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Validation of the spanish version of the Anxiety Sensitivity Index in a clinical sample.

In this study we validated the Spanish version of the Anxiety Sensitivity Index (ASI) in a sample of anxiety disordered patients. The results revealed that: (1) ASI scores were higher for anxiety disordered patients than for normal control subjects, and higher for patients with panic disorder (PD) than for patients with other anxiety disorders (OAD). In contrast, there were no differences among the groups on the Cognitive-Somatic Anxiety Questionnaire (CSAQ). (2) Using discriminant analysis, we were able to differentiate PD patients from patients with OAD on the ASI, but not on the CSAQ. (3) Results supported a unidimensional factor-structure for the ASI. (4) Data provide cross-cultural evidence for construct validity and concurrent validity of the Spanish ASI, and provide further evidence for the usefulness of the concept of anxiety sensitivity.

Adolescent↗

Comorbidity in the anxiety disorders: the use of a life-chart approach.

Findings of comorbidity across the anxiety and depressive disorders have implications for aetiology, diagnosis and treatment. This paper describes a method to assess one aspect of the relationship between comorbid disorders: the degree to which one illness experience is believed to be caused by the earlier experience of a different illness. The life-chart method involves the use of a semi-structured interview to document the lifetime course of disorders. The method was reliable in a sample of patients treated at a specialized treatment unit for anxiety disorders. Patients fell into three major groupings: those with one disorder only (19%); those who fulfilled criteria for two or more disorders, but with one disorder primary and other disorders secondary to it (55%); and those who fulfilled criteria for two or more independent disorders (26%).

Adult↗

What are the roles of perfectionism and responsibility in checking and cleaning compulsions?

Empirical findings revealed that an inflated sense of responsibility has a major impact on obsessive-compulsive symptomatology (OCS). Another cognitive variable, perfectionism, is also theoretically linked to OCS. The assumption about the insufficient but necessary role of perfectionism for OCS and the view of perfectionism as a manifestation of avoidance of serious consequences led us to explore the role of an important cognitive mediator (responsibility) in this relationship. The present study aimed to explore the mediational role of responsibility for the effects of perfectionism on checking and cleaning symptom profiles of OCS in a nonclinical population in Turkey. Findings of the present study suggested that responsibility appraisals mediate effects of self-oriented and socially prescribed perfectionism on checking and the effect of socially prescribed perfectionism on cleaning. There was a partial mediation for self-oriented perfectionism on cleaning. The findings are discussed within the scope of current literature and implications for clinical applications are suggested.

Adolescent↗

Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders.

The Beck Anxiety Inventory (BAI) and the Anxiety Disorders Interview Schedule (ADIS-IV) were administered to 193 adults at a major Midwestern university recruited from an anxiety research and treatment center. The BAI and its four factor scores were compared from individuals with a primary diagnosis of generalized anxiety disorder (GAD), specific or social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), and no psychiatric diagnosis. The cut scores on the BAI and its factors, their sensitivity, specificity, as well as positive and negative predictive values were calculated for each group. The results of this study support previous findings that the strongest quality of the BAI is its ability to assess panic symptomatology. The present study also expands on this notion by establishing that the BAI can be used as an efficient screening tool for distinguishing between individuals with and without panic disorder.

Adolescent↗

Anxiety sensitivity and its dimensions across the anxiety disorders.

Anxiety sensitivity (AS) refers to the fear of anxiety-related sensations, which is thought to arise from beliefs about their harmful consequences. AS is a multidimensional construct that consists of fears of somatic, social, and cognitive aspects of anxiety. In the present study, we examined the relationship between AS dimensions, assessed by factor-analytically derived subscales of the Anxiety Sensitivity Index-Revised (ASI-R), and anxiety-related psychopathology in a sample of 232 treatment-seeking patients with anxiety disorders. Correlational analyses and comparisons among anxiety disorder patient groups and undergraduate students revealed a specific pattern of relationships between ASI-R subscale scores and anxiety-related psychopathology. In contrast, ASI-R total scores evidenced less discriminant validity. Implications for theoretical models of anxiety and directions for future research are discussed.

Adult↗

Perfectionism in obsessive-compulsive disorder patients.

Considerable theory and anecdotal evidence has suggested that patients with Obsessive-Compulsive Disorder (OCD) are more perfectionistic. Evidence with non-clinical populations supports this hypothesis. However, no data are available on levels of perfectionism among patients diagnosed with OCD. The present study extends findings on perfectionism and OCD by comparing perfectionism levels of OCD-diagnosed patients with those of non-patients and a group of patients diagnosed with panic disorder with agoraphobia (PDA). As predicted, patients with OCD had significantly elevated scores on Total Perfectionism, Concern Over Mistakes, and Doubts About Actions compared to non-patients controls. However, they did not differ from patients with PDA on Total Perfectionism or Concern Over Mistakes. Patients with OCD did have higher Doubts Actions scores than those with PDA. The implications for role of perfectionism in OCD and other anxiety disorders are discussed.

Adult↗

Obsessive-compulsive disorder, anxiety disorders, and self-esteem: an exploratory study.

In a preliminary investigation of the link between self-esteem and obsessional problems, patients with OCD were compared with people suffering from other anxiety disorders and non-anxious controls. A questionnaire was devised which allowed the reliable coding of open ended responses focussed on issues surrounding self-worth; standardized measures of self-esteem and clinical symptomatology were also administered. Results indicated that both clinical groups differed significantly from non-clinical controls on generalized self-esteem assessments. There was some evidence of OCD specific effects; obsessionals were more likely than anxious controls to link their self-worth to other people and their relationships. They also regarded the possibility of causing harm as likely to result in other people making extreme negative and critical judgements of them; the other groups expected the responses of others towards them to be more lenient. The implications for future research and for treatment of OCD are discussed.

Adult↗

Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia.

Eighty-seven patients with current episode of depression were assessed by the SCID-P and subdivided in bipolar depressives (N = 24), unipolar depressives (n = 38) and dysthymics (n = 25). Anxiety disorders comorbidity in these three groups was investigated by means of the SCID-P. Panic disorder comorbidity was found in 36.8% of bipolar depressives, 31.4% of unipolar depressives and 13% of dysthymics. Prevalence of obsessive-compulsive disorder was 21.1% in bipolars, 14.3% in unipolars and 8.7% in dysthymics. Generalized anxiety disorder resulted in being much more associated with dysthymia (65.2%) than with bipolar (31.6%) or unipolar depression (37.1%). Social phobia comorbidity was exhibited mainly by unipolars (11.4%), while no cases were detected in the bipolar group. Odds ratios revealed that generalized anxiety disorder is significantly more likely to co-occur with dysthymia. Panic disorder showed a higher trend to be associated with bipolar and unipolar depression. Social phobia was more frequent among unipolar depression.

Adult↗

Executive function deficits associated with symptoms of schizotypy and obsessive-compulsive disorder.

Research suggests that executive dysfunction is seen both in disorders of the schizophrenia constellation and in obsessive-compulsive disorder (OCD), but that the patterns of executive deficits may differ. While disorders of the schizophrenia spectrum reflect impairment of functions such as integration of cognitive activities, a tendency to perseverate, and a failure to notice details (e.g. impairment associated with the dorsolateral prefrontal cortex), OCD may involve problems of impulse control and regulation of behavior, and an inability to maintain cognitive set (e.g. impairment associated with the orbitofrontal cortex). The present study examined differences between high-scorers on a measure of schizotypy, high-scorers on a measure of OCD, high-scorers on both schizotypy and OCD and a control group in performance on executive function tests. As expected, the OCD group demonstrated relative deficits on measures thought to reflect orbitofrontal functioning. However, contrary to expectations, the schizotypal group did not demonstrate deficits on neuropsychological tests thought to reflect dorsolateral prefrontal cortex functioning, and the combined group showed no executive impairment.

Adolescent↗

Pathological worry in depressed and anxious patients.

Anxious apprehension is present in all anxiety disorders and concerns have been raised that worry is not confined to Generalized Anxiety Disorder (GAD). The aims of the present project were three-fold. First, we reexamined whether the level of pathological worry is higher in patients with GAD than other anxiety disorders. Second, we compared worry scores of patients with "pure" GAD, "pure" MDD, and MDD with comorbid GAD. And third, to examine whether worry is specific to psychopathology in general rather than anxiety or depression, we included a control group (psychiatric outpatients without an affective or anxiety disorder). Twelve hundred outpatients were interviewed and completed the Penn State Worry Questionnaire (PSWQ) upon presentation for treatment. Patients with "pure" GAD had the highest scores. Depressed patients were similar to those with anxiety disorders other than GAD, and the control group showed worrying similar to that in general population and nonanxious samples.

Adolescent↗

A neuro-evolutionary approach to the anxiety disorders.

BACKGROUND: Advances in our understanding of the anxiety disorders and in the application of evolutionary principles to medicine provide the possible basis for a neuro-evolutionary approach to these conditions. In this paper, initial steps taken towards such an approach are described. METHODS: Neuro-evolutionary accounts of each of the anxiety disorders have been offered. Notably, several of these accounts have suggested that particular anxiety disorders are mediated by specific brain-based false alarms. This paper reviews the strengths and weaknesses of such accounts. RESULTS: The false suffocation alarm of panic attack is the most fully elaborated of the neuro-evolutionary accounts of an anxiety disorder. However, viable neuro-evolutionary approaches have also been offered for other anxiety disorders, such as obsessive-compulsive disorder and social phobia. CONCLUSIONS: Further work is necessary to consolidate a neuro-evolutionary approach to the anxiety disorders. Although the theoretical basis for such an approach has become increasingly appealing over the last several years, this foundation requires supplementation by further empirical research.

Adolescent↗

The role of the family in childhood obsessive-compulsive disorder.

While obsessive-compulsive disorder is widely recognized to have a strong genetic component, psychosocial factors are also acknowledged to be important. The primary focus of this paper is on familial factors associated with OCD in children and adolescents. It explores the family context as a possible risk factor in the development and maintenance of the disorder, including parental modeling, expressed emotion, parenting style, and family accommodation of the child's symptoms. The involvement of the family in the treatment of the disorder is also reviewed. Finally, future directions for research investigating familial factors in childhood OCD are presented.

Child↗

Comparison of bulimics, obese binge eaters, social phobics, and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders.

Eighty-two women, presenting as normal-weight bulimics, obese binge eaters, social phobics, and individuals with panic disorder, were compared on anxiety, depression, and substance abuse. All were administered the Anxiety Disorder Interview Schedule-Revised and completed the Michigan Alcohol Screening Test, Drug Abuse Screening Test, and Self-Consciousness Scale. A striking proportion of eating disorder subjects were comorbid for one or more anxiety disorders, the most frequent diagnoses being generalized anxiety disorder and social phobia. The results suggest that the place of anxiety in bulimia nervosa goes beyond that discussed within the context of the anxiety reduction model. Conflicting comorbidity findings among this and prior investigations are noted, however, and discussed in terms of the issue of differential diagnosis between eating and anxiety disorders.

Anxiety Disorders↗

Development of the OCDS--revised: a measure of alcohol and drug urges with outpatient substance abuse clients.

Urges to use substances is an important construct in understanding the maintenance of substance use as well as relapse. There is a need to evaluate single instruments measuring global urges to use substances (including alcohol). The Obsessive Compulsive Drinking Scale (OCDS; R. F. Anton, D. H. Moak, & P. Latham, 1995) was revised and tested as a single measure of urges to use substances. Participants were 252 adults entering outpatient substance abuse treatment. Results suggest that the revised scale (OCDS-R) primarily assesses 1 global factor for urges to use substances. In addition, strong support was found for the reliability and concurrent validity of the OCDS-R, although results for its predictive validity were mixed. The OCDS-R is a brief, psychometrically sound self-report instrument that has applicability within clinical and research settings.

Adult↗

Autistic spectrum disorder: diagnostic difficulties.

Recognition of the autistic spectrum disorders is becoming more widespread amongst basic scientists, clinicians, and the general population. The term does not imply anything about pathology or aetiology, although it has proved to be a useful concept clinically. From Kanner's classical autism the concept has widened in scope to include milder and more subtle impairments. From a clinical perspective, there are many alternative diagnoses in an individual with autistic-like symptoms, and thorough investigation is necessary to exclude these.

Asperger Syndrome↗