1
|
Kelso KC, Gros DF. Intolerance of uncertainty on distress and impairment: The mediating role of repetitive negative thinking. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2024; 2024. [PMID: 39246301 PMCID: PMC11378962 DOI: 10.1007/s10862-024-10157-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 09/10/2024]
Abstract
Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population.
Collapse
Affiliation(s)
- Kerry C Kelso
- Mental Health Service, Durham Veterans Affairs Healthcare System
| | - Daniel F Gros
- Mental Health Service, Ralph H. Johnson Veterans Affairs Healthcare System, and the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| |
Collapse
|
2
|
Sowan W, Kissane D. Demoralization and well-being among self-employed individuals with cardiac disease: the role of intolerance of uncertainty. Front Psychol 2024; 15:1388032. [PMID: 39021650 PMCID: PMC11253239 DOI: 10.3389/fpsyg.2024.1388032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background Individuals with cardiac disease (CD) who are self-employed may experience ability limitations and especially intensive challenges and uncertainties. These challenges may cause demoralization and impaired well-being. Objectives To examine: (a) whether work ability limitations are related to demoralization and well-being among self-employed people with CD; (b) rates of demoralization; and (c) how demoralization and intolerance of uncertainty (IU) are associated with well-being. Methods The study involved 120 self-employed individuals with CD. The PROCESS macro was used to analyze mediation and moderation processes. Results The prevalence of demoralization syndrome was 37.4%. Work ability-limitations were associated with higher demoralization levels. Demoralization was associated with well-being only among participants with high IU. Further, demoralization mediated the relationship between work ability limitations and well-being only for individuals with high IU. Conclusion Encountering limitations among self-employed was associated with demoralization and lower levels of well-being, especially among those with high IU. In addition, demoralization syndrome is prevalent among individuals with CD in general. Early recognition and treatment of demoralization as a treatable psychological syndrome are essential for preventing its degeneration into more complex forms. In addition to uncertainty related to health, it is important to pay special attention to other sources of uncertainty.
Collapse
Affiliation(s)
- Wafaa Sowan
- School of Social Work, University of Haifa, Haifa, Israel
| | - David Kissane
- Centre for Palliative Care, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
3
|
Grogans SE, Bliss-Moreau E, Buss KA, Clark LA, Fox AS, Keltner D, Cowen AS, Kim JJ, Kragel PA, MacLeod C, Mobbs D, Naragon-Gainey K, Fullana MA, Shackman AJ. The nature and neurobiology of fear and anxiety: State of the science and opportunities for accelerating discovery. Neurosci Biobehav Rev 2023; 151:105237. [PMID: 37209932 PMCID: PMC10330657 DOI: 10.1016/j.neubiorev.2023.105237] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Abstract
Fear and anxiety play a central role in mammalian life, and there is considerable interest in clarifying their nature, identifying their biological underpinnings, and determining their consequences for health and disease. Here we provide a roundtable discussion on the nature and biological bases of fear- and anxiety-related states, traits, and disorders. The discussants include scientists familiar with a wide variety of populations and a broad spectrum of techniques. The goal of the roundtable was to take stock of the state of the science and provide a roadmap to the next generation of fear and anxiety research. Much of the discussion centered on the key challenges facing the field, the most fruitful avenues for future research, and emerging opportunities for accelerating discovery, with implications for scientists, funders, and other stakeholders. Understanding fear and anxiety is a matter of practical importance. Anxiety disorders are a leading burden on public health and existing treatments are far from curative, underscoring the urgency of developing a deeper understanding of the factors governing threat-related emotions.
Collapse
Affiliation(s)
- Shannon E Grogans
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
| | - Eliza Bliss-Moreau
- Department of Psychology, University of California, Davis, CA 95616, USA; California National Primate Research Center, University of California, Davis, CA 95616, USA
| | - Kristin A Buss
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802 USA
| | - Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Andrew S Fox
- Department of Psychology, University of California, Davis, CA 95616, USA; California National Primate Research Center, University of California, Davis, CA 95616, USA
| | - Dacher Keltner
- Department of Psychology, University of California, Berkeley, Berkeley, CA 94720, USA
| | | | - Jeansok J Kim
- Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Philip A Kragel
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Perth, WA 6009, Australia
| | - Dean Mobbs
- Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, California 91125, USA; Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA 91125, USA
| | - Kristin Naragon-Gainey
- School of Psychological Science, University of Western Australia, Perth, WA 6009, Australia
| | - Miquel A Fullana
- Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain; Imaging of Mood, and Anxiety-Related Disorders Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Alexander J Shackman
- Department of Psychology, University of Maryland, College Park, MD 20742, USA; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA; Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA.
| |
Collapse
|
4
|
Altan-Atalay A, Tuncer İ, King N, Önol B, Sözeri Y, Tezel S. Repetitive negative thinking during ambiguous situations: Interactive roles of looming cognitive style and intolerance of uncertainty. J Behav Ther Exp Psychiatry 2023; 79:101840. [PMID: 36805151 DOI: 10.1016/j.jbtep.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 11/16/2022] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Looming cognitive style (LCS) and intolerance of uncertainty (IUC) are both cognitive risk factors that play an important role in development of anxiety disorders. Even though both are known to be triggered by ambiguous situations, there is inadequate research on how they predict anxiety and repetitive negative thinking (RNT) patterns in response to ambiguity. The current study aimed to examine the interactive association of IUC and LCS with state anxiety and intensity of RNT following exposure to a stressor that involves ambiguity. METHODS Data were collected from 292 (153 women) individuals aged between 18 and 63 (M = 20.82, SD = 5.20) who were administered self-report measures of LCS, IUC, and anxiety followed by a vignette describing an ambiguous situation. State RNT and anxiety were assessed following exposure to the vignette. RESULTS The results indicated that IUC moderated the association of physical looming with state RNT. Individuals who have elevated levels of both physical looming and IUC reported experiencing more higher frequency of RNT when compared with other individuals. LIMITATIONS Although the manipulation check has shown that the scenario is effective it was not pilot tested. Also, since the manipulation was conducted online, the manipulation may not have been presented in a standardized way to all the participants. CONCLUSIONS Overall, the study shows that the two risk factors enhance each other's effect and lead to more intense levels of repetitive, uncontrollable, and distressing thoughts following exposure to ambiguity.
Collapse
Affiliation(s)
| | - İrem Tuncer
- Koç University, Department of Psychology, Turkey
| | - Naz King
- Koç University, Department of Psychology, Turkey
| | - Bengü Önol
- Bilgi University, Department of Psychology, Turkey
| | - Yaren Sözeri
- Koç University, Department of Psychology, Turkey
| | - Selin Tezel
- University of Rotterdam, Department of Psychology, the Netherlands
| |
Collapse
|
5
|
Do perfectionists show negative, repetitive thoughts facing uncertain situations? CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04409-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
Abstract
Abstract
Perfectionism, intolerance of uncertainty and repetitive negative thinking are all psychological traits, which are treated as transdiagnostic phenomena for the development and the maintenance of psychopathology. The aim of the current work was to investigate the associations between repetitive negative thinking and the multidimensional aspects of perfectionism (perfectionistic strivings and perfectionistic concerns) and intolerance of uncertainty (prospective and inhibitory) in one model. Two studies were conducted in which participants (N1 = 227; N2 = 148) completed questionnaires in an online survey. The first study measured rumination and worry separately as repetitive negative thinking processes. The second study measured repetitive negative thinking as an underlying construct of rumination and worry using a single questionnaire. We applied hierarchical regression analyses and mediation analyses in both studies. The mediation analyses in both studies showed that inhibitory intolerance of uncertainty significantly partially mediated the relationship between perfectionistic concerns and repetitive negative thinking (as well as worry and rumination). Perfectionistic concerns seem to be the more crucial perfectionism aspect for transdiagnostic considerations, particularly in association with a heighten inhibitory intolerance of uncertainty and repetitive negative thinking. Both studies strongly affirm the necessity to use the multidimensional aspects of perfectionism and intolerance of uncertainty in psychological research.
Collapse
|
6
|
Gökdağ C. The effects of two individual differences in emotional process on psychological problems: The mediating role of emotion dysregulation between emotional reactivity and distress. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.112008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Solé-Padullés C, Cattaneo G, Marchant NL, Cabello-Toscano M, Mulet-Pons L, Solana J, Bargalló N, Tormos JM, Pascual-Leone Á, Bartrés-Faz D. Associations between repetitive negative thinking and resting-state network segregation among healthy middle-aged adults. Front Aging Neurosci 2022; 14:1062887. [PMID: 36589537 PMCID: PMC9797808 DOI: 10.3389/fnagi.2022.1062887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Repetitive Negative Thinking (RNT) includes negative thoughts about the future and past, and is a risk factor for depression and anxiety. Prefrontal and anterior cingulate cortices have been linked to RNT but several regions within large-scale networks are also involved, the efficiency of which depends on their ability to remain segregated. Methods Associations between RNT and system segregation (SyS) of the Anterior Salience Network (ASN), Default Mode Network (DMN) and Executive Control Network (ECN) were explored in healthy middle-aged adults (N = 341), after undergoing resting-state functional magnetic resonance imaging. Regression analyses were conducted with RNT as outcome variable. Explanatory variables were: SyS, depression, emotional stability, cognitive complaints, age and sex. Results Analyses indicated that RNT was associated with depression, emotional stability, cognitive complaints, age and segregation of the left ECN (LECN) and ASN. Further, the ventral DMN (vDMN) presented higher connectivity with the ASN and decreased connectivity with the LECN, as a function of RNT. Conclusion Higher levels of perseverative thinking were related to increased segregation of the LECN and decreased segregation of the ASN. The dissociative connectivity of these networks with the vDMN may partially account for poorer cognitive control and increased self-referential processes characteristic of RNT.
Collapse
Affiliation(s)
- Cristina Solé-Padullés
- Department of Medicine, Faculty of Medicine and Health Sciences; Institute of Neurosciences, University of Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
| | | | - María Cabello-Toscano
- Department of Medicine, Faculty of Medicine and Health Sciences; Institute of Neurosciences, University of Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Lídia Mulet-Pons
- Department of Medicine, Faculty of Medicine and Health Sciences; Institute of Neurosciences, University of Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Javier Solana
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
| | - Álvaro Pascual-Leone
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences; Institute of Neurosciences, University of Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,*Correspondence: David Bartrés-Faz,
| |
Collapse
|
8
|
Vishwanathan A, Kashyap H, Reddy RP, Philip M, Thippeswamy H, Desai G. Neurocognition and Metacognition in Anxiety Disorders. Indian J Psychol Med 2022; 44:558-566. [PMID: 36339691 PMCID: PMC9615456 DOI: 10.1177/02537176211072408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Neurocognitive deficits are noted in anxiety disorders (ADs), albeit with several inconsistencies. The relationship between neurocognition and metacognition may have potential implications for understanding cognitive dysfunction but is poorly understood in ADs. This study aimed to examine the relationship between neurocognition and metacognition in ADs, with a cross-sectional design. Methods The sample included ADs (n = 25) and nonclinical (n = 25) groups matched on age, gender, and education. Neurocognition was assessed using tests for intelligence, attention, working memory, fluency, flexibility, set-shifting, inhibition, planning, and memory; and metacognition using Metacognition Questionnaire-30 (MCQ-30) and Metacognitive Awareness and Regulation Scale (MARS). Results Compared to comparison/normative scores, the anxiety group showed significantly poorer performance on zoo map test (low demand trial; P = 0.007), rule shift cards 1 (P ≤ 0.001), rule shift cards 2 (P ≤ 0.001), and logical memory immediate recall (P ≤ 0.001) and delayed recall (P ≤ 0.001); greater negative beliefs about worry (P = 0.005), and poorer metacognitive awareness and regulation (P = 0.01). Greater cognitive self-consciousness was correlated with better planning (Spearman's rho = -0.509, P = 0.009). Conclusions Individuals with ADs show neurocognitive difficulties in planning, set-shifting, and logical memory, dysfunctional metacognition, and reduced metacognitive awareness and regulation. Cognitive self-consciousness is linked to better planning. The interrelationships between neurocognition and metacognition may have potential implications for clarifying inconsistent findings and designing novel cognitive interventions in ADs.
Collapse
Affiliation(s)
| | - Himani Kashyap
- Dept. of Clinical Psychology, NIMHANS, Bengaluru, Karnataka, India
| | | | - Mariamma Philip
- Dept. of Biostatistics, NIMHANS, Bengaluru, Karnataka, India
| | | | - Geetha Desai
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| |
Collapse
|
9
|
Intolerance of uncertainty as a transdiagnostic vulnerability to anxiety disorders in youth. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
10
|
Always Saying the Wrong Thing: Negative Beliefs About Losing Control Cause Symptoms of Social Anxiety. COGNITIVE THERAPY AND RESEARCH 2022; 46:1137-1149. [PMID: 36117751 PMCID: PMC9469065 DOI: 10.1007/s10608-022-10325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/03/2022]
Abstract
Background Individuals with social anxiety disorder (SAD) often report a fear that they will lose control of their emotions or report intense, unpleasant thoughts or images of uncontrollably humiliating themselves in social situations. These fears and associated beliefs that one is likely to lose control may underlie the anxiety and/or cognitive biases (e.g., self-focused attention and negative post-event processing) experienced during and following social situations. The present experiment examined whether manipulating beliefs about losing control would cause changes in symptoms of SAD. Methods One hundred and twenty-six undergraduate psychology students were given false feedback that they were either at high or low risk of losing control, and then completed a social interaction task with an actor. Participants rated their anxiety before and during the interaction and completed a post-event processing questionnaire 24-hours later. Results Participants in the high beliefs about losing control (HLC) condition reported significantly greater subjective anxiety than those in the low beliefs about losing control (LLC) condition leading up to the social interaction task, and significantly more negative post-event processing. Conclusion Results suggest beliefs about losing control may play a causal role in the development and maintenance of SAD. These beliefs may represent a novel domain to be targeted in CBT. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-022-10325-w.
Collapse
|
11
|
The role of relief, perceived control, and prospective intolerance of uncertainty in excessive avoidance in uncertain-threat environments. Int J Psychophysiol 2022; 179:89-100. [PMID: 35820508 DOI: 10.1016/j.ijpsycho.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/20/2022]
Abstract
Excessive avoidance is a key feature of pathological anxiety. However, the precise mechanisms underlying the development of excessive avoidance are still unknown. In the present study, we tested the hypothesis that excessive avoidance, especially in individuals with high Intolerance of Uncertainty (IU) is aimed at distress reduction via the enhancement of subjective perceived control in uncertain-threat environments. In our experiment, participants learned to avoid an uncertain aversive sound through a discriminated free operant procedure. In a later test phase in extinction, we manipulated the amount of avoidance responses available per trial by creating a limited and an unrestricted response condition. Nonetheless, the aversive sound could be effectively avoided in both conditions. We measured response frequency, avoidance confidence ratings and anxiety-predisposing traits such as intolerance of uncertainty, trait anxiety and distress tolerance. The degree of distress suffered during trials was inferred from post-trial relief ratings that were requested after trials in which the aversive sound had been omitted. In the avoidance acquisition phase, we found a positive association between prospective intolerance of uncertainty (P-IU) and the decline rate of distress. This relationship was not significant, however, when inhibitory intolerance of uncertainty (I-IU) was controlled for. At test, we found that the increase in avoidance responses led to distress reduction through the enhancement of avoidance confidence. Finally, we found a significant modulating role of P-IU in the effect of response limit on distress reduction that lends further support to our hypothesis. Specifically, P-IU was positively associated with the effect of response limit on distress. However, such modulating role was not significant when controlling for trait anxiety or I-IU.
Collapse
|
12
|
Time-Varying and Time-Invariant Dimensions in Intolerance of Uncertainty: Specificity in the Prediction of Obsessive-Compulsive Symptoms. Behav Ther 2022; 53:686-700. [PMID: 35697431 PMCID: PMC9193982 DOI: 10.1016/j.beth.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/18/2022] [Accepted: 01/30/2022] [Indexed: 11/21/2022]
Abstract
Intolerance of uncertainty (IU) is the tendency to respond negatively toward uncertain situations. IU consists of a Prospective factor (desire for predictability) and an Inhibitory factor (uncertainty paralysis) and is central to theoretical approaches to obsessive-compulsive disorder (OCD). However, time-invariant (TI) and time-varying (TV) components of IU and their association with OCD symptoms are not yet understood. The present study examined the association between TI and TV components of IU and OCD symptoms in community adults (N = 1,280) over a 5-month period. Latent variable models were fit to the data to examine the relative impact of TI and TV components of IU on OCD symptoms. As a test of specificity, models examining the association between TI and TV components of IU and depressive symptoms were also examined. The results showed that IU consists of significant TI and TV components, although the TI component accounted for most of the variance (76-84%) and was more strongly associated with OCD and depressive symptoms than the TV component. Furthermore, the TI component of IU was strongly associated with OCD symptoms when controlling for depressive symptoms, and the TI component of IU was strongly associated with depressive symptoms when controlling for OCD symptoms. A consistent pattern was observed for both Prospective and Inhibitory IU factors, with stable TI components demonstrating stronger relations with OCD and depressive symptoms than TV components. These findings have implications for conceptualizing the TI component of IU as a risk for OCD and other emotional disorders.
Collapse
|
13
|
Mansueto G, Marino C, Palmieri S, Offredi A, Sarracino D, Sassaroli S, Ruggiero GM, Spada MM, Caselli G. Difficulties in emotion regulation: The role of repetitive negative thinking and metacognitive beliefs. J Affect Disord 2022; 308:473-483. [PMID: 35460736 DOI: 10.1016/j.jad.2022.04.086] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Using the Self-Regulatory Executive Function model as a basis, this study explored whether, in both general population and clinical samples, metacognitive beliefs and repetitive negative thinking (i.e., rumination and worry) are associated with higher levels of emotion dysregulation. METHODS 395 participants from the general population and 388 outpatients seeking psychological treatment were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, depression, personality disorders were assessed. ANOVA and Welch's tests, correlation and path analyses were run. RESULTS Repetitive negative thinking was found to play a mediating role in the relationship between metacognitive beliefs and emotion dysregulation in both general population and clinical samples. Moreover, metacognitive beliefs were found to be directly associated to emotion dysregulation. LIMITATIONS The cross-sectional design. CONCLUSIONS Emotion dysregulation appears to be associated with the tendency to engage in repetitive negative thinking and metacognitive beliefs. Repetitive negative thinking and metacognitive beliefs could be a suitable therapeutic target to reduce difficulties in emotion regulation.
Collapse
Affiliation(s)
- Giovanni Mansueto
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; Department of Health Sciences, University of Florence, Via di San Salvi 12, 50135 Florence, Italy.
| | - Claudia Marino
- School of Applied Sciences, London South Bank University, 103 Borough Rd, SE1 0AA London, UK; Department of Developmental and Social Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
| | - Sara Palmieri
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; School of Applied Sciences, London South Bank University, 103 Borough Rd, SE1 0AA London, UK; Studi Cognitivi, Cognitive Psychotherapy School and Research Center Milan, Foro Buonaparte 57, 20121 Milan, Italy
| | - Alessia Offredi
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center Milan, Foro Buonaparte 57, 20121 Milan, Italy
| | - Diego Sarracino
- Department of Psychology, University of Milano Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Sandra Sassaroli
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; Studi Cognitivi, Cognitive Psychotherapy School and Research Center Milan, Foro Buonaparte 57, 20121 Milan, Italy
| | - Giovanni Maria Ruggiero
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; Psicoterapia Cognitiva e Ricerca, Cognitive Psychotherapy School and Research Center Milan, Foro Buonaparte 57, 20121 Milan, Italy
| | - Marcantonio M Spada
- School of Applied Sciences, London South Bank University, 103 Borough Rd, SE1 0AA London, UK
| | - Gabriele Caselli
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; Studi Cognitivi, Cognitive Psychotherapy School and Research Center Milan, Foro Buonaparte 57, 20121 Milan, Italy
| |
Collapse
|
14
|
Fear of Sleep Inventory- Short Form (FoSI-SF): A validation study for Turkish speaking populations. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02991-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Kaçar-Başaran S, Arkar H. Common vulnerability factors in obsessive-compulsive and major depressive disorders: a transdiagnostic hierarchical model. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02599-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
16
|
Aadahl V, Wells A, Hallard R, Pratt D. Metacognitive Beliefs and Suicidal Ideation: An Experience Sampling Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312336. [PMID: 34886060 PMCID: PMC8656543 DOI: 10.3390/ijerph182312336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/20/2022]
Abstract
The current study aimed to examine the relationship between metacognitive beliefs about suicidal ideation and the content and process of suicidal ideation. This was to examine the potential contribution of the Self-Regulatory Executive Function (S-REF) model (Wells and Matthew, 2015) to suicidal ideation. Twenty-seven participants completed both trait and state-level measures of suicidal ideation, negative affect, defeat, hopelessness, entrapment and metacognitive beliefs. Experience Sampling Methodology (ESM) was adopted to measure state-level measurements with participants invited to complete an online diary up to seven times a day for six days. Multi-level modelling enabled a detailed examination of the relationships between metacognitive beliefs and suicidal ideation. Positive (β = 0.241, p < 0.001) and negative (β = 0.167, p < 0.001) metacognitive beliefs about suicidal ideation were positively associated with concurrent suicidal ideation even when known cognitive correlates of suicide were controlled for. The results have important clinical implications for the assessment, formulation and treatment of suicidal ideation. Novel meta-cognitive treatments targeting beliefs about suicidal ideation are now indicated. A limited range of characteristics reported by participants affects the generalizability of findings. Future research is recommended to advance understanding of metacognition and suicide but results demonstrate an important contribution of the S-REF model.
Collapse
Affiliation(s)
- Vikki Aadahl
- Centre for New Treatments and Understanding in Mental Health (CeNTrUM), Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (A.W.); (R.H.); (D.P.)
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester M25 3BL, UK
- Correspondence: ; Tel.: +44-0161-716-2777
| | - Adrian Wells
- Centre for New Treatments and Understanding in Mental Health (CeNTrUM), Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (A.W.); (R.H.); (D.P.)
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester M25 3BL, UK
| | - Robert Hallard
- Centre for New Treatments and Understanding in Mental Health (CeNTrUM), Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (A.W.); (R.H.); (D.P.)
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester M25 3BL, UK
| | - Daniel Pratt
- Centre for New Treatments and Understanding in Mental Health (CeNTrUM), Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (A.W.); (R.H.); (D.P.)
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester M25 3BL, UK
| |
Collapse
|
17
|
Mohammadkhani S, Akbari M, West A, Mazloom M, Gezloo F. The Relationship of Metacognition with Worry: The Mediating Role of Emotional Flexibility and Affective Style. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Bongelli R, Canestrari C, Fermani A, Muzi M, Riccioni I, Bertolazzi A, Burro R. Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic-A Multi-Group Path-Analysis. Healthcare (Basel) 2021; 9:1086. [PMID: 34442223 PMCID: PMC8391534 DOI: 10.3390/healthcare9081086] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs' interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks.
Collapse
Affiliation(s)
- Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, 62100 Macerata, Italy;
| | - Carla Canestrari
- Department of Education, Cultural Heritage and Tourism, University of Macerata, 62100 Macerata, Italy; (C.C.); (A.F.); (M.M.); (I.R.)
| | - Alessandra Fermani
- Department of Education, Cultural Heritage and Tourism, University of Macerata, 62100 Macerata, Italy; (C.C.); (A.F.); (M.M.); (I.R.)
| | - Morena Muzi
- Department of Education, Cultural Heritage and Tourism, University of Macerata, 62100 Macerata, Italy; (C.C.); (A.F.); (M.M.); (I.R.)
| | - Ilaria Riccioni
- Department of Education, Cultural Heritage and Tourism, University of Macerata, 62100 Macerata, Italy; (C.C.); (A.F.); (M.M.); (I.R.)
| | - Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, 62100 Macerata, Italy;
| | - Roberto Burro
- Department of Human Sciences, University of Verona, 37129 Verona, Italy;
| |
Collapse
|
19
|
Wahlund T, Hesser H, Perrin S, Johansson S, Huhn V, Sörhus S, Lindskog S, Serlachius E, Hedman-Lagerlöf E, Ljótsson B, Andersson E. Therapist-guided online metacognitive intervention for excessive worry: a randomized controlled trial with mediation analysis. Cogn Behav Ther 2021; 51:21-41. [PMID: 34283004 DOI: 10.1080/16506073.2021.1937695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Previous studies have found an association between excessive worrying and negative beliefs about worry. It is unclear if change in these beliefs mediate worry reduction. This study aimed to examine (1) if a simplified online metacognitive intervention can reduce worry, (2) whether changes in negative beliefs about worry mediate changes in worry severity, and (3) moderated mediation, i.e., if the mediating effect is more pronounced in individuals with a high degree of negative beliefs about worry at baseline. Adult excessive worriers (N = 108) were randomized to 10-weeks of the online metacognitive intervention (MCI) aimed at reducing negative beliefs about worry, or to wait-list (WL). Outcomes, mediation, and moderated mediation were examined via growth curve modelling. Results indicated a significant reduction in the MCI group (d = 1.6). Reductions in negative beliefs about worry and depressive symptoms separately mediated changes in worry severity during the intervention, but in a multivariate test only the former remained significant. Sensitivity analysis indicated that the hypothesized mediation was robust to possible violations of mediator-outcome confounding. The moderated mediation hypothesis was not supported. The results from this randomized trial add to the growing literature suggesting that negative beliefs about worry play a key role in worry-related problems. ClinicalTrials.gov Identifier: NCT03393156.
Collapse
Affiliation(s)
- Tove Wahlund
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Hugo Hesser
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,School of Law, Psychology and Social Work, Center for Health and Medical Psychology, Örebro University, Örebro, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Sanna Johansson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| | - Vilgot Huhn
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| | - Sara Sörhus
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| | - Severin Lindskog
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| | - Eva Serlachius
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| | - Erik Andersson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet
| |
Collapse
|
20
|
The linkage between negative affectivity with emotional distress in college student: The mediator and moderator role of difficulty in emotion regulation, repetitive negative thinking, and emotional invalidation. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01904-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
21
|
Hawes MT, Farrell MR, Cannone JL, Finsaas MC, Olino TM, Klein DN. Early childhood temperament predicts intolerance of uncertainty in adolescence. J Anxiety Disord 2021; 80:102390. [PMID: 33857835 DOI: 10.1016/j.janxdis.2021.102390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/21/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022]
Abstract
Intolerance of uncertainty (IU) is the trait propensity to react negatively to uncertainty. To date, very few studies have explored early childhood predictors of IU. The current study identifies relations between child temperament assessed at age 3 (N = 559) and IU assessed at ages 12 (N = 432) and 15 (N = 415). Temperament was assessed through both laboratory observation (Laboratory Temperament Assessment Battery) and maternal report (Children's Behavior Questionnaire). IU was assessed through both maternal rating and child self-report using the 12-item Intolerance of Uncertainty Scale for Children. Higher levels of temperamental negative emotionality/neuroticism and lower levels of temperamental positive emotionality/extraversion assessed at age 3 predicted higher levels of IU in early-mid adolescence. Unique relationships were found at the trait facet level, and differences were observed between informants. These findings suggest that certain early child temperament traits can serve as markers of risk for difficulty dealing with uncertainty later in life. Future research should explore whether this relationship translates to increased risk for psychopathology.
Collapse
|
22
|
Chen SX, Ng JCK, Hui BPH, Au AKY, Wu WCH, Lam BCP, Mak WWS, Liu JH. Dual impacts of coronavirus anxiety on mental health in 35 societies. Sci Rep 2021; 11:8925. [PMID: 33903603 PMCID: PMC8076265 DOI: 10.1038/s41598-021-87771-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
The spread of coronavirus disease 2019 (COVID-19) has affected both physical health and mental well-being around the world. Stress-related reactions, if prolonged, may result in mental health problems. We examined the consequences of the COVID-19 pandemic on mental health in a multinational study and explored the effects of government responses to the outbreak. We sampled 18,171 community adults from 35 countries/societies, stratified by age, gender, and region of residence. Across the 35 societies, 26.6% of participants reported moderate to extremely severe depression symptoms, 28.2% moderate to extremely severe anxiety symptoms, and 18.3% moderate to extremely severe stress symptoms. Coronavirus anxiety comprises two factors, namely Perceived Vulnerability and Threat Response. After controlling for age, gender, and education level, perceived vulnerability predicted higher levels of negative emotional symptoms and psychological distress, whereas threat response predicted higher levels of self-rated health and subjective well-being. People in societies with more stringent control policies had more threat response and reported better subjective health. Coronavirus anxiety exerts detrimental effects on subjective health and well-being, but also has the adaptive function in mobilizing safety behaviors, providing support for an evolutionary perspective on psychological adaptation.
Collapse
Affiliation(s)
- Sylvia Xiaohua Chen
- The Hong Kong Polytechnic University, Hong Kong, China.
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| | | | | | - Algae K Y Au
- The Hong Kong Polytechnic University, Hong Kong, China
| | - Wesley C H Wu
- The Hong Kong Polytechnic University, Hong Kong, China
| | - Ben C P Lam
- The University of New South Wales, Sydney, Australia
| | | | | |
Collapse
|
23
|
Chen J, Tan Y, Cheng X, Peng Z, Qin C, Zhou X, Lu X, Huang A, Liao X, Tian M, Liang X, Huang C, Zhou J, Xiang B, Liu K, Lei W. Maladaptive metacognitive beliefs mediated the effect of intolerance of uncertainty on depression. Clin Psychol Psychother 2021; 28:1525-1534. [PMID: 33780079 DOI: 10.1002/cpp.2589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 01/20/2023]
Abstract
Both elevated intolerance of uncertainty (IU) and maladaptive metacognitive beliefs (MBs) were associated with depression. However, the relationship between MBs and IU in clinical depression is unclear. The current study aimed to investigate the putative impairment of MBs and IU in major depressive disorder (MDD) and explore the relationship between these two factors with depressive symptoms. Metacognition Questionnaire-30 Items (MCQ-30), Intolerance of Uncertainty Scale-Short Form (IUS-12) and clinical rating scales were administered to 53 patients with MDD and 56 healthy controls (HCs). Stepwise regressions were performed to explore independent contributions of MBs and IU on depression. Mediation analysis was used to examine associations among variables. Patients with MDD reported higher IUS-12 and MCQ-30 scores than HCs. Stepwise regressions revealed a unique contribution of negative MBs concerning the consequences of not controlling thoughts (MCQ-NC) on depression symptoms while controlling the effects of age, gender, anxiety symptoms and IU. MCQ-NC and negative MBs concerning the uncontrollability and danger of negative thinking (MCQ-NEG) completely mediated the effects of IU on depression and anxiety symptoms. Our results provided clear evidence that maladaptive negative MBs are directly associated with depression symptoms, and mediated the effect of IU on depression and anxiety symptoms, suggesting that IU and MBs influence clinical symptoms in a hierarchical manner.
Collapse
Affiliation(s)
- Jing Chen
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Youguo Tan
- Zigong Mental Health Center, Zigong, China
| | - Xiaotong Cheng
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhenlei Peng
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Cheng Qin
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xinyi Zhou
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xingzi Lu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Anqi Huang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaoyuan Liao
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Mingyuan Tian
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xuemei Liang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chaohua Huang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jia Zhou
- School of Humanities and Management Science, Southwest Medical University, Luzhou, China
| | - Bo Xiang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kezhi Liu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wei Lei
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| |
Collapse
|
24
|
Baptista MN, Falcone EMDO, Viegas MP, Oliveira ER, Krieger S, Pereira LB, Alves AJDCP, Peluso ML, Silva FTD. Estrutura Interna da Escala Cognitiva de Ansiedade (ECOGA). PSICO-USF 2020. [DOI: 10.1590/1413/82712020250413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo objetivou investigar evidências de validade de estrutura interna para a Escala Cognitiva de Ansiedade (ECOGA) por análise fatorial exploratória (AFE). A amostra foi formada por 874 participantes, sendo 656 da população geral, 179 de instituições de saúde e 39 de consultórios particulares com hipótese diagnóstica de transtornos de ansiedade. A maioria da amostra foi masculina (55%), solteiros (61,1%) com ensino superior incompleto (46%). A análise paralela da ECOGA, contendo inicialmente 73 itens, demonstrou a existência de até quatro fatores, a MAP com três e a Hull com um. Análises com três e quatro fatores (teoricamente aceitáveis) foram realizadas, utilizando cargas fatoriais acima de 0,40 e 0,50. O modelo teórico e psicométrico mais adequado compreendeu 31 itens e três fatores, com cargas fatoriais mínimas de 0,50. Os índices de ajuste (CFI, GFI, RMSEA) unidimensionalidade (ÚNICO e MIREAL) e confiabilidade (Orion e Cronbach) complementaram as adequadas propriedades psicométricas desta versão.
Collapse
|
25
|
Prospective intolerance of uncertainty is associated with maladaptive temporal distribution of avoidance responses: An extension of Flores, López, Vervliet, and Cobos (2018). J Behav Ther Exp Psychiatry 2020; 68:101527. [PMID: 31743800 DOI: 10.1016/j.jbtep.2019.101527] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/10/2019] [Accepted: 11/06/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Excessive maladaptive avoidance has been claimed to be one of the mechanisms through which intolerance of uncertainty (IU) may play its causal role in the development and maintenance of several anxiety and compulsive disorders. Consistently, Flores et al. (2018) found that individuals with higher Prospective IU (P-IU), a specific IU subfactor, display excessive avoidance response repetitions in a free-operant discriminative task to avoid an aversive noise. In the present study we tested the hypothesis that P-IU not only predicts the amount of avoidance responses but also how well the temporal distribution of such responses fits the temporal distribution of threats. METHODS Further correlation and hierarchical regression analysis of Flores et al.'s (2018) data served to test this hypothesis. We evaluated two aspects of the temporal distribution of responses: a) for how long participants were performing the responses; b) the behavioral discrimination between threatening and safe time periods. RESULTS The results showed that scoring high in P-IU was positively associated with longer periods of time dedicated to avoiding and with worse behavioral discrimination between threatening and safe time periods. Hierarchical regression analyses indicated that later addition of inhibitory intolerance of uncertainty and trait anxiety did not significantly improved the explained variance. LIMITATIONS Our results are exclusively based on the use of a low-cost avoidance response, and the present study does not clarify the precise mechanisms that lead high P-IU people to engage in non-optimal avoidance response distribution through time. CONCLUSIONS These results suggest that excessive avoidance is also driven by uncertainty of threat timing and highlight the relevance of P-IU as a vulnerability factor for excessive and outspread avoidance behaviors.
Collapse
|
26
|
Zuccala M, Menzies RE, Hunt CJ, Abbott MJ. A systematic review of the psychometric properties of death anxiety self-report measures. DEATH STUDIES 2019; 46:257-279. [PMID: 31809665 DOI: 10.1080/07481187.2019.1699203] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Recent research suggests that the transdiagnostic construct of death anxiety may be a basic fear underlying a range of anxiety disorders. Although the investigation of death anxiety in clinical populations is relatively recent, the death anxiety literature as a whole has a longer history evidenced by the number of instruments developed to measure this construct. This systematic review aimed to evaluate the evidence supporting the psychometric properties of self-report death anxiety measures. Relevant studies were identified via a systematic search of four electronic databases in addition to reference list searches. Two independent reviewers evaluated relevant studies using the established Terwee et al. quality appraisal tool. Of the 1831 studies identified, 89 met inclusion criteria. These studies investigated the psychometric properties of 21 self-report scales of death anxiety as well as six subscales. No measure was found to possess evidence of adequacy on all evaluated quality criteria. The Templer Death Anxiety Scale, Concerns about Dying Instrument and Death Concern Scale were found to possess the most evidence supporting their validity and reliability. Overall findings suggest that additional research is needed to establish the psychometric adequacy of death anxiety instruments, especially given increased utilization of these measures in both clinical and research settings.
Collapse
Affiliation(s)
- Matteo Zuccala
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
| | - Rachel E Menzies
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
| | - Caroline J Hunt
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
| | - Maree J Abbott
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
| |
Collapse
|
27
|
Salguero JM, Ramos-Cejudo J, García-Sancho E. Metacognitive Beliefs and Emotional Dysregulation Have a Specific Contribution on Worry and the Emotional Symptoms of Generalized Anxiety Disorder. Int J Cogn Ther 2019. [DOI: 10.1007/s41811-019-00048-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
28
|
Fusar‐Poli P, Solmi M, Brondino N, Davies C, Chae C, Politi P, Borgwardt S, Lawrie SM, Parnas J, McGuire P. Transdiagnostic psychiatry: a systematic review. World Psychiatry 2019; 18:192-207. [PMID: 31059629 PMCID: PMC6502428 DOI: 10.1002/wps.20631] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.
Collapse
Affiliation(s)
- Paolo Fusar‐Poli
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,OASIS Service, South London and Maudsley NHS Foundation TrustLondonUK,Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Neuroscience Department, Psychiatry UnitUniversity of PaduaPaduaItaly
| | - Natascia Brondino
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Cathy Davies
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Chungil Chae
- Applied Cognitive Science Lab, Department of Information Science and TechnologyPennsylvania State University, University ParkPAUSA
| | - Pierluigi Politi
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | | | - Josef Parnas
- Center for Subjectivity ResearchUniversity of CopenhagenCopenhagenDenmark
| | - Philip McGuire
- OASIS Service, South London and Maudsley NHS Foundation TrustLondonUK,Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,National Institute for Health Research Maudsley Biomedical Research CentreSouth London and Maudsley NHS Foundation TrustLondonUK
| |
Collapse
|
29
|
Ranney RM, Behar E, Bartoszek G. Individuals Intolerant of Uncertainty: The Maintenance of Worry and Distress Despite Reduced Uncertainty. Behav Ther 2019; 50:489-503. [PMID: 31030868 DOI: 10.1016/j.beth.2018.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/16/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
The intolerance of uncertainty model of worry posits that individuals worry as a means to cope with the discomfort they feel when outcomes are uncertain, but few experimental studies have investigated the causal relationships between intolerance of uncertainty, situational uncertainty, and state worry. Furthermore, existing studies have failed to control for the likelihood of future negative events occurring, introducing an important rival hypothesis to explain past findings. In the present study, we examined how individuals with high and low trait intolerance of uncertainty differ in their behavioral, cognitive, and emotional reactions to situational uncertainty about an upcoming negative event (watching emotionally upsetting film clips), holding constant the likelihood of that negative event taking place. We found that although individuals high in trait prospective intolerance of uncertainty reported a higher degree of belief that being provided with detailed information about the upcoming stressor would make them feel more at ease, they did not experience an actual decrease in distress or state worry upon being provided with more information, during anticipation of the film clips, or during the film clips themselves. Our results suggest that heightened distress regarding negative events may be more central than intolerance of uncertainty to the maintenance of worry.
Collapse
|
30
|
Does intolerance of uncertainty mediate improvement in anger during group CBT for GAD? A preliminary investigation. Behav Cogn Psychother 2019; 47:585-593. [PMID: 30914070 DOI: 10.1017/s1352465819000249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individuals with generalized anxiety disorder (GAD) have elevated intolerance of uncertainty (IU) and anger, and IU mediates the relationship between GAD symptoms and anger. AIMS The current pilot study examined whether group cognitive behavioural therapy (CBT) improves anger in people with GAD, and the degree to which change in IU mediates improved anger. METHOD Individuals diagnosed with GAD completed measures of worry, IU, and facets of anger, before and at the end of group CBT for GAD. RESULTS Worry, IU, and internally felt and outwardly expressed anger, reduced significantly over treatment, but anger control (inwardly and outwardly) did not. CBT for GAD led to improvement in both internally felt and outwardly expressed anger, even though anger is not directly targeted in this treatment. Improvement in IU significantly mediated improvement in internally felt and outwardly expressed anger. CONCLUSIONS This preliminary study contributes to the literature on the importance of IU in understanding worry and other symptoms such as elevated anger, experienced by people with excessive worry.
Collapse
|
31
|
Lee AH, Woodruff-Borden J. Roles of emotional reactivity, intolerance of uncertainty, and negative problem orientation on developing childhood worry. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.06.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
32
|
Akbari M, Khanipour H. The transdiagnostic model of worry: The mediating role of experiential avoidance. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
33
|
Boelen PA, Lenferink LI. Latent class analysis of indicators of intolerance of uncertainty. Scand J Psychol 2018; 59:243-251. [DOI: 10.1111/sjop.12440] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/09/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Paul A. Boelen
- Department of Clinical Psychology; Faculty of Social Sciences; Utrecht University; Utrecht the Netherlands
- Arq Psychotrauma Expert Group; Diemen the Netherlands
| | - Lonneke I.M. Lenferink
- Department of Clinical Psychology; Faculty of Social Sciences; Utrecht University; Utrecht the Netherlands
- Department of Clinical Psychology and Experimental Psychopathology; Faculty of Behavioral and Social Sciences; University of Groningen; Groningen the Netherlands
| |
Collapse
|
34
|
Pain anxiety differentially mediates the association of pain intensity with function depending on level of intolerance of uncertainty. J Psychiatr Res 2018; 97:30-37. [PMID: 29175295 DOI: 10.1016/j.jpsychires.2017.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/13/2017] [Accepted: 11/10/2017] [Indexed: 01/13/2023]
Abstract
Uncertainty about symptom duration, cause, prognosis and treatment is common in patients who seek medical care, yet individual ability to manage this uncertainty varies. Intolerance of uncertainty is considered an important factor in the etiology and persistence of negative emotions- in particular, depression and anxiety. We explored the contribution of intolerance of uncertainty to anxiety due to pain and physical function in patients seeking care at an orthopedic medical practice. Participants (N = 105, mean age of 51 ± 17, 63% male) were administered PROMIS Physical Function v1.2 Upper Extremity CAT, Numerical Rating Scale (NRS), Pain Anxiety Symptoms Scale-short form (PASS-20), and the Intolerance of Uncertainty Scale-short version (IUS-12). Results showed that the mediating role of pain anxiety is contingent upon the level of intolerance of uncertainty. Specifically, a minimum level of intolerance of uncertainty is required for the development of pain anxiety and its effect on function, and as intolerance of uncertainty rises from low to medium to high levels, the effect of pain on function goes from being independent of the anxiety to being more and more carried by and through anxiety about pain. These findings support the contention that intolerance of uncertainty plays a crucial role in the relationship between pain, pain anxiety, and physical function. Intolerance of uncertainty appears to be a trans-diagnostic target for coping skills training.
Collapse
|
35
|
A longitudinal investigation of perfectionism and repetitive negative thinking in perinatal depression. Behav Res Ther 2017; 97:26-32. [DOI: 10.1016/j.brat.2017.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 05/31/2017] [Accepted: 06/26/2017] [Indexed: 11/17/2022]
|
36
|
Intolerance of uncertainty and adolescent sleep quality: The mediating role of worry. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.12.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
37
|
Ramos-Cejudo J, Salguero JM. Negative metacognitive beliefs moderate the influence of perceived stress and anxiety in long-term anxiety. Psychiatry Res 2017; 250:25-29. [PMID: 28135644 DOI: 10.1016/j.psychres.2017.01.056] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/17/2017] [Accepted: 01/21/2017] [Indexed: 01/20/2023]
Abstract
Metacognitive theory of emotional disorders (Matthews and Wells, 1994; Wells, 2009) suggests that metacognitive beliefs can play a causal role in the development and maintenance of anxiety symptoms. In this prospective study, we examine the relationships between metacognitive beliefs, perceived stress and anxiety in a non-clinical sample. Participants were 135 undergraduate students who completed a battery of questionnaire at two time points (3- months apart). Results revealed metacognitive beliefs do not predict long-term anxiety independently. However, moderation analyses demonstrated negative beliefs about uncontrollability and danger prospectively moderated the relationship between perceived stress and Time 2 anxiety. Negative metacognitive beliefs also interacted with baseline anxiety to predict the change in anxiety symptoms. The results confirm metacognitions play a causal role in anxiety and have implications for cognitive models and the treatment of anxiety.
Collapse
Affiliation(s)
- Juan Ramos-Cejudo
- Dept. Personality, Evaluation, and Psychological Treatment II (Differential Psychology). School of Psychology, Complutense University of Madrid, Madrid, Spain.
| | - J Martín Salguero
- Personality, Evaluation, and Psychological Treatment. School of Psychology, University of Malaga, Malaga, Spain
| |
Collapse
|
38
|
Gavric D, Moscovitch DA, Rowa K, McCabe RE. Post-event processing in social anxiety disorder: Examining the mediating roles of positive metacognitive beliefs and perceptions of performance. Behav Res Ther 2017; 91:1-12. [DOI: 10.1016/j.brat.2017.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/22/2016] [Accepted: 01/03/2017] [Indexed: 11/17/2022]
|
39
|
Sellers R, Varese F, Wells A, Morrison AP. A meta-analysis of metacognitive beliefs as implicated in the self-regulatory executive function model in clinical psychosis. Schizophr Res 2017; 179:75-84. [PMID: 27670237 DOI: 10.1016/j.schres.2016.09.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 09/15/2016] [Accepted: 09/22/2016] [Indexed: 11/17/2022]
Abstract
This meta-analysis investigated whether the five metacognitive beliefs implicated in the Self-Regulatory Executive Function (S-REF) model (Wells and Matthews, 1994; Wells and Matthews, 1996) are elevated in people with clinical psychosis compared to people with emotional disorder and non-psychiatric controls. The review followed guidance set-out in the PRISMA statement. Primary analyses compared summary effect sizes on each sub-scale of the Metacognitions Questionnaire (MCQ) for people with psychosis and non-psychiatric controls; and people with psychosis and people with emotional disorder. Eleven eligible studies were identified comprised of 568 psychosis participants, 212 emotional disorder participants and 776 non-psychiatric controls. Findings indicated that people with psychosis had higher scores on all sub-scales of the MCQ compared to non-psychiatric controls; and higher scores on the positive beliefs about worry sub-scale compared to people with emotional disorder. This suggests metacognitive beliefs may be associated with the presence of psychological disorder and distress in general, rather than specific diagnoses. Implications for models of psychosis and treatment are discussed.
Collapse
Affiliation(s)
- Rachel Sellers
- School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom; Psychosis Research Unit, Greater Manchester West Mental Health Foundation NHS Trust, Bury New Road, Prestwich, Manchester, M25 3BL, United Kingdom.
| | - Filippo Varese
- School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Adrian Wells
- School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Anthony P Morrison
- School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom; Psychosis Research Unit, Greater Manchester West Mental Health Foundation NHS Trust, Bury New Road, Prestwich, Manchester, M25 3BL, United Kingdom
| |
Collapse
|
40
|
Burrows CA, Usher LV, Mundy PC, Henderson HA. The salience of the self: Self-referential processing and internalizing problems in children and adolescents with autism spectrum disorder. Autism Res 2016; 10:949-960. [PMID: 27868365 DOI: 10.1002/aur.1727] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 10/17/2016] [Accepted: 10/22/2016] [Indexed: 12/27/2022]
Abstract
Children and adolescents with autism spectrum disorder (ASD) demonstrate atypical processing of, and memory for, self-referenced information, which may contribute to the heightened rates of co-occurring internalizing problems. We assessed affective and cognitive aspects of self-referential processing in verbally-fluent children with ASD (N = 79), and an age-matched comparison sample (COM, N = 73) of children without an autism diagnosis. We examined group differences in these two aspects of the self-system, and their joint contributions to individual differnces in internalizing problems. Using a self-referenced memory (SRM) task, participants indicated whether a series of positive and negative trait adjectives described themselves and a well-known fictional character. Participants were then surprised with a recognition memory test on the same adjectives. Overall, individuals with ASD showed a reduction in the extent to which they preferentially endorsed positive over negative trait adjectives about themselves, and a reduction in their preferential memory for self- over other-referenced information. Across the full sample, these two aspects of self-referential processing jointly predicted self-reported internalizing problems. Specifically, self-evaluations were strongly and inversely associated with internalizing problems but only for children with relatively high SRM. These findings suggest that the salience of the self influences the extent to which affective self-evaluations impact emotional functioning for youth both with and without ASD. Implications for basic (e.g., developmental) and translational (e.g., intervention) research are discussed. Autism Res 2017, 10: 949-960. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
Collapse
Affiliation(s)
| | - Lauren V Usher
- Department of Psychology, University of Miami, Coral Gables, Florida
| | | | | |
Collapse
|
41
|
Vander Haegen M, Etienne AM. Cognitive processes across anxiety disorders related to intolerance of uncertainty: Clinical review. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1215773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Marie Vander Haegen
- Unit of Health Psychology, Université de Liège, Quartier Village 2, Rue de l’Aunaie 30, Liège 4000, Belgium
| | - Anne-Marie Etienne
- Unit of Health Psychology, Université de Liège, Quartier Village 2, Rue de l’Aunaie 30, Liège 4000, Belgium
| |
Collapse
|
42
|
Carleton RN. Fear of the unknown: One fear to rule them all? J Anxiety Disord 2016; 41:5-21. [PMID: 27067453 DOI: 10.1016/j.janxdis.2016.03.011] [Citation(s) in RCA: 260] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 03/26/2016] [Accepted: 03/26/2016] [Indexed: 12/14/2022]
Abstract
The current review and synthesis was designed to provocatively develop and evaluate the proposition that "fear of the unknown may be a, or possibly the, fundamental fear" (Carleton, 2016) underlying anxiety and therein neuroticism. Identifying fundamental transdiagnostic elements is a priority for clinical theory and practice. Historical criteria for identifying fundamental components of anxiety are described and revised criteria are offered. The revised criteria are based on logical rhetorical arguments using a constituent reductionist postpositivist approach supported by the available empirical data. The revised criteria are then used to assess several fears posited as fundamental, including fear of the unknown. The review and synthesis concludes with brief recommendations for future theoretical discourse as well as clinical and non-clinical research.
Collapse
Affiliation(s)
- R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada.
| |
Collapse
|
43
|
Stomaching uncertainty: Relationships among intolerance of uncertainty, eating disorder pathology, and comorbid emotional symptoms. J Anxiety Disord 2016; 41:88-95. [PMID: 27019977 DOI: 10.1016/j.janxdis.2016.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/23/2016] [Accepted: 03/17/2016] [Indexed: 11/22/2022]
Abstract
Intolerance of uncertainty (IU) is proposed to be a transdiagnostic vulnerability factor for various emotional disorders. There is robust evidence for the role of IU in anxiety and depressive disorders, but a paucity of evidence in eating disorders (ED). This study evaluated the factorial validity, internal consistency, and convergent validity of the Intolerance of Uncertainty Scale-Short Form (IUS-12; Carleton, Norton, & Asmundson, 2007), and examined whether IU is associated with ED pathology and comorbid emotional symptoms, in a clinical sample with EDs (N=134). A unitary factor solution provided the best fit. The IUS-12 showed excellent internal consistency, and good convergent validity. IU had an indirect effect on dietary restraint, purging, and emotional symptoms via overvaluation of eating, weight, and shape. The indirect effect was not significant for bingeing. Findings provide partial support for the notion that IU is a vulnerability factor for ED pathology and support the notion that IU is a transdiagnostic vulnerability factor for emotional symptoms. Limitations, research implications, and future directions for research are discussed.
Collapse
|
44
|
McEvoy PM, Erceg-Hurn DM. The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty. J Anxiety Disord 2016; 41:96-107. [PMID: 26898177 DOI: 10.1016/j.janxdis.2016.02.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 11/20/2022]
Abstract
The search for universal processes associated with symptom change across emotional disorders and different forms of psychotherapy offers hope of increased theoretical parsimony and treatment efficiencies. This study investigated whether intolerance of uncertainty (IU) is a universal process by examining whether changes in IU were associated with changes in symptoms across three different cognitive behavior therapy protocols for depression (n=106), social anxiety disorder (n=88), or generalized anxiety disorder (n=62) in a community mental health clinic. IU was associated with reductions in repetitive negative thinking in all treatments, which is consistent with IU being a transdiagnostic and 'trans-therapy' process of change. Changes in IU were also associated with symptom relief in the social anxiety disorder and generalized anxiety disorder groups, but not in the depression group. Implications of these findings are discussed within the broader literature of transdiagnostic approaches to emotional disorders.
Collapse
Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | | |
Collapse
|
45
|
Michel NM, Rowa K, Young L, McCabe RE. Emotional distress tolerance across anxiety disorders. J Anxiety Disord 2016; 40:94-103. [PMID: 27161839 DOI: 10.1016/j.janxdis.2016.04.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/06/2016] [Accepted: 04/21/2016] [Indexed: 11/28/2022]
Abstract
Emotional distress tolerance (EDT) has increasingly been recognized as a transdiagnostic vulnerability factor. However, research assessing EDT in anxiety disorder populations is lacking. The current study addressed this gap in the literature by examining EDT in a sample of outpatients with panic, social anxiety, generalized anxiety, or obsessive compulsive disorders (n=674), and by assessing its relationship to symptom severity and impairment. Results showed that poor EDT was common across diagnostic groups. However, correlation and regression analyses suggested that although EDT was associated with symptom severity and impairment, it did not account for unique variance in scores beyond the effect of negative affect, stress, intolerance of uncertainty (IU) and anxiety sensitivity (AS). IU and AS had a stronger relationship with overall symptom severity and impairment in the regression models. Together, findings suggest that although EDT may be transdiagnostic, IU and AS are more relevant to our understanding of anxiety disorders.
Collapse
Affiliation(s)
- Natalie M Michel
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare, West 5th Campus, 100 West 5th Street, Hamilton, ON L8 N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
| | - Lisa Young
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare, West 5th Campus, 100 West 5th Street, Hamilton, ON L8 N 3K7, Canada.
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare, West 5th Campus, 100 West 5th Street, Hamilton, ON L8 N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
| |
Collapse
|
46
|
Into the unknown: A review and synthesis of contemporary models involving uncertainty. J Anxiety Disord 2016; 39:30-43. [PMID: 26945765 DOI: 10.1016/j.janxdis.2016.02.007] [Citation(s) in RCA: 468] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 12/15/2022]
Abstract
The current review and synthesis serves to define and contextualize fear of the unknown relative to related constructs, such as intolerance of uncertainty, and contemporary models of emotion, attachment, and neuroticism. The contemporary models appear to share a common core in underscoring the importance of responses to unknowns. A recent surge in published research has explored the transdiagnostic impact of not knowing on anxiety and related pathologies; as such, there appears to be mounting evidence for fear of the unknown as an important core transdiagnostic construct. The result is a robust foundation for transdiagnostic theoretical and empirical explorations into fearing the unknown and intolerance of uncertainty.
Collapse
|
47
|
Clinicians’ attitudes toward video games vary as a function of age, gender and negative beliefs about youth: A sociology of media research approach. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2015.06.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
48
|
McEvoy PM, Erceg-Hurn DM, Anderson RA, Campbell BNC, Nathan PR. Mechanisms of change during group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder. J Anxiety Disord 2015; 35:19-26. [PMID: 26311192 DOI: 10.1016/j.janxdis.2015.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/18/2015] [Accepted: 07/29/2015] [Indexed: 11/15/2022]
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic process that serves to maintain emotional disorders. Metacognitive theory suggests that positive and negative metacognitive beliefs guide the selection of RNT as a coping strategy which, in turn, increases psychological distress. The aim of this study was to test the indirect effect of metacognitive beliefs on psychological distress via RNT. Patients (N=52) with primary and non-primary generalized anxiety disorder attended a brief, six-week group metacognitive therapy program and completed measures of metacognitive beliefs, RNT, and symptoms at the first and final treatment sessions, and at a one-month follow-up. Prospective indirect effects models found that negative metacognitive beliefs (but not positive metacognitive beliefs) had a significant indirect effect on psychological distress via RNT. As predicted by metacognitive theory, targeting negative metacognitions in treatment appears to reduce RNT and, in turn, emotional distress. Further research using alternative measures at multiple time points during therapy is required to determine whether the absence of a relationship with positive metacognitive beliefs in this study was a consequence of (a) psychometric issues, (b) these beliefs only being relevant to a subgroup of patients, or (c) a lack of awareness early in treatment.
Collapse
Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | | | - Rebecca A Anderson
- Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | | | | |
Collapse
|
49
|
Barahmand U, Haji A. The impact of intolerance of uncertainty, worry and irritability on quality of life in persons with epilepsy: Irritability as mediator. Epilepsy Res 2014; 108:1335-44. [DOI: 10.1016/j.eplepsyres.2014.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/06/2014] [Accepted: 07/14/2014] [Indexed: 10/25/2022]
|
50
|
Kuiper NA, Klein D, Vertes J, Maiolino NB. Humor Styles and the Intolerance of Uncertainty Model of Generalized Anxiety. EUROPES JOURNAL OF PSYCHOLOGY 2014. [DOI: 10.5964/ejop.v10i3.752] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Past research suggests that sense of humor may play a role in anxiety. The present study builds upon this work by exploring how individual differences in various humor styles, such as affiliative, self-enhancing, and self-defeating humor, may fit within a contemporary research model of anxiety. In this model, intolerance of uncertainty is a fundamental personality characteristic that heightens excessive worry, thus increasing anxiety. We further propose that greater intolerance of uncertainty may also suppress the use of adaptive humor (affiliate and self-enhancing), and foster the increased use of maladaptive self-defeating humor. Initial correlational analyses provide empirical support for these proposals. In addition, we found that excessive worry and affiliative humor both served as significant mediators. In particular, heightened intolerance of uncertainty lead to both excessive worry and a reduction in affiliative humor use, which, in turn, increased anxiety. We also explored potential humor mediating effects for each of the individual worry content domains in this model. These analyses confirmed the importance of affiliative humor as a mediator for worry pertaining to a wide range of content domains (e.g., relationships, lack of confidence, the future and work). These findings were then discussed in terms of a combined model that considers how humor styles may impact the social sharing of positive and negative emotions.
Collapse
|