Bethany A. Teachman

A New Mode of Fear Expression: Perceptual Bias in Height Fear

Emotion and psychopathology researchers have described the fear response as consisting of four main components--subjective affect, physiology, cognition, and behavior. The current study provides evidence for an additional component in the domain of height fear (perception) and shows that it is distinct from measures of cognitive processing. Individuals High (N = 35) and Low (N = 36) in acrophobic symptoms looked over a two-story balcony ledge and estimated its vertical extent using a direct height estimation task (visual matching), and an indirect task (size estimation); the latter task seems to exhibit little influence from cognitive factors. In addition, implicit and explicit measures of cognitive processing were obtained. Results indicated that, as expected, the High Fear group showed greater relative, implicit height fear associations and explicit threat cognitions. Of primary interest, the High (compared to Low) Fear group estimated the vertical extent to be higher, and judged target sizes to be greater, even when controlling for the cognitive bias measures. These results suggest that emotional factors such as fear are related to perception.

Automatic associations and panic disorder: Trajectories of change over the course of treatment

Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tested these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over a 12-week course of cognitive behavior therapy (CBT) is related to the trajectory of change in panic symptoms. Individuals with panic disorder (N = 43) completed a measure of automatic panic associations--the Implicit Association Test (A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998), which reflects elements of the schema construct--every 3 weeks over the course of therapy and measures of panic symptoms each week. Dynamic bivariate latent difference score modeling not only indicated that automatic panic associations changed over the course of CBT for panic disorder but showed these changes were correlated with symptom reduction. Moreover, change in automatic panic associations was a significant predictor of change in panic symptom severity. These findings permit inferences about the temporality of change, suggesting that cognitive change does in fact precede and contribute to symptom change.

Implicit and explicit stigma of mental illness: links to clinical care.

This study examined implicit and explicit measures of bias toward mental illness among people with different levels of mental health training, and investigated the influence of stigma on clinically-relevant decision-making. Participants (N = 1539) comprised of (1) mental health professionals and clinical graduate students, (2) other health care/social services specialists, (3) undergraduate students, and (4) the general public self-reported their attitudes toward people with mental illness, and completed implicit measures to assess mental illness evaluations that exist outside of awareness or control. In addition, participants predicted patient prognoses and assigned diagnoses after clinical vignettes. Compared with people without mental health training, individuals with mental health training demonstrated more positive implicit and explicit evaluations of people with mental illness. Further, explicit (but not implicit) biases predicted more negative patient prognoses, but implicit (and not explicit) biases predicted over-diagnosis, underscoring the value of using both implicit and explicit measures.

Automaticity in anxiety disorders and major depressive disorder

In this paper we examine the nature of automatic cognitive processing in anxiety disorders and Major Depressive Disorder (MDD). Rather than viewing automaticity as a unitary construct, we follow a social cognition perspective (Bargh, 1994) that argues for four theoretically independent features of automaticity: unconscious (processing of emotional stimuli occurs outside awareness), efficient (processing emotional meaning uses minimal attentional resources), unintentional (no goal is needed to engage in processing emotional meaning), and uncontrollable (limited ability to avoid, alter or terminate processing emotional stimuli). Our review of the literature suggests that most anxiety disorders are characterized by uncontrollable, and likely also unconscious and unintentional, biased processing of threat-relevant information. In contrast, MDD is most clearly typified by uncontrollable, but not unconscious or unintentional, processing of negative information. For the anxiety disorders and for MDD, there is no sufficient evidence to draw firm conclusions about efficiency of processing, though early indications are that neither anxiety disorders nor MDD are characterized by this feature. Clinical and theoretical implications of these findings are discussed and directions for future research are offered. In particular, it is clear that paradigms that more directly delineate the different features of automaticity are required to gain a more comprehensive and systematic understanding of the importance of automatic processing in emotion dysregulation.

Training implicit social anxiety associations: An experimental intervention

The current study investigates an experimental anxiety reduction intervention among a highly socially anxious sample (N=108; n=36 per Condition; 80 women). Using a conditioning paradigm, our goal was to modify implicit social anxiety associations to directly test the premise from cognitive models that biased cognitive processing may be causally related to anxious responding. Participants were trained to preferentially process non-threatening information through repeated pairings of self-relevant stimuli and faces indicating positive social feedback. As expected, participants in this positive training condition (relative to our two control conditions) displayed less negative implicit associations following training, and were more likely to complete an impromptu speech (though they did not report less anxiety during the speech). These findings offer partial support for cognitive models and indicate that implicit associations are not only correlated with social anxiety, they may be causally related to anxiety reduction as well.

Aging and negative affect: the rise and fall and rise of anxiety and depression symptoms.

The relationship between aging and negative affect is dynamic and complex. Although prior studies have often cited lower prevalence rates of anxiety and mood disorders among older individuals, these studies may miss the dynamic relationship between symptoms and aging. To evaluate a nonlinear model of the relationship between aging and negative affect, the author examined measures of neuroticism, anxiety, and depression symptoms in a cross-sectional, community sample (N = 335), ages 18 to 93. Results indicated a curvilinear relationship, with mean symptom levels increasing during early adulthood (until the mid-30s) and then showing a small decline until older adulthood (the mid-70s), when symptoms again increase with age.

Psychopathology and thought suppression: a quantitative review.

Recent theories of psychopathology have suggested that thought suppression intensifies the persistence of intrusive thoughts, and proposed that difficulty with thought suppression may differ between groups with and without psychopathology. The current meta-analytic review evaluates empirical evidence for difficulty with thought suppression as a function of the presence and specific type of psychopathology. Based on theoretical proposals from the psychopathology literature, diagnosed and analogue samples were expected to show greater recurrence of intrusive thoughts during thought suppression attempts than non-clinical samples. However, results showed no overall differences in the recurrence of thoughts due to thought suppression between groups with and without psychopathology. There was, nevertheless, variation in the recurrence of thoughts across different forms of psychopathology, including relatively less recurrence during thought suppression for samples with symptoms of Obsessive-Compulsive Disorder, compared to non-clinical samples. However, these differences were typically small and provided only mixed support for existing theories. Implications for cognitive theories of intrusive thoughts are discussed, including proposed mechanisms underlying thought suppression.

Information processing and anxiety sensitivity : Cognitive vulnerability to panic reflected in interpretation and memory biases

The relationship between panic and anxiety sensitivity (AS) has been well established. Further, cognitive theories of panic have received substantial support through demonstrations of cognitive biases toward threatening information. However, past research has produced mixed findings on whether AS is itself associated with biased information processing. To explore this question, the current study examined evidence for and relationships among attention (on a modified Stroop), interpretation (using the Brief Body Sensations Interpretation Questionnaire), and schematic/memory biases (on Implicit Association Tests) in individuals with high (N = 55) and low (N = 48) AS. Results indicated interpretation and memory biases favoring threat among the high AS group, but no attentional bias. Further, the memory bias was positively related to the interpretation bias and to measures of anxiety and panic, offering the first evidence for a schema potentially related to the development of panic. Findings are discussed regarding implications for cognitive models of vulnerability.

Sadder and Less Accurate? False Memory for Negative Material in Depression

Previous research has demonstrated that induced sad mood is associated with increased accuracy of recall in certain memory tasks; the effects of clinical depression, however, are likely to be quite different. The authors used the Deese-Roediger-McDermott paradigm to examine the impact of clinical depression on erroneous recall of neutral and/or emotional stimuli. Specifically, they presented Deese-Roediger-McDermott lists that were highly associated with negative, neutral, or positive lures and compared participants diagnosed with major depressive disorder and nondepressed control participants on the accuracy of their recall of presented material and their false recall of never-presented lures. Compared with control participants, major depressive disorder participants recalled fewer words that had been previously presented but were more likely to falsely recall negative lures; there were no differences between major depressive disorder and control participants in false recall of positive or neutral lures. These findings indicate that depression is associated with false memories of negative material.

The meaning of beauty : Implicit and explicit self-esteem and attractiveness beliefs in body dysmorphic disorder

Body dysmorphic disorder (BDD) is characterized by imagined or slight defects in ones appearance. We evaluated implicit and explicit biases among individuals diagnosed with BDD (n=21), individuals with subclinical BDD symptoms (n=21), and healthy control participants (n=21). Specifically, we used the Implicit Association Test [IAT; Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: the implicit association test. Journal of Personality and Social Psychology, 74, 1464-1480] to examine automatic associations related to self-esteem, associations between attractive and important, and a physical attractiveness stereotype (associations between attractive and competent). BDD participants had significantly lower implicit self-esteem, relative to control participants, and the subclinical BDD participants were intermediate between these groups. Although no group differences were observed on the implicit Attractive Important IAT; as predicted, BDD participants had significantly stronger implicit associations between attractive and competent than the other groups, in line with a common stereotype about physical attractiveness. Both the Attractive Competent IAT and Self-Esteem IAT were significant predictors of BDD symptom severity, and distress and avoidance during a mirror exposure task. Findings are discussed in light of cognitive-behavioral models of BDD.