The looming maladaptive style predicts shared variance in anxiety disorder symptoms: further support for a cognitive model of vulnerability to anxiety

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.

Review: Inflammation and anxiety-based disorders in children and adolescents - a systematic review and meta-analysis

BACKGROUND

Anxiety-based disorders are common and are often chronic with an onset during childhood or adolescence. An emerging literature has examined the role of inflammation in these disorders by measuring blood concentrations of inflammatory markers such as cytokines, C-reactive protein (CRP) and immune markers such as white blood cell counts. However, existing results are inconsistent, with available meta-analyses only including adult populations. We believe this is the first systematic review and meta-analysis to investigate these inconsistencies among the population of children and adolescents.

METHODS

A systematic search of five electronic databases was conducted to identify studies which compared inflammatory markers between individuals with an anxiety-based disorder and healthy controls. Study quality was assessed, and pooled effect sizes (Hedges' g) were calculated using random-effects meta-analyses.

RESULTS

Nine independent studies were identified. The combined meta-analysis of 16 cytokines and CRP was approaching significance; however, no significant between-group difference was observed for meta-analyses of individual inflammatory or immune markers. Heterogeneity was high, and quality assessments identified important limitations; primarily, small sample sizes and a lack of control over confounding variables.

CONCLUSIONS

Although no significant effects were observed, the small number of included studies and limitations in study or reporting quality render these findings provisional. Research in this area has the potential for important clinical implications in relation to therapeutic interventions. Important recommendations for further research are put forth.

Longitudinal associations of radiation risk perceptions and mental health among non-evacuee residents of Fukushima prefecture seven years after the nuclear power plant disaster

We aimed to explore the effects of prolonged radiation risk perceptions on mental health after the Fukushima nuclear power plant accident occurred in 2011. We investigated the longitudinal associations of radiation risk perceptions five years after the accident with psychological distress and posttraumatic stress symptoms two years later among non-evacuee community residents of Fukushima prefecture. A two-wave questionnaire survey was administered for 4,900 randomly sampled residents in 49 municipalities of Fukushima prefecture excluding the evacuation area designated by the Japanese government. Radiation risk perceptions were assessed with a seven-item scale. Psychological distress and posttraumatic stress symptoms were measured by the K6 and the six-item abbreviated version of the Posttraumatic Stress Disorder Checklist-Specific version, respectively. We investigated the associations of radiation risk perceptions in the first survey conducted in 2016 with psychological distress and posttraumatic stress symptoms in the follow-up survey conducted in 2017–18, controlling for the baseline level of distress or symptoms using multivariate logistic regression analyses. Valid responses were obtained from 1,148 residents (23.4%). Higher risk perceptions of radiation exposure in the first survey predicted later posttraumatic stress symptoms but not psychological distress after controlling for baseline symptoms or distress. High risk perceptions of radiation exposure after nuclear power plant accidents can lead to posttraumatic stress symptoms.

•

Radiation anxiety predicted later posttraumatic stress symptoms.

•

Radiation anxiety did not predict later psychological distress.

•

Radiation anxiety affected later mental health status among non-evacuee residents.

Moderator Role of Looming Cognitive Style (LCS) in the Relationship Between Attentional Control and Anxiety: Difference Between Shifting and Focusing Dimensions

Attentional control (AC) that is composed of shifting and focusing dimensions had been suggested as a transdiagnostic risk factor, associated with development and maintenance of various psychological disorders. In comparison, Looming Cognitive Style (LCS) had been documented as a trait-based, disorders-specific characteristic that is linked to high levels of subjectively felt anxiety. The present study investigated whether individual differences in LCS moderated the association of shifting and focusing with anxiety. Participants were 402 individuals between ages 18 and 68 recruited through advertisements posted on various forums, e-mail groups, and social media websites. They filled out questionnaires assessing AC, LCS, anxiety, and depression online. Results of the moderation analyses indicated that at high levels of LCS, low attentional shifting ability was associated with more intense anxiety. A similar relationship with LCS was not observed for focusing. In conclusion, for individuals who have high LCS and low shifting ability, content of and distress coming from looming images is experienced in a more intense manner due to difficulty in shifting to another (perhaps less anxiety provoking) content more flexibly. The findings are providing support for the interactive-synergistic perspective, indicating that deficits in shifting capacity may potentiate negative impact of looming cognitions.

Development of the Interpretation Bias Index for PTSD

Cognitive models of posttraumatic stress disorder (PTSD) implicate interpretation biases as a maintaining factor of symptoms. Existing measures index symptoms and negative beliefs in PTSD patients, but not threatening interpretation of socially-ambiguous information, which would further inform cognitive models of PTSD. Here we describe the development of a measure of interpretation bias specific to individuals with PTSD. Studies 1 and 2 utilized analog samples to identify the smallest set of items capable of differentiating PTSD-specific interpretation biases. Study 3 utilized a clinical sample to examine the factor structure of the 9-item Interpretation Bias Index for PTSD (IBIP). A bifactor model fit the IBIP best, comprising a general PTSD factor and two subfactors. The IBIP was most strongly related to PTSD symptoms and demonstrated sensitivity and specificity to detecting true PTSD cases. The IBIP has potential clinical utility for tracking interpretation bias in PTSD, or even screening for PTSD diagnoses.

The "weakest link" as an indicator of cognitive vulnerability differentially predicts symptom dimensions of anxiety in adolescents in China

This multiwave longitudinal study examined the cognitive vulnerability-stress component of hopelessness theory to differentially predict symptom dimensions of anxiety using a "weakest link" approach in a sample of adolescents from Hunan Province, China. Baseline and 6-month follow-up data were obtained from 553 middle-school students. During an initial assessment, participants completed measures of assessing their weakest links, anxious symptoms, and the occurrence of stress. Participants subsequently completed measures assessing stress, and anxious symptoms one a month for six months. Higher weakest link scores were associated with greater increases in the harm avoidance and separation anxiety/panic dimensions, but not the physical or social anxiety dimension, of anxious symptoms following stress in Chinese adolescents. These results support the applicability of the "weakest link" approach, derived from hopelessness theory, in Chinese adolescents. Weakest link scores as cognitive vulnerability factors may play a role in the development of anxious symptoms, especially in the cognitive dimensions (e.g., harm avoidance and separation anxiety/panic). Our findings also have potential value in explaining the effectiveness of cognitive relevant therapy in treating the cognitive dimensions of anxious symptoms.

Stressful Life Events and Child Anxiety: Examining Parent and Child Mediators

While a number of factors have been linked with excessive anxiety (e.g., parenting, child temperament), the impact of stressful life events remains under-studied. Moreover, much of this literature has examined bivariate associations rather than testing more complex theoretical models. The current study extends the literature on life events and child anxiety by testing a theory-driven meditational model. Specifically, one child factor (child cognitions/locus of control), two parent factors (parent psychopathology and parenting stress), and two parent-child relationship factors (parent-child dysfunctional interaction and parenting style) were examined as mediators in the relationship between stressful life events and severity of child anxiety. One hundred and thirty anxious parents and their nonanxious, high-risk children (ages ranged from 7 to 13 years) participated in this study. Results indicated that levels of parenting stress, parental anxious rearing, and dysfunctional parent-child interaction mediated the association between stressful life events and severity of anxiety symptoms. Child cognition and parent psychopathology factors failed to emerge as mediators. Findings provide support for more complex theoretical models linking life events and child anxiety and suggest potential targets of intervention.

Test of an hypothesized structural model of the relationships between cognitive style and social anxiety: a 12-month prospective study

The aim of this study was to test whether social looming cognitive style accounts for the predictive association between early maladaptive schema domains and social anxiety. We predicted that early maladaptive schema domains would predict the increase of social anxiety over time and that social looming would act as a mediator between schema domains and social anxiety. A three-wave longitudinal design was used. The participants (N=471, 56.95% women) were Spanish adolescents and young adults aged between 16 and 25 years old (Mage=17.81, SD age=3.19). The results showed that three schema domains (impaired autonomy and performance, impaired limits, and other-directedness) predicted the increase in social anxiety and that LCS for social threat acted as a mediator between other-directedness and social anxiety at T3. These results are important to improve the knowledge of the cognitive mechanisms that are involved in the occurrence and development of social anxiety.

Cognitive vulnerability to comorbidity: looming cognitive style and depressive cognitive style as synergistic predictors of anxiety and depression symptoms

BACKGROUND AND OBJECTIVES

Because anxiety and depression are highly comorbid, it is likely that individuals with co-occurring cognitive vulnerabilities to depression and anxiety will experience more severe symptoms of anxiety and depression. However, no study to date has examined the effects of co-occurring (simultaneous) cognitive vulnerabilities to depression and anxiety on the severity of symptoms.

METHOD

The present study examines the co-occurring effects of Alloy and Abramson's (1999) Negative Cognitive Style, a vulnerability to depression, and Riskind's (2000) looming cognitive style, a vulnerability to anxiety.

RESULTS

Results indicated that those with co-occurring vulnerabilities experience a more severe level of anxiety and depression symptoms.

LIMITATIONS

The present study used a measure of symptoms rather than actual clinical diagnoses.

CONCLUSION

These findings address the previously ignored area of cognitive vulnerability to comorbidity. Co-occurring cognitive vulnerabilities to anxiety and depression synergistically confer risk for more severe anxiety and depression symptoms than the individual or additive effects of either vulnerability do alone.

A consideration of select pre-trauma factors as key vulnerabilities in PTSD

Posttraumatic stress disorder (PTSD) is a pathological response to a traumatic event. A number of risk and vulnerability factors predicting PTSD development have been identified in the literature. Many of these variables are specific factors occurring during and after exposure to a traumatic event or are not measured prospectively to assess temporal sequence. Recent research, however, has begun to focus on pre-trauma individual differences that could contribute to risk for developing PTSD. The present review proposes that a number of biological and cognitive vulnerability factors place individuals at risk for PTSD development prior to the actual experience of trauma. Accordingly, this review provides a summary of evidence for a select number of these factors as pre-trauma vulnerabilities to PTSD. Included is a discussion of biological factors, including molecular genetic studies of systems regulating serotonin, catecholamines, and glucocorticoids as well as aspects of the neuroendocrine system. Specific cognitive factors are also considered, including intelligence, neuropsychological functioning and cognitive biases such as negative attributional style and appraisals. For each factor, the present review summarizes evidence to date regarding PTSD vulnerability and highlights directions for future research in this area.

Examination of the convergent validity of looming vulnerability in the anxiety disorders

The looming vulnerability model proposes that individuals with anxiety generate dynamic mental scenarios of threats as intensifying and approaching faster than they can cope or respond. In addition to the looming cognitive style posing a general cognitive vulnerability for anxiety, the looming vulnerability model posits that different anxiety disorders can be distinguished based on the specific content of their looming vulnerability themes. The current study examined whether different anxiety disorders have distinct looming vulnerability content along the lines of disorder-specific themes. A treatment-seeking sample of individuals with DSM-IV anxiety disorders (N=172) completed measures of looming vulnerability prior to treatment initiation. Consistent with the looming vulnerability model, the results indicated that individuals with social phobia, obsessive compulsive disorder, and panic disorder reported significantly greater disorder-specific looming content compared to non-disorder specific looming content. Individuals with generalized anxiety disorder reported the same level of looming social threat as those with social phobia. The results suggest that different anxiety disorders can be distinguished by the specific content of looming vulnerability themes and provide empirical support for the convergent validity of the Looming Vulnerability Scale.

Looming cognitive style and quality of life in a cancer cohort

OBJECTIVE

Looming cognitive styles (LCS) bias the velocity of potential threats and have been implicated in anxiety and depression vulnerability. This study aims to explore their contribution to impaired quality of life (QOL), beyond that of depression and anxiety, in a cancer cohort.

METHOD

In a cross-sectional design, an ambulatory chronic lymphocytic leukemia (CLL) cohort completed a psychological battery that included the Beck Depression and Anxiety Inventories, the SF-36 Health Survey, the Functional Assessment of Chronic Illness Therapy (FACT), the Looming Cognitive Style Questionnaire (LCSQ), and the Looming Cancer measure.

RESULTS

The Looming Cancer measure correlated significantly with overall QOL (FACT-G, p = 0.005). This effect was largely due to the contribution of emotional QOL (Mental Component Score: SF-36, p = 0.001; FACT-emotional, p = 0.001) and functional QOL (FACT-functional, p = 0.001). Looming, unlike anxiety and depression, did not correlate with a worse physical QOL (Physical Component Score: SF-36, FACT-physical). Looming did not impact on social QOL. Hierarchical regression analysis showed that looming predicted 5.4% of the varience on the FACT-emotional, 5.1% on the Mental Component Score (SF-36), and 9.3% on the mental health subscale (SF-36), above and beyond the varience predicted by a constellation of psychosocial factors (including age, marital status, education, income) and the combined effect of depression and anxiety.

SIGNIFICANCE OF RESULTS

LCS predicts worse emotional and functional QOL, above and beyond the contribution of anxiety, depression, and other psycho-social variables. This suggests that it makes a unique contribution to a worse QOL. Nevertheless, the looming construct still remains primarily a research tool in psycho-oncology at this time.

Interoception in anxiety and depression

We review the literature on interoception as it relates to depression and anxiety, with a focus on belief, and alliesthesia. The connection between increased but noisy afferent interoceptive input, self-referential and belief-based states, and top-down modulation of poorly predictive signals is integrated into a neuroanatomical and processing model for depression and anxiety. The advantage of this conceptualization is the ability to specifically examine the interface between basic interoception, self-referential belief-based states, and enhanced top-down modulation to attenuate poor predictability. We conclude that depression and anxiety are not simply interoceptive disorders but are altered interoceptive states as a consequence of noisily amplified self-referential interoceptive predictive belief states.

The effects of social evaluation and looming threat on self-attentional biases and social anxiety

This paper examines how two proposed cognitive vulnerabilities of social anxiety, the fear of negative evaluation, and looming cognitive style may combine with socially demanding situations in predicting social anxiety symptoms and performance deficits. Fifty-two individuals previously identified as possessing these two cognitive vulnerabilities were randomly assigned to conditions in a 2 (high versus low social evaluation)x2 (high versus low temporal looming) experimental design. Significant interaction effects were found for: (a) residual change in anxiety symptoms from baseline level, and (b) performance on a speech task. Specifically, cognitively at-risk individuals exhibited the most increase in anxiety and the most performance deficits in the condition where social evaluation and temporal looming were high. In addition, a mediational effect of illusion of transparency (a form of self-attentional bias) between situational demands and residual change in anxiety was found. Implications arising from these results are discussed.

Cognitive vulnerability to anxiety in the stress generation process: interaction between the Looming Cognitive Style and Anxiety Sensitivity

This study sought to extend the investigation of cognitive-personality vulnerability in the stress generation process to the field of anxiety. We examined two well documented cognitive vulnerabilities to anxiety: the Looming Cognitive Style (LCS) and Anxiety Sensitivity (ASI). Investigating 72 undergraduates who were assessed twice over a 4-month interval, we found support for the hypothesis that the two cognitive vulnerabilities to anxiety augment each other's stress generating effect. Results indicated that combination of LCS and ASI together had a far stronger stress generation effect that would just one factor alone. Each factor was positively associated with Time 2 stressful events under high levels of the other, but not under low levels. Thus findings revealed that the joint combination of the two cognitive vulnerabilities seemed to play a particularly marked role over a 4-month time interval. These findings are important because they are among the first to show stress generation effects for anxiety-related cognitive styles.

The looming maladaptive style in social anxiety

This exploratory study examined the relationship between the looming maladaptive style (i.e., an enduring and traitlike cognitive pattern to appraise threat as rapidly rising in risk, progressively worsening, or actively speeding up and accelerating) and three different aspects of trait social anxiety (i.e., fear of negative evaluation, social interaction anxiety, and public scrutiny fears) as well as general anxiety and depression. A large nonclinical, female-only sample (n=152) completed the Looming Maladaptive Style Questionnaire-II (Riskind, J. H., Williams, N. L., Theodore, L. G., Chrosniak, L. D., & Cortina, J. M. (2000). The looming maladaptive style: Anxiety, danger, and schematic processing. Journal of Personality and Social Psychology, 79, 837-852), which assesses two types of looming vulnerability: social (i.e., looming appraisals in response to potentially threatening social situations) and physical (i.e., looming appraisals in response to potentially threatening physical stimuli). Multiple regression analyses indicated that social looming uniquely predicted fear of negative evaluation, social interaction anxiety, and public scrutiny fears, accounting for 7%, 4%, and 3% of the variance, respectively. However, social looming did not predict depression. These findings support the looming model of anxiety and encourage further attention to the possible role of social looming as an anxiety-specific vulnerability factor in social anxiety.

Understanding animal fears: a comparison of the cognitive vulnerability and harm-looming models

BACKGROUND

The Cognitive Vulnerability Model holds that both clinical and sub-clinical manifestations of animal fears are a result of how an animal is perceived, and can be used to explain both individual differences in fear acquisition and the uneven distribution of fears in the population. This study looked at the association between fear of a number of animals and perceptions of the animals as uncontrollable, unpredictable, dangerous and disgusting. Also assessed were the perceived loomingness, prior familiarity, and negative evaluation of the animals as well as possible conditioning experiences.

METHODS

162 first-year University students rated their fear and perceptions of four high-fear and four low-fear animals.

RESULTS

Perceptions of the animals as dangerous, disgusting and uncontrollable were significantly associated with fear of both high- and low-fear animals while perceptions of unpredictability were significantly associated with fear of high-fear animals. Conditioning experiences were unrelated to fear of any animals. In multiple regression analyses, loomingness did not account for a significant amount of the variance in fear beyond that accounted for by the cognitive vulnerability variables. However, the vulnerability variables accounted for between 20% and 51% of the variance in all animals fears beyond that accounted for by perceptions of the animals as looming. Perceptions of dangerousness, uncontrollability and unpredictability were highly predictive of the uneven distribution of animal fears.

CONCLUSION

This study provides support for the Cognitive Vulnerability Model of the etiology of specific fears and phobias and brings into question the utility of the harm-looming model in explaining animal fear.

The specificity of cognitive vulnerabilities to emotional disorders: anxiety sensitivity, looming vulnerability and explanatory style

Mood and anxiety disorders share considerable phenomenological and diagnostic overlap. Several models have advanced the understanding of the phenomenological overlap of anxiety and depression; however, identification of disorder-specific etiological mechanisms remains elusive. Recently, research has advanced several cognitive vulnerability-stress models proposing that one's characteristic way of attending to, interpreting, and remembering negative events contributes vulnerability to psychopathology. These cognitive vulnerabilities may elucidate specific etiological mechanisms that distinguish mood and anxiety pathology. The present study examines the specificity of three cognitive vulnerability constructs, the looming cognitive style, anxiety sensitivity, and explanatory style, in the prediction of latent anxiety disorder symptoms and latent depression symptoms. Structural equation modeling analyses indicated that the looming cognitive style demonstrated specificity predicting only anxiety disorder symptoms whereas anxiety sensitivity and a pessimistic explanatory style predicted both anxiety disorder and mood disorder symptoms. Implications for future research are discussed.

Short-term predictive effects of the looming cognitive style on anxiety disorder symptoms under restrictive methodological conditions

The looming cognitive style (LCS), an overarching cognitive vulnerability for anxiety syndromes, pertains to a tendency to construct dynamic expectations (mental scenarios, images) of negative events as progressively increasing in danger and rapidly escalating in risk. This study tested the hypothesis that the LCS has functions as a cognitive antecedent and moderator for even short-term changes over a brief time interval in anxiety syndromes (worry, obsessive-compulsive disorder (OCD) symptoms, social anxiety, general anxiety) under restrictive methodological conditions. These included: (a) a one-week interval during which very little changes in anxiety were observed, and (b) controlling for participants' depression and intolerance of uncertainty. As hypothesized by our model, the looming cognitive style predicted short-term changes in worry and OCD symptoms over the week interval, and tended to predict changes in social (audience) anxiety. This style also functioned as a moderator and predicted changes in OCD symptoms among participants already high on this anxiety outcome. Intolerance of uncertainty predicted changes in social (audience) anxiety but not changes in OCD symptoms or worry. These findings support the looming vulnerability theory of anxiety, and encourage further attention into the possible role of the LCS as a cognitive antecedent and moderator of changes in a spectrum of anxiety syndromes.

Interpretation biases in victims and non-victims of interpersonal trauma and their relation to symptom development

Previous studies examining information processing in posttraumatic stress disorder (PTSD) have focused on attention and memory biases, with few studies examining interpretive biases. The majority of these studies have employed lexically based methodologies, rather than examining the processing of visual information. In the present study, victims (N=40) and non-victims (N=41) of interpersonal trauma viewed a series of short positive, neutral, and threatening filmstrips of social situations with ambiguous endings. Participants were then asked about their perceptions and interpretations of the situations. Victims perceived threatening situations as more predictable and more quickly increasing in risk than non-victims. Trauma status interacted with the perceived predictability of positive situations and the perceived speed with which neutral situations reached their conclusion to predict anxious symptoms. In addition, trauma status interacted with the perceived increase in risk of positive situations to predict PTSD symptoms. The implications of these findings for theories of PTSD are discussed.

PERFORMANCE ANXIETY, DYSFUNCTIONAL ATTITUDES AND GENDER IN UNIVERSITY MUSIC STUDENTS

The aims of this study were twofold: 1) to investigate the relationships between anxiety and general dysfunctional attitudes, perfectionism, and the need for approval in the solo performance examination of Turkish university music students, and 2) to examine the effects of perfectionism, need for approval, and gender on anxiety. Fifty-four instrumental music students participated in this study. Research data were collected using the Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988) and the Dysfunctional Attitudes Scale (Weissman & Beck, 1978). The results revealed that there are significant positive correlations between anxiety and total score of dysfunctional attitudes, and the need for approval (p < .05). The ANOVA results also showed that while there was no main effect of perfectionism, need for approval and gender had significant effects (p < .05) on anxiety. However, interaction effects of perfectionism, need for approval, and gender on anxiety were not significant. Results are discussed in the context of related literature.

Looming threat-processing style in a cancer cohort

OBJECTIVE

Looming threat-processing style, where threats are perceived to be progressing (looming) at a frightening velocity, is implicated in anxiety vulnerability. This study aims to validate a new measure of looming, the looming cancer, and explore its clinical correlates in a chronic lymphocytic leukemia (CLL) cohort.

METHODS

In a cross-sectional design, 105 CLL patients completed the Looming Cancer Scale, Looming Cognitive Style Questionnaire (LCSQ), SF-36, Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II).

RESULTS

Exploratory factor analysis reduced the 20-item Looming Cancer Scale to a 10-item version, which demonstrated good psychometric properties (Cronbach's alpha=.926). Convergent validity was demonstrated by Pearson correlation with the LCSQ (0.418), BAI (0.380), BDI-II (0.336) and the mental component score of the SF-36 (-0.434) (all P<.001). Divergent validity was demonstrated by a lack of correlation with the SF-36 physical component score and cross tabulation frequencies of high and low loomers. High vs. low loomers showed significantly more anxiety (31% vs. 13%), depression (23% vs. 2%) and mixed anxiety-depression (18% vs. 2%). An area under the receiver operating characteristic curve analysis revealed high sensitivity (82%) and specificity (69%) in detecting mixed anxiety-depression using a cutoff score of >/=20/30.

CONCLUSIONS

The Looming Cancer Scale is a valid measurement of looming cognitive style and is the first time that the looming construct has been studied in a cancer cohort. The importance of this research lies in its potential to identify populations vulnerable to developing anxiety, depression and mixed anxiety-depression symptoms.

Anticipation of aversive visual stimuli is associated with increased insula activation in anxiety-prone subjects

BACKGROUND

Anticipation is a critical component of affective processing in general and for anxiety in particular. Prior research suggests that the right insula plays an important role in anticipation of affective processing during aversive images. This study aimed to test the hypothesis that individuals with increased anxiety-related temperamental traits (anxiety-prone [AP]) relative to anxiety-normative (AN) subjects would show an exaggerated insula response during anticipation of an aversive image.

METHODS

16 AP and 16 AN individuals performed a task in the functional magnetic resonance imaging scanner, during which they viewed pictures of spiders and snakes. Subjects were prompted 4-6 sec before the onset of each aversive image. Blood oxygenation level-dependent signal was contrasted during cued anticipation of images versus non-anticipatory task performance as well as viewing images.

RESULTS

As hypothesized, AP subjects showed greater response than AN subjects in the bilateral insula during anticipation. In addition, these individuals had lower activity within the superior/medial frontal gyrus. During the image presentation phase, AN subjects showed greater activation than AP subjects in the bilateral temporal lobes and left superior frontal gyrus. Moreover, bilateral temporal lobe activation during image presentation was inversely correlated with bilateral insula activation during anticipation both within groups and in the combined group.

CONCLUSIONS

These data suggest that greater activation of the insula during visual anticipation is associated with visual processing of aversive stimuli in AP individuals. Insula hyperactivity might be a common feature in persons with elevated trait anxiety and, as such, might be a neuroimaging marker for anxiety proneness.

Applying Biological Data in the Forensic and Policy Arenas

Of the biological measures in the field of traumatic stress studies, the script-driven imagery paradigm has yielded the most consistent data. Approximately, two-thirds of individuals with a diagnosis of posttraumatic stress disorder (PTSD) exhibit heightened psychophysiologic reactivity while listening to audiotaped descriptions of their traumatic autobiographical memories. Nevertheless, these findings do not necessarily indicate the presence of PTSD or even that the memories are genuine. For example, people reporting (presumably) false memories of having been abducted by space aliens similarly exhibit heightened reactivity, even though they do not suffer from PTSD. To enhance the validity of diagnostic decision making in the forensic and policy arenas, we can use the methods of historians, specifically, consulting archival records to verify trauma histories and supplement biological data.

Cognitive vulnerability: a model of the etiology of fear

This paper attempts to fill the partial theoretical vacuum surrounding the understanding of fear acquisition. A review of recent and contemporary theories of the etiology of fear is presented, serving as a justification for further theorizing and allowing for greater understanding of those aspects of fear that remain to be adequately explained. A new model of the etiology of specific fears is subsequently put forward and the various aspects and implications of this model are discussed. How an individual perceives a stimulus is proposed as being critical in determining fear in relation to the stimulus. In particular, perceptions of the stimulus as uncontrollable, unpredictable, dangerous and disgusting create a schema of vulnerability. The Cognitive Vulnerability Model integrates much of the extensive body of research on fears and specific phobias into a unifying theory of the etiology of fear. The model offers parsimonious explanations for the various characteristics of specific fears and phobias.