Carol R. Glass

Assessing computer anxiety: Development and validation of the Computer Anxiety Rating Scale

Abstract Despite the growing role of computers in society, some individuals may actually avoid and resist learning about computers due to their anxiety. The present study was conducted in order to develop and validate the Computer Anxiety Rating Scale (CARS), by examining the behavioral, cognitive, and affective components of computer anxiety. The CARS was shown to be a reliable and valid measure. Higher levels of computer anxiety were related to greater math and test anxiety, and to less computer experience and mechanical interest. During an actual computer interaction, greater computer anxiety was associated with lower expectations and poorer task performance, as well as with greater state anxiety, reported physiological arousal, and debilitative thoughts. These results are consistent with a cognitive-attentional theory of computer anxiety and suggest directions for future research. Consistent differences between women and men on indices of computer anxiety were not found.

Nonresponse and Dropout Rates in Outcome Studies on PTSD: Review and Methodological Considerations

Abstract Post-traumatic stress disorder (PTSD) represents a frequent consequence of a variety of extreme psychological stressors. Lists of empirically supported treatments for PTSD usually include cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), but nonresponse and dropout rates in these treatments often are high. We review the treatment dropout and nonresponse rates in 55 studies of empirically supported treatments for PTSD, review the literature for predictors of dropout and nonresponse, discuss methodological inconsistencies in the literature that make comparisons across studies difficult, and outline future directions for research. Dropout rates ranged widely and may have depended, at least in part, on the nature of the study population. It was not uncommon to find nonresponse rates as high as 50%. Standard methods of reporting dropout and nonresponse rates are needed for reporting outcomes. We suggest guidelines for collecting data to help identify characteristics and predictors of dropouts and nonresponders.

Self-statements and self-evaluations: A cognitive-response analysis of heterosocial anxiety

In the present investigation, an inductive measurement technique was employed to test some of the shared assertions made by theories of emotional behavior and behavior change. Specifically, the effects of heterosocial anxiety and anonymity on self-statements and self-evaluation by men were investigated. It was found that the anticipation of a discussion with an unfamiliar woman resulted in (a) the spontaneous generation of more negative self-statements and self-evaluation by high than by low heterosocially anxious men, (b) high and low heterosocially anxious men emitting their self-statements, which were clearly distinguishable; and (c) the anonymity of the impending discussion affecting neither the self-statements nor the self-evaluation of high and low heterosocially anxious men. These results provide evidence that an individuals idiosyncratic cognitive responses can be assessed objectively and easily, and that the nature of the self-statements is affected by individual differences even though the individuals involved may be unaware of these effects.

Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma

Mindfulness- and acceptance-based conceptualizations of PTSD implicate experiential avoidance and non-mindful behavior in the etiology and maintenance of the disorder. If experiential avoidance is associated with vulnerability to PTSD, then a mindful and accepting orientation toward experience may confer psychological resilience following exposure to trauma. This article examines how mindfulness- and acceptance-based theories of psychopathology relate to risk of and resilience to PTSD. Research is reviewed dealing with the impact of experiential avoidance, avoidant coping, dissociation, acceptance, and mindfulness on PTSD symptom severity and posttraumatic functioning. This review suggests that trait mindfulness and acceptance are associated with greater psychological adjustment following exposure to trauma, while experiential avoidance, persistent dissociation, and coping strategies involving emotional disengagement are associated with greater PTSD symptom severity and related psychopathology. Methodological challenges are explored and suggestions for future research and PTSD prevention programs are discussed.

Cognitive factors in computer anxiety

The recent growth of computer technology has been accompanied by an increasing number of individuals who are anxious or intimidated by computers. The current study was designed to test a cognitive model of computer anxiety, where computer anxiety is seen as a function of internal dialogue, underlying meaning systems, behavioral acts, and behavioral outcomes when working on a computer. The Self-Statements About Computers (SSAC) checklist was empirically developed to assess thoughts or internal dialogue associated with anxiety and computer use, as well as the meaning of those thoughts for the individual. Analyses revealed that high computer-anxious subjects had lower expectations of performance and reported more debilitative thoughts during an actual computer task. They also reported higher levels of anxiety during this computer interaction, had more bodily sensations, and took longer to complete the task. In addition, high computer-anxious individuals reported less computer experience and mechanical interest, and higher levels of math anxiety. These results support the proposed cognitive model of computer anxiety and suggest directions for clinical intervention.

Questionnaire methods of cognitive self-statement assessment.

Questionnaire methods can be used to assess thoughts, which are cognitive products often referred to as self-statements, automatic thoughts, or internal dialogue. This review examines the nature of endorsement measures of self-statements and considers their advantages and disadvantages as well as scoring issues. A psychometric evaluation of self-statement questionnaires discusses the issues of reliability, content validity and scale development, criterion validity, construct validity, and clinical utility. Descriptions of and psychometric findings for over 2 dozen measures are summarized, including measures for depression, anxiety, eating disorders, pain, and applications with children and adolescents, and conclusions and future directions are suggested.

Contributions of Psychodynamic Approaches to Treatment of PTSD and Trauma: A Review of the Empirical Treatment and Psychopathology Literature

Abstract Reviews of currently empirically supported treatments for post-traumatic stress disorder (PTSD) show that despite their efficacy for many patients, these treatments have high nonresponse and dropout rates. This article develops arguments for the value of psychodynamic approaches for PTSD, based on a review of the empirical psychopathology and treatment literature. Psychodynamic approaches may help address crucial areas in the clinical presentation of PTSD and the sequelae of trauma that are not targeted by currently empirically supported treatments. They may be particularly helpful when treating complex PTSD. Empirical and clinical evidence suggests that psychodynamic approaches may result in improved self–esteem, increased ability to resolve reactions to trauma through improved reflective functioning, increased reliance on mature defenses with concomitant decreased reliance on immature defenses, the internalization of more secure working models of relationships, and improved social functioning. Additionally, psychodynamic psychotherapy tends to result in continued improvement after treatment ends. Additional empirical studies of psychodynamic psychotherapy for PTSD are needed, including randomized controlled outcome studies.

Cognitive assessment in social anxiety and social phobia

Abstract Several current theories of social anxiety and social phobia emphasize cognitive processes. The recent emphasis on cognition in psychopathology has led to the development of a variety of cognitive assessment techniques. This review discusses the major assessment instruments developed for the investigation of social anxiety, with particular emphasis on findings from the social phobia studies that have included cognitive assessment. The measures reviewed assess selfstatements, irrational beliefs, attributions, schemata, expectancies, and self-focused attention. Future directions are discussed, and it is suggested that studies on both the psychopathology and treatment of social phobia include cognitive assessment measures for a more complete understanding of the disorder.

Behavioral and cognitive-behavioral approaches to the reduction of dental anxiety

The effects of cognitive-behavior therapy (CBT) and a semi-automated behavioral intervention (BT) for the treatment of dental anxiety were compared to a waiting-list (WL) control and to a positive dental experience condition (PDE), which use dentists particularly gentle with anxious patients. Multimodal assessment of cognition, behavior, physiological response, and dental anxiety was employed. Both BT and CBT subjects showed significant improvement compared to PDE and WL groups on their level of dental anxiety and negative thoughts during a dental procedure. On measures of self-efficacy, negative anticipatory thoughts, and pain experienced, the WL group improved significantly less than did the other three conditions. At a 1-year follow-up, subjects treated with BT and CBT reported less dental anxiety and had been to the dentist more often than WL controls. All three approaches thus show promise, with semi-automated behavior therapy and contact with a sensitive dentist being especially cost-effective methods of treatment.

Validity issues in self-statement measures of social phobia and social anxiety

Measures to assess internal dialogue or self-statements in socially phobic or anxious clients are now frequently used in clinical and research settings. Such cognitive assessment techniques are rarely considered, however, with regard to psychometric criteria. This article reviews the literature on self-statement assessment of social phobia and social anxiety from the perspective of content, criterion, convergent and discriminant validity. In general, most measures have shown good evidence of validity. Different scoring systems in addition to thought valence appear worthwhile, and multiple measures and assessment occasions should be considered.