% female) aged 19 to 79. The findings show that the Behavioural Inhibition System is the most important vulnerability factor for the development of social anxiety, and it has both a direct effect and an indirect one through the ruminative thought style. Also, Freeze has an additional contribution to the increased experience of social anxiety. The Behavioural Approach System has complex effects on social anxiety ? with a direct protective effect, and indirectly ? with a facilitation of the ruminative thought style. Thus, BAS can also act as a risk factor. The findings support the revised Reinforcement Sensitivity Theory and provide a basis for the extension of the Kimbrel?s Mediation Model of Social Anxiety.

Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model

Reinforcement Sensitivity Theory (RST) posits that individual differences in reward and punishment processing predict differences in cognition, behavior, and psychopathology. We performed a quantitative review of the relationships between reinforcement sensitivity, depression and anxiety, in two separate sets of analyses. First, we reviewed 204 studies that reported either correlations between reinforcement sensitivity and self-reported symptom severity or differences in reinforcement sensitivity between diagnosed and healthy participants, yielding 483 effect sizes. Both depression (Hedges' g = .99) and anxiety (g = 1.21) were found to be high on punishment sensitivity. Reward sensitivity negatively predicted only depressive disorders (g = -.21). More severe clinical states (e.g., acute vs remission) predicted larger effect sizes for depression but not anxiety. Next, we reviewed an additional 39 studies that reported correlations between reinforcement sensitivity and both depression and anxiety, yielding 156 effect sizes. We then performed meta-analytic structural equation modeling to simultaneously estimate all covariances and control for comorbidity. Again we found punishment sensitivity to predict depression (β = .37) and anxiety (β = .35), with reward sensitivity only predicting depression (β = -.07). The transdiagnostic role of punishment sensitivity and the discriminatory role of reward sensitivity support a hierarchical approach to RST and psychopathology.

Negative urgency and reward/punishment sensitivity in intermittent explosive disorder

Intermittent explosive disorder (IED) is the sole psychiatric diagnosis in which affective aggression is the cardinal symptom. Previous research has been equivocal with regard to the relationship between IED and impulsivity. This inconsistency may reflect the varied facets of impulsivity, with some aspects of impulsivity (e.g. negative urgency) as well as some overlapping, albeit distinct constructs (e.g. reward and punishment sensitivity) yet to be studied.

METHODS

The present study compared individuals diagnosed with IED (n=81) with psychiatric controls (PCs; n=52) and healthy volunteers (HVs; n=58) on the impulsivity domains of negative and positive urgency, perseverance, sensation seeking, and premeditation, as well as on reward and punishment sensitivity. We hypothesized that individuals with IED would show greater negative and positive urgency, reward sensitivity, punishment sensitivity, with negative urgency independently predicting IED status. We also hypothesized that negative urgency would predict levels of anger, aggression, and aggression control among those with IED.

RESULTS

The IED participants reported greater negative urgency than both comparison groups, and greater levels of positive urgency, reward sensitivity, and punishment sensitivity compared to HVs. Further, heightened negative urgency was the sole predictor an IED diagnosis. Within the IED group negative urgency uniquely predicted decreased aggression control and increased trait anger.

LIMITATIONS

Limitations included reliance on self-report measures to assess RS/PS, impulsivity, and aggression.

CONCLUSIONS

These findings suggest that negative urgency is a key factor associated with IED and is associated with dampened control of aggression within those with IED.

Reinforcement Sensitivity and Social Anxiety in Combat Veterans

OBJECTIVE

The present study tested the hypothesis that low behavioral approach system (BAS) sensitivity is associated with social anxiety in combat veterans.

METHOD

Self-report measures of reinforcement sensitivity, combat exposure, social interaction anxiety, and social observation anxiety were administered to 197 Iraq/Afghanistan combat veterans.

RESULTS

As expected, combat exposure, behavioral inhibition system (BIS) sensitivity, and fight-flight-freeze system (FFFS) sensitivity were positively associated with both social interaction anxiety and social observation anxiety. In contrast, BAS sensitivity was negatively associated with social interaction anxiety only. An analysis of the BAS subscales revealed that the Reward Responsiveness subscale was the only BAS subscale associated with social interaction anxiety. BAS-Reward Responsiveness was also associated with social observation anxiety.

CONCLUSION

The findings from the present research provide further evidence that low BAS sensitivity may be associated with social anxiety over and above the effects of BIS and FFFS sensitivity.

Handedness and social anxiety: Using Bryden's research as a catalyst to explore the influence of familial sinistrality and degree of handedness

Phil Bryden's work has impacted on many areas of laterality, including degree and measurement of hand preference, as well as influences of familial sinistrality (FS). For example, Bryden[(1977). Measuring handedness with questionnaires. Neuropsychologia, 15, 617-624] is a well-cited and influential paper that remains relevant to this day. Inspired by this we extended our analysis of the relationship between handedness and anxiety in a number of ways. We used familial handedness and strength of handedness to examine their potential influences on anxiety, and extended our research by exploring their relationship to social anxiety, using the Social Phobia Inventory (SPIN). Inconsistent left-handers (ILH) were found to be more socially anxious. In all categories of SPIN except avoidance, ILH were significantly more anxious than consistent right- and left-handers. There were FS differences between ILH with a first degree left-handed relative (FS+) compared to ILH with no first degree left-handed relative (FS-) on all categories of anxiety scores. Within FS+ participants, ILH had significantly higher anxiety scores, compared with consistent handers across all categories. This suggests that ILH's social anxiety may be influenced by a close left-handed relative. Inspired by examining Bryden's work for this special issue, we will continue to add both strength of preference and familial handedness to our work.

Can hoarding be a symptom of social anxiety disorder? A case study

BACKGROUND

Hoarding is defined as the excessive collection and failure to discard possessions of apparently little value, leading to clutter, distress, and disability. Although patients with hoarding typically may feel ludicrous for not discarding useless, and sometimes bizarre, possessions, we are not aware of any previous description of patients displaying hoarding as a result of social anxiety.

METHOD

Single case report.

RESULTS

In this article, we describe a patient with severe social anxiety disorder who displayed hoarding as a direct consequence of social anxiety-related beliefs and atypical safety behaviors.

CONCLUSIONS

This case is of particular interest to current debates concerning the status of hoarding in new versions of classificatory systems. It also indicates that social anxiety disorder should be included in the list of conditions that needs to be excluded in order to diagnose "primary" hoarding disorder.

The interaction between self-regulation and motivation prospectively predicting problem behavior in adolescence

A large literature suggests associations between self-regulation and motivation and adolescent problem behavior; however, this research has mostly pitted these constructs against one another or tested them in isolation. Following recent neural-systems based theories (e.g., Ernst & Fudge, 2009 ), the present study investigated the interactions between self-regulation and approach and avoidance motivation prospectively predicting delinquency and depressive symptoms in early adolescence. The community sample included 387 adolescents aged 11 to 13 years old (55% female; 17% minority). Laboratory tasks were used to assess self-regulation and approach and avoidance motivation, and adolescent self-reports were used to measure depressive symptoms and delinquency. Analyses suggested that low levels of approach motivation were associated with high levels of depressive symptoms, but only at high levels of self-regulation (p = .01). High levels of approach were associated with high levels of rule breaking, but only at low levels of self-regulation (p < .05). These findings support contemporary neural-based systems theories that posit integration of motivational and self-regulatory individual differences via moderational models to understand adolescent problem behavior.

BIS and BAS interact with perceived parental affectionless control to predict personality disorder symptomatology

The objective of this study was to examine if and how two basic dimensions of temperament-behavioral inhibition system (BIS) and behavioral approach system (BAS) sensitivity-might interact with exposure to perceived parental affectionless control (AFC) to predict personality disorder (PD) symptomatology. Measures of BIS, BAS, AFC, and PD symptomatology were administered to a large nonclinical sample (n = 318). As predicted, exposure to AFC was positively associated with PD symptoms in general, BIS was positively associated with Cluster A and C symptoms, and BAS was positively associated with Cluster B symptoms. BIS and BAS were also found to interact with each other to predict Cluster B symptomatology. In addition, BIS, BAS, and maternal AFC interacted to predict Cluster A symptomatology. In the latter case, it was found that individuals who reported high BIS, high BAS, and high maternal AFC reported the highest overall level of Cluster A symptoms.

The role of gender, affectivity and parenting in the course of disordered eating: a 4-year prospective case-control study among adolescents

BACKGROUND

Prolonged eating disturbances increase the risk for a full-blown eating disorder and lifelong health impairment. Screening will improve early detection of eating pathology, but the major question still remains: who will benefit from early treatment and who needs little or no intervention. To answer this question, information about the factors that predict the course of disordered eating is valuable.

OBJECTIVES

To investigate the course of eating disturbance from middle to late adolescence, to test certain individual and parental factors potentially explaining the differences in the course of eating disturbance, and to estimate the predictive power of these factors in terms of the recurrence of eating disturbance and the onset of new presentations of eating pathology after mid-adolescence.

DESIGN

A four-year follow-up study with a case-control design.

SETTINGS

School health care and community settings in south-western Finland.

PARTICIPANTS

Students who had reported eating disturbance at baseline (n=208, response rate 69%) and a group of non-symptomatic controls (n=514, response rate 81%) were enrolled and matched by school, grade, and gender.

METHODS

At baseline assessment, mid-adolescent students (mean age 14.9 years) self-administered the SCOFF eating disorder questionnaire as part of their regular health examination. Background information, including self-reported mood questionnaire RBDI, was obtained from the students' health care records. Four years later, the participants (mean age 19.0 years) responded to the questionnaire by mail. Logistic regression analyses were used to assess the recurrence and onset of eating disturbance and the associated factors.

RESULTS

Altogether 52% of girls and 17% of boys who reported eating disorder symptoms in the baseline assessment remained symptomatic at follow-up. Depressiveness--even transient--in mid-adolescence predicted recurrence of eating disturbance in late adolescence. Prolonged dissatisfaction with appearance predicted the onset of eating disturbance in previously symptom-free girls. In general, experience of average parenting was good enough for the girls in terms of recovering from eating disturbance and avoiding the onset of eating problems after mid-adolescence.

CONCLUSIONS

Adolescent girls who report both eating disturbance and negative affectivity may benefit from extra support. The beneficial role that parents may have in helping these girls must not be forgotten.

An examination of the relationship between behavioral approach system (BAS) sensitivity and social interaction anxiety

BACKGROUND

Both behavioral inhibition system (BIS) and behavioral approach system (BAS) sensitivity have been proposed to play a role in social anxiety; however, findings concerning the relationship between BAS and social anxiety have been mixed. Moreover, recent evidence suggests that low levels of BAS may only be associated with the social interaction subdimension of social anxiety.

METHOD

Measures of BIS, BAS, social interaction anxiety, and social observation anxiety were administered to three large analogue samples.

RESULTS

As hypothesized, BAS was inversely related to social interaction anxiety, but was unrelated to social observation anxiety across all three samples. In addition, individuals with generalized social fears were found to report both higher levels of BIS and lower levels of BAS compared to individuals with few or specific social fears.

CONCLUSION

These findings suggest that a complete motivational account of generalized social anxiety should include both BIS and BAS.

Anxiety in mice and men: a comparison

Anxiety is one of the most fundamental emotions required to survive or to cope with potential threatening stimuli. Under certain circumstances, it can change to excessive or maladaptive response and might manifest in anxious personality or even anxiety disorders. Genetic studies provide a number of promising candidate genes that, however, account for only a few percent of the phenotypic variance. Social and material environmental effects such as stressful life events, drugs or chemicals and particular behavioural influences such as parental care are suggested to interact with gene effects presumably involving epigenetic processes. Such interaction probably modifies an individual's predisposition, personality and susceptibility to develop normal or low anxiety or even maladaptive or excessive anxiety. Since human anxiety involves complex emotions as well as cognitions, unique experiences and an individual genetic make-up, studies trying to clarify the complex and functionally interwoven pathogenesis of anxious personality or anxiety disorders often adopt a reductionistic, simplifying approach. Therein, mice constitute an invaluable tool for modelling human anxiety in its various forms as they display remarkable similarities on anatomical, physiological, biochemical, molecular and behavioural levels. This review aims to fit observations and results obtained from men and mice on behavioural, genetic and environmental levels in response to different threatening stimuli elucidating different genetic and epigenetic effects.