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Background and Objectives: Cognitive-behavioral models highlight the conjoint roles of self-focused attention (SFA), post-event processing (PEP), and performance appraisals in the maintenance of social anxiety. SFA, PEP, and biased performance appraisals are related to social anxiety; however, limited research has examined how SFA affects information-processing following social events. The current study examined whether SFA affects the relationships between performance appraisals and PEP following a social event.., Methods: 137 participants with high (n = 72) or low (n = 65) social anxiety were randomly assigned to conditions of high SFA or low SFA while engaging in a standardized social performance. Subsequent performance appraisals and PEP were measured., Results: Immediate performance appraisals were not affected by SFA. High levels of SFA led to a stronger, inverse relationship between immediate positive performance appraisals and subsequent negative PEP. High levels of SFA also led to a stronger, inverse relationship between negative PEP and changes in positive performance appraisals.., Limitations: Future research should examine whether the current findings, which involved a standardized social performance event, extend to interaction events as well as in a clinical sample., Conclusions: These findings suggest that SFA affects the processing of positive information following a social performance event. SFA is particularly important for understanding how negative PEP undermines positive performance appraisals.., (Published by Elsevier Ltd.)

This study examined the moderating role of shyness mindset on the reduction of social anxiety during exposure-based treatment. Participants (N=60) in an intensive outpatient program for anxiety disorders were assessed at pre- and post-treatment. Social performance anxiety decreased dramatically during treatment, but the amount of decrease differed as a function of pre-treatment shyness mindset. At one standard deviation above the mean on both the social performance anxiety and shyness mindset measures, an average reduction of 15 points on the social performance anxiety measure was observed. At one standard deviation above the mean on the social performance anxiety measure and one standard deviation below the mean on the shyness mindset measure, an average reduction of 27 points on the social performance anxiety measure was observed. These results suggest that targeting shyness mindset during exposure-based treatments for social anxiety disorder might increase the effectiveness of treatment for individuals with a high shyness mindset., (Published by Elsevier Ltd.)

Researchers postulate that both shame and guilt are emotions important to anxiety disorders. Extant data, however, indicate that guilt-proneness shares non-significant relationships with psychopathology symptoms after controlling for shame-proneness. To further investigate the relevance of shame and guilt to the anxiety disorders domain, the current study examined associations between shame- and guilt-proneness and anxiety disorder symptoms using data from patients (N=124) with primary anxiety disorder diagnoses. Results indicated that only symptoms of social anxiety disorder (SAD) and generalized anxiety disorder (GAD) shared significant relations with shame-proneness after controlling for other types of anxiety disorder symptoms, depression symptoms, and guilt-proneness. Further, changes in shame-proneness during treatment were found to share significant relations with changes in obsessive-compulsive disorder, SAD, and GAD symptoms. The current results indicate that shame is more relevant to symptoms of the anxiety disorders domain than is guilt. The implications of these results for the conceptualization and treatment of anxiety disorders are discussed., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The current study uses data from a large nonclinical college student sample (N = 503) to examine a structural model of hypochondriasis (HC). This model predicts the distinctiveness of two dimensions (disease phobia and disease conviction) purported to underlie the disorder, and that these two dimensions are differentially related to variables important to health anxiety and somatoform disorders, respectively. Results were generally consistent with the hypothesized model. Specifically, (a) body perception variables (somatosensory amplification and anxiety sensitivity - physical) emerged as significant predictors of disease phobia, but not disease conviction; (b) emotion dysregulation variables (cognitive avoidance and cognitive reappraisal) emerged as significant predictors of disease conviction, but not disease phobia; and (c) both disease phobia and disease conviction independently predicted medical utilization. Further, collapsing disease phobia and disease conviction onto a single latent factor provided an inadequate fit to the data. Conceptual and therapeutic implications of these results are discussed., (2010 Elsevier Ltd. All rights reserved.)

Cognitive models of social anxiety suggest that fear of negative evaluation (FNE) is the central cognitive dimension underlying the disorder. The Fear of Positive Evaluation Scale (FPES; Weeks, Heimberg, & Rodebaugh, 2008) was recently developed to assess an additional cognitive dimension purported to underlie social anxiety disorder (SAD), but its psychometric properties have yet to be examined in clinical populations. The present study, with 133 treatment-seeking patients, examined the applicability of the FPES with a clinical sample. Results indicated that the FPES was factorially distinct from a measure assessing FNE, and patients with SAD (n=51) had higher mean scores on the FPES than patients with other anxiety disorders (n=82). The FPES also showed adequate reliability (internal consistency), good convergent and discriminant validity, acceptable criterion-related validity in predicting social interaction anxiety symptoms, and appropriate sensitivity to treatment. The FPES appears to have good psychometric properties and is a promising new assessment tool for better understanding SAD.

The present study examined utility of the Illness Attitudes Scale (IAS; [Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger Publishers]) in a non-clinical college sample (N=235). Relationships among five recently identified IAS dimensions (fear of illness and pain, symptom effects, treatment experience, disease conviction, and health habits) and self-report measures of several anxiety-related constructs (health anxiety, body vigilance, intolerance of uncertainty, anxiety sensitivity, and non-specific anxiety symptoms) were examined. In addition, this study investigated the incremental validity of the IAS dimensions in predicting medical utilization. The fear of illness and pain dimension and the symptom effects dimension consistently shared stronger relations with the anxiety-related constructs compared to the other three IAS dimensions. The symptom effects dimension, the disease conviction dimension, and the health habits dimension showed incremental validity over the anxiety-related constructs in predicting medical utilization. Implications for the IAS and future conceptualizations of HC are discussed.

The Disgust Propensity and Sensitivity Scale-Revised (DPSS-R [Pers. Indiv. Differ. 41 (2006) 1241-1252]) is a new assessment tool thought to assess two distinguishable factors contributing to disgust reactions, Disgust Propensity and Disgust Sensitivity. Extant data though indicate the presence of four unreliable DPSS-R items. The present study examined the psychometric properties of a reduced-item version of the DPSS-R, in which these four problematic items were removed, using data from two large independent samples of nonclinical college students. Results from Study 1 revealed that the reduced-item DPSS-R factor structure provided more favorable goodness-of-fit indices than the two previous full-length DPSS-R factor structures. In Study 2, the reduced-item DPSS-R scales showed good reliability, stronger relationships with symptoms of disgust-relevant than fear-relevant phobias, and adequate incremental concurrent validity in predicting symptoms of disgust-relevant phobias. The present study suggests that the reduced-item DPSS-R is both reliable and valid, and likely addresses the limitations of the full-length version.

The Body Vigilance Scale (BVS) is a measure developed to assess one's conscious attendance to internal cues. The present report investigated the structure, correlates, and predictive utility of the BVS in nonclinical (N=442) and anxiety (N=135) disorder samples. The findings of Study 1 suggest that the BVS is 1-dimensional in a nonclinical sample, and Study 2 replicated the factor structure of the BVS in an anxiety disorder sample. Correlations between the BVS and related (i.e., anxiety sensitivity) and unrelated (i.e., social anxiety) variables were consistent with predictions in both studies. Study 2 also showed that body vigilance is primarily elevated in patients with panic disorder relative to other anxiety disorders. Relative elevations in body vigilance were also observed for patients with hypochondriasis and generalized anxiety disorder. The BVS also demonstrated a specific association with medical utilization and health-related safety-seeking behaviors after controlling for related variables in nonclinical and anxiety disorder samples. The implications of our findings for the nature and measurement of body vigilance as a predictor of health concerns in anxiety disorders are considered.

We tested several hypotheses derived from the emotional processing theory of fear reduction by manipulating claustrophobic participants' focus of attention during in vivo exposure. Sixty participants displaying marked claustrophobic fear were randomized to one of four exposure conditions. Each participant received a total of 30-min of self-guided exposure 2-weeks after pretreatment testing. One group attended to threatening words and images during exposure (TW) and was compared to a control group that attended to neutral words and images (NW). A third group performed a demanding cognitive load task--a modified Seashore Rhythm Test during exposure (SR) and was compared to an exposure only (EO) control group. Contrary to prediction, the threat word manipulation was not associated with lower levels of fear following treatment. Consistent with prediction, the distraction manipulation resulted in less fear reduction at post-treatment. Treatment process analyses revealed that the negative effects of distraction on treatment outcome manifested early as slower between-trial habituation. These results and their relevance to emotional processing theory are discussed.

This study examines panic attacks and substance use in a sample of incoming college freshman (n = 399 ) using questionnaires. Panickers (n = 47 ) were significantly more likely than nonpanickers (n = 290) to report having ever used sedatives, stimulants, opiods, and other drugs, but not tobacco, alcohol, cocaine, or hallucinogens. Gender and race did not substantially moderate the associations between substance use and panic attacks. Sedative, stimulant, opiod, and other drug use was not associated with panic attack frequency or the occurrence of unexpected attacks. The relationships of anxiety and depression with substance use were larger for panickers than nonpanickers. These results are consistent with the idea that self-medication and symptom exacerbation play a role in the development of co-occurring substance use disorders and mood and anxiety disorders.

This study examines the psychometric properties of three recently published anxiety measures, including their incremental validity in predicting adolescent suicidal ideation and behavior. One hundred and eighteen adolescents aged 12-18 completed measures of anxiety, depression, positive and negative affect, and suicidal ideation and behavior. All of the anxiety scales showed limitations. For example, most of the anxiety scales appeared to lack divergent validity with regard to measures of depression and positive affect. Scales in the panic domain predicted suicidal ideation after controlling for depression. Surprisingly, scales in the social phobia domain were related to lower levels of suicidal behavior after controlling for depression and suicidal ideation. The implications of these results for research on adolescent suicide and the assessment of adolescent anxiety are discussed.