Janet W. Borden

The Beck Anxiety Inventory in nonclinical samples: Initial psychometric properties

The Beck Anxiety Inventory (BAI) was recently developed to assess clinical anxiety. Because one of its main features is a focus upon physiological sequelae of anxiety, the inventory may prove useful in nonclinical samples as well. The current paper provides initial psychometric properties with a nonclinical sample. Two studies are presented. The first presents scores and factor structure. A five factor solution was obtained, with one subjective and four somatic factors accounting for approximately 60% of the variance. The second study utilizes the total and factor scores to assess concordance with physiological responding. The total BAI correlated moderately with several physiological domains and with subjective distress. Factor scores were not consistently correlated with corresponding physiological domains. When subjects were divided into high- and low-anxiety groups, the relationships between self-report and physiological response increased in subjects with higher levels of anxiety. Results are discussed in terms of comparing clinical and nonclinical findings, use of the BAI in nonclinical samples, and future research.

Social phobia: Axis I and II correlates.

The presence of Axis I and Axis II disorders in 71 social 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 agoraphobia. 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 social phobia and anxiety inventory: concurrent validity with a clinic sample

The Social Phobia and Anxiety Inventory (SPAI) is an empirically derived self-report inventory developed as a specific measure of social phobia. The current investigation included two studies. The first examined the correlation of the SPAI with daily social behavior of a clinic sample of social phobics. The results indicated that the SPAI provides a reasonable indication of the distress experienced during daily social encounters in three dimensions: behavior, cognitions, and overall distress. The second study examined the validity of the SPAI with reference to the somatic response and avoidance behavior of social phobics. The results indicated that the somatic items of the SPAI are related to the somatic response of social phobics and that performance on the SPAI is associated with avoidance behavior in an anxiety-producing task.

Validity and reliability of the panic attack symptoms and cognitions questionnaires

The present article reports on the development and validation of two self-report instruments designed to assess the symptoms and cognitions associated with panic attacks. The Panic Attack Symptoms Questionnaire (PASQ) as well as the Panic Attack Cognitions Questionnaire (PACQ) successfully differentiated a group of anxiety-disordered individuals with panic attacks from a group of anxiety-disordered individuals without panic attacks. Reliability estimates based on Cronbachs alpha were adequate, and two discriminant functions designed to determine whether each of these questionnaires contributed uniquely to the separation of individuals with and without panic attacks beyond that provided by standard measures of anxiety and depression supported the validity of these questionnaires. The PASQ and PACQ appear to be useful vehicles for assessing the presence and severity of panic attacks.

Nonclinical hair-pulling: Affective correlates and comparison with clinical samples

The purposes of the current study were to examine the affective states associated with hair-pulling in a nonclinical sample and to compare levels of general psychopathology in nonclinical hair-pullers and clinic patients with trichotillomania (TM) or obsessive-compulsive disorder (OCD). Subjects included 66 college undergraduates who engaged in hair-pulling unrelated to grooming, 18 patients with TM and 29 patients with OCD. Dimensional (but not categorical) ratings of affective experiences in the nonclinical sample indicated that hair-pulling was associated with decreases in tension, boredom, anger and sadness. Further, the relationship between emotional experiences before and after hair-pulling was more salient than the pre-during relationship conceptualized as central in current diagnostic criteria for TM. Comparisons of psychopathology in nonclinical and clinical samples failed to support a continuum notion of increasing symptomatology in nonclinical pullers, TM patients and individuals with OCD. Some evidence of increased pathology in nonclinical pullers relative to TM patients was obtained, as was further support for a distinction between TM and OCD. Implications of this investigation for conceptualization of TM are discussed.

Mechanisms of change in the treatment of panic

A growing body of research indicates that cognitive-behavioral (CB) treatments are superior to no treatment for panic. However, few compelling differences exist between treatments, questioning whether the addition of CB elements is necessary for effective treatments. The current study examined two questions. First, does the addition to treatment of CB elements enhance outcome? Second, can a more general construct such as self-efficacy account for treatment outcome? Nineteen subjects with panic disorder were assigned to one of two treatments (panic education or guided imaginal coping). There were minimal differences in outcome between groups. Subjects became more efficacious and efficacy appeared to lead to reductions in catastrophic thoughts, but not panic symptoms. Results are discussed in terms of the potential role of personal control in the treatment of panic and in terms of the necessity to conduct more powerful comparisons to clarify the role of CB strategies in the treatment of panic.

Nonclinical hair pulling: Phenomenology and related psychopathology

Abstract Two hundred eighty-eight college students were assessed to examine the epidemiology, phenomenology, and associated psychopathology of hair pulling in a nonclinical population. With regard to the latter, the severity of obsessive-compulsive symptoms was of particular interest given hypotheses regarding diagnostic overlap between trichotillomania (TM) and obsessive-compulsive disorder (OCD). Forty-four individuals (15.3%) reported that they engaged in hair pulling, with 20.4% indicating that the behavior occured at least once per day. As is the case with TM, the behavior occured more frequently in women. In addition, the most frequent hair-pulling sites and precipitating situations were similar to those reported previously by clinic TM patients. The presence of hair pulling was associated with severity of obsessive-compulsive symptoms primarily in women, although in the total sample hair pulling was related to higher levels of interpersonal sensitivity, anxiety, and neuroticism. It is hypothesized that overlap between symptoms of TM and OCD may not be unique, but in fact may be a function of a generalized state of anxiety that accompanies both disorders. Directions for future research should include comparison of psychopathology in clinical and nonclinical groups, with a critical assessment of the relationship between hair pulling and symptoms of the anxiety disorders.

Coping strategies and panic

Abstract The current investigation examined coping repertoires of individuals who experience panic. Ninety-three subjects were divided into those with panic (n = 60), regardless of diagnosis, and those without panic (n = 33). Based upon a 27-item coping questionnaire, panic subjects reported utilization of strategies that were significantly greater in number and in frequency of use. Reliability estimates on the questionnaire were adequate. The questionnaire was factor analyzed, revealing seven factors: activity-indirect symptom focus, activity-direct symptom focus, help seeking, focus change, active struggle, self-injurious, and distraction. Panic subjects utilized more help seeking and change of focus coping techniques as compared to subjects without panic. When coping factors were examined for differences in perceived effectiveness, a self-injurious factor was found to be significantly less effective in reducing catastrophic thoughts and symptoms. A significant group x factor interaction occurred for thought reduction with panic subjects reporting greater effectiveness from help seeking. Results are discussed in terms of a re-evaluation of skill-based treatment rationales for panic given that subjects report coping strategies prior to treatment.

Is panic a unique emotional experience

The establishment of Panic Disorder (PD) as a distinct diagnostic category stems largely from the conceptualization of panic as a phenomenon qualitatively different from severe levels of anxiety. The current study utilized patients with Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD) as comparison groups to examine the validity of this conceptualization. Seventeen PD, 29 OCD, and 12 GAD patients completed self-report inventories from which a panic factor was derived. Controlling for level of overall anxiety, the total panic factor was rated significantly higher by the PD group. A cluster of symptoms emerged which differentiated the PD group from the other two groups. The panic items and total score were correlated with total levels of state and trait anxiety but correlations were generally low, accounting for a limited amount of the total variance. Results were interpreted as providing only equivocal support for viewing panic as a separate dimension apart from high levels of general anxiety. A discussion of conceptual issues is presented.

The anxiety sensitivity construct: Cognitive reactions to physiological change

Abstract Anxiety sensitivity is proposed as an individual difference variable distinguishable from anxiety. Theoretically, individuals with high levels of anxiety sensitivity believe the experiences of anxiety are harmful and monitor their physiological responses by focusing attention to their internal stimuli. The current study assessed four groups of subjects: those with high and low levels of anxiety sensitivity; and those with or without recent experiences of panic attacks. Subjects completed a physiological protocol and reported their cognitions and subjective distress. Results support physiological change; however, reactions to the change did not differ significantly by ASI groupings, but were impacted by prior experiences with panic. Results are discussed in terms of support for a conditioning paradigm, with no apparent contribution from the postulated trait of anxiety sensitivity.