Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that h... more Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that has been applied broadly and successfully to treat a variety of clinical problems, including the anxiety disorders. Throughout treatment ACT balances acceptance and mindfulness processes with commitment and behavior change processes. As applied to anxiety disorders, ACT seeks to undermine excessive struggle with anxiety and experiential avoidance--attempts to down-regulate and control unwanted private events (thoughts, images, bodily sensations). The goal is to foster more flexible and mindful ways of relating to anxiety so individuals can pursue life goals important to them. This article describes in some detail a unified ACT protocol that can be adapted for use with persons presenting with any of the major anxiety disorders. To exemplify this approach, we present pre-and posttreatment data from three individuals with different anxiety disorders who underwent treatment over a 12-week period. The results showed positive pre-to posttreatment changes in ACT-relevant process measures (e.g., reductions in experiential avoidance, increases in acceptance and mindfulness skills), increases in quality of life, as well as significant reductions in traditional anxiety and distress measures. All three clients reported maintaining or improving on their posttreatment level of functioning.
Introdução: É crescente a produção científica brasileira referente à adaptação de instrumentos ut... more Introdução: É crescente a produção científica brasileira referente à adaptação de instrumentos utilizados internacionalmente para avaliação de ansiedade, porém a realização de estudos envolvendo ansiedade, especificamente na população geriátrica, ainda é menos frequente. Com isso, existe carência de instrumentos de medida criados com finalidade de atender essa população. A tradução e a adaptação transcultural são o primeiro passo para disponibilização de uma medida para investigação em diferentes contextos culturais, permitindo, desse modo, estudos comparativos. Objetivo: Elaborar a equivalência semântica da Geriatric Anxiety Inventory para o português brasileiro. Método: O processo foi realizado em quatro etapas: duas traduções; duas retrotraduções, ambas realizadas por tradutores cegos entre si e ao instrumento original; elaboração de uma versão sintética e pré-teste realizado com uma amostra da população-alvo. Resultados: Para cada item do instrumento, apresentam-se os resultados das quatro etapas. Ao longo do processo, eventuais problemas detectados puderam ser resolvidos, garantindo a qualidade do instrumento e sua adequação à população à qual se destina. Conclusão: A utilização do método em quatro etapas demonstrou ser eficaz e segura para o processo de equivalência semântica.
Our previous research suggests the importance of perceived competence for coping with chronic pai... more Our previous research suggests the importance of perceived competence for coping with chronic pain indicating that perceived competence determines how intensely persons experience pain, how much they are disturbed by pain, and whether they engage in ...
Journal of the Experimental Analysis of Behavior, 1998
Four college students were exposed to a Sidman avoidance procedure to determine if an avoidance c... more Four college students were exposed to a Sidman avoidance procedure to determine if an avoidance contingency involving 20% carbon dioxide-enriched air (CO2) would produce and maintain responding. In Phase 1, two conditions (contingent and noncontingent) were conducted each day. These conditions were distinguished by the presence or absence of a blue or green box on a computer screen. In the contingent condition, CO2 presentation were delivered every 3 s unless a subject pulled a plunger. Each plunger pull postponed CO2 presentations for 10 s. In the noncontingent condition, CO2 presentations occurred on the average of every 5 min independent of responding. Following stable responding in Phase 1, condition-correlated stimuli were reversed. In both conditions, plunger response rate was high during the contingent condition and low or zero during the noncontingent condition. Furthermore, subjects avoided most CO2 presentations. However, CO2 presentations did not increase verbal reports of fear. Overall, the results from the present study suggest that CO2 can be used effectively in basic studies of aversive control and in laboratory analogues of response patterns commonly referred to as anxiety.
Journal of Psychopathology and Behavioral Assessment, 1990
The present study examined the nature of generalized anxiety, which was defined as the constellat... more The present study examined the nature of generalized anxiety, which was defined as the constellation of symptoms listed as diagnostic criteria for generalized anxiety disorder in DSM-III-R. Generalized anxiety was assessed by means of a questionnaire that was especially constructed for this study. Although multidimensional scaling of symptoms reported by a clinically anxious sample produced orthogonal anxiety and panic dimensions, many symptoms were common to both dimensions. Whereas worry was found to be the cardinal feature of generalized anxiety, respiratory symptoms were found to associate closely with panic. These dimensions were replicated in a student sample. It is argued that while generalized anxiety symptoms constitute a unique dimension in the field of anxiety disorders, both panic and generalized anxiety may be linked with a basic anxiety response system. The findings also indicated that worry associated more closely with generalized anxiety than did apprehensive expectations. The heuristic value of the findings are discussed in light of the issue relating to an anxiety-panic continuum.
Psychological features and complaints of persons presenting to medical settings with heart-focuse... more Psychological features and complaints of persons presenting to medical settings with heart-focused anxiety and noncardiac chest pain are poor~s understood. Comparing 20 healthy heart-anxious patients to cardiac and surgical inpatients and nonpatient controls, we found that healthy heart-anxious patients (a ) were as afraid of chest pain and heart palpitations as inpatients with heart disease, (b) were as incapacitated by symptoms and using medical services as much as both inpatient groups; and (c) reported higher levels of cardiac disease conviction, heart awareness, and behaviors designed to protect their heart than surgical patients and nonpatients. Compared to all other groups, healthy heart-anxious patients reported more panic and other anxiety disorders, hypochondriacal beliefs, physical symptoms, obsessive-compulsive concerns, and negative affect. Following a hyperventilation test, heart-anxious patients also indicated more distressing symptoms and thoughts, and felt less safe and in control than surgical patients and nonpatients. Results support efforts for a timely recognition, diagnosis, and behavioral treatment of persons with heart-focused anxiety.
Journal of Behavior Therapy and Experimental Psychiatry, 1983
This article reviews the manner in which overt behavioral measures of fear (usually Behaviour Avo... more This article reviews the manner in which overt behavioral measures of fear (usually Behaviour Avoidance Tests) are reported in major behaviour therapy journals. It was investigated whether instructions and procedures of BATs were outlined in sufficient detail to enable a potential researcher to replicate them. The results show that only one third (62) of 185 reviewed studies on fear, anxiety or phobias included some form of overt behavioral assessment. Only one third of these 62 studies gave a fair or detailed account of BAT instructions and procedures whereas the remaining studies provided only vague information or no details at all.
Journal of Behavior Therapy and Experimental Psychiatry, 1996
... At this time, neither a rigid application of manuals nor their total rejection appears feasib... more ... At this time, neither a rigid application of manuals nor their total rejection appears feasible or even desirable. ... and fixed numbers of sessions, the most important task of behavior therapists is to conduct functional analyses of ... Journal of Applied Behavior Analysis, 27, 215240. ...
cutoff of 14 g/dL was selected to dichotomize groups, as this represents the point necessitating ... more cutoff of 14 g/dL was selected to dichotomize groups, as this represents the point necessitating treatment with heparin prophylaxis. Biochemical pregnancies and miscarriages were excluded. The rate of increase in log transformed HCG for each day was compared using general linear mixed effects regression which was extended to deal with repeated measures over time in a subject. Observed data included only values taken from cycle days 18 to 40. A linear association with log transformed HCG was assumed. One-and 2-day relative increases in HCG along with slopes are estimated separately.
... The first couple, Landon (33) and Wendy (28) reported low levels of marital satisfaction and ... more ... The first couple, Landon (33) and Wendy (28) reported low levels of marital satisfaction and high levels of conflict due to rigidity in joint decision-making. Landon was raised in Europe and moved to the United States as an adult. ...
... These findings are particularly interesting with respect to the study by Kleinknecht (1982), ... more ... These findings are particularly interesting with respect to the study by Kleinknecht (1982), who found that the large majority of his 5s attributed their fear reduction to acquired knowledge of the phobic objects and to observation. ... Julian Press, New York. ...
Three investigations of the mercury-in-rubber (MIR) strain gauge were completed to study its mens... more Three investigations of the mercury-in-rubber (MIR) strain gauge were completed to study its mensural properties under typical laboratory conditions. Study I found that basal penile circumference measurement was highly reliable (r = .94); Study II showed that at full erection reliability was somewhat lower (r = .75). Study III compared MIR circumference measures to videotaped records of erectile angle. The two measures were generally highly correlated over the initial arousal phase but were less so once circumference reached its asymptote. Overall, the MIR strain gauge can be used with some confidence, especially if its limitations are carefully considered.
ABSTRACT This paper presents a summarizing overview of the present conceptual, empirical, and pra... more ABSTRACT This paper presents a summarizing overview of the present conceptual, empirical, and practical status of the recent “cognitive trend” in behaviour therapy. The theoretical and practical similarities and differences of the three most influential cognitive-behavioural approaches are presented and some empirical evidence of their theoretical bases is critically examined. Finally, the therapeutic efficacy of these approaches is briefly reviewed.
Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have t... more Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who receive...
Fear of bodily sensations has received extensive attention in relation to panic disorder, and mor... more Fear of bodily sensations has received extensive attention in relation to panic disorder, and more recently, other types of anxiety pathology and chronic pain problems. Extending this work, the present study examined fear of bodily sensations and its underlying dimensions in emergency room patients with Noncardiac Chest Pain (NCCP; n = 63). We posited a "differential specificity" hypothesis, expecting that specific cardiopulmonary fears would be more strongly associated with NCCP symptoms relative to other bodily fears. As hypothesized, participants reported cardiopulmonary sensations as significantly more fear-provoking than numbness, dissociation, and gastrointestinal sensations. Additionally, regression analysis indicated that after accounting for theoretically relevant demographic variables and health status, cardiopulmonary fear was the best predictor of a composite index of cardiac complaints intensity, even after removing variance related to the absolute number of c...
The present cross-sectional study sought to examine the extent to which heart-focused anxiety is ... more The present cross-sectional study sought to examine the extent to which heart-focused anxiety is associated with the co-occurrence of coronary artery disease (CAD) and a history of regular smoking in a sample of 148 postangiography patients from a cardiology unit. Individuals with CAD who regularly smoked demonstrated significantly greater heart-focused attention, but no greater degree of avoidance and fear of heart-focused sensations, than did nonsmoking persons with CAD and smokers without CAD. We also found evidence that heart-focused attention and fear incrementally predicted (above and beyond demographic variables and body mass index) intensity of average chest pain. Overall, this study provides some of the first empirical evidence that the occurrence of regular smoking and CAD is associated with specific dimensions of health anxiety. We discuss these findings in relation to models of panic pathology and anxious responding to bodily sensations.
We examined whether certain “risky” drinking motives mediate the previously established relation ... more We examined whether certain “risky” drinking motives mediate the previously established relation between elevated anxiety sensitivity (AS) and increased drinking behavior in college student drinkers (n=109 women, 73 men). Specifically, we administered the Anxiety Sensitivity Index (ASI), Revised Drinking Motives Questionnaire, and a quantity-frequency measure of typical drinking levels. Participants were parceled according to high (n=30), moderate (n=29), and low
Objective: We investigated the degree and course of heartfocused anxiety (HFA) in patients with c... more Objective: We investigated the degree and course of heartfocused anxiety (HFA) in patients with cardiac diseases before and after cardiac surgery. Methods: We examined 90 patients undergoing coronary bypass, valve replacement, or combined surgery before surgery, 6 weeks after surgery, and 6 months after surgery. Patients completed the Cardiac Anxiety Questionnaire (CAQ), which assesses heart-focused fear, attention, and avoidance, and a set of other questionnaires assessing general anxiety, depression, and quality of life. Data were compared with an age-and sexcontrolled contrast group of 72 orthopedic patients with no history of cardiac disease. Results: All dimensions of HFA were elevated in patients before surgery. CAQ-Fear was significantly reduced 6 weeks after surgery and at 6-month follow-up. CAQ-Avoidance was stable after surgery but declined on follow-up, while there was only a statistical tendency indicating reduction in CAQ-Attention. Approximately 20% of patients continued to experience clinically elevated levels of HFA at 6-month follow-up. Furthermore, we found decreases in global anxiety and depression, and an increase in quality of life after surgery. Conclusions: In contrast to global psychosocial indicators, the more specific assessment of HFA may help identify individuals with elevated levels of HFA who might benefit from interventions to help them adjust to the effects of surgery and lingering cardiac problems.
Predictability of aversive events impacts the development and maintenance of anxiety, particularl... more Predictability of aversive events impacts the development and maintenance of anxiety, particularly panic disorder. Although animal studies typically have found a preference for signaled (predictable) over unsignaled (unpredictable) aversive events, results of research with human participants have been less clear. Using a panic-relevant paradigm, the authors examined predictability preference with humans as a function of anxiety sensitivity and gender during repeated administrations of 20% carbon-dioxide-enriched air. Participants preferred predictable administrations, with high-anxiety individuals showing greater preference than low-anxiety individuals and women showing greater preference than men. In addition to providing information to better understand human predictability preference for panic-related events, results also may aid in determining the applicability of predictability to the cognitive-behavioral treatment of panic disorder.
Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that h... more Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that has been applied broadly and successfully to treat a variety of clinical problems, including the anxiety disorders. Throughout treatment ACT balances acceptance and mindfulness processes with commitment and behavior change processes. As applied to anxiety disorders, ACT seeks to undermine excessive struggle with anxiety and experiential avoidance--attempts to down-regulate and control unwanted private events (thoughts, images, bodily sensations). The goal is to foster more flexible and mindful ways of relating to anxiety so individuals can pursue life goals important to them. This article describes in some detail a unified ACT protocol that can be adapted for use with persons presenting with any of the major anxiety disorders. To exemplify this approach, we present pre-and posttreatment data from three individuals with different anxiety disorders who underwent treatment over a 12-week period. The results showed positive pre-to posttreatment changes in ACT-relevant process measures (e.g., reductions in experiential avoidance, increases in acceptance and mindfulness skills), increases in quality of life, as well as significant reductions in traditional anxiety and distress measures. All three clients reported maintaining or improving on their posttreatment level of functioning.
Introdução: É crescente a produção científica brasileira referente à adaptação de instrumentos ut... more Introdução: É crescente a produção científica brasileira referente à adaptação de instrumentos utilizados internacionalmente para avaliação de ansiedade, porém a realização de estudos envolvendo ansiedade, especificamente na população geriátrica, ainda é menos frequente. Com isso, existe carência de instrumentos de medida criados com finalidade de atender essa população. A tradução e a adaptação transcultural são o primeiro passo para disponibilização de uma medida para investigação em diferentes contextos culturais, permitindo, desse modo, estudos comparativos. Objetivo: Elaborar a equivalência semântica da Geriatric Anxiety Inventory para o português brasileiro. Método: O processo foi realizado em quatro etapas: duas traduções; duas retrotraduções, ambas realizadas por tradutores cegos entre si e ao instrumento original; elaboração de uma versão sintética e pré-teste realizado com uma amostra da população-alvo. Resultados: Para cada item do instrumento, apresentam-se os resultados das quatro etapas. Ao longo do processo, eventuais problemas detectados puderam ser resolvidos, garantindo a qualidade do instrumento e sua adequação à população à qual se destina. Conclusão: A utilização do método em quatro etapas demonstrou ser eficaz e segura para o processo de equivalência semântica.
Our previous research suggests the importance of perceived competence for coping with chronic pai... more Our previous research suggests the importance of perceived competence for coping with chronic pain indicating that perceived competence determines how intensely persons experience pain, how much they are disturbed by pain, and whether they engage in ...
Journal of the Experimental Analysis of Behavior, 1998
Four college students were exposed to a Sidman avoidance procedure to determine if an avoidance c... more Four college students were exposed to a Sidman avoidance procedure to determine if an avoidance contingency involving 20% carbon dioxide-enriched air (CO2) would produce and maintain responding. In Phase 1, two conditions (contingent and noncontingent) were conducted each day. These conditions were distinguished by the presence or absence of a blue or green box on a computer screen. In the contingent condition, CO2 presentation were delivered every 3 s unless a subject pulled a plunger. Each plunger pull postponed CO2 presentations for 10 s. In the noncontingent condition, CO2 presentations occurred on the average of every 5 min independent of responding. Following stable responding in Phase 1, condition-correlated stimuli were reversed. In both conditions, plunger response rate was high during the contingent condition and low or zero during the noncontingent condition. Furthermore, subjects avoided most CO2 presentations. However, CO2 presentations did not increase verbal reports of fear. Overall, the results from the present study suggest that CO2 can be used effectively in basic studies of aversive control and in laboratory analogues of response patterns commonly referred to as anxiety.
Journal of Psychopathology and Behavioral Assessment, 1990
The present study examined the nature of generalized anxiety, which was defined as the constellat... more The present study examined the nature of generalized anxiety, which was defined as the constellation of symptoms listed as diagnostic criteria for generalized anxiety disorder in DSM-III-R. Generalized anxiety was assessed by means of a questionnaire that was especially constructed for this study. Although multidimensional scaling of symptoms reported by a clinically anxious sample produced orthogonal anxiety and panic dimensions, many symptoms were common to both dimensions. Whereas worry was found to be the cardinal feature of generalized anxiety, respiratory symptoms were found to associate closely with panic. These dimensions were replicated in a student sample. It is argued that while generalized anxiety symptoms constitute a unique dimension in the field of anxiety disorders, both panic and generalized anxiety may be linked with a basic anxiety response system. The findings also indicated that worry associated more closely with generalized anxiety than did apprehensive expectations. The heuristic value of the findings are discussed in light of the issue relating to an anxiety-panic continuum.
Psychological features and complaints of persons presenting to medical settings with heart-focuse... more Psychological features and complaints of persons presenting to medical settings with heart-focused anxiety and noncardiac chest pain are poor~s understood. Comparing 20 healthy heart-anxious patients to cardiac and surgical inpatients and nonpatient controls, we found that healthy heart-anxious patients (a ) were as afraid of chest pain and heart palpitations as inpatients with heart disease, (b) were as incapacitated by symptoms and using medical services as much as both inpatient groups; and (c) reported higher levels of cardiac disease conviction, heart awareness, and behaviors designed to protect their heart than surgical patients and nonpatients. Compared to all other groups, healthy heart-anxious patients reported more panic and other anxiety disorders, hypochondriacal beliefs, physical symptoms, obsessive-compulsive concerns, and negative affect. Following a hyperventilation test, heart-anxious patients also indicated more distressing symptoms and thoughts, and felt less safe and in control than surgical patients and nonpatients. Results support efforts for a timely recognition, diagnosis, and behavioral treatment of persons with heart-focused anxiety.
Journal of Behavior Therapy and Experimental Psychiatry, 1983
This article reviews the manner in which overt behavioral measures of fear (usually Behaviour Avo... more This article reviews the manner in which overt behavioral measures of fear (usually Behaviour Avoidance Tests) are reported in major behaviour therapy journals. It was investigated whether instructions and procedures of BATs were outlined in sufficient detail to enable a potential researcher to replicate them. The results show that only one third (62) of 185 reviewed studies on fear, anxiety or phobias included some form of overt behavioral assessment. Only one third of these 62 studies gave a fair or detailed account of BAT instructions and procedures whereas the remaining studies provided only vague information or no details at all.
Journal of Behavior Therapy and Experimental Psychiatry, 1996
... At this time, neither a rigid application of manuals nor their total rejection appears feasib... more ... At this time, neither a rigid application of manuals nor their total rejection appears feasible or even desirable. ... and fixed numbers of sessions, the most important task of behavior therapists is to conduct functional analyses of ... Journal of Applied Behavior Analysis, 27, 215240. ...
cutoff of 14 g/dL was selected to dichotomize groups, as this represents the point necessitating ... more cutoff of 14 g/dL was selected to dichotomize groups, as this represents the point necessitating treatment with heparin prophylaxis. Biochemical pregnancies and miscarriages were excluded. The rate of increase in log transformed HCG for each day was compared using general linear mixed effects regression which was extended to deal with repeated measures over time in a subject. Observed data included only values taken from cycle days 18 to 40. A linear association with log transformed HCG was assumed. One-and 2-day relative increases in HCG along with slopes are estimated separately.
... The first couple, Landon (33) and Wendy (28) reported low levels of marital satisfaction and ... more ... The first couple, Landon (33) and Wendy (28) reported low levels of marital satisfaction and high levels of conflict due to rigidity in joint decision-making. Landon was raised in Europe and moved to the United States as an adult. ...
... These findings are particularly interesting with respect to the study by Kleinknecht (1982), ... more ... These findings are particularly interesting with respect to the study by Kleinknecht (1982), who found that the large majority of his 5s attributed their fear reduction to acquired knowledge of the phobic objects and to observation. ... Julian Press, New York. ...
Three investigations of the mercury-in-rubber (MIR) strain gauge were completed to study its mens... more Three investigations of the mercury-in-rubber (MIR) strain gauge were completed to study its mensural properties under typical laboratory conditions. Study I found that basal penile circumference measurement was highly reliable (r = .94); Study II showed that at full erection reliability was somewhat lower (r = .75). Study III compared MIR circumference measures to videotaped records of erectile angle. The two measures were generally highly correlated over the initial arousal phase but were less so once circumference reached its asymptote. Overall, the MIR strain gauge can be used with some confidence, especially if its limitations are carefully considered.
ABSTRACT This paper presents a summarizing overview of the present conceptual, empirical, and pra... more ABSTRACT This paper presents a summarizing overview of the present conceptual, empirical, and practical status of the recent “cognitive trend” in behaviour therapy. The theoretical and practical similarities and differences of the three most influential cognitive-behavioural approaches are presented and some empirical evidence of their theoretical bases is critically examined. Finally, the therapeutic efficacy of these approaches is briefly reviewed.
Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have t... more Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who receive...
Fear of bodily sensations has received extensive attention in relation to panic disorder, and mor... more Fear of bodily sensations has received extensive attention in relation to panic disorder, and more recently, other types of anxiety pathology and chronic pain problems. Extending this work, the present study examined fear of bodily sensations and its underlying dimensions in emergency room patients with Noncardiac Chest Pain (NCCP; n = 63). We posited a "differential specificity" hypothesis, expecting that specific cardiopulmonary fears would be more strongly associated with NCCP symptoms relative to other bodily fears. As hypothesized, participants reported cardiopulmonary sensations as significantly more fear-provoking than numbness, dissociation, and gastrointestinal sensations. Additionally, regression analysis indicated that after accounting for theoretically relevant demographic variables and health status, cardiopulmonary fear was the best predictor of a composite index of cardiac complaints intensity, even after removing variance related to the absolute number of c...
The present cross-sectional study sought to examine the extent to which heart-focused anxiety is ... more The present cross-sectional study sought to examine the extent to which heart-focused anxiety is associated with the co-occurrence of coronary artery disease (CAD) and a history of regular smoking in a sample of 148 postangiography patients from a cardiology unit. Individuals with CAD who regularly smoked demonstrated significantly greater heart-focused attention, but no greater degree of avoidance and fear of heart-focused sensations, than did nonsmoking persons with CAD and smokers without CAD. We also found evidence that heart-focused attention and fear incrementally predicted (above and beyond demographic variables and body mass index) intensity of average chest pain. Overall, this study provides some of the first empirical evidence that the occurrence of regular smoking and CAD is associated with specific dimensions of health anxiety. We discuss these findings in relation to models of panic pathology and anxious responding to bodily sensations.
We examined whether certain “risky” drinking motives mediate the previously established relation ... more We examined whether certain “risky” drinking motives mediate the previously established relation between elevated anxiety sensitivity (AS) and increased drinking behavior in college student drinkers (n=109 women, 73 men). Specifically, we administered the Anxiety Sensitivity Index (ASI), Revised Drinking Motives Questionnaire, and a quantity-frequency measure of typical drinking levels. Participants were parceled according to high (n=30), moderate (n=29), and low
Objective: We investigated the degree and course of heartfocused anxiety (HFA) in patients with c... more Objective: We investigated the degree and course of heartfocused anxiety (HFA) in patients with cardiac diseases before and after cardiac surgery. Methods: We examined 90 patients undergoing coronary bypass, valve replacement, or combined surgery before surgery, 6 weeks after surgery, and 6 months after surgery. Patients completed the Cardiac Anxiety Questionnaire (CAQ), which assesses heart-focused fear, attention, and avoidance, and a set of other questionnaires assessing general anxiety, depression, and quality of life. Data were compared with an age-and sexcontrolled contrast group of 72 orthopedic patients with no history of cardiac disease. Results: All dimensions of HFA were elevated in patients before surgery. CAQ-Fear was significantly reduced 6 weeks after surgery and at 6-month follow-up. CAQ-Avoidance was stable after surgery but declined on follow-up, while there was only a statistical tendency indicating reduction in CAQ-Attention. Approximately 20% of patients continued to experience clinically elevated levels of HFA at 6-month follow-up. Furthermore, we found decreases in global anxiety and depression, and an increase in quality of life after surgery. Conclusions: In contrast to global psychosocial indicators, the more specific assessment of HFA may help identify individuals with elevated levels of HFA who might benefit from interventions to help them adjust to the effects of surgery and lingering cardiac problems.
Predictability of aversive events impacts the development and maintenance of anxiety, particularl... more Predictability of aversive events impacts the development and maintenance of anxiety, particularly panic disorder. Although animal studies typically have found a preference for signaled (predictable) over unsignaled (unpredictable) aversive events, results of research with human participants have been less clear. Using a panic-relevant paradigm, the authors examined predictability preference with humans as a function of anxiety sensitivity and gender during repeated administrations of 20% carbon-dioxide-enriched air. Participants preferred predictable administrations, with high-anxiety individuals showing greater preference than low-anxiety individuals and women showing greater preference than men. In addition to providing information to better understand human predictability preference for panic-related events, results also may aid in determining the applicability of predictability to the cognitive-behavioral treatment of panic disorder.
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