Thomas A. Fergus

Shame- and guilt-proneness: Relationships with anxiety disorder symptoms in a clinical sample

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.

The Fear of Positive Evaluation Scale: Psychometric properties in a clinical sample

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 Disgust Propensity and Sensitivity Scale-Revised : An examination of a reduced-item version

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.

Do Symptoms of Generalized Anxiety and Obsessive-Compulsive Disorder Share Cognitive Processes?

There is tremendous interest in understanding the role of cognitive processes within generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD). Regarding one process, intolerance of uncertainty (IU), extant data provide equivocal conclusions as to whether it shares a specific relation with either disorder. This study tested the specificity of IU and other cognitive processes, including negative problem orientation, responsibility and threat estimation, perfectionism and certainty, and importance and control of thoughts, in relation to symptoms of GAD and OCD in a large nonclinical sample. All cognitive processes except importance and control of thoughts (ICT) shared comparable relations with symptoms of both disorders and IU was the only cognitive process to predict unique variance—that above and beyond the other cognitive processes—in both GAD and OCD symptoms. We discuss the implications of these findings for conceptualizing points of convergence and divergence between the symptoms of two disorders that historically have shown meaningful overlap.

Disease phobia and disease conviction are separate dimensions underlying hypochondriasis

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.

Assessing Psychological Inflexibility: The Psychometric Properties of the Avoidance and Fusion Questionnaire for Youth in Two Adult Samples.

The current study examined whether the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; L. A. Greco, W. Lambert, & R. A. Baer, 2008), a self-report measure of psychological inflexibility for children and adolescents, might be useful for measuring psychological inflexibility for adults. The psychometric properties of the AFQ-Y were examined using data from a college student sample (N = 387) and a clinical sample of patients with anxiety disorders (N = 115). The AFQ-Y, but not the Acceptance and Action Questionnaire-II (AAQ-II; F. W. Bond et al., in press), demonstrated a reading level at or below the recommended 5th or 6th grade reading level. The AFQ-Y also demonstrated adequate reliability (internal consistency), factorial validity, convergent and discriminant validity, and concurrent validity predicting psychological symptoms. Moreover, the AFQ-Y showed incremental validity over the AAQ-II in predicting several psychological symptom domains. Implications for the assessment of psychological inflexibility are discussed.

Short Forms of the Social Interaction Anxiety Scale and the Social Phobia Scale

Mattick and Clarkes (1998) Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) are commonly used self-report measures that assess 2 dimensions of social anxiety. Given the need for short, readable measures, this research proposes short forms of both scales. Item-level analyses of readability characteristics of the SIAS and SPS items led to the selection of 6 items from each scale for use in the short forms. The SIAS and SPS short forms had reading levels at approximately the 6th and 5th grade level, respectively. Results using nonclinical (Study 1: N = 469) and clinical (Study 2: N = 145) samples identified these short forms as being factorially sound, possessing adequate internal consistency, and having strong convergence with their full-length counterparts. Moreover, these short forms showed convergence with other measures of social anxiety, showed divergence from measures assessing related constructs, and predicted concurrent interpersonal functioning. Recommendations for the use of these short forms are discussed.

The Short Health Anxiety Inventory and Multidimensional Inventory of Hypochondriacal Traits: A Comparison of Two Self-Report Measures of Health Anxiety

Using data from a large nonclinical sample (Nxa0=xa0503), the current study examined the convergence and utility of the Short Health Anxiety Inventory (SHAI; Salkovskis et al., in Psychol Med 32:843–853, 2002) and the Multidimensional Inventory of Hypochondriacal Traits (MIHT; Longley et al., in Psychol Assess 17: 3–14, 2005). Results from a higher-order measurement model indicated that the SHAI and the MIHT factors were distinguishable and generally shared significant intercorrelations. The affective factor of the SHAI and the MIHT shared the strongest convergence and the MIHT cognitive factor clustered with both affective factors. Further, a higher-order health anxiety factor adequately accounted for SHAI-MIHT factor intercorrelations, with the affective and cognitive factors of the SHAI and the MIHT loading strongest upon the higher-order factor. Finally, only the affective and cognitive SHAI and MIHT scales incrementally contributed—beyond general distress and the other SHAI and MIHT scales—in regression analyses predicting medical utilization and somatic symptoms. Implications for the conceptualization and assessment of health anxiety are discussed.

Reexamining the domain of hypochondriasis: Comparing the Illness Attitudes Scale to other approaches

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 Intolerance of Uncertainty Scale Measurement Invariance, Population Heterogeneity, and Its Relation With Worry Among Self-Identifying White and Black Respondents

Although it is understood that assessment tools require evaluation using diverse samples, such evaluations are relatively rare. There are obstacles to such work, but it remains important to pursue psychometric data in broad samples. As such, we evaluated measurement invariance and population heterogeneity of two versions of a widely used measure in the anxiety literature—the Intolerance of Uncertainty Scale (IUS)—among self-identifying White (N = 1,185) and Black (N = 301) students. Data from multiple-groups confirmatory factor analysis supported the equivalence of the equal form and factor loadings of both IUS versions in White and Black respondents. However, specific IUS items functioned differently in the two groups, with more IUS items appearing biased in the full-length relative to the short-form version. Correlations between IUS factors and worry were equivalent among White and Black respondents. We discuss the implications of these results for future research.