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The causal role of biased attention in worry was investigated in an experiment in which high worriers were assigned either to a condition requiring attention to nonthreatening words and text while ignoring worry-related material or to a mixed-attention control condition. The former procedure led to fewer negative thought intrusions in a worry test (as rated by both participants and an assessor) than did the control condition. These findings suggest that attentional bias plays a causal role in worry and that its modification can reduce excessive worry. Keywords: worry, anxiety, cognitive bias modification, attention DOI: 10.1037/a0018264

Cognitive and neurobiological accounts of clinical anxiety and depression were examined via event-related brain potentials (ERPs) recorded from patients with panic disorder and healthy controls as they performed an old/new recognition memory task with emotionally negative and neutral words. The emotive connotation of words systematically influenced control subjects'--but not patients'--ERP effects at prefrontal sites in a latency range (~300-500 ms) generally assumed to reflect greater contribution of automatic than controlled memory processes. This provides evidence for dysfunctional inhibitory modulation of affective information processing in panic disorder. The ERP effects after 700 ms, however, suggest that some patients may adopt conscious strategies to minimize the impact of these early processing abnormalities on overt behaviors.

The relation of anxiety sensitivity (AS) to personality dimensions has received little attention. In this study, 4 AS indexes were administered along with measures of personality, fears, and panic attacks to 220 undergraduates. At the higher order level, AS was positively correlated with negative emotionality (NE) but was largely unrelated to either positive emotionality or constraint. At the lower order level, AS was positively correlated with absorption and NE indexes. Most of these correlations were significant even among participants with no panic attack history. AS exhibited incremental validity above and beyond a number of personality variables, including absorption and trait anxiety, in the prediction of fears and panic attack history. These findings are consistent with the hypothesis that a propensity toward immersion in sensory experiences is a diathesis for panic attacks.

Predictors of response to carbon dioxide challenge ( i.e., breathing deeply and rapidly into a paper bag for 5 min) were evaluated in 78 college students. Zero-order correlations revealed that scores on the Suffocation Fear Scale (SFS; S. Rachman & S. Taylor, 1994) and the Anxiety Sensitivity Index (S. Reiss, R. A. Peterson, D. M. Gursky, & R. J. McNally, 1986) predicted anxiety end self-reported bodily sensations, whereas a behavioral measure of carbon dioxide sensitivity (i.e., maximum breath-halding duration ) did not. Multiple regression analyses revealed that the SFS was the only significant predictor of anxiety and bodily sensations. Just as anxiety sensitivity is a better predictor than trait anxiety of the response to biological challenges in general, suffocation fear is a better predictor than anxiety sensitivity for challenges that increase carbon dioxide.

Study of differences in hearing asymmetry and explicit memory biases for threat among 12 panic disorder patients, 12 generalized anxiety disorder patients and 12 controls showed no significant variations among the groups. However, among the patients there was a significant positive association between right hemisphere advantage and cognitive reluctance to recall threat related words. The study measured perceptual asymmetry with a dichotic listening task and memory biases through a recall test of various types of words.

Study of the relationship between anxiety and increases in conditioned response (CR) after a cued-unconditioned stimulus (UCS) rehearsal shows that CR responses following UCS rehearsal were higher in anxious subjects, and that inducing physiological anxiety increased CR responses while inducing cognitive worrying had no effect. UCS rehearsal makes anxious subjects more averse to the rehearsal itself. General anxiety and rehearsal of perceived threats contribute to the development of anxiety-based reactions.

A comparison of the effectiveness of the Anxiety Sensitivity Index (ASI) in predicting reactions to hyperventilation and that of the State-Trait Anxiety Inventory (STAI) shows that the ASI explains a much larger portion of the variations in the responses than the STAI, and that most of the differences are cognitive and affective symptoms. The ASI measures somatic sensation related anxiety while the STAI measures general trait anxiety, suggesting that the STAI is a measure of fear of social threats. This study was based on three experiments, two of which allowed both measures to vary randomly while in the third, the subjects differed on the ASI but had similar scores on the STAI.

Goal-based personal projects analysis methodology by Beck Anxiety Inventory and Beck Depression Inventory reveals the negative effect induced by depression and anxiety in difficult and stressful conditions. Efficacy/structure factor is related to depression relative to anxiety in the planning of daily activities. Depression-specific expression is derived from an inverse relation of depression to social behavior.

Snake and spider fearing subjects tested for phobic stimuli with unconscious preattentive anxiety reveal an aggravated negative response and fear of the objects used in the experiment. Skin conductance responses (SCR) to nonmasked phobic stimuli are recorded by fearful and nonfearful subjects. High SCR responses of fearful subjects to the pictures, and low responses of fearful subjects to normal pictures, is compared with that of nonfearful subjects under masking conditions.

A study was conducted on the relationships between negative mood regulation and anxiety sensitivity and on their ability to serve as predictors of emotional distress to determine the usefulness of integrating behavior-outcome and stimulus-outcome expectancies in emotional distress expectancy models. Using the Beck Depression Inventory and Trait Anxiety Inventory, both expectancy types were found to be independently related to distress. The highest distress levels were observed in subjects who weakly believed that they could control negative moods and strongly believed that anxiety results in more negative consequences.

The selective processing of emotional information by anxious and depressed individuals was examined using a refined Stroop color naming task. Together with a control group, anxious and depressed subjects were asked to identify the background colors of stimulus words presented either subliminally or supraliminally. Results revealed that anxious subjects performed more slowly than depressed and normal subjects regardless of the type of presentation, suggesting that these individuals have a preattentive bias for negative information.

A study was conducted on the link between bulimia nervosa, social self and body esteem. A negative relationship was obtained between nonclinical women's body esteem and their scores in measures of Perceived Fraudulence, Social Anxiety and Public Self-Consciousness. A comparison between bulimic women, subjects with high Eating Attitudes Test (EAT) scores and control subjects on the same measures revealed differences in Perceived Fraudulence. Furthermore, bulimic women and those with high-EAT scores had higher scores on Public Consciousness and Social Anxiety compared with control subjects.

A study was conducted on self-discrepancies in university students who were either depressed, anxious, both depressed and anxious or without any psychiatric disorder. Results were consistent with self-discrepancy theory, which held that conflicting self-beliefs give rise to anxiety and depression. Specifically, it was found that high anxiety or depression was related to high self-discrepancy levels. Compared with nondepressive subjects, depressed students exhibited higher actual-ideal discrepancies, while anxious subjects showed the same compared with non-anxious subjects.

A study was conducted to determine the validity of the cognitive-specificity hypothesis stipulated by Beck's cognitive model of psychopathology as applied to children. An analysis of the results of anxious and depressive cognition measures completed by schoolchildren revealed that, compared with positively worded items, negatively worded items were less effective in distinguishing between groups. Results partially support Beck's hypothesis and the positive-negative affectivity construct.

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., A study to compare the psychological profiles of people suffering from bulimia, binge-eating, social phobias and panic disorders was conducted. Subjects of the study included 20 bulimics, 20 obese binge eaters, 20 social phobics and 20 suffering from panic disorders. They were all female. Results indicate that bulimics and obese binge eaters suffered from other anxiety disorders. Depression was prevalent among all cases.

We tested the hypothesis that self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism are related differentially to unipolar depression. The Multidimensional Perfectionism Scale was adminitered along with measures of depression and anxiety to 22 depressed patients, 22 matched normal control subjects, and 13 anxiety patients. It was found that the depressed patients had higher levels of self-oriented perfectionism than did either the psychiatric or normal control subjects. In addition, depressed patients and anxious patients reported higher levels of socially prescribed perfectionism than did the normal control subjects. The results suggest that various dimensions of perfectionism may play an important role in clinical depression.

The presence of Axis I and Axis II disorders in 71 social public phobic patients was examined. Generalized anxiety disorder was the most common secondary Axis I disorder, followed by simple phobia. Avoidant personality disorder and obsessive-compulsive personality disorder were the most common Axis II diagnoses, and 88% of the sample exhibited features of these 2 personality styles. Subjects with additional Axis I diagnoses were more anxious and depressed than those with no additional Axis I disorder. Social phobics with additional Axis II disorders were more depressed but not more anxious than those with no Axis II diagnosis. Furthermore, those with an additional Axis I disorder had higher scores on measures of neuroticism, interpersonal sensitivity, and agora-phobia. The prevalence and impact of additional Axis I and II disorders on the etiology, maintenance, and treatment outcome for persons with social phobia are discussed.

The physiological and cognitive effects of anxiety on sexual arousal were studied among 16 sexually dysfunctional and 16 sexually functional women. The women in the dysfunctional group were 22 to 39 years old and being treated for one or more sexual problems (such as low sexual desire or the inability to achieve orgasm). Women in the functional group ranged in age from 22 to 50, and had never experienced sexual problems. In a laboratory setting, during two one-hour sessions, the women were shown pairs of videotape stimuli sequences. The first was either a one-minute neutral (e.g. a travelogue) or anxiety-provoking (e.g. a threatened amputation) film, followed by a three-minute erotic film. A vaginal photoplethysmograph and digital recording device measured physiological sexual arousal. The women also completed a self-report rating scale to assess perceived physiological and cognitive arousal and effects induced by anxiety. Data analysis revealed that the anxiety-provoking stimuli significantly increased physical sexual arousal during the erotic films in both groups of women, although to a lesser degree in the dysfunctional group. The functional group also demonstrated genital arousal after the neutral stimuli. However, all 16 women in the dysfunctional group only achieved significant increases in genital arousal after the anxiety stimuli. On the self-report measure, both groups rated the anxiety-erotic condition as being less sexually arousing than the neutral condition. Discrepancies between subjective and physiological measures of sexual arousal were discussed in terms of socialization standards, the lack of synchrony between bodily cues of physiological arousal and cognitively experienced arousal, and the importance of understanding physiological-cognitive interactions when treating sexual dysfunctions in women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Effects of anxiety on sexual arousal were examined to determine if sexually dysfunctional and functional women exhibit different patterns of physiological and subjective response. Subjects viewed 2 videotape conditions: an anxiety-evoking and neutral-control preexposure stimulus, each paired with a sexual arousal-evoking stimulus. Anxiety preexposure enhanced the rate and magnitude of genital arousal for both dysfunctional and functional subjects in relation to the neutral condition. Despite increased genital responses, both groups reported less subjective sexual arousal after anxiety preexposure. Functional subjects exhibited greater physiological but not subjective arousal than dysfunctional subjects in both conditions. Results are discussed in terms of desynchronous patterns of sexual response, mechanisms by which sympathetic activation enhances sexual arousal, and implications for treatment of sexual dysfunction in women.

Understanding memory processes in social anxiety is important because these individuals often report negative memories of anxiety-provoking situations and because of the recent emphasis on learning and memory in models of anxiety. The authors examined the effect of learning on memory for negative social, positive social, and nonsocial information using the retrieval-induced forgetting paradigm in individuals with generalized social phobia (GSPs) and in nonanxious controls (NACs). Words were presented in 1 of 3 practice conditions: practiced words from a practiced category, unpracticed words from a practiced category, and unpracticed words from an unpracticed category. GSPs and NACs showed the same patterns of memory for practice categories for positive social and nonsocial words. However, for negative social words, GSPs benefited less from practice and were hurt less from the effect of practicing competing negative social information than were NACs. This pattern of processing may hamper GSPs' learning of, and habituation to, negative social information.

A large sampling of college students was evaluated to assess the prevalence of panic disorder and panic attacks in individuals who had not been clinically diagnosed. The students completed questionnaires and mental health histories were taken. Of the total group of 2,375 subjects, 12 percent reported having at least one unexpected panic attack. When the clinical criteria in the Diagnosis and Statistical Manual of Mental Disorders, third edition, (DSM-III) were used, 2.36 percent of the total group were diagnosed with panic disorder. The overall prevalence of panic attack was equally observed in men and women. However, women reported higher frequencies of panic episodes, while men were significantly more worried about having a panic attack than the women were. The 12 percent who experienced nonclinical panic incidents exhibited fewer symptoms and episodes, less worry and anxiety, and less panic-related avoidance behavior when compared with the subjects who met the DSM-III criteria. Fear of dying or going insane were also less prevalent among the infrequent panickers. These results support the hypothesis that anxious apprehension may be a factor indicating vulnerability to the development of panic disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)

Implicit memory refers to information that may not be available for recall, but is stored in such a way that it affects the responses of an individual. This phenomenon has been demonstrated in cases such as amnesia, where patients make an appropriate response, but are unaware of any influences on their behavior. Explicit memory refers to the process of recalling information on demand. Clinical studies have shown that individuals may often be biased in their recollection of anxiety-producing information. Three groups composed of 18 individuals who were classified as anxious, recovered from an anxious state, or normal were tested. Each person was given a set of words that had a positive, threatening, or neutral association. Cued recall and word completion tests were then given to each subject using these word sets. The results of measurements of explicit memory did not distinguish normal subjects from those in a state of anxiety. When implicit memory was measured, anxious individuals were more likely to produce threat word completions than positive or neutral. The mechanisms involved in memory biases for threatening information are considered to be different and independent of one another in implicit and explicit memory. The results also implied that threatening words are more easily activated by the individual when he is in a state of anxiety. (Consumer Summary produced by Reliance Medical Information, Inc.)

Two experiments were conducted to study selective memory bias favoring anxiety-relevant materials in patients with anxiety disorders. In the 1st experiment, 32 patients with generalized anxiety disorder (GAD), 30 with social phobia (speaking anxiety), and 31 control participants incidentally learned GAD-relevant words, speech anxiety-relevant words, strongly pleasant words, and words with a neutral valence. Participants did not show any explicit memory bias for threatening materials. Thirty patients suffering from panic disorder (PD) with agoraphobia and 30 controls took part in the 2nd experiment. The design was similar to the 1st experiment. This time a highly specific selective memory bias for threatening words was found. Words describing symptoms of anxiety were better recalled by PD patients. Results are consistent with previous findings but are inexplicable by existing theories.