Biomedical subjects

M H Freeston

Publications and source records attributed to M H Freeston.

35 records · Page 2Linked to original sources

PubMed1994

Perceived symptoms and discomfort during induced bronchospasm: the role of temporal adaptation and anxiety.

Using a mixed within-between design, this study was designed to evaluate the sensorial and cognitive/evaluative aspects of bronchoconstriction induced by progressive methacholine inhalation. 25 asthmatic patients and 15 normal controls were given two consecutive bronchoconstriction tests, inducing a fall of > 30% of the forced expiratory volume in 1 sec (FEV1), which was measured after each inhalation of methacholine. Immediately before each FEV1 measurement, Ss rated perceived bronchial closing, discomfort of breathing and anxiety, as well as the need to use a bronchodilator. In addition to state-anxiety, after each bronchoconstriction test asthma symptoms were evaluated by means of a Free Symptom Report and the Asthma Symptom Checklist. The results show that during the first test, asthmatic patients perceived their symptoms more accurately than non-asthmatic controls. However, during the second test, asthmatic patients became less accurate, while normal controls increased their accuracy of symptom report. These changes were not parallelled for the Free Symptom Report or the Asthma Symptom Checklist. These results suggest that, depending on situational circumstances, patients rely on their cognitive schemata to report asthma symptoms. Need for bronchodilator use was related to perceived discomfort but not to actual or perceived bronchial closing. Clinical implications of this study are discussed.

Adaptation, Psychological↗

PubMed1994

Self-report of obsessions and worry.

The relationships between self-reported worry and obsessional-compulsive symptoms were examined among 145 hospital outpatients. Subjects completed the Penn State Worry Questionnaire and the Padua Inventory. Despite moderately strong correlations, the scales measured distinct constructs. Eliminating five items from the Padua Inventory may improve its discriminant validity. Correlations with the Padua Inventory subscales showed that obsessional loss of mental control was moderately correlated to both worry and checking, whereas worry and checking were only weakly correlated. The results are discussed in terms of possible relationships between worry and obsessions.

Adult↗

PubMed1994

Health-related intrusive thoughts.

Two studies address the prevalence, concomitants, and appraisal of health-related intrusive thoughts. Eighty-three percent of adults (N = 658) in waiting rooms of two general hospitals reported at least one intrusive thought during the preceding month and 75.0% of patients and 55.5% of people accompanying them reported a health-related intrusive thought in the same period. The intrusions were associated with anxious and depressive symptoms. Health related intrusive thoughts were reported by 61% of a sample of university students (N = 608) and were the most frequent intrusive thought among 19.9% of the students. First, triggering stimuli reported by the subjects were significant predictors of thought frequency, worry, removal difficulty, and effort used in removing the thought. Second, appraisals of high probability were significant predictors of high frequency, worry, and especially difficulty in removing the thought. Finally, perceived responsibility and disapproval of the thought were also significant predictors of thought frequency, worry, removal difficulty, effort used in removing the thought, and guilt. These data support the position that cognitive appraisal of intrusive thoughts is closely linked to the subjective experience of the thought: more extreme appraisals were associated with more troublesome thoughts. The clinical implications of these studies are discussed in terms of current models of hypochondriasis and health anxiety.

Adult↗

PubMed1993

Idiographic considerations in the behavioral treatment of obsessional thoughts.

Despite impressive improvement in the behavioral treatment of obsessive-compulsive disorder over the last 15 years, progress has been slower for obsessional thoughts with few or no overt rituals. Encouraging case reports suggest that exposure to obsessional thoughts combined with covert response prevention is an effective treatment. Three cases are presented that required adaptation from the guidelines laid out by Salkovskis and Westbrook (1989). They provide clear evidence of the need to adopt a creative and flexible approach to exposure that enables access and activation of fear structures.

Adult↗

PubMed1993

Appraisal of cognitive intrusions and response style: replication and extension.

In a replication and extension of an earlier study of cognitive intrusions, appraisal and response strategies (Freeston, Ladouceur, Thibodeau & Gagnon, Behaviour Research and Therapy, 29, 585-597, 1991a), cognitive intrusions were studied among 534 outpatients and escorts recruited in waiting rooms of two large urban hospitals. Appraisals of high probability and low disapproval were associated with greater use of continued attention strategies whereas appraisals of low probability and high disapproval were associated with greater use of escape/avoidance strategies. These results support the distinction between the ego-dystonic nature of obsessional intrusive thoughts and ego-syntonic concerns about subjectively probable events found in worry.

Adult↗

PubMed1992

Cognitive intrusions in a non-clinical population. II. Associations with depressive, anxious, and compulsive symptoms.

The relationships between experimental dimensions of cognitive intrusions and depressive, anxious, and compulsive symptoms were studied among 125 university students. The students completed a questionnaire describing and evaluating seven cognitive intrusions and inventories of depressive, anxious, and compulsive symptoms. Principal component factor analysis on the 14 cognitive intrusion questionnaire dimensions identified five factors that were interpreted as general distress, evaluation, control, diversity and attention. Hierarchical regression analysis showed that effortful strategies in response to cognitive intrusions, general distress and diversity were predictors of both Beck Depression and Beck Anxiety Inventory scores. The evaluation factor consisting of perceived responsibility, disapproval and guilt ratings was also associated with depression and was the only significant predictor of Compulsive Activity Checklist scores. The control factor, consisting of items describing successful application of response strategies, was negatively related to BAI scores. The results are discussed as providing support for Salkovskis' formulation of obsessive-compulsive disorder.

Adult↗

PubMed1991

Cognitive intrusions in a non-clinical population. I. Response style, subjective experience, and appraisal.

The present study identified distinctive response styles to unpleasant cognitive intrusions to further understanding of intrusive phenomena similar to those observed in obsessive-compulsive disorder and other anxiety disorders. Response styles were studied among 125 university students who completed a questionnaire describing and evaluating seven cognitive intrusions and inventories of depressive, anxious, and compulsive symptoms. Almost all subjects (99%) reported intrusions and 92% included effortful strategies in response to intrusions in their repertoire. Large differences were observed in the dominant strategy used. Three distinctive dominant response styles were identified including no effortful response (26%) and two effortful styles, attentive thinking (34%), and escape/avoidance (40%). The two groups using effortful strategies were more anxious and reported more difficulty removing intrusions. The group using escape/avoidance strategies reported more sadness, worry, guilt, and disapproval than subjects reporting no effortful response. The attentive thinking group reported more varied forms and more frequently triggered intrusions then the no effortful response group. Within subject analyses support the group comparisons and showed that intrusions eliciting escape/avoidance strategies were evaluated more disapprovingly than thoughts eliciting attentive thinking. The results are discussed in terms of Salkovskis' (Behavior Research and Therapy, 27, 677-682, 1985) formulation of obsessive-compulsive disorder and Borkovec's (Journal of Consulting and Clinical Psychology, 23, 481-482, 1985) and Barlow's (Anxiety and its disorders: The nature and treatment of anxiety and panic, 1988) discussions of worry and generalized anxiety.

Adaptation, Psychological↗

PubMed1989

Externality and burnout among dentists.

This study investigates the relationship between burnout as measured by the Maslach Burnout Inventory and locus of control as measured by the Adult Nowicki-Strickland Internal-External Locus of Control (ANS-IE) for 82 dentists. Significant Pearson correlations between two Maslach subscales and locus of control show Personal Accomplishment to be negatively associated -.31 and Emotional Exhaustion to be positively correlated .21 to externality.

Adult↗

PubMed1989

Locus of control and anxiety in children from intact and maritally disrupted families.

This study investigated the associations of Locus of Control (Children Nowicki-Strickland Internal-External Control Scale) with state and trait anxiety (State-Trait Anxiety Inventory for Children) in 302 children aged 9 to 12 yr. No significant differences were found between the groups. No significant correlations were found between the anxiety measures and externality for the 31 children from maritally disrupted families, but significant positive Pearson correlations were found for the 271 children of intact families. The results are discussed in terms of the possibility of under-reporting of marital disruption by children.

Anxiety↗

PubMedDate not supplied

Correcting faulty appraisals of obsessional thoughts.

Cognitive techniques are becoming more widely established in the treatment of obsessive-compulsive disorder (OCD). This paper extends previous work by van Oppen and Arntz (1994, Behaviour Research and Therapy, 33, 79-87) on overestimation of threat and excessive responsibility by discussing other types of appraisals that may be involved in OCD, particularly when overt compulsions are absent. Examples are given of types of intervention that may be useful to correct faulty appraisals concerning the overestimation of the importance of thoughts such as thought-action fusion, excessive responsibility, perfectionistic concerns such as the need for absolute certainty, and expectations about anxiety and its consequences.

Arousal↗

PubMedDate not supplied

Cognitive analysis of unwanted intrusive thoughts and facial hair: an idea before its time?

Durac (1997, Behaviour Research and Therapy, 35, 371-372) recently attempted a cognitive analysis of unwanted intrusive thoughts and the growth of facial hair. Though provocative, there are a number of conceptual, methodological and clinical issues that are inadequately addressed by this paper. Based on a thorough reading of a relevant body of literature from 1963 to 1994, five issues are addressed in a hirsute manner: (1) the origin of the phenomenon, (2) behavioral analysis of unwanted intrusive thoughts and the growth of facial hair (UIFHG), (3) the role of behavioral exercises in the disappearance of unwanted facial hair, (4) the serotonin connection underlying this disorder, and (5) ethical concerns in the treatment of UIFHG. Finally, important theoretical and clinical implications of the cognitive model are not discussed here: they will be reported elsewhere in a more extensive analysis.

Attention↗

PubMedDate not supplied

Structured and free-recall measures of worry themes: effect of order of presentation on worry report.

Structured instruments (SI) or free-recall instruments (FRI) can be used to examine worry themes. In the case where both types are use jointly, order of presentation may influence number and content of free-recall worries. Half of a large undergraduate sample (N = 609) received the SI before the FRI and the other half received them in the opposite order. Highly prevalent worries (i.e., common worries reported by more than 25% of the sample) were more numerous when the FRI was used first. However, moderately prevalent and rare worries (reported by 5% to 24% and 0% to 4% of the sample, respectively) were more numerous when the FRI was administered second. Results are discussed in terms of a possible priming effect produced by SI on moderately prevalent and rare free-recall worries.

Adult↗

PubMedDate not supplied

Problem solving and problem orientation in generalized anxiety disorder.

The present study's main objective is to examine whether problem orientation and problem-solving skills differ according to generalized anxiety disorder (GAD) symptom level or clinical status (seeking help for GAD). Its secondary goal is to examine whether two cognitive variables (intolerance of uncertainty and beliefs about worry) vary according to GAD symptom level or clinical status. Three groups of subjects participated in the study: (a) nonclinical moderate worriers (N = 15), (b) nonclinical subjects meeting GAD criteria by questionnaire (N = 14), and (c) GAD patients (N = 14). Problem orientation and problem-solving skills were measured with the Social Problem-Solving Inventory (D'Zurilla & Nezu, 1990) and the Problem-Solving Inventory (Heppner & Petersen, 1982), whereas the cognitive variables were assessed with the Intolerance of Uncertainty questionnaire (Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994) and the Why Worry? questionnaire (Freeston, Rhéaume et al., 1994). The results show that problem orientation, intolerance of uncertainty, and beliefs about worry were similar in subjects meeting GAD criteria by questionnaire and GAD patients, whereas moderate worriers had different scores on these variables. Thus, these variables are more highly affected by GAD symptom level than by clinical status. The results also show that problem-solving skills were unaffected by symptom level and clinical status, thereby indicating that knowledge of problem-solving skills is unrelated to both GAD symptom level and GAD clinical status. The findings are discussed in terms of their theoretical and clinical implications.

Adult↗

PubMedDate not supplied

Worry themes in primary GAD, secondary GAD, and other anxiety disorders.

This study examines worry themes among 87 anxiety disorder patients divided into three groups: (a) 24 primary generalized anxiety disorder (GAD) patients, (b) 25 secondary GAD patients, and (c) 38 other anxiety disorder patients (primarily obsessive-compulsive disorder, social phobia and panic disorder with agoraphobia). Structured and free-recall measures were used to measure five worry themes: relationships, work, finances, physical threat, and the future. Both types of measures revealed that GAD patients worry more about the future than non-GAD patients. Further, post hoc analyses testing for linear relationships indicated that primary GAD patients worry more about the future than secondary GAD patients who in turn worry more about the future than other anxiety disorder patients. The results suggest that although worry about immediate problems may not differentiate GAD patients from other anxiety disorder patients, high levels of worry about future events may be a distinguishing feature of GAD.

Adaptation, Psychological↗

PubMedDate not supplied

[Evaluation of worry: validation of a French translation of the Penn State Worry Questionnaire].

UNLABELLED: Excessive worry, which is the central feature of Generalized Anxiety Disorder (GAD), is recognized as an important clinical phenomenon with many negative consequences on people's health. For example, studies report that excessive worry is associated with higher frequencies of work absenteeism and medical consultations, increased risk of other anxiety disorders, depression, heart disease, diabetes and cancer. It is thus imperative to develop effective measures to assess worry among adult. Until now, no measures were available in French for the practitioners and researchers to evaluate the tendency to engage in excessive and uncontrollable worry. One of the most frequently used questionnaires to assess worry in English is The Penn State Worry Questionnaire (PSWQ). This self-report measure has been widely studied and has shown excellent psychometric properties among the non-clinical and clinical populations. This manuscript presents the results of three studies evaluating the psychometric properties of a French Translation of the PSWQ, the Questionnaire sur les Inquiétudes de Penn State (QIPS). The first study includes the translation procedures used to create the French version of the questionnaire, the factorial structure, the internal consistency, the quality of the items, and the convergent validity among non-clinical participants. The second study examines the temporal stability, and the convergent and divergent validity of the questionnaire. Finally, the third study investigates the internal consistency, the quality of the items, and the convergent and divergent validity of the questionnaire among GAD patients. Study 1. This study describes the translation procedures used to create the QIPS, the factorial structure, the internal consistency, the quality of the items, and the convergent validity among non-clinical participants. The French version was translated by a group of clinical psychologists with the assistance of a professional translator and a linguist. A back translation procedure was also conducted. Finally, a pilot study confirmed the intelligibility of the questionnaire. French-speaking university students (N = 352) completed a battery of questionnaires during a lecture. The questionnaires were: The Questionnaires sur les Inquiétudes de Penn State, the Intolerance of Uncertainty Questionnaire, the Cognitive Avoidance Questionnaire, the Why Worry Questionnaire-Revised, and the Social Problem-Solving Inventory-Revised. The statistical analyses reveal that the QIPS shows an appropriate factorial structure, an excellent internal consistency and a very good convergent validity. This French Questionnaire thus seems to be suitable to assess the tendency to worry among the nonclinical population. Study 2. This second study examines the temporal stability, and the convergent and divergent validity of the QIPS. The sample includes 95 French-speaking University students who volunteered to complete the QIPS and the Beck anxiety Inventory. Two self-rating questions were also asked to evaluate the percentage of time spent worrying and to what extent does worrying causes a problem. Eighty-six students participated at the second administration of the questionnaires, four weeks later. The results indicate that the QIPS is very stable over time, thus supporting its temporal stability. Different correlations confirm its convergent and divergent validity. It is concluded that the QIPS is a suitable measure of worry in a non-clinical population. Study 3. This study investigates the internal consistency, the quality of the items, and the convergent and divergent validity of the questionnaire among GAD patients. Seventy-seven GAD patients, as defined by the Diagnostic and Statistical Manual of Mental disorders, fourth edition (DSM IV), participated in this study. They completed the QIPS, the Worry Domains Questionnaire, The Worry and Anxiety Questionnaire, the Intolerance of Uncertainty Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, and a daily diary of differents aspects of worry. The results reveal that the QIPS has an excellent internal consistency, a very good convergent and divergent validity. The QIPS thus seems to be suitable to assess the tendency to worry among GAD patients. CONCLUSION: The overall results presented in these studies confirm the excellent psychometric properties of the QIPS. This French questionnaire is a useful tool for clinicians and researchers to assess the tendency to worry among non-clinical and clinical populations.

Adult↗

PubMedDate not supplied

[Anxiety and physical limitation: a complex relation].

Psychological problems affecting physically handicapped individuals are understudied. However, some studies suggest a higher risk of developing an elevated level of anxiety among these individuals. A previous study reported that people with multiple sclerosis show more anxiety than patients suffering from another type of physical limitations. These results raise questions about the specificity of the link between anxiety and some medical conditions. The aim of the present study is to increase our understanding of manifestations of anxiety associated with degenerative illnesses. Three groups of patients with different physical limitations were compared on their level of anxiety and on various cognitive process. Groups were composed as: 1) 20 patients suffering from multiple sclerosis, 2) 18 patients diagnosed with another degenerative illness (either arthritis, muscular dystrophy or ataxia), and 3) 20 participants presenting a non-degenerative handicap. The 3 groups were not significantly different on age, sex and duration of the physical limitations. Symptoms of anxiety were measured with 3 questionnaires:1) the Hospital Anxiety and Depression Scale, 2) the Penn State Worry Questionnaire, used to assess the tendency to worry, and 3) the Worry Domains Questionnaire, assessing diversity and intensivity of worry themes. In turn, cognitive processes were evaluated with 4 questionnaires: 1) the Acceptance of Disability scale, used to assess the person's level of acceptance regarding a disability, 2) the Interpretation of Disturbing Thoughts questionnaire, an idiographical measure about the interpretation of thoughts associated with a physical handicap, 3) the Intolerance of Uncertainty scale, presenting beliefs about uncertainty and its consequences, and 4) the Cognitive Avoidance questionnaire, to evaluate the tendency of avoiding disturbing thoughts and images. Participants completed all questionnaires alone and the experimenter was available to answer any questions. MANOVAs were used to compare the 3 groups on the studied variables. Statistical analysis revealed no significant differences among groups for symptoms of anxiety and depression, tendency to worry and worry themes. Similarly, no significant differences were obtained on cognitive processes. The multiple sclerosis group and the other degenerative illness group were combined and compared to the non-degenerative handicap group. MANOVAs conducted on symptoms and cognitive processes did not yield any significant differences. Results of the present study seem to indicate that the type of physical limitations is not an indicator of the presence of specific anxiety symptoms or cognitive processes. On an exploratory basis, all participants were compared according to their level of acceptance of disability. Results indicated that a lower level of acceptance was significantly associated with more anxious and depressive symptoms, excessive worries, and a greater intolerance of uncertainty. It seems that acceptance of disability plays a key role in maintaining psychological distress among people with a physical handicap. The influence of intolerance of uncertainty on acceptance of disability needs to be further explored.

Adult↗

PubMedDate not supplied

[The Beck Anxiety Inventory. Psychometric properties of a French translation].

The Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988) is a 21-item checklist developed with large clinical samples to measure anxiety symptoms associated with DSM III-R (APA, 1987) anxiety disorders. Administration and scoring are rapid; the patient rates symptom intensity during the last seven days on a 0 to 3 scale. The BAI adequately covers the major cognitive, affective, and physiological symptoms of anxiety. Care was taken during scale construction to eliminate items that would be confounded with depression items. The authors demonstrate excellent reliability and appropriate convergent and discriminant validity with other measures of anxiety and depression as well as criterion-related validity with in patient samples (Beck et al., 1988). The properties of the BAI have been further studied by Beck and collaborators as well as by other groups of researchers. Since its appearance in 1988 the BAI has quickly been adopted by clinical researchers in the United States, Canada, and the United Kingdom. Five studies present psychometric data on a French translation of the BAI. The translation process involved alternative versions by three translators, a panel of experts, and pilot testing on a group of 20 volunteers. The first study with university students (N = 72) indicated good internal consistence (Cronbach's alpha = .85) and stability (r = .63) at four weeks. The second study (N = 91) demonstrated convergent and discriminant validity significant positive: correlations with measures of obsessive-compulsive symptoms, irrational beliefs, and depression; significant negative correlations with assertiveness and self-esteem, and non-significant correlations with two measures of social desirability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗