Kristin Naragon-Gainey

On the specificity of positive emotional dysfunction in psychopathology: Evidence from the mood and anxiety disorders and schizophrenia/schizotypy

We review recent research to establish that the associations between positive emotional experience and major forms of psychopathology show considerable specificity. Although indicators of low positive affect are consistently related to both social anxiety/social phobia and schizophrenia/schizotypy, they are more strongly linked to depression, thereby displaying relative specificity. Moreover, low positive affect actually shows greater specificity than the diagnostic criteria for depression and is most strongly related to those symptoms (anhedonia, dysphoria, lassitude, suicidality) that are specific to the disorder. With regard to social phobia, findings suggest that low positive affect is more strongly related to the generalized subtype than to the non-generalized performance subtype. Analyses of schizophrenia/schizotypy indicate that although low positive affect is consistently associated with the negative symptoms (e.g., constricted affect, social aloofness), it is only weakly related to positive symptoms (e.g., magical thinking, perceptual aberrations, suspiciousness). Other data suggest that schizophrenia is associated with an anticipatory pleasure deficit, such that individuals with the disorder engage in rewarding activities less frequently because they do not expect to derive pleasure from them. Finally, we summarize evidence indicating that elevated positive affect is both a risk factor for bipolar disorder and a concomitant of manic symptoms.

Differential Relations of Depression and Social Anxiety Symptoms to the Facets of Extraversion/Positive Emotionality

Previous research has shown that both depression and social anxiety--2 facets of internalizing psychopathology--are characterized by low levels of extraversion/positive emotionality (E/PE). However, little is known about the relations of the facets of E/PE with the symptoms of depression and social anxiety. This study utilized multiple measures of each facet of E/PE, as well as depression and social anxiety symptoms. Self-report data were collected from large samples of college students and psychiatric outpatients. Separate factor analyses in each sample revealed a 4-factor structure of E/PE consisting of Sociability, Positive Emotionality, Ascendance, and Fun-Seeking. Structural equation modeling revealed that, after controlling for the higher order internalizing factor and the overlap among the E/PE facets, social anxiety was broadly related to all 4 facets of E/PE, whereas depression was strongly related to only low positive emotionality. Implications for hierarchical models of personality and psychopathology, assessment and treatment, and etiological models are discussed.

Development and Validation of New Anxiety and Bipolar Symptom Scales for an Expanded Version of the IDAS (the IDAS-II)

The original Inventory of Depression and Anxiety Symptoms (IDAS) contains 11 nonoverlapping scales assessing specific depression and anxiety symptoms. In creating the expanded version of the IDAS (the IDAS-II), our goal was to create new scales assessing other important aspects of the anxiety disorders as well as key symptoms of bipolar disorder. Factor analyses of the IDAS-II item pool led to the creation of seven new scales (Traumatic Avoidance, Checking, Ordering, Cleaning, Claustrophobia, Mania, Euphoria) plus an expanded version of Social Anxiety. These scales are internally consistent and show strong convergent and significant discriminant validity in relation to other self-report and interview-based measures of anxiety, depression, and mania. Furthermore, the scales demonstrate substantial criterion and incremental validity in relation to interview-based measures of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) symptoms and disorders. Thus, the expanded IDAS-II now assesses a broad range of depression, anxiety, and bipolar symptoms.

Personality, Emotions, and the Emotional Disorders.

We examined symptom-level relations between the emotional disorders and general traits within the five-factor model of personality. Neuroticism correlated strongly with the symptoms of general distress/negative affectivity (depressed mood, anxious mood, worry) that are central to these disorders; more moderately with symptoms of social phobia, affective lability, panic, posttraumatic stress disorder, lassitude, checking, and obsessive intrusions; and more modestly with agoraphobia, specific phobia, and other symptoms of depression and obsessive-compulsive disorder. Extraversion was negatively correlated with symptoms of social anxiety/social phobia and was positively related to scales that assess expansive positive mood and increased social engagement in bipolar disorder. Conscientiousness, agreeableness, and openness showed weaker associations and generally added little to the prediction of these symptoms. It is noteworthy, moreover, that our key findings replicated well across (a) self-rated versus (b) interview-based symptom measures. We conclude by discussing the diagnostic and assessment implications of these data.

Evaluation of the Unique and Specific Contributions of Dimensions of the Triple Vulnerability Model to the Prediction of DSM-IV Anxiety and Mood Disorder Constructs

The triple vulnerability model (Barlow, 2000, 2002) posits that three vulnerabilities contribute to the etiology of emotional disorders: (1) general biological vulnerability (i.e., dimensions of temperament such as neuroticism and extraversion); (2) general psychological vulnerability (i.e., perceived control over life stress and emotional states); (3) disorder-specific psychological vulnerability (e.g., thought-action fusion for OCD). Despite the prominence of this model, a comprehensive empirical evaluation has not yet been undertaken. The current study used structural equation modeling to test the triple vulnerability model in a large clinical sample (N=700), focusing on vulnerabilities for depression, social phobia, generalized anxiety disorder (GAD), and OCD. Specifically, we examined the incremental prediction of each level of the triple vulnerability model for each disorder, with the following putative disorder-specific psychological vulnerabilities: thought-action fusion (TAF) for OCD, the dysfunctional attitudes (DAS) for depression, and intolerance of uncertainty (IoU) for GAD. In the final model that included all three levels of vulnerabilities, neuroticism had significant direct effects on all four disorder constructs, and extraversion was inversely associated with depression and social phobia. However, perceived control was significantly associated with GAD and OCD only. Of the disorder-specific psychological vulnerabilities, TAF was significantly and specifically related to OCD. In contrast, DAS and IoU were not significant predictors of depression and GAD respectively, instead contributing to other disorders. The results are discussed in regard to structural models of the emotional disorders and the various roles of general and specific vulnerability dimensions in the onset, severity, and temporal course of psychopathology.

Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services

Abstract The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.

Consensually Defined Facets of Personality as Prospective Predictors of Change in Depression Symptoms

Depression has robust associations with personality, showing a strong relation with neuroticism and more moderate associations with extraversion and conscientiousness. In addition, each Big Five domain can be decomposed into narrower facets. However, we currently lack consensus as to the contents of Big Five facets, with idiosyncrasies across instruments; moreover, few studies have examined associations with depression. In the current study, community participants completed six omnibus personality inventories; self-reported depressive symptoms were assessed at baseline and 5 years later. Exploratory factor analyses suggested three to five facets in each domain, and these facets served as prospective predictors of depression in hierarchical regressions, after accounting for baseline and trait depression. In these analyses, high anger (from neuroticism), low positive emotionality (extraversion), low conventionality (conscientiousness), and low culture (openness to experiences) were significant prospective predictors of depression. Results are discussed in regard to personality structure and assessment, as well as personality–psychopathology associations.

The structure of common emotion regulation strategies: A meta-analytic examination.

Emotion regulation has been examined extensively with regard to important outcomes, including psychological and physical health. However, the literature includes many different emotion regulation strategies but little examination of how they relate to one another, making it difficult to interpret and synthesize findings. The goal of this meta-analysis was to examine the underlying structure of common emotion regulation strategies (i.e., acceptance, behavioral avoidance, distraction, experiential avoidance, expressive suppression, mindfulness, problem solving, reappraisal, rumination, worry), and to evaluate this structure in light of theoretical models of emotion regulation. We also examined how distress tolerance—an important emotion regulation ability — relates to strategy use. We conducted meta-analyses estimating the correlations between emotion regulation strategies (based on 331 samples and 670 effect sizes), as well as between distress tolerance and strategies. The resulting meta-analytic correlation matrix was submitted to confirmatory and exploratory factor analyses. None of the confirmatory models, based on prior theory, was an acceptable fit to the data. Exploratory factor analysis suggested that 3 underlying factors best characterized these data. Two factors— labeled Disengagement and Aversive Cognitive Perseveration— emerged as strongly correlated but distinct factors, with the latter consisting of putatively maladaptive strategies. The third factor, Adaptive Engagement, was a less unified factor and weakly related to the other 2 factors. Distress tolerance was most closely associated with low levels of repetitive negative thought and experiential avoidance, and high levels of acceptance and mindfulness. We discuss the theoretical implications of these findings and applications to emotion regulation assessment.

The correspondence of daily and retrospective PTSD reports among female victims of sexual assault.

Research addressing the association between daily and retrospective symptom reports suggests that retrospective reports are typically inflated. The present study examined the association between daily posttraumatic stress disorder (PTSD) symptom reports over 1 month and a corresponding retrospective report (PTSD Checklist [PCL]; Weathers et al., 1993) for both total scores and symptom clusters. The authors hypothesized that greater PTSD symptom instability and greater depression would be associated with poorer agreement between daily and retrospective reports. Data were collected from 132 female college students who were sexually assaulted. Multilevel modeling indicated very strong agreement between mean daily and retrospective reports for total scores and symptom clusters, with pseudo-R2 ranging from .55 to .77. Depression symptoms did not moderate this association, but daily-retrospective agreement was lowest for the avoidance cluster, which was also the most unstable. Finally, retrospective recall for each symptom cluster showed acceptable specificity to the corresponding daily symptom clusters. Overall, these findings suggest that retrospective memories for global PTSD symptoms and symptom clusters, as assessed by the PCL, are consistent with daily reports over a 1-month period. Implications for clinical assessment methodology are discussed.

Pathological eating behaviors, BMI, and facet-level traits: the roles of conscientiousness, neuroticism, and impulsivity.

The current study examined the bivariate and multivariate associations of personality with Body Mass Index (BMI) and several eating behavior inventories, focusing on facets of Neuroticism, Conscientiousness, and Impulsivity. Simultaneous multiple regressions showed that the facets Traditionalism, Urgency, and low Vulnerability were significant predictors of BMI. A factor analysis of the eating behavior scales revealed two dimensions: (a) Food and Body Preoccupation and (b) Cued Eating; Neuroticism, low Conscientiousness, and Perfectionism were significant predictors of both eating behavior factors. In addition, the Depression facet predicted Food and Body Preoccupation, and low Temperance predicted Cued Eating. Implications are discussed for the structure of eating pathology and the specificity of facet traits to eating behaviors and obesity.