Biomedical subjects

Martin M Antony

Publications and source records attributed to Martin M Antony.

At least 19 recordsLinked to original sources

PubMed2007

Changes in perfectionism following cognitive-behavioral treatment for social phobia.

Previous studies have found that social phobia (social anxiety disorder) is associated with elevated levels of perfectionism, particularly concerns over making mistakes (CM) and doubts about actions (DA). This study investigated the extent to which various dimensions of perfectionism change as a result of participating in a 12-session cognitive-behavioral group treatment for social phobia. One hundred seven individuals completed the Frost Multidimensional Perfectionism Scale before and after treatment. Participants improved on several measures of social anxiety, generalized anxiety, and depression. With respect to perfectionism, significant reductions were seen on total perfectionism scores and scores on particular dimensions (CM, DA, organization), but not on other dimensions (personal standards, parental expectations, parental criticism). Furthermore, changes in DA and to some extent CM predicted posttreatment levels of social anxiety after controlling for pretreatment levels of social anxiety and changes in anxiety and depression. Implications of these findings are discussed.

Adult↗

PubMed2006

Group cohesion in cognitive-behavioral group therapy for social phobia.

Cognitive-behavior therapy (CBT) for Social Phobia is effective in both group and individual formats. However, the impact of group processes on treatment efficacy remains relatively unexplored. In this study we examined group cohesion ratings made by individuals at the midpoint and endpoint of CBT groups for social phobia. Symptom measures were also completed at the beginning and end of treatment. We found that cohesion ratings significantly increased over the course of the group and were associated with improvement over time in social anxiety symptoms, as well as improvement on measures of general anxiety, depression, and functional impairment. In conclusion, findings are consistent with the idea that changes in group cohesion are related to social anxiety symptom reduction and, therefore, speak to the importance of nonspecific therapeutic factors in treatment outcome.

Adult↗

PubMed2006

The assessment and treatment of specific phobias: a review.

Specific phobia is one of the most common and easily treated mental disorders. In this review, empirically supported assessment and treatment procedures for specific phobia are discussed. Exposure-based treatments in particular are highlighted given their demonstrated effectiveness for this condition. The format and characteristics of exposure-based treatment and predictors of treatment response are outlined to provide recommendations for maximizing outcome. In addition, several other treatments for specific phobia are reviewed and critiqued, including cognitive therapy, virtual reality, eye movement desensitization and reprocessing, applied tension, and pharmacologic treatments. The review concludes with a discussion of future directions for research.

Antidepressive Agents↗

PubMed2006

Responses to symptom induction exercises in panic disorder.

Exposure to panic symptoms (interoceptive exposure) is often included as part of treatment for panic disorder (PD), although little is known about the relative effects of particular symptom induction exercises. This study describes responses of individuals with PD and nonclinical controls to 13 standard symptom induction exercises and 3 control exercises. Generally, individuals with PD responded more strongly to symptom induction exercises than did controls. The exercises producing the most fear included spinning, hyperventilation, breathing through a straw, and using a tongue depressor. This study also reports findings regarding specific symptoms triggered by each exercise, the percentage of participants reporting fear during each exercise, and predictors of fear.

Adult↗

PubMed2005

Psychometric properties of the social phobia inventory: further evaluation.

This study investigated the psychometric properties of the Social Phobia Inventory [SPIN; Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Foa, E., Wesler, R.H., 2000. Psychometric properties of the Social Phobia Inventory (SPIN). British Journal of Psychiatry, 176, 379-386], a measure of severity in social phobia (social anxiety disorder). Participants included 132 participants with social phobia, 57 participants with panic disorder and agoraphobia (PDA), and 62 participants with obsessive-compulsive disorder (OCD). Confirming findings from an initial validation study, the SPIN was found to have excellent internal consistency and good test-retest reliability. It also distinguished well between those with social phobia and those with either PDA or OCD. Good convergent and discriminant validity were established by examining correlations with other conceptually related and unrelated scales. Finally, the SPIN was sensitive to changes in social phobia severity following cognitive behavioral group treatment. In conclusion, the SPIN is both reliable and valid for the measurement of social phobia severity and outcome following psychological treatment.

Adult↗

PubMed2005

Why are some obsessions more upsetting than others?

Little is known about why certain obsessional thoughts are more upsetting than others for people with obsessive compulsive disorder (OCD). Obsessional thought content often seems arbitrary to sufferers. The current study examined three possible reasons why particular thoughts would be especially upsetting for individuals, based on suggestions put forth by cognitive theories of obsessional thoughts. Twenty-eight individuals with a principal diagnosis of OCD completed questionnaires and interviews at two different periods of time on (1) their most upsetting current obsession and (2) their least upsetting current obsession. Results suggested that more upsetting obsessions were evaluated as more meaningful or significant than less upsetting obsessions, and more upsetting obsessions contradicted valued aspects of the self to a greater degree. All examples of current obsessions, both most and least upsetting, arose in the context of life concerns or issues. Results support cognitive theories in that the strength and nature of appraisal appears to be linked with the distress associated with a thought, and more upsetting thoughts are those that have implications for a person's sense of self.

Adult↗

PubMed2005

Psychometric validation of a monitoring-blunting measure for social anxiety disorder: the coping styles questionnaire for social situations (CSQSS).

The purpose of this investigation was to conduct a psychometric validation of the Coping Styles Questionnaire for Social Situations (CSQSS). The CSQSS was developed to measure monitoring and blunting coping styles in social situations based on Miller's conceptualization of how individuals cope with threat-related information. Study 1 evaluated the content validity of the CSQSS monitoring and blunting items. Study 2 examined factor structure, reliability, and construct validity of the CSQSS in a sample of 443 college students. Evidence supported the content and face validity of the CSQSS. In addition, an exploratory factor analysis revealed a two-factor solution consistent with the monitoring and blunting constructs. Both monitoring and blunting scores were positively correlated with measures of social anxiety, with blunting having a stronger relationship. Moreover, individuals with high social anxiety engaged in a significantly higher degree of monitoring and blunting than did individuals with low social anxiety. Taken together, these results provide support for the reliability and validity of the CSQSS. The CSQSS may serve as a useful measure for further examination of monitoring and blunting coping styles in a social anxiety disorder sample.

Adaptation, Psychological↗

PubMed2005

Thought suppression and its effects on thought frequency, appraisal and mood state in individuals with obsessive-compulsive disorder.

Leading models of obsessive-compulsive disorder (OCD) implicate thought suppression as a key factor in the escalation and persistence of the disorder. This experiment examined the effects of suppression on the frequency of obsessional thoughts in 50 individuals with a primary diagnosis of OCD, and also investigated the effects of participants' appraisals regarding their failures in thought control on distress about intrusive thoughts and on mood. Participants' most upsetting obsessional thought was primed and they then monitored its occurrence over two 4-min intervals. In the first interval, half of the participants were instructed to suppress their obsessional thought and half were instructed not to suppress any thoughts. In the second interval, all participants were given the 'Do Not Suppress' instructions. Participants rated their suppression effort and discomfort over thought occurrences after each interval and recorded their appraisals of thought recurrences during the first interval. Mood state was then reassessed. No ironic effect of suppression on frequency was noted. However, negative appraisals of thought recurrences were associated with more discomfort over thought occurrences and more negative mood at Time 2. These findings suggest that interpretations regarding failures in thought control may be of central importance in understanding obsessional problems.

Adaptation, Psychological↗

PubMed2005

Evaluating the role of panic disorder in emotional sensitivity processes involved with smoking.

The present study investigated the relationship between panic disorder and emotional sensitivity processes related to smoking. Participants were 170 young adult (mean age = 25.2 [8.4]) regular smokers (mean cigarettes per day = 15.6 [2.4]) with (n = 69) and without (n = 101) a primary diagnosis of panic disorder. Consistent with prediction, smokers with panic disorder showed greater motivation to smoke in order to reduce negative affect (but not other reasons for smoking), reported anxiety symptoms but not non-anxiety symptoms as problematic obstacles to quitting during past (lifetime) quit attempts, and reported lower levels of confidence in remaining abstinent when emotionally distressed. Results are discussed in relation to panic-relevant emotional sensitivity processes involved with smoking.

Adult↗

PubMed2005

Screening for obsessive and compulsive symptoms: validation of the Clark-Beck Obsessive-Compulsive Inventory.

The 25-item Clark-Beck Obsessive-Compulsive Inventory (CBOCI) was developed to assess the frequency and severity of obsessive and compulsive symptoms. The measure uses a graded-response format to assess core symptom features of obsessive-compulsive disorder (OCD) based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria and current cognitive-behavioral formulations. Revisions were made to the CBOCI on the basis of psychometric and item analyses of an initial pilot study of clinical and nonclinical participants. The construct validity of the revised CBOCI was supported in a subsequent validation study involving OCD, nonobsessional clinical, and nonclinical samples. A principal-factor analysis of the 25 items found 2 highly correlated factors of Obsessions and Compulsions. OCD patients scored significantly higher on the measure than nonobsessional anxious, depressed, and nonclinical samples. The questionnaire had strong convergent validity with other OCD symptom measures but more modest discriminant validity.

Adult↗

PubMed2005

Evidence-based assessment of anxiety disorders in adults.

This article discusses issues related to the development and dissemination of evidence-based assessment strategies for anxiety disorders and associated problems. It begins with a review of the criteria that should be considered when determining whether particular assessment procedures are evidence-based. These include such factors as reliability, validity, cost-effectiveness, consumer acceptability, utility across different populations, and ease of dissemination. The importance of considering the purpose of the assessment process when deciding whether a procedure is evidence-based is emphasized. Next, the major assessment domains that are particularly important in the area of anxiety disorders (e.g., triggers for anxiety symptoms, avoidance behaviors) are reviewed. Finally, some potential obstacles to the dissemination of evidence-based assessment procedures are discussed along with suggestions for managing these obstacles.

Adult↗

PubMed2005

Psychological treatments for social phobia.

OBJECTIVE: To review the empirical status of psychological treatments for social phobia (SP), commenting both on cognitive-behavioural interventions and on more recent iterations of those approaches. We also review the effective components of cognitive-behavioural therapy (CBT). METHOD: We qualitatively reviewed the empirical literature on the psychological treatment of SP. We include empirical studies, metaanalyses, and recent conference presentations in this review. RESULTS: Cognitive and behavioural interventions for SP appear to be more effective than wait-list controls and supportive therapy. Comparisons of CBT and pharmacologic treatment have produced inconsistent results. Several new treatments for SP demonstrate promising results. CONCLUSION: Evidence suggests that various psychosocial treatments for SP are better than wait-list controls and credible placebo interventions. Ongoing projects investigate the relative efficacy of combining medication and psychosocial treatments over monotherapies; this line of research is important to continue. Further research should also focus on which components of CBT are most effective.

Attention↗

PubMed2004

The relationship between miscellaneous symptoms and major symptom factors in obsessive-compulsive disorder.

The diverse symptomatology of obsessive-compulsive disorder (OCD) is being increasingly regarded as reducible to a few symptom dimensions. However, prevailing factor-analytically derived models of symptom structure omit a number of the well-recognized "miscellaneous" symptoms of OCD. This study sought to determine whether miscellaneous OCD symptoms, ascertained by the Yale-Brown Obsessive-Compulsive Scale symptom checklist, could be differentially and reliably predicted by four symptom factors (obsessions and checking, symmetry and ordering, contamination and cleaning, and hoarding) in two independent groups of individuals with OCD (n=381 and n=107). Logistic regression analyses were used to determine the association of each of the miscellaneous symptoms with the symptom factors; then a single confirmatory factor analysis was conducted to test the model of associations in the smaller sample. Sixteen (89%) of the 18 symptoms examined were reliably predicted by one (11 items) or two (5 items) of the factors, with obsessions and checking and symmetry and ordering emerging as foremost predictors. The expanded four-factor model showed good fit with data from the second sample. Results are conceptually meaningful, but suggest the inadequacy of groupings based solely upon overt behaviors. These findings may aid clinical understanding of OCD and be of value to studies using symptom factors to guide investigation of its causes and correlates.

Adult↗

PubMed2004

Smoking behaviors across anxiety disorders.

The purpose of this study was to test the theory put forth by Zvolensky et al. [Clin. Psychol. Sci. Pract. 10 (2003) 29] that smoking is specifically associated with panic disorder (PD) and not more generally associated with other anxiety disorders. Smoking behaviors were examined across three anxiety disorders: panic disorder with or without agoraphobia, social phobia (SP), and obsessive-compulsive disorder (OCD). A greater proportion of the PD group (40.4%) reported smoking compared to the SP (20%) and OCD (22.4%) groups. Those in the PD group were also more likely than those in the other groups to report being a heavy smoker (greater than 10 cigarettes daily). No significant interaction between diagnosis and smoking status was found for any of the symptom measures. However, participants who smoked had significantly higher scores than nonsmokers on a number of scales, including measures of depression, general anxiety, and distress. Differences in anxiety sensitivity between smokers and nonsmokers approached significance. These findings provide support for Zvolensky et al.'s [Clin. Psychol. Sci. Pract. 10 (2003) 29] theoretical conceptualization and suggest a specific link between smoking and panic disorder. Further investigation is warranted to determine the causal direction of this association.

Activities of Daily Living↗

PubMed2003

Obsessive-compulsive spectrum conditions in obsessive-compulsive disorder and other anxiety disorders.

In light of current interest in an obsessive-compulsive spectrum of disorders, this study sought to determine whether comorbidity patterns support the unique relationship hypothesized between these conditions and obsessive-compulsive disorder (OCD). Comparisons were made of lifetime rates of several proposed spectrum conditions in individuals with one of three anxiety disorder principal diagnoses (OCD, social phobia, or panic disorder [PD], N=277). Spectrum conditions examined included tic-related disorders, trichotillomania, skin picking, and eating disorders, with analyses performed on rates both of clinical disorder alone, and clinical and subclinical manifestations jointly. The OCD group was found to differ from both other groups in showing 1) a greater proportion of individuals affected with any lifetime spectrum condition, 2) a greater number of lifetime spectrum conditions affecting each individual, and 3) a greater proportion of individuals having a lifetime history of multiple spectrum conditions. Analyses for specific spectrum conditions indicated differences among the anxiety disorder groups for all spectrum categories except eating disorders, though only in the case of tic-related conditions did OCD differ significantly from both comparison groups. For the other conditions, dissimilar patterns of differences were observed among the three groups, particularly when subclinical manifestations were included. These findings have conceptual and clinical implications, including 1) the salience of tic-related disorders in the OC spectrum, 2) the possibility that the relationship between spectrum conditions and anxiety disorders may take several different forms, and 3) the need for refinement of the hypothesized spectrum.

Adult↗

PubMed2003

Preliminary examination of the relationship between anxiety disorders in adults and self-reported history of teasing or bullying experiences.

This preliminary study examined the relationship between anxiety disorders and self-reported history of teasing or bullying experiences, comparing individuals with social phobia, obsessive compulsive disorder, and panic disorder with or without agoraphobia. Given that aversive conditioning experiences, such as severe teasing, have been proposed to play a role in the development of social phobia and that the core feature of social phobia is a fear of social situations in which a person may be embarrassed or humiliated, we hypothesized that the social phobia group would have a higher rate of self-reported teasing history than would the obsessive compulsive disorder or panic disorder groups. Consistent with this hypothesis, a relationship between reported history of teasing and diagnosis was found. A significantly greater percentage of participants in the social phobia group (92%) reported a history of severe teasing experiences compared with the obsessive compulsive disorder (50%) and panic disorder (35%) groups. History of teasing experiences was also significantly related to an earlier age of onset for all 3 anxiety disorders, and to a greater number of self-reported additional problems in childhood. These findings suggest further directions for research in this area and highlight the significant link between perceptions of teasing in childhood and social phobia.

Journal Article↗

PubMed2003

Measuring outcomes in aesthetic surgery: a comprehensive review of the literature.

Outcomes research examines the end results of medical interventions, taking into account patients' experiences, preferences, and values. The purpose of assessing outcomes is to provide evidence on which to base clinical decisions. The assessment of outcomes in aesthetic surgery is especially pertinent because patient satisfaction is the predominant factor in determining success. In cosmetic surgery, various scales have been used to assess outcomes. Unfortunately, none of these methods has achieved widespread use. The adoption of broadly accepted, relevant scales to measure outcomes would be advantageous, because this would allow the comparison of techniques, quantification of positive effects, and identification of patients unlikely to benefit from surgery. The purpose of this study was to critically review the present literature to identify the appropriate instruments to assess outcomes in aesthetic surgery. After a comprehensive review of aesthetic surgery outcome instruments, the authors identified body-image and quality-of-life measures to be of the greatest value in determining aesthetic surgery outcomes. These conclusions were based on a critical evaluation of the feasibility, validity, reliability, and sensitivity to change of these measures. The Multidimensional Body-States Relations Questionnaire (MBSRQ), a psychological assessment of body image, was selected as a potential candidate for further study. Two additional body-image assessment instruments, the Facial Appearance Sorting Test (FAST) and the Breast Chest Ratings Scale (BCRS), may be useful in the assessment of rhinoplasty and breast surgery, respectively. The Derriford Scale (DAS59), an instrument that assesses appearance-related quality of life, was also selected. In addition, the authors recommend the use of a generic, utility-based quality-of-life instrument, such as the Health Utilities Index (HUI) or the EuroQol (EQ-5D).

Body Image↗

PubMed2003

Competency assessment in the McMaster Psychotherapy Program.

In January 2001 the Residency Review Committee (RRC) mandated that all psychiatric training programs must demonstrate competency in five forms of psychotherapy. Assessing competency in psychotherapy is a complex and difficult task, with many conceptual and practical issues needing consideration before programs are implemented. Existing competency-based programs can offer some assistance to institutions struggling with this issue. This paper discusses competency assessment in the McMaster Psychotherapy Program, paying special attention to instruments used in the evaluation process. Preliminary results with respect to resident satisfaction with the Program and resident competency in certain therapies are also discussed.

Accreditation↗