Yongrae Cho

Mechanism of Change in Cognitive-Behavioral Treatment of Panic Disorder: Evidence for the Fear of Fear Mediational Hypothesis.

Numerous clinical trials have demonstrated the efficacy of cognitive-behavioral treatment (CBT) for panic disorder. However, studies investigating the mechanisms responsible for improvement with CBT are lacking. The authors used regression analyses outlined by R. M. Baron and D. A. Kenny (1986) to test whether a reduction in fear of fear (FOF) underlies improvement resulting from CBT. Pre- and posttreatment measures were collected from 90 CBT-treated patients and 40 wait-list control participants. Overall, treatment accounted for 31% of the variance in symptom reduction. The potency of FOF as a mediator varied as a function of symptom facet, as full mediation was observed for the change in global disability, whereas the effects of CBT on agoraphobia, anxiety, and panic frequency were partially accounted for by reductions in FOF. Clinical implications and future research directions are discussed.

Testing the Cognitive Content-Specificity Hypothesis of Social Anxiety and Depression: An Application of Structural Equation Modeling

The present research examined three key issues of the cognitive content-specificity hypothesis of social anxiety and depression using structural equation modeling (SEM) approach. First, using confirmatory factor analyses on data from a sample of 507 undergraduate students, we found that both positive and negative self-statements factors of the modified Social Interaction Self-Statement Test were empirically differentiated from those of the Automatic Thoughts Questionnaire-Positive and the Automatic Thoughts Questionnaire. Next, SEM was used to analyze data from a subsample of 489 students to identify unique and common cognitive contents that contribute to social anxiety or depressive symptoms and then to evaluate their magnitudes simultaneously. Both positive and negative social interaction self-statements were unique to social anxiety symptoms. However, negative depressive self-statement was specific to depressive symptoms, whereas positive affect self-statement was common to the symptoms of social anxiety and depression. Furthermore, the effects of unique components of self-statements seemed stronger than that of common component on the symptoms of social anxiety and depression. In conclusion, these findings provide general support for the cognitive content-specificity hypothesis of social anxiety and depression.

Do Changes in Panic Appraisal Predict Improvement in Clinical Status Following Cognitive-Behavioral Treatment of Panic Disorder?

The effects of changes in panic appraisal dimensions during cognitive-behavioral treatment (CBT) on both short- and long-term improvement in panic disorder symptoms were examined. Panic disorder severity and panic appraisal measures were collected from 120 CBT-treated patients at pretreatment, post-treatment, and 6-month follow-up. Several panic appraisal dimensions investigated in panic disorder and agoraphobia include (a) perceived likelihood of panic occurrence (i.e., anticipated panic), (b) perceived negative consequences of panic occurrence, and (c) perceived panic coping efficacy. Of those panic appraisal dimensions studied, change in anticipated panic during treatment emerged as the most potent predictor of short-term improvement across each of the major clinical status measures (i.e., panic attack frequency, agoraphobic avoidance, and anxiety). Change in perceived consequences of panic uniquely contributed to short-term improvement in both anxiety and global disability, and reduction in perceived panic coping efficacy was unique predictor of short-term improvement in only agoraphobic avoidance. Both changes in perceived consequences of panic and in anticipated panic uniquely contributed to long-term improvement in agoraphobic avoidance and anxiety, respectively. In addition, only change in perceived consequences of panic uniquely contributed to long-term improvement in global disability. In contrast, perceived panic coping efficacy was generally a weak predictor of long-term improvement in any measures of clinical status. These results suggest that changes in cognitive appraisal factors predict both short- and long-term improvement during CBT of panic disorder.

The New Factor Structure of the Korean Version of the Difficulties in Emotion Regulation Scale (K-DERS) Incorporating Method Factor

The factor structure of the Korean version of the Difficulties in Emotion Regulation Scale was examined. Rather than the six-factor model, the five-factor model with a method factor was supported. This result suggests that the AWARENESS and CLARITY factors can be combined into one construct, controlling for the method factor.

Prevalence and Correlates of Complete Mental Health in the South Korean Adult Population

This chapter summarizes the findings supporting the two continua model of mental health and illness, the benefits of flourishing to psychosocial functioning, and sociodemographic correlates of subjective well-being in South Korea. The results of our confirmatory factor analysis showed that a correlated two-factor solution provided a suitable fit to the present data. Completely mentally healthy adults reported the highest levels of mental, emotional, and physical health and the highest levels of resilience, goal formation, and intimacy. However, 7.9 % of South Koreans were completely mentally healthy, and roughly one in five adults met the criteria for languishing, indicating that there is much room for improvement in the positive mental health of South Koreans. The analysis of determinants of mental health indicates that family income, education level, and community type play an important role in explaining variations in positive mental health in South Korea.

The factor structure and concurrent validity of the Korean version of the Metacognitions Questionnaire 30 (K-MCQ-30).

OBJECTIVES We aimed to examine the factor structure of a Korean version of the Metacognitions Questionnaire 30 (K-MCQ-30) and to further evaluate its concurrent validity. METHOD Confirmatory factor analyses were conducted on the data sets from two independent samples of Korean college students (n = 662; n = 664). Correlation and multiple regression analyses were conducted on the cross-sectional data from another sample (n = 97). RESULTS The 5-factor model of the K-MCQ-30 showed a good fit to the first sample after minor modification. The revised 5-factor model was replicated with the second sample. Five factors of the K-MCQ-30 had positive correlations with measures of emotional disorder symptoms and predicted each of the symptoms in different ways. CONCLUSIONS These results provide general support for the 5-factor structure of the K-MCQ-30 and its good concurrent validity in nonclinical samples.

Exploratory Factor Analysis of the Beck Anxiety Inventory and the Beck Depression Inventory-II in a Psychiatric Outpatient Population

Background To further understand the relationship between anxiety and depression, this study examined the factor structure of the combined items from two validated measures for anxiety and depression. Methods The participants were 406 patients with mixed psychiatric diagnoses including anxiety and depressive disorders from a psychiatric outpatient unit at a university-affiliated medical center. Responses of the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)-II, and Symptom Checklist-90-Revised (SCL-90-R) were analyzed. We conducted an exploratory factor analysis of 42 items from the BAI and BDI-II. Correlational analyses were performed between subscale scores of the SCL-90-R and factors derived from the factor analysis. Scores of individual items of the BAI and BDI-II were also compared between groups of anxiety disorder (n = 185) and depressive disorder (n = 123). Results Exploratory factor analysis revealed the following five factors explaining 56.2% of the total variance: somatic anxiety (factor 1), cognitive depression (factor 2), somatic depression (factor 3), subjective anxiety (factor 4), and autonomic anxiety (factor 5). The depression group had significantly higher scores for 12 items on the BDI while the anxiety group demonstrated higher scores for six items on the BAI. Conclusion Our results suggest that anxiety and depressive symptoms as measured by the BAI and BDI-II can be empirically differentiated and that particularly items of the cognitive domain in depression and those of physical domain in anxiety are noteworthy.

Factor Structure and Other Psychometric Properties of the Social Phobia Inventory in Korean Samples

ABSTRACT We examined the factor structure and other psychometric properties of the Social Phobia Inventory (SPIN) in Korean nonclinical (N1 = 457, N2 = 444) and clinical undergraduate samples (N3 = 12). Results support the revised 3-factor structure and applicability of the SPIN as a measure yielding valid and reliable scores of social anxiety to Koreans.

Depressive symptoms following natural disaster in Korea: psychometric properties of the Center for Epidemiologic Studies Depression Scale

BackgroundDepressive symptoms have been recognized as one of the most frequent complaints among natural disaster survivors. One of the most frequently used self-report measures of depressive symptoms is the Center for Epidemiologic Studies Depression Scale (CES-D). To our knowledge, no study has yet examined the factor structure, reliability, and validity of the CES-D in a sample of natural disaster survivors. Thus, the present study investigated the factor structure, reliability, and validity of a Korean language version of the CES-D (KCES-D) for natural disaster survivors.MethodsWe utilized two archived datasets collected independently for two different periods in 2008 in the same region of Korea (n = 192 for sample 1; n = 148 for sample 2). Participants were survivors of torrential rains in the mid-eastern region of the Korean peninsula. For analysis, Samples 1 and 2 were merged (N = 340). Confirmatory factor analysis was performed to evaluate the one-factor model, the four-factor model, and the bi-factor models, as well as the second-order factor model. Composite reliability was computed to examine the internal consistency of the KCES-D total and subscale scores. Finally, Pearson’s r was computed to examine the relationship between the KCES-D and the trauma-related measures.ResultsThe four-factor model provided the best fit to the data among the alternatives. The KCES-D showed adequate internal consistency, except for the ‘interpersonal difficulties’ subscale. Also regarding concurrent validity, weak to moderate positive correlations were observed between the KCES-D and the trauma-related measures.ConclusionsThe results support the four-factor model and indicate that the KCES-D has adequate psychometric properties for natural disaster survivors. If these findings are further confirmed, the KCES-D can be used as a useful, rapid, and inexpensive screening tool for assessing depressive symptoms in natural disaster survivors.