Adult separation anxiety and TCI-R personality dimensions in patients with anxiety, alcohol use, and gambling: a preliminary report

Portuguese validation of the Adult Separation Anxiety-Questionnaire (ASA-27)

Adult separation anxiety disorder (ASAD) is characterized by developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached. Despite the high rates of this diagnosis among Portuguese adults, there is a lack of measures to assess it. In this study, we assessed the psychometric properties of a Portuguese adaptation of the Adult Separation Anxiety questionnaire (ASA-27) on a sample of 267 adults (72.7% women) aged 18–80 years (M = 40.5, SD = 13.1). Factor structure, internal consistency, and convergence validity were examined. This study confirmed the single-factor structure of the Portuguese version of ASA-27. Consistency was high for the total sample (ω = .92) and by gender (ω = .93 and 92, men and women groups, respectively). The scale was positively related to the Portuguese version of State-Trait Anxiety Inventory (STAI) (r = .57, p< .001, for both State and trait anxiety scales) and Composite Codependency Scale total score (r = .29, p< .001). In addition, the ASA-27 total score showed incremental validity in the explanation of anxiety measured by STAI. In conclusion, results show that the Portuguese version of the ASA-27 is a reliable and valid measure of ASAD.

Psychometric analysis of the adult separation anxiety symptom questionnaire: Item functioning and invariance across gender and time

The Adult Separation Anxiety Symptom Questionnaire (ASA-27) is the most widely used self-report assessment of adult separation anxiety (ASA). Despite its widespread use, relatively little is known about its psychometric properties, specifically whether it is unidimensional, its degree of precision (or information) across latent levels of ASA, the functioning of individual items in general and of DSM-derived versus non-DSM-derived items in particular, and whether the measure is invariant across gender and time. We addressed these issues in a sample of 509 adult women and 407 adult men from the local community participating in a longitudinal study of temperament and psychopathology in children. Two items from the ASA-27 were removed so that the measure met the item response theory (IRT) assumption of unidimensionality. Findings from a graded response model for categorical items suggested that the ASA-27 assesses ASA most reliably at moderate to high levels and that the DSM-derived items were more closely related to latent ASA than the non-DSM-derived items. Invariance tests employing single-factor confirmatory factor analysis models suggested that the measure is partially invariant across gender and time at the unique factor level, with fewer than 7% of parameters freed in both cases; this implies that the means and variances of the latent factors and differences in the observed responses are attributable to true differences in ASA. Future work should replicate these findings in a sample that includes individuals with a wider range of ASA severity and may consider removing additional items that provide little or redundant information. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Childhood adversities, bonding, and personality in social anxiety disorder with alcohol use disorder

Social anxiety disorder (SAD) is frequently associated with alcohol use disorders (abuse/dependence). However, there has been little research on the characteristics of this subgroup so far. In the current study we investigated individuals with SAD and comorbid alcohol use disorder (AUD) with regard to socialization experiences and personality. The sample comprised 410 individuals diagnosed with SAD by the Structured Clinical Interview of DSM-IV. 108 participants with comorbid AUD were compared to 302 participants without comorbid AUD concerning traumatic experiences during childhood and adolescence (Adverse Childhood Experiences Questionnaire; ACE), parental bonding (Parental Bonding Instrument; PBI), and personality (Temperament and Character Inventory; TCI). MANCOVA with covariates sex and depression displayed that individuals with SAD plus AUD reported significantly more traumatic events during childhood and adolescence, lower levels of maternal care, as well as lower cooperativeness. Our results highlight that adverse childhood experiences and unfavourable maternal bonding characterize individuals suffering from SAD plus AUD. These experiences might be reflected in a personality-based tendency to distance themselves from others, which corresponds to low scores on the character dimension cooperativeness. A deeper understanding of personality and specific socialization experiences is necessary to develop new treatment options in this clinically challenging subgroup.

Assessment of co-morbidity of adult separation anxiety in patients with bipolar disorder

OBJECTIVE

The aim of this study was to assess the co-morbidity of adult separation anxiety in bipolar patients and evaluate its effects on the course of disorder and functionality.

METHOD

A total of 70 patients who have been regularly followed in the Bipolar Disorder Unit were included in the study. The Structured Clinical Interview for DSM-IV - Axis I and Axis II disorders and demographic form were used. Separation anxiety was investigated by the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Hamilton Anxiety Rating Scale (HAM-A) was filled out by an interviewer. In addition, all patients completed the Bipolar Disorder Functioning Questionnaire (BDFQ), Separation Anxiety Symptom Inventory (SASI) and Adult Separation Anxiety Questionnaire (ASA).

RESULTS

The prevalence rate of co-morbid adult separation anxiety disorder (A-SepAD) was 54% (n = 38) in our sample. Age of onset was in adulthood among 36% of patients with a diagnosis of A-SepAD and the others (64%) were childhood-onset. Co-morbidity of personality disorders was more common in bipolar patients with childhood-onset separation anxiety disorder (C-SepAD). The lifetime prevalence of co-morbidity of specific phobias and number of suicide attempts were significantly higher in the group with A-SepAD. Functionality loss due to feeling of stigmatization was higher, and total functionality as measured by the BDFQ was found to be lower in bipolar patients with A-SepAD.

CONCLUSION

The results of this study have shown that 54% of bipolar patients had a diagnosis of A-SepAD. A-SepAD seems to increase the number of suicide attempts and have negative effects on functionality. A-SepAD should be assessed in regular interviews of patients with bipolar disorder.