Establishing a trait anxiety threshold that signals likelihood of anxiety disorders

Psychometric properties of the PSWQ in a sample of pregnant and postpartum women

BACKGROUND

Generalized anxiety disorder (GAD)-characterised by excessive and uncontrollable worry-is the most frequently diagnosed anxiety disorder during pregnancy and the postpartum period. Identification of GAD often relies on assessment of its cardinal feature, pathological worry. The Penn State Worry Questionnaire (PSWQ) is the most robust measure of pathological worry to date but has not been extensively evaluated for use during pregnancy and the postpartum period. This study evaluated the internal consistency, construct validity, and diagnostic accuracy of the PSWQ in a sample of pregnant and postpartum women with and without a principal GAD diagnosis.

METHODS

One hundred forty-two pregnant and 209 postpartum women participated in this study. Sixty-nine pregnant and 129 postpartum participants met criteria for a principal diagnosis of GAD.

RESULTS

The PSWQ demonstrated good internal consistency and converged with measures assessing similar constructs. Pregnant participants with principal GAD scored significantly higher on the PSWQ than those with no psychopathology and postpartum participants with principal GAD scored significantly higher than those with principal mood disorders, other anxiety and related disorders, and no psychopathology. A cut-off score of 55 and 61 or greater was determined for detecting probable GAD during pregnancy and the postpartum period, respectively. Screening accuracy of the PSWQ was also demonstrated.

CONCLUSIONS

This study underscores the robustness of the PSWQ as a measure of pathological worry and probable GAD and supports its use in the detection and monitoring of clinically significant worry symptoms during pregnancy and postpartum period.

No association between error-related ERPs and trait anxiety in a nonclinical sample: Convergence across analytical methods including mass-univariate statistics

Enhanced error monitoring, as indexed by increased amplitude of the error-related negativity (ERN) event-related potential (ERP) component, has been suggested to reflect a vulnerability neuro-marker of anxiety disorders. Another error-related ERP component is the error positivity (Pe), which reflects late-stage error processing. The associations between heightened ERN and Pe amplitudes and anxiety levels in the nonclinical population have been inconsistent. In this preregistered study, we examined the association between anxiety, ERN, and Pe, using different analytical methods (mass-univariate analyses, MUAs and conventional analyses), self-reported anxiety scales (STAI and STICSA), and trial numbers (all correct trials and equal numbers of correct and error trials). In a sample of 82 healthy adults, both conventional and MUAs demonstrated a robust enhancement of the ERN and Pe to errors relative to the correct-response ERPs. However, the mass-univariate approach additionally unveiled a wider array of electrodes and a longer effect duration for this error enhancement. Across the analytic methods, the results showed a lack of consistent correlation between trait anxiety and error-related ERPs. Findings were not modulated by trial numbers, analyses, or anxiety scales. The present results suggest a lack of enhancement of error monitoring by anxious traits in individuals with subclinical anxiety and those with clinical anxiety but without a clinical diagnosis. Importantly, the absence of such correlation questions the validity of the ERN as a neural marker for anxiety disorders. Future studies that investigate neuro-markers of anxiety may explore alternative task designs and employ robust statistics to provide a more comprehensive understanding of anxiety vulnerability.

Gastrointestinal distress, State and Trait anxiety, and dietary intake among college students during the COVID-19 pandemic

OBJECTIVE

This study examined the impact of State and Trait anxiety and dietary intake on college students' gastrointestinal symptoms during the COVID-19 pandemic.

PARTICIPANTS

A total of 455 students, aged 18-23, from two residential colleges in the midwestern United States participated in the study during April 2021.

METHODS

An online questionnaire that included the National Cancer Institute Dietary Screener, State-Trait Inventory for Cognitive and Somatic Anxiety, and an adapted version of the Gastrointestinal Symptoms Questionnaire was used. Stepwise multiple regression analyses and Spearman rho correlation coefficients were used to analyze the data.

RESULTS

High rates of State-somatic, State-cognitive, and Trait-somatic anxiety were present in our study population. These anxiety subscales and dietary intake predicted 26% and 3.8% of the GI symptoms variance, respectively.

CONCLUSION

State-anxiety and Trait-somatic anxiety are large factors in predicting GI symptoms compared to dietary intake. College students could seek anxiety-reducing techniques to ease GI symptoms.

The Worry Behaviors Inventory-Perinatal Revised: Adaptation and Initial Validation for Use in Perinatal Samples

Generalized anxiety disorder (GAD) is a leading mental health concern during pregnancy and the postpartum (perinatal) period. People with GAD engage in problematic behaviors to manage their distress. However, the extent of GAD behaviors during the perinatal period may not be adequately captured by the Worry Behaviors Inventory (WBI), the most comprehensive measure of GAD behaviors to date. We evaluated the structure of the initial WBI item-pool and then evaluated the internal consistency, construct validity, and predictive utility of the Perinatal Revised WBI (WBI-PR) in a sample of 214 perinatal women with and without GAD. A two-factor, 10-item scale was supported, and some of the retained items differed from the original WBI. Internal consistency of the WBI-PR was acceptable, and evidence of construct validity was demonstrated. The WBI-PR predicted GAD diagnostic status both alone and beyond existing generalized anxiety and depression symptoms. Implications of these findings are discussed.

Visually assessing work performance using a smartwatch via day-to-day fluctuations in heart rate variability

Objective

To optimize workplace health promotion, a simple method for quantifying allostatic load response is needed. This study examines the feasibility of optimizing objective anxiety and presenteeism monitoring using daily smartwatch-measured ultra-short heart rate variability (HRV).

Methods

Office workers without diagnosed disease prospectively performed 30 s HRV self-measurement each morning for two months and responded to the State-Trait Anxiety Inventory (STAI) and Work Limitation Questionnaire (WLQ). Logistic regression analysis examined daily HRV parameters in the high-trait anxiety group (HTA, STAI ≥ 40) using mean and variance HRV, age, self-reported gender, and body mass index (BMI). The ideal cutoff value enabled comparison of WLQ using the Mann-Whitney U test. Heart rate variability data were collected for 279 participants (male ratio, 83.9%; age, 42 ± 10 years) who completed questionnaires and monitored HRV for 30+ days.

Results

Compared to the low-trait anxiety group, HTA exhibited higher variance of the log-transformed coefficient of component variance of high-frequency component (LnccvHF) and low-frequency per HF (Lnccv L/H), in addition to differences in the means of these HRV parameters. In addition to BMI (odds ratio [OR] = 0.92, p = 0.02) and mean LnccvL/H (OR = 10.75, p < 0.01), the variance of Lnccv L/H was an independent predictor of HTA (OR = 2.39E + 8, p = 0.011). The daily Lnccv L/H dispersion group had a lower WLQ productivity loss score (p = 0.02, r = 0.17).

Conclusions

By focusing on HRV dispersion status, this simple and instantly applicable daily HRV monitoring system enables optimized quantitative monitoring of anxiety and productivity.

Specific topics, specific symptoms: linking the content of recurrent involuntary memories to mental health using computational text analysis

Researchers debate whether recurrent involuntary autobiographical memories (IAMs; memories of one's personal past retrieved unintentionally and repetitively) are pathological or ordinary. While some argue that these memories contribute to clinical disorders, recurrent IAMs are also common in everyday life. Here, we examined how the content of recurrent IAMs might distinguish between those that are maladaptive (related to worse mental health) versus benign (unrelated to mental health). Over two years, 6187 undergraduates completed online surveys about recurrent IAMs; those who experienced recurrent IAMs within the past year were asked to describe their memories, resulting in 3624 text descriptions. Using a previously validated computational approach (structural topic modeling), we identified coherent topics (e.g., "Conversations", "Experiences with family members") in recurrent IAMs. Specific topics (e.g., "Negative past relationships", "Abuse and trauma") were uniquely related to symptoms of mental health disorders (e.g., depression, PTSD), above and beyond the self-reported valence of these memories. Importantly, we also found that content in recurrent IAMs was distinct across symptom types (e.g., "Communication and miscommunication" was related to social anxiety, but not symptoms of other disorders), suggesting that while negative recurrent IAMs are transdiagnostic, their content remains unique across different types of mental health concerns. Our work shows that topics in recurrent IAMs-and their links to mental health-are identifiable, distinguishable, and quantifiable.

Mind wandering in anxiety disorders: A status report

Many investigations have targeted the subject of worry in anxiety disorders. Worry can be regarded as a subtype of mind wandering (MW), which is undeliberate, perseverative, negatively-valenced, and mainly future-oriented. Nevertheless, until now only a few studies have explored the role of overall MW in the origin and course of anxiety disorders. To foster progress in this field, we briefly describe and discuss relevant studies addressing MW in subjects with anxiety disorders or symptoms or disorders associated with anxiety symptoms. Provisional synthesis suggests that: a) the overall amount of MW is positively correlated with anxiety symptoms; b) MW characteristics reflecting worry and rumination appear to be relevant in anxiety; c) comorbid depressive and ADHD symptoms may contribute to excessive MW in anxiety; d) MW-related therapeutic interventions may be useful as complementary treatments in anxiety disorders. However, more studies related to MW in anxiety disorders or symptoms are necessary to corroborate and extend these initial findings. Such investigations should ideally combine experience sampling with self-rating assessments of both MW and worry/rumination.

Anxiety is not the right choice! Individual differences in trait anxiety modulate biases in pseudoneglect

Pseudoneglect, the tendency to display a leftward perceptual bias, is consistently observed in line bisection tasks. Some studies have shown that pseudoneglect is sensitive to emotions. This emotion-related modulation is likely related to valence-dependent hemispheric lateralization, although the results do not converge. A possible explanation for these inconsistencies could be individual differences in emotional tone. Considering that negative and positive emotions produce different basic activations of the two hemispheres, emotional characteristics of the subjects, such as trait anxiety, could in fact modulate the pseudoneglect phenomenon. To verify this, high- and low-anxiety participants were asked to centrally bisect horizontal lines delimited by neutral or emotional (happy and sad) faces. In line with previous studies, results here showed a decrease in the leftward bisection error in the presence of happy faces, indicating a greater involvement of the left hemisphere in processing positive emotional stimuli. In addition, trait anxiety influenced the magnitude of the visual bias. High-anxiety subjects, compared to low-anxiety subjects, showed a general bias in visual attention toward the left space as a function of emotional valence. Results are discussed within the framework of valence-dependent hemispheric specialization and the relative degree of activation. In sum, our data highlight the relevance of considering emotional individual differences in studying the pseudoneglect phenomenon.

Psychometric properties of the difficulties in emotion regulation Scale in a perinatal sample

BACKGROUND

One in five pregnant and postpartum individuals experience an anxiety, depressive, and/or trauma-related disorder. Emotion dysregulation (ED) underlies the development and maintenance of various mental health disorders. The Difficulties in Emotion Regulation Scale (DERS) is the most comprehensive and commonly used measure of emotion dysregulation, yet limited evidence supports its use in the perinatal population. The present study aims to evaluate the validity of the DERS and its six subscales in a perinatal sample and to assess its predictive utility in identifying perinatal individuals with a disorder characterised by emotion dysregulation.

METHODS

Pregnant and postpartum individuals (N = 237) completed a diagnostic clinical interview and self-report measures of anxiety, depression, and perceived social support.

RESULTS

The DERS subscales demonstrated good internal consistency and construct validity, as it strongly correlated with measures of anxiety and depression and failed to correlate with a measure of perceived social support. Results from an exploratory factor analysis supported a 6-factor solution, suggesting structural validity. An ROC analysis revealed good to excellent discriminative ability for the DERS full scale and four of the subscales. Finally, an optimal clinical cut-off score of 87 or greater was established with a sensitivity of 81% for detecting a current anxiety, depressive, and/or trauma-related disorder.

CONCLUSIONS

This study provides evidence for the validity and clinical utility of the DERS in a treatment-seeking and community sample of pregnant and postpartum individuals.

Mass Shootings Anxiety Scale: A preliminary psychometric study

Mass shootings have caused many to feel anxious and afraid of this seemingly common event. Therefore, the objective of this study was to develop and evaluate the properties of the Mass Shootings Anxiety Scale (MSAS), which is a five-item scale that was based on 759 adults. The MSAS demonstrated solid reliability (α and ω of 0.93), factorial validity (PCA and CFA support), and convergent validity (e.g., correlations with functional impairment and drug/alcohol coping). The MSAS also measures anxiety equivalently across gender, political orientation, and gun violence exposure groups. The MSAS not only discriminates well between persons with and without dysfunctional anxiety, using a cut score of ≥10 (92% sensitivity and 89% specificity), but also demonstrates incremental validity by explaining 5% to 16% additional variance in important outcomes beyond sociodemographics and posttraumatic stress. These preliminary results support the MSAS as a valid screening tool for clinical practice and scholarly inquiry.

Brazilian Adaptation of the Coronavirus Anxiety Scale: A Psychometric Investigation of a Measure of Coronaphobia

This study examined the psychometric properties of a Brazilian adapted version of the Coronavirus Anxiety Scale (CAS-BR) in a sample of adults in Brazil. Confirmatory factor analyses demonstrated that the CAS-BR produces a reliable (α = .84), unidimensional construct whose structure was shown to be invariant across gender, race, and age. However, some items of the CAS-BR were stronger indicators of the coronavirus anxiety construct for women and younger adults. Although the CAS-BR demonstrated evidence of discrimination ability for functional impairment (AUC = .77), Youden indexes were low to identify a clinical cut-score. Construct validity was demonstrated with correlations between CAS-BR scores and measures of functional impairment, generalized anxiety, and depression. Exploratory analyses revealed that CAS-BR total scores were higher among women and participants with a history of anxiety disorder. These findings are consistent with previous investigations and support the validity of CAS-BR for measuring coronavirus anxiety with Brazilian adults.

Specific Pandemic-Related Worries Predict Higher Attention-Related Errors and Negative Affect Independent of Trait Anxiety in UK-Based Students

Background

The COVID-19 pandemic has resulted in many individuals experiencing increased symptoms of anxiety. We predict that this increase may be underpinned by pandemic-related worry (PRW), characterised by repetitive negative thinking about pandemic-specific outcomes; and that this relationship is mediated through reduced attentional capacity required to regulate negative affect.

Methods

We developed a novel scale to measure the contents of PRW in an initial sample of 255 participants, and explored its relationship with cognitive functioning and negative affect in a sample of 382 UK-based university students, whilst controlling for recalled pre-pandemic trait anxiety.

Results

A five-factor model of PRW was identified, with factors reflecting worry about decline in quality of life (QoL) and probability of infection correlating with attention and memory-related errors. Importantly, attention-related errors partially mediated the positive relationship between PRW and negative affect, even when controlling for pre-pandemic trait anxiety.

Conclusion

PRW's relationship with negative affect was partially mediated through attentional function, consistent with models of anxiety and attentional control. In UK-based students PRW may be predominantly focused on the decline in QoL; therefore, interventions targeting worry about the decline in QoL caused by COVID-19 are especially important in this population in the wake of the pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-022-10336-7.

Problematic behaviours associated with generalized anxiety disorder during pregnancy and the postpartum period: A thematic analysis

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders in pregnancy and the postpartum (perinatal) period. Perinatal women with GAD engage in problematic behaviours, yet the focus and function of these behaviours remain unknown.

OBJECTIVE

Given that worry during the perinatal period is largely maternally focused, the objective of this study was to explore the accompanying behavioural features of GAD during pregnancy and the postpartum period.

DESIGN

A qualitative study was conducted.

METHODS

Twenty-five pregnant (n = 10) and postpartum (n = 15) women were recruited through clinical referrals and the Hamilton community. Following the completion of a semistructured diagnostic interview and symptom measures, participants participated in one of seven focus groups to learn about behaviours utilized in response to their worries. A thematic analysis was conducted to identify behaviour themes and subthemes in pregnant and postpartum women.

RESULTS

Five behaviour themes and 12 subthemes were identified. Specifically, participants endorsed engaging in excessive reassurance seeking, checking and repeating, overcontrol, overpreparation and avoidance behaviours.

CONCLUSIONS

Our results confirm that perinatal women with GAD engage in comparable problematic behaviours to those with GAD in the general population, yet the presentation, frequency and focus of those behaviours differ. These findings have implications for theoretical formulations of GAD, and the clinical management of this disorder during the perinatal period.

Internalized Weight Stigma, Psychological Well-Being, and Sleep in Women

BACKGROUND

Many women internalize negative attitudes regarding body shape and size because of the societal standards for women's ideal body shapes and sizes. Internalized weight stigma is related to poorer physical and psychological health. A growing body of research has documented the links between other forms of internalized stigma (e.g., HIV-stigma) and poor sleep quality; however, little research examines the links between internalized weight stigma and sleep or the mechanisms that explain this relationship. Internalized weight stigma may be associated with poor sleep through increases in psychological distress. This study hypothesized that the links between internalized weight stigma and sleep would be mediated by higher levels of depression and anxiety.

METHODS

About 257 women were recruited via social media, word of mouth, and an undergraduate participant pool. Participants completed an online survey assessing various aspects of weight stigma and health through self-report questionnaires. Most women were non-Hispanic White (86.8%) and had a mean age of 31.40.

RESULTS

The indirect effects of internalized weight stigma on poorer global sleep quality and daily disturbances through depression and anxiety were significant. In contrast, depressive symptoms but not anxiety explained the links between internalized weight stigma and perceived sleep quality and neither depressive symptoms nor anxiety explained the link between internalized weight stigma and sleep efficiency.

CONCLUSIONS

Internalized weight stigma is linked to poorer sleep quality, and these links may be explained by psychological well-being. Understanding the mechanisms by which internalized weight stigma is associated with sleep quality can inform the psychological interventions employed.

How Can We Actually Change Help-Seeking Behaviour for Mental Health Problems among the General Public? Development of the 'PLACES' Model

Good treatment uptake is essential for clinically effective interventions to be fully utilised. Numerous studies have examined barriers to help-seeking for mental health treatment and to a lesser extent, facilitators. However, much of the current research focuses on changing help-seeking attitudes, which often do not lead to changes in behaviour. There is a clear gap in the literature for interventions that successfully change help-seeking behaviour among the general public. This gap is particularly relevant for early intervention. Here we describe the development of a new model which combines facilitators to treatment and an engaging, acceptable intervention for the general public. It is called the 'PLACES' (Publicity, Lay, Acceptable, Convenient, Effective, Self-referral) model of treatment engagement. It is based on theoretical work, as well as empirical research on a low intensity psychoeducational cognitive behavioural therapy (CBT) intervention: one-day workshops for stress and depression. In this paper, we describe the development of the model and the results of its use among four different clinical groups (adults experiencing stress, adults experiencing depression, adolescents (age 16-18) experiencing stress, and mothers with postnatal depression). We recorded high rates of uptake by people who have previously not sought help and by racial and ethnic minority groups across all four of these clinical groups. The clinical and research implications and applications of this model are discussed.

Untangling the tingle: Investigating the association between the Autonomous Sensory Meridian Response (ASMR), neuroticism, and trait & state anxiety

The Autonomous Sensory Meridian Response (ASMR) is an intensely pleasant tingling sensation originating in the scalp and neck and is elicited by a range of online video-induced triggers. Many individuals now regularly watch ASMR videos to relax, and alleviate symptoms of stress and insomnia, all which are indicative of elevated levels of anxiety. Emerging literature suggests that ASMR-capable individuals are characterised by high trait neuroticism, which is associated with a tendency to experience negative emotional states such as anxiety. To date however no literature has empirically linked these personality constructs and watching ASMR videos on the effect of reducing anxiety. In the current study, 36 ASMR-experiencers and 28 non-experiencers watched an ASMR video, and completed assessments of neuroticism, trait anxiety, and pre- / post-video state anxiety. MANCOVA with Group as the independent measures factor showed that ASMR-experiencers had significantly greater scores for neuroticism, trait anxiety, and video engagement than non-experiencers. Pre-video state anxiety was also significantly greater in the ASMR-experiencers and was significantly attenuated on exposure to the ASMR video, whereas non-experiencers reported no difference in state anxiety pre- and post-video. Thus, watching ASMR alleviated state anxiety but only in those who experienced ASMR. Subsequent mediation analyses identified the importance of pre-existing group differences in neuroticism, trait and (pre-video) state anxiety in accounting for the group difference in the reduction of state anxiety. The mediation analysis further lends support for watching ASMR videos as an intervention for the reduction of acute state anxiety. Future areas for research are discussed.

Multidimensional assessment of anxiety through the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): From dimensionality to response prediction across emotional contexts

The assessment of mal-adaptive anxiety is crucial, considering the associated personal, economic, and societal burden. The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a self-report instrument developed to provide multidimensional anxiety assessment in four dimensions: trait-cognitive, trait-somatic, state-cognitive and state-somatic. This research aimed to extend STICSA’s psychometric studies through the assessment of its dimensionality, reliability, measurement invariance and nomological validity in the Portuguese population. Additionally, the predictive validity of STICSA-Trait was also evaluated, through the analysis of the relationship between self-reported trait anxiety and both the subjective and the psychophysiological response across distinct emotional situations. Similarly to previous studies, results supported both a four-factor and two separated bi-factor structures. Measurement invariance across sex groups was also supported, and good nomological validity was observed. Moreover, STICSA trait-cognitive dimension was associated with differences in self-reported arousal between groups of high/low anxiety, whereas STICSA trait-somatic dimension was related to differences in both the subjective and psychophysiological response. Together, these results support STICSA as a useful instrument for a broader anxiety assessment, crucial for an informed diagnosis and practice.

Differential beta desynchronisation responses to dynamic emotional facial expressions are attenuated in higher trait anxiety and autism

Daily life demands that we differentiate between a multitude of emotional facial expressions (EFEs). The mirror neuron system (MNS) is becoming increasingly implicated as a neural network involved with understanding emotional body expressions. However, the specificity of the MNS's involvement in emotion recognition has remained largely unexplored. This study investigated whether six basic dynamic EFEs (anger, disgust, fear, happiness, sadness, and surprise) would be differentiated through event-related desynchronisation (ERD) of sensorimotor alpha and beta oscillatory activity, which indexes sensorimotor MNS activity. We found that beta ERD differentiated happy, fearful, and sad dynamic EFEs at the central region of interest, but not at occipital regions. Happy EFEs elicited significantly greater central beta ERD relative to fearful and sad EFEs within 800 - 2,000 ms after EFE onset. These differences were source-localised to the primary somatosensory cortex, which suggests they are likely to reflect differential sensorimotor simulation rather than differential attentional engagement. Furthermore, individuals with higher trait anxiety showed less beta ERD differentiation between happy and sad faces. Similarly, individuals with higher trait autism showed less beta ERD differentiation between happy and fearful faces. These findings suggest that the differential simulation of specific affective states is attenuated in individuals with higher trait anxiety and autism. In summary, the MNS appears to support the skills needed for emotion processing in daily life, which may be influenced by certain individual differences. This provides novel evidence for the notion that simulation-based emotional skills may underlie the emotional difficulties that accompany affective disorders, such as anxiety.

Characterizing Worry Content and Impact in Pregnant and Postpartum Women with Anxiety Disorders During COVID-19

The novel COVID pandemic has had a substantial impact on global mental health, including those populations that are inherently vulnerable such as pregnant and postpartum (perinatal) women. Anxiety disorders (ADs) are the most common mental health disorders during the perinatal period, affecting up to 1 in 5 women. However, since the onset of the pandemic, up to 60% of perinatal women are experiencing moderate to severe levels of anxiety. Given the substantial increase in perinatal anxiety during COVID, we sought to better understand its phenomenology by characterizing the collective worry content and impact of COVID using a content analysis. Eighty-four treatment-seeking pregnant (n = 35) and postpartum (n = 49) women with a principal AD, participated in this study between April and October 2020. In addition to completing questionnaire measures and a semi-structured diagnostic interview, participants were asked to 1) describe their top excessive and uncontrollable worries; 2) describe additional COVID and non-COVID worries; and 3) describe how the pandemic had affected their lives. All responses were given verbally and transcribed verbatim by assessors. A content analysis led to the emergence of various COVID and non-COVID worry and impact themes. One third of participant's principal worries were specific to COVID, and 40% of COVID worries were specific to the perinatal context. Understanding the worry content and impact of COVID may improve symptom detection and inform the development of targeted treatment strategies to support the mental health needs of perinatal women with ADs throughout the pandemic and thereafter. Understanding pandemic-specific worries is important for perinatal symptom screening and may allow for the development of targeted treatment strategies to address COVID-specific worries and impact.

Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety

Background

To date, there is a significant lack of research validating clinical tools for early and accurate detection of anxiety disorders in perinatal populations. Intolerance of uncertainty was recently identified as a significant risk factor for postpartum anxiety symptoms and is a key trait of non-perinatal anxiety disorders. The present study aimed to validate the Intolerance of Uncertainty Scale (IUS) in a perinatal population and evaluate its use as a screening tool for anxiety disorders.

Methods

Psychiatric diagnoses were assessed in a sample of perinatal women (n = 198), in addition to completing a self-report battery of questionnaires. Psychometric properties including internal consistency and convergent and discriminant validity were assessed. Determination of an optimal clinical cut-off score was measured through a ROC analysis in which the area under the curve, sensitivity, specificity, as well as positive and negative predictive values were calculated.

Results

The IUS demonstrated excellent internal consistency (α = 0.95) and an optimal clinical cut-off score of 64 or greater was established, yielding a sensitivity of 89%. The IUS also demonstrated very good positive (79%) and negative (80%) predictive values.

Conclusions

These findings suggest that the IUS represents a clinically useful screening tool to be used as an aid for the early and accurate detection of perinatal anxiety.

COVID-19 Life Events-Anxiety Inventory (C-19LAI): development, reliability, and validity study on Egyptian population

Background

The COVID-19 Life Events-Anxiety Inventory (C-19LAI) is a newly developed tool and the only Arabic tool for assessing and measuring anxiety related to different life events during the COVID-19 pandemic. The aim of the study was to test the validity and reliability of this newly designed tool. We used a cross sectional validation multiphasic study and applied the tool on 500 subjects together with the State-Trait Anxiety Inventory (STAI).

Results

The COVID-19 Life Events-Anxiety Inventory (C-19LAI) showed validity of 73.6% and sensitivity of 85.2%, with acceptable reliability of α = 0.815 and 0.947, respectively. The Life Events Scale and Anxiety Scale of the C-19LAI correlated significantly (p ≤ 0.01) with the State-Trait Anxiety Inventory (r = 0.289 and r = 0.407, respectively).

Conclusion

The COVID-19 Life Events-Anxiety Inventory (C-19LAI) Scale is a reliable and valid scale that can measure anxiety and events related to anxiety during the COVID 19 pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43045-021-00101-z.

The role of emotion dysregulation in cognitive behavioural group therapy for perinatal anxiety: Results from a randomized controlled trial and routine clinical care

BACKGROUND

Emotion dysregulation (ED) has been implicated in anxiety disorders and may play an important role in Cognitive Behavioural Therapy (CBT) treatment for perinatal anxiety outcomes although there is a dearth of research in this area. The current study investigated the role of ED in perinatal anxiety treatment outcome to determine whether it impacts CBT treatment outcomes and whether CBT reduces ED.

METHODS

Secondary analyses were run on a sample of N = 75 women participating in a CBT for perinatal anxiety randomized controlled trial (RCT), and N = 47 women who received the treatment as part of routine clinical care. Participants completed measures of anxiety, depression and ED at baseline, post-CBT/post-waitlist and 3-month follow-up (CBT-RCT group only). MANOVAs were conducted to determine if level of ED moderates treatment outcomes and whether CBT reduces ED. Reliable and clinically meaningful change was calculated.

RESULTS

Baseline level of ED did not moderate treatment outcomes. There were significant changes in some ED subscales over time in the CBT group compared to waitlist. Changes were reliable and clinically meaningful in 28.6% (RCT) and 16% (routine clinical care) of participants. Participants with high ED at baseline remained in the high range at post-treatment.

LIMITATIONS

Limitations include low sample size; homogeneity of sample, use of measures not validated in perinatal populations.

CONCLUSIONS

These findings suggest that ED during the perinatal period may be a stand-alone factor that will need to be separately addressed in psychological treatment.

Cognitive Behavior Therapy for Women With Generalized Anxiety Disorder in the Perinatal Period: Impact on Problematic Behaviors

Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder among women in the perinatal period (pregnancy to one year postpartum). Recent studies have examined the relationship between problematic behaviors and GAD symptoms. Studies in nonperinatal samples indicate that adults with GAD engage in avoidance and safety behaviors and these behaviors are associated with greater symptom severity. Little research has examined the use of problematic behaviors among pregnant or postpartum women. However, preliminary research suggests that these behaviors may have a negative impact on both anxious women and their children. Our aim was to examine the extent to which women with GAD in pregnancy or the postpartum engage in problematic behaviors and whether cognitive behavioral therapy is effective in reducing these behaviors. Fifty-eight women with GAD in pregnancy or postpartum were recruited from a larger clinical trial (Clinicaltrials.gov ID NCT02850523) evaluating the effectiveness of group-based cognitive behavioral therapy (CBGT) for perinatal anxiety disorders. The results indicated that women with perinatal GAD reported high levels of avoidance and safety behaviors and greater engagement in these behaviors was associated with higher levels of worry and related symptoms. CBGT was effective in reducing GAD symptoms and problematic behaviors and a bidirectional relationship was found between changes in worry and problematic behaviors during treatment. Limitations and future directions are discussed.

Responses to social evaluative stress in regular cannabis smokers

BACKGROUND

Aspects of the canonical stress response differ in stimulant, opioid, and alcohol users relative to controls, and dysregulated responses to stress may contribute to continued use of these drugs. Little prior research has focused on stress responses in regular cannabis smokers. We assessed responses to a standardized laboratory social stress assay (the Trier Social Stress Task; TSST) in regular cannabis smokers (CANs) compared with controls (CONs).

METHODS

Healthy, non-treatment-seeking adult CANs (⩾4×/week; smoking cannabis as usual) and demographically matched CONs completed the TSST. Outcome measures were subjective mood, heart rate, and salivary cortisol.

RESULTS

Nineteen CANs (1 female) and 20 CONs (2 female) participated; groups were matched on trauma exposure, sex, race, and age. CANs smoked cannabis 6.4 ± 1.1 days/week. Eight CANs and one CON smoked tobacco cigarettes daily. Overall, the TSST produced expected increases in anxiety, negative mood states, cortisol, and heart rate. CANs had blunted subjective response to stress relative to CONs, but they did not differ in physiological (cortisol and cardiovascular) stress responding.

CONCLUSION

These results indicate that CANs have blunted mood responses to social stress, but normative physiological stress responding. Observed differences could be due to residual effects of cannabis, reluctance to endorse negative mood states, or to issues related to identifying (i.e., emotional identification) or feeling (i.e., interoception) stress-related affective states. Further research is warranted to characterize the mechanisms of these differences and assess implications for daily functioning and treatment outcomes.

Dimensions of relationship adjustment as correlates of depressive and anxiety symptoms among individuals with chronic pain

Research suggests that partner relationship quality influences the psychological well-being of individuals with chronic pain, but the specific components of the relationship involved remain understudied. This study examined which dimensions of relationship adjustment influence the depressive and anxiety symptoms reported by the partner with chronic pain. A community sample of 214 adults in a romantic relationship for at least a year were recruited. Participants completed online questionnaires assessing pain characteristics (pain duration, pain intensity), relationship characteristics (marital status, duration of relationship), quality of relationship (dyadic adjustment, conjugal support) and emotional state (symptoms of depression and anxiety). Overall, participants reported well-adjusted relationships with their partners and higher levels of dyadic adjustment and conjugal support were associated with reduced symptoms of depression and anxiety. Most importantly, dyadic consensus, marital status, and pain intensity revealed to be predictive of depressive symptoms, whereas dyadic consensus and pain intensity were predictive of anxiety symptoms. These findings highlight the need to consider the interpersonal functioning of this population to enhance their psychological well-being.

Too afraid to Travel? Development of a Pandemic (COVID-19) Anxiety Travel Scale (PATS)

Pandemics are affecting tourism in many ways. Being a niche research field before, the coronavirus (COVID-19) pandemic created a strong urgency to develop this topic. For researching pandemic-induced changes in tourist beliefs and travel behaviour, we developed a construct that measures the intra-personal anxiety of travellers (and non-travellers): the Pandemic (COVID-19) Anxiety Travel Scale (PATS), using two large online studies (N = 2180; N = 2062) and including two different cultural contexts (US and Denmark). In Study 1, explorative and confirmative factors analysis confirms a short and easy-to-use 5-item solution, while the presented model adds face validity. Study 2 confirmed the structure (reliability) and tested nomological validity, by putting PATS into the context of different constructs (xenophobia and prevention focus). Although the proposed scale arose from the coronavirus (COVID-19), it is not limited to this specific pandemic and will hopefully prove to be a valuable measurement tool for future pandemics as well.

Italians on the Age of COVID-19: The Self-Reported Depressive Symptoms Through Web-Based Survey

The pandemic of coronavirus disease 2019 (COVID-19) has affected the Italian community. The widespread use of quarantine had the desired impact of controlling the epidemic, although it caused many psychological consequences. To date, compliance of the Italian public with voluntary home quarantine has been very high, but little is known about the impact of psychological health on sociodemographic categories during the quarantine. The purpose of this study was to assess the prevalence of depressive symptoms in specific sociodemographic categories during the COVID-19 quarantine lockdown and the potential factors that contribute to, or mitigate, these effects. In the very early stage of the nationwide lockdown, 3,672 quarantined Italian adult residents (65% females, ranging from 18 to 85 years) participated in a web-based cross-sectional survey, including measures of depressive symptoms, which were measured by the Teate depression inventory, and state anxiety levels. The overall prevalence was 27.8% for moderate and 9.3% for severe levels of depressive symptoms. A generalized logistic model was used to identify the factors associated with mental health problems. Among these factors, sociodemographic variables (e.g., sex, age, employment status) and adherence to quarantine guidelines were analyzed. Females, younger people, students, singles, residents in northern Italy, people who were reluctant to adhere to quarantine guidelines, and people less worried about being infected with COVID-19 were at high risk of developing depressive symptoms during the COVID-19 epidemic, also after controlling for state anxiety. These findings showed that public levels of depressive symptoms did not increase the greater likelihood of being infected. Our study suggested that the monitoring of psychological outcomes for outbreaks could identify groups at higher risk of psychological morbidities due to the current pandemic in order to target future psychological interventions for implementation.

Let Nature Take Its Course: Cultural Adaptation and Pilot Test of Taoist Cognitive Therapy for Chinese American Immigrants With Generalized Anxiety Disorder

This report describes initial results from a multi-stage project to manualize and adapt an indigenous therapy, Chinese Taoist Cognitive Psychotherapy (CTCP), for dissemination in the United States context. Study aims were to (a) integrate cultural adaptation and implementation science frameworks to manualize and adapt the original intervention and (b) explore the feasibility, acceptability, and effectiveness of the modified intervention, renamed Taoist Cognitive Therapy (TCT), in a sample of Chinese immigrants with generalized anxiety disorder (GAD). Incorporating bottom-up and top-down adaptation approaches, we involved Chinese American clinician stakeholders and experts in Taoist philosophy, cognitive-behavioral therapy, and GAD to help identify cultural and contextual barriers and solutions to enhance treatment acceptability and implementation. Five treatment-seeking Chinese American immigrants (average age = 43.2 years) with a primary diagnosis of GAD completed 14–16 sessions of TCT. Two participants also had secondary diagnoses of major depressive disorder. Changes on primary measures of worry and anxiety were assessed for statistical and clinical significance using reliable change indices (RCIs; Jacobson and Truax, 1991) and comparisons to normative data. In this sample of patients with limited prior exposure to Taoism, results found evidence of feasibility and acceptability of the modified intervention, with strong endorsement of Taoist principles at termination. Statistically and clinically significant improvements in anxiety, worry, psychological inflexibility, and emotional avoidance were found only for the participants without comorbid depression. Results suggest that Taoist principles of acceptance and flexible adaptation to natural laws may be helpful to Chinese immigrants coping with anxiety. However, additional treatment modifications may be required to address the low self-efficacy and fatalism expressed among those with comorbid depression.

Dysregulated brain salience within a triple network model in high trait anxiety individuals: A pilot EEG functional connectivity study

Although previous studies have reported the association between large-scale brain networks alterations and pathological anxiety, abnormalities in the dynamic interaction among the triple network model in anxiety disorders and, especially, in trait anxiety is still poorly explored. Thus, the main aim of the current study was to investigate triple network functional dynamics in subjects with high trait anxiety during resting state (RS) through electroencephalography (EEG) connectivity. Twenty-three individuals with high-trait-anxiety (HTA) and forty-five participants with low-trait-anxiety (LTA) were enrolled. EEG analyses were conducted by means of the exact Low-Resolution Electromagnetic Tomography software (eLORETA). Compared to LTA participants, HTA subjects showed a decrease of alpha connectivity within the salience network (SN), between the dorsal anterior cingulate cortex (dACC) and both left and right anterior insula (AI). Furthermore, SN functional connectivity strength was negatively correlated with higher trait anxiety, even when controlling for potential confounding variables (e.g., depressive and obsessive-compulsive symptoms). Taken together, our results point out a specific functional connectivity pattern in HTA individuals, which consists in a dysfunctional communication within the SN, specifically in the AI-dACC pathway. This functional pattern could underline, at rest, saliency detection and brain correlates of altereted emotion regulation and cognitive control processes typically involved in anxiety.

Dimensionality of the State-Trait Inventory of Cognitive and Somatic Anxiety

The State-Trait Inventory of Cognitive and Somatic Anxiety (STICSA) is a commonly administered self-report instrument of state-trait cognitive and somatic anxiety. Extant research has consistently supported the intended oblique two-factor scoring structure for the STICSA. However, this model assumes that population-level data have (or approximate) a simple structure and that item-level variance is unidimensional. These assumptions may not be tenable and have unintended consequences for STICSA subscore interpretation. Consequently, we tested these assumptions by fitting confirmatory and exploratory structural equation models to STICSA scores for a diverse sample of college students enrolled at a large Southwestern university in the United States (n = 635). Results indicated that cognitive and somatic factors are not equally robust and that STICSA items appear to measure a nonnegligible mixture of both latent cognitive and somatic anxiety. It is recommended that future research use exploratory structural equation model in tandem with CFA to directly model data complexity.

Coronaphobia among healthcare professionals in Mexico: A psychometric analysis

The present study examined the validity of the coronaphobia phenomenon with healthcare professionals using a psychometric approach. Using SurveyMonkey, an adapted version of the Coronavirus Anxiety Scale-Healthcare version (CAS-HC) was administered to 231 adult healthcare professionals in Mexico. Confirmatory factor analysis demonstrated that dysfunctional coronavirus anxiety symptoms cohered into a reliable, single factor structure of coronaphobia. A receiver operating characteristic curve analysis indicated that the classification features of the CAS-HC were strong, but supported a less stringent cut-score for this population. Construct validity was supported by the positive correlations between the CAS-HC and measures of depression and generalized anxiety, while known groups validity was found with high CAS-HC scores exhibited by those working in emergency rooms, triage, and intensive care units. The findings collectively support the coronaphobia construct with healthcare professionals, and the finding that over one third of the participants in the study scored in the clinical range on this measure points to the critical importance of assessing and alleviating this form of distress in this vulnerable but indispensable workforce.

Clinically significant fear and anxiety of COVID-19: A psychometric examination of the Coronavirus Anxiety Scale

The present study examined the psychometric properties of the Coronavirus Anxiety Scale (CAS) using an online survey of 398 adult Amazon MTurk workers in the U.S. Confirmatory factor analyses demonstrated that the CAS measures a reliable (α = 0.92), unidimensional construct with a structure that was shown to be invariant across gender, race, and age. Construct validity was demonstrated with correlations between CAS scores and demographics, coronavirus diagnosis, history of anxiety, coronavirus fear, functional impairment, alcohol/drug coping, religious coping, hopelessness, suicidal ideation, as well as social attitudes (e.g., satisfaction with President Trump). The CAS also demonstrated solid discrimination ability for functional impairment (AUC =0.88), while the original cut score of ≥9 (76% sensitivity and 90% specificity) showed the strongest diagnostic effectiveness among scores. Overall, these findings are largely consistent with the results of the first CAS investigation and support the validity of this mental health screener for COVID-19 related research and practice.

Life stress and background anxiety are not associated with resting metabolic rate in healthy adults

This study examined associations between anxiety, stress, and resting metabolic rate (RMR). Thirty women and 23 men had RMR measured at two visits. Participants also had body composition assessed and completed several questionnaires: State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA), Anxiety Sensitivity Index (ASI)-3, and Perceived Stress Scale (PSS)-14. The state version of the STICSA was completed at both visits, while the other questionnaires were completed at visit one. RMR was expressed in kilocalories per day and relative to lean mass (RMR_relative). Participants were divided into low-, medium-, and high-anxiety groups based on STICSA trait scores, and RMR was compared among groups using one-way ANOVA. Changes between visits were evaluated using paired t tests and Wilcoxon signed-rank tests. RMR did not change from visit one to visit two (1589 to 1586 kcal/day, p = 0.86) even though STICSA state scores slightly declined (Z-statistic = -2.39, p = 0.017). RMR_relative values were 30.3 ± 3.7, 29.0 ± 1.9, and 29.9 ± 3.6 kcal/kg of lean mass among low, medium, and high trait anxiety groups, respectively (F = 0.70, p = 0.50). No RMR variable significantly correlated with PSS-14, ASI-3, or STICSA scores. This study provides evidence that trait anxiety and life stress do not impact RMR. Whether an association between these factors exists in anxiety disorders remains to be evaluated. Novelty Contrary to previous research, this study found no associations between anxiety and RMR. It is doubtful whether practitioners need to account for healthy subjects' trait anxiety and stress when analyzing RMR data.

Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety

Mental health concerns of people impacted by the coronavirus pandemic have not been adequately addressed. The objective of this study was to develop and evaluate the properties of the Coronavirus Anxiety Scale (CAS), which is a brief mental health screener to identify probable cases of dysfunctional anxiety associated with the COVID-19 crisis. This 5-item scale, which was based on 775 adults with anxiety over the coronavirus, demonstrated solid reliability and validity. Elevated CAS scores were found to be associated with coronavirus diagnosis, impairment, alcohol/drug coping, negative religious coping, extreme hopelessness, suicidal ideation, as well as attitudes toward President Trump and Chinese products. The CAS discriminates well between persons with and without dysfunctional anxiety using an optimized cut score of ≥ 9 (90% sensitivity and 85% specificity). These results support the CAS as an efficient and valid tool for clinical research and practice.

Tailored Screening for Late-Life Depression: A Short Version of the Teate Depression Inventory (TDI-E)

A number of assessment instruments have been developed as efficacy measures of geriatric depression in clinical trials but most showed several weaknesses, such as time-consuming administration, development and validation in younger populations, and lack of discrimination between anxiety and depression. Among the extant self-report measures of depression, the 21-item Teate Depression Inventory (TDI; Balsamo and Saggino, 2013), developed via Rasch analysis, showed a satisfactory level of diagnostic accuracy, and allowed the reduction of false positives in test scoring in adult population. The present study explored the potential improvement in the psychometric performance of the TDI in the elderly by item refinement through Rasch analysis in a sample of 836 elderly people (49.5% males; mean age = 73.28; SD = 6.56). A resulting shorter version was composed of the best-fitting and discriminative nine items from the full form. The Teate Depression Inventory (TDI-E) (E for elderly) presented good internal construct validity, with unidimensional structure, local dependency, good reliability (person separation index and Cronbach's alpha), and no signs of differential item functioning or measurement bias due to gender and age (65 vs. 75+ years). Cut-off points and normative data provided could enhance the clinical usefulness of the TDI-E, which seems to be a promising valid and reliable tool for the screening of geriatric depression, with less risk of finding false positives due to overlapping of depression in elderly with other comorbid conditions.

Social motivational processing and interpersonal function in aging cocaine smokers

Illicit drug use among aging cohorts is increasing, yet little is known about functional impairments in older drug users. Given the importance of social integration for aging and documented social decrements in cocaine users, we examined social function and its neurocognitive substrates in aging cocaine users relative to carefully matched non-cocaine users. Regular (≥twice/week), long-term (≥15 years) cocaine smokers 50-60 years old (COCs; n = 22; four women) and controls (CTRLs; n = 19; four women) underwent standardized probes of social reward and threat processing during functional magnetic resonance imaging and a behavioral facial affect recognition task. Self-report and peer-report of daily interpersonal function were also collected. COCs, and CTRLs reporting current marijuana or alcohol use, were tested after four drug-free inpatient days. COCs had pronounced problems in daily social function relative to CTRLs indicated by both their own and their peers' reports. Compared with CTRLs, COCs had stronger amygdala responses to social threat versus control stimuli, with no other differences in social processing or cognition. Aging cocaine users appear to have marked, generalized difficulties in 'real-world' interpersonal function but largely intact social processing on laboratory-based measures when compared with appropriately matched controls and tested under well-controlled conditions. Daily social difficulties may be related to transient factors such as acute/residual drug effects or cocaine-related changes in health behaviors (e.g. disrupted sleep and poor diet). These data suggest that interpersonal function may be a valid intervention target for aging cocaine users and warrants further study in older drug users.

The scent of the other women: Body odor-induced behavioral and physiological effects on face categorization

In body odor research, the interaction of female donors and receivers is scarcely investigated. With the aim to investigate effects of female body odor in a competitive context, we tested 51 women divided into two groups (i.e., a competitive and a non-competitive group, based on verbal instructions). Between groups, we explored whether female body odor exposure (vs. masker odor) modulates emotion categorization (via RT variance and distribution) and physiological reactions (via instantaneous heart rate) in a task with dynamic male and female faces as either angry or happy. Women in the competitive group reported to feel more competitive and performed more accurately. They gathered more emotional information to categorize dynamic faces and when additionally exposed to female body odor, they showed a resistance to cardiac deceleration. Lapses of attention (via RT distribution) occurred irrespective of body odor exposure. Our results support the idea that female body odors, presented in a competitive context, contrast cardiac deceleration and, by tendency, modulate emotion categorization. Data are discussed in the context of chemosignaling and social interactions among women.

Dimensions of Anxiety, Age, and Gender: Assessing Dimensionality and Measurement Invariance of the State-Trait for Cognitive and Somatic Anxiety (STICSA) in an Italian Sample

The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a widely used measure of state and trait anxiety that permits a specific assessment of cognitive and somatic anxiety. Previous research provided inconsistent findings about its factor structure in non-clinical samples (e.g., hierarchical or bi-factor structure). To date, no psychometric validation of the Italian version of the STICSA has been conducted. Our study aimed to determine the psychometric functioning of the Italian version of the STICSA, including its dimensionality, gender and age measurement equivalence, and convergent/divergent validity in a large sample of community-dwelling participants (N = 2,938; 55.9% female). Through confirmatory factor analysis, the multidimensional structure of both State and Trait STICSA scales, with each including Cognitive and Somatic dimensions, was supported. Factor structure invariance was tested and established at configural, metric, and scalar levels for males and females. Additionally, full factorial measurement invariance was supported for the State scale across young, middle age, and old adult groups whereas the Trait scale was partially invariant across age groups. The STICSA also showed good convergent validity with concurrent anxiety measures (State-Trait Anxiety Inventory and Beck Anxiety Inventory), and satisfactory internal discriminant validity with two depression measures (Teate Depression Inventory and Beck Depression Inventory-II). Results provided support for the multidimensionality of the STICSA, as well as the generalizability of the State and Trait scales as independent measures of Cognitive and Somatic symptomatology across gender in the general population. Implications for research and personality and clinical assessment are discussed.

Testing Factor Structure and Measurement Invariance Across Gender With Italian Geriatric Anxiety Scale

Late-life anxiety is an increasingly relevant psychiatric condition that often goes unnoticed and/or untreated compared to anxiety in younger populations. Consequently, assessing the presence and severity of clinical anxiety in older adults an important challenge for researchers and clinicians alike. The Geriatric Anxiety Scale is a 30-item geriatric-specific measure of anxiety severity, grouped in three subscales (Somatic, Affective, and Cognitive), with solid evidence for the reliability and validity of its scores in clinical and community samples. Translated into several languages, it has been proven to have strong psychometric properties. In Italy only one recent preliminarily investigative study has appeared on its psychometric properties. However, sample data was largely collected from one specific Italian region (Lombardy) alone. Here, our aim in testing the items of the GAS in a sample of 346 healthy subjects (50% females; 52% from Southern Italy), with mean age of 71.74 years, was 2-fold. First, we aimed to determine factor structure in a wider sample of Italian participants. Confirmatory factor analysis showed that the GAS fits an originally postulated three-factor structure reasonably well. Second, results support gender invariance, entirely supported at the factorial structure, and at the intercept level. Latent means can be meaningfully compared across gender groups. Whereas the means of F1 (Somatic) and F3 (Affective) for males were significantly different from those for females, the means for F2 (Cognitive) were not. More specifically, in light of the negative signs associated with these statistically significant values, the finding showed that F1 and F3 for males appeared to be less positive on average than females. Overall, the GAS displayed acceptable convergent validity with matching subscales highly correlated, and satisfactory internal discriminant validity with lower correlations between non-matching subscales. Implications for clinical practice and research are discussed.

Disentangling intolerance of uncertainty and threat appraisal in everyday situations

Intolerance of Uncertainty is a transdiagnostic risk and maintenance factor in a range of anxiety disorders and major depressive disorder. However, the mechanism of action in the development and maintenance of anxiety disorders is poorly understood, with the relationship between the constructs of uncertainty and threat appraisal remaining unclear. Most research to date has investigated IU in situations that are explicitly or implicitly threatening (i.e. where they have a negative outcome), which makes it difficult to establish whether it is the uncertainty or the prospect of a negative outcome (or threat) that people find aversive. If the construct of IU is about uncertainty (and not threat), it should also be operating in situations where there are no negative outcomes possible. Participants (N = 224) completed a battery of online measures in tasks designed to evaluate level of situational uncertainty and perception of threat level. These tasks required responses to scenarios which displayed or implied varying levels of estimated threat. Regression analyses indicated that IU was related to perceiving threat and uncertainty in negative situations and positive situations, with the greatest contribution from uncertainty within the situations, supporting the conceptualisation of IU as a response to uncertainty that is largely independent of threat although may contribute to perceptions of threat.

Co-rumination, anxiety, and maladaptive cognitive schemas: when friendship can hurt

Background

This study investigated maladaptive cognitive schemas as mediators of the relationship between co-rumination and anxiety.

Methods

Self-report measures of co-rumination, trait cognitive and somatic anxiety, and early maladaptive cognitive schemas were provided to a nonclinical sample of 461 young adults. Mediation of co-rumination and trait somatic and cognitive anxiety by each early maladaptive schema domain was tested using nonparametric, bootstrap-based resampling.

Results

Significant associations between co-rumination and trait and cognitive anxiety were mediated by schema domains related to Rejection and Disconnection, Overvigilance and Inhibition, and Impaired Autonomy. The association between co-rumination and somatic anxiety was mediated by domains related to Rejection and Disconnection and Impaired Autonomy.

Conclusion

The results of this study showed that those who engage in co-rumination, potentially resulting in clinical levels of anxiety, might benefit from treatment that focuses on themes of rejection sensitivity and belonging, beliefs about autonomy, and when the anxiety is more cognitive, treatment that focuses on hypercriticalness and emotional inhibition too.

Psychometric Properties of the Italian Version of the Young Schema Questionnaire L-3: Preliminary Results

Schema Therapy (ST) is a well-known approach for the treatment of personality disorders. This therapy integrates different theories and techniques into an original and systematic treatment model. The Young Schema Questionnaire L-3 (YSQ-L3) is a self-report instrument, based on the ST model, designed to assess 18 Early Maladaptive Schemas (EMSs). During the last decade, it has been translated and validated in different countries and languages. This study aims to establish the psychometric properties of the Italian Version of the YSQ-L3. We enrolled two groups: a clinical (n = 148) and a non-clinical one (n = 918). We investigated the factor structure, reliability and convergent validity with anxiety and depression between clinical and non-clinical groups. The results highlighted a few relevant findings. Cronbach's alpha showed significant values for all the schemas. All of the factor models do not seem highly adequate, even if the hierarchical model has proven to be the most significant one. Furthermore, the questionnaire confirms the ability to discriminate between clinical and non-clinical groups and could represent a useful tool in the clinical practice. Limitations and future directions are discussed.

Evaluation of the contribution of values clarification to a brief mindfulness meditation intervention for anxiety

OBJECTIVE

Evaluate the incremental effects of a computerized values clarification (VC) activity on anxiety symptomology and quality of life over and above establishment of a mindfulness meditation (MM) practice.

METHOD

Anxious participants (N = 120, Female = 86; M_age  = 22.26) were randomly assigned to a 2-week, 10-min daily MM practice + control task or a 2-week, 10-min daily MM practice + VC task. Pre-assessments and post-assessments included well-established and ideographic self-report measures.

RESULTS

Overall decreases in past week and past 24-h anxiety symptom frequency, as well as increased quality of life during the previous 24-h cycle only. VC did not have a demonstrable impact on outcomes.

CONCLUSIONS

Though findings are preliminary, brief VC exercises may not enhance outcomes that follow from mindfulness practice. Additional research is needed to isolate specific and shared impacts of mindfulness-based and values-based treatment strategies on anxiety symptoms and quality of life.

Mechanisms of Change During Attention Training and Mindfulness in High Trait-Anxious Individuals: A Randomized Controlled Study

The first aim of this study was to compare attention manipulation techniques deriving from metacognitive therapy (the Attention Training Technique; ATT) and mindfulness-based approaches (Mindfulness-Based Progressive Muscle Relaxation, MB-PMR) to a thought wandering control (TWC) condition, in terms of their impact on anxiety and four mechanisms: distancing, present-focused attention, uncontrollability and dangerousness, metacognitive beliefs, and cognitive flexibility (Stroop task). The second aim was to test indirect effects of the techniques on anxiety via the mechanism measures. High trait anxious participants (N = 81, M_age = 23.60, SD_age = 7.66, 80% female) were randomized to receive ATT, MB-PMR, or the TWC condition. Measures of cognitive and somatic anxiety, distancing, present-focused attention, metacognitive beliefs, and cognitive flexibility were administered before or after the attention manipulation task. Compared to the TWC group, ATT and MB-PMR were associated with greater changes on cognitive (but not somatic) anxiety, present-focused attention, metacognitive beliefs, and uncorrected errors for threat-related words on the Stroop task. The pattern of means was similar for distancing, but this did not reach statistical significance, and Stroop speed increased equally for all conditions. Indirect effects models revealed significant effects of condition on state anxiety via distancing, metacognitive beliefs, and present-focused attention, but not via Stroop errors. ATT and MB-PMR were associated with changes on anxiety and the mechanism measures, suggesting that the mechanisms of change may be more similar than different across these techniques.

Effects of task demands on the early neural processing of fearful and happy facial expressions

Task demands shape how we process environmental stimuli but their impact on the early neural processing of facial expressions remains unclear. In a within-subject design, ERPs were recorded to the same fearful, happy and neutral facial expressions presented during a gender discrimination, an explicit emotion discrimination and an oddball detection tasks, the most studied tasks in the field. Using an eye tracker, fixation on the face nose was enforced using a gaze-contingent presentation. Task demands modulated amplitudes from 200 to 350ms at occipito-temporal sites spanning the EPN component. Amplitudes were more negative for fearful than neutral expressions starting on N170 from 150 to 350ms, with a temporo-occipital distribution, whereas no clear effect of happy expressions was seen. Task and emotion effects never interacted in any time window or for the ERP components analyzed (P1, N170, EPN). Thus, whether emotion is explicitly discriminated or irrelevant for the task at hand, neural correlates of fearful and happy facial expressions seem immune to these task demands during the first 350ms of visual processing.

Perceived distress tolerance accounts for the covariance between discrimination experiences and anxiety symptoms among sexual minority adults

Sexual orientation-related discrimination experiences have been implicated in elevated rates of anxiety symptoms within sexual minority groups. Theory suggests that chronic discrimination experiences may dampen the ability to tolerate distress, increasing vulnerability for anxiety. This study examined the role of distress tolerance, or the capacity to withstand negative emotions, as a construct underlying associations between discriminatory experiences and anxiety among sexual minority adults. Participants (N=119;M_age=36.4±14.8; 50% cisgender male, 31% cisgender female, 19% transgender; 37% non-Latino white) were recruited from Houston, Texas. Measures administered included the Heterosexist Harassment, Rejection, and Discrimination Scale (discrimination experiences), Distress Tolerance Scale (distress tolerance), and the State-Trait Inventory for Cognitive and Somatic Anxiety (anxiety). The association of discrimination experiences and anxiety through distress tolerance was assessed using covariate-adjusted mediation modeling. Results indicated that sexual orientation-related discrimination experiences were significantly and positively associated with anxiety and that this association was mediated through lower distress tolerance. Significant indirect effects were specific to cognitive (versus somatic) anxiety symptoms. Results suggest that distress tolerance may be an explanatory mechanism in the association between discriminatory experiences and cognitive symptoms of anxiety and a potentially relevant target within clinical interventions to address anxiety-related health disparities among sexual minority adults. However, more sophisticated designs are needed to delineate causal associations.