Background: Socially anxious individuals are theorized to avoid social cues and engage in safety behaviors to prevent negative evaluation, which prevents disconfirmation of social fears. Cognitive models propose that this avoidance is driven by (1) self-focused attention (SFA) and (2) physiological arousal. Design: To examine these proposed mechanisms, we compared high socially anxious (HSA; n =29) and low socially anxious (LSA; n = 28) participants on a view-time task involving faces. Method: Participants engaged in a task in which they viewed socially threatening (i.e., disgust, anger) and nonthreatening (i.e., happy, neutral) faces. Results: Results revealed that HSA participants endorsed greater SFA during the view-time task and spent less time viewing angry, disgusted, and neutral facial expressions relative to LSA participants. Regression analyses revealed that arousal, as indexed by salivary ?-amylase, was a unique predictor of increased face-viewing time among HSA participants. In contrast, arousal predicted decreased face-viewing time among LSA participants. Conclusions: Findings underscore the need for further investigation of avoidance mechanisms in social anxiety.
Evidence suggests that obsessive-compulsive disorder (OCD) is characterized by heightened self-reported disgust, however, it is unclear if this extends to physiology. The relationship between obsessive beliefs and disgust also remains poorly understood. Therefore, we examined whether the heightened trait and self-reported disgust observed in individuals with OCD is reflected in heightened physiological disgust responses. We also examined whether obsessive beliefs are associated with disgust responding.
Cognitive bias modification (CBM) interventions have demonstrated efficacy in augmenting core biases implicated in psychopathology. The current randomized controlled trial (RCT) will evaluate the efficacy of an internet-delivered positive imagery cognitive bias modification intervention for obsessive compulsive disorder (OCD) when compared to a control condition.
Abnormalities in cognitive control and disgust responding are well-documented in obsessive-compulsive disorder (OCD), and also interfere with flexible, outcome-driven utilitarian moral reasoning. The current study examined whether individuals with OCD differ from healthy and anxious individuals in their use of utilitarian moral reasoning, and whether abnormalities in inhibitory control, cognitive flexibility and disgust contribute to moral rigidity.
Cognitive bias modification (CBM) protocols have been developed to help establish the causal role of biased cognitive processing in maintaining psychopathology and have demonstrated therapeutic benefits in a range of disorders. The current study evaluated a cognitive bias modification training paradigm designed to target interpretation biases (CBM-I) associated with obsessive compulsive disorder (OCD).
Physical disgust is elicited by, and amplifies responses to, moral transgressions, suggesting that moral disgust may be a biologically expanded form of physical disgust. However, there is limited research comparing the effects of physical disgust to that of other emotions like anger, making it difficult to determine if the link between disgust and morality is unique. The current research evaluated the specificity of the relationship between disgust and morality by comparing links with anger, using state, physiological and trait measures of emotionality. Participants (N=90) were randomly allocated to have disgust, anger or no emotion induced. Responses to images depicting moral, negative non-moral, and neutral themes were then recorded using facial electromyography. Inducing disgust, but not anger, increased psychophysiological responses to moral themes. Trait disgust, but not trait anger, correlated with levator labii responses to moral themes. These findings provide strong evidence of a unique link between physical disgust and morality.
Despite the enormous costs associated with unrestrained anger, little is known about the neural mechanisms underlying anger regulation. Behavioral evidence supports the effectiveness of reappraisal in reducing anger, and demonstrates that rumination typically maintains or augments anger. To further understand the effects of different anger regulation strategies, during functional magnetic resonance imaging 21 healthy male and female undergraduates recalled an anger-inducing autobiographical memory. They then engaged in three counterbalanced anger regulation strategies: reappraisal, analytical rumination, and angry rumination. Reappraisal produced the least self-reported anger followed by analytical rumination and angry rumination. Rumination was associated with increased functional connectivity of the inferior frontal gyrus with the amygdala and thalamus. Understanding how neural regions interact during anger regulation has important implications for reducing anger and violence.
The concept of emotion regulation features in many models of psychopathology and it has been proposed that individuals with poorly regulated emotions often engage in maladaptive behaviours to escape from or down-regulate their emotions, creating risk for a range of disorders. One such disorder may be pathological gambling. To our knowledge, no study had assessed the use of emotion-regulation strategies in this population. The goal of the present study was therefore to examine emotion-regulation difficulties among a sample of pathological gamblers (n= 56), a mixed clinical comparison group (n= 50), and a sample of healthy community controls (n= 49).
Previous research suggests that the pervasive tendency to avoid perceived risks (i.e., the safety bias) may be implicated in the maintenance of pathological anxiety. These studies have not explored, however, the potential clinical implications of such a bias, such as the influence of risk aversion on treatment seeking. The aim of this study was to investigate how risk-avoidance is related to willingness to seek treatment in an online sample of clinically anxious individuals with social phobia (SP), obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD). Healthy control participants (n=117) and those endorsing criteria for one or more anxiety disorder(s) (n=92; SP, n=33; OCD, n=19; GAD, n=40) were recruited from various online sources. Respondents completed an online survey comprised of a validated diagnostic interview, self-report measures assessing for symptom severity, risk-taking across various domains, a generalized index of risk-taking and treatment utilization. Consistent with hypotheses, SP and GAD individuals reported significantly more risk-avoidance when compared to non-clinical controls. Furthermore, willingness to seek treatment was found to be positively associated with social risk-taking and generalized risk-taking orientation in clinically anxious individuals who had never sought treatment. These results suggest that certain individual cognitive factors may contribute to the decision to seek treatment and may provide an interesting avenue of future investigation for increasing service utilization and treatment seeking in anxious populations.
The manner in which individuals recall negative life events has important affective consequences. The present experiment investigated the effects of emotion regulation strategies on anger experience. One hundred and twenty-one undergraduates recalled an anger-inducing memory and were instructed to engage in either analytical rumination, cognitive reappraisal, or distraction for 20 minutes. In the remaining (control) condition, participants were instructed to write about their thoughts but were not given any emotion regulation instructions. Rumination maintained anger, whereas participants in the remaining conditions reported decreased anger following the writing task. Our results suggest that reappraisal facilitates adaptive processing of anger-inducing memories and distraction facilitates rapid reductions in anger experience. These findings have implications for the management of clinical populations that commonly experience difficulty with anger regulation.
It has been proposed that a persistent and pervasive tendency to avoid risks is involved in the development and maintenance of clinically significant anxiety. Few studies, however, have examined the clinical implications of risk-aversion, and particularly the association between risk-aversion and treatment outcome. The current study investigated how risk-aversion in specific domains (Social and Recreational) related to treatment outcome in a clinical sample of patients with generalized anxiety disorder (GAD) undergoing internet-delivered cognitive-behavioral therapy (CBT). We hypothesized that: (i) risk-taking would increase as a result of treatment and (ii) risk-taking would mediate changes in symptom severity and impairment as a result of treatment. Individuals recruited online (N=44) meeting diagnostic criteria for GAD were randomized to the treatment (n=24) or control group (n=20). Participants completed measures of symptom severity, impairment and risk-taking before and after treatment. Results partially confirmed our hypotheses, demonstrating that participants in the treatment group significantly increased social and recreational risk-taking scores relative to the control group and risk-taking mediated treatment outcome for depression, but not for anxiety symptoms. The results of this study suggest that social and recreational risk-avoidance decreases following CBT treatment, and this change may mediate treatment outcome for depression. Clinical implications of these findings are discussed.
OBJECTIVES. Evidence suggests that ostracism exerts an immediate and painful threat to an individuals primary needs for belonging, meaningful existence, control, and self-esteem. Individuals with schizophrenia are particularly likely to experience the effects of ostracism, being amongst the most stigmatized of all the mental illnesses. The aims of the present study were therefore to assess the immediate and delayed effects of ostracism in these individuals, and to explore associations between any observed effects and indices of negative affect and clinical symptoms. METHODS. Individuals diagnosed with schizophrenia or schizoaffective disorder, and non-clinical controls engaged in a virtual ball-toss game with two fictitious others. All participants played the game on two separate occasions, participating in both an inclusion and an ostracism condition. Measures of primary needs were obtained after each game. RESULTS. Findings suggest that the negative impact of social exclusion lasts longer in individuals with schizophrenia, compared with non-clinical controls. Further, clinical participants who reported lower primary needs after a delay were more likely to exhibit higher levels of depression, anxiety, and stress. CONCLUSIONS. Future studies should examine the use of regulatory strategies and personal responses to stigma as potential mediators in the maintenance of the negative effects of social exclusion. These lines of research may offer insight into interventions that may assist individuals to better cope with this experience.
Numerous studies have shown that social phobia patients experience negative self-impressions or images during social situations. Clark and Wells (1995) posited that such negative self-images are involved in the maintenance of social phobia. Thus, the present study investigated the effects of negative self-imagery on cognition and emotion during and following a brief social situation. Specifically, high and low socially anxious participants (N = 77) were instructed to hold either a negative or control self-image as they engaged in a brief speech. Participants then rated their anxiety, performance, cognitions, and focus of attention. Twenty-four hours later, they returned to the laboratory and completed questionnaires assessing the amount of post-event processing (PEP) they engaged in. The results showed that, irrespective of the level of social anxiety or depressive symptoms, participants that held the negative self-image experienced higher levels of anxiety, were more self-focused, experienced more negative thoughts, rated their anxiety as more visible, appraised their performance more negatively, and engaged in more negative and less positive PEP than participants that held the control self-image. Collectively the results indicate that negative imagery is causally involved in the maintenance of social phobia, as well as in the generation of social anxiety among non-anxious individuals.
Compulsive hoarding is a disabling psychological disorder characterized by excessive collecting and saving behavior. This article reviews four key areas of recent advances in hoarding research. First, we provide an overview of the evolving controversy regarding the diagnostic status of hoarding, highlighting accumulating evidence that it may be best conceptualized as a separate syndrome. Second, we describe advances in our understanding of the epidemiology, course, and demographic features of compulsive hoarding. Third, we review the latest findings regarding possible neuropsychological correlates of the disorder. Finally, we discuss ongoing progress and future directions related to the clinical management of compulsive hoarding.
According to the cognitive-behavioural model of compulsive hoarding, information-processing deficits in the areas of attention, memory, decision-making, and categorization contribute to hoarding behaviour. The purpose of the current study was to examine whether individuals with compulsive hoarding exhibited impairment on executive functioning and categorization tasks. Three groups of participants were recruited (N = 60): individuals with compulsive hoarding syndrome, individuals with an Axis I mood or anxiety disorder, and non-clinical control participants. All participants completed self-report measures of cognitive difficulties, neuropsychological tests of executive functioning and decision-making, and four categorization tasks. Results suggested that hoarding participants reported more cognitive failures and more problems with attention and decision-making than non-clinical control participants. In addition, hoarding participants performed worse than both control groups on the Stockings of Cambridge (SOC), a neuropsychological test of planning ability, and were slower and more anxious during a categorization task. These findings suggest that specific deficits in executive functioning may be associated with the difficulties hoarding patients have organizing their possessions.
Existing neuropsychological studies of obsessive-compulsive disorder (OCD) are cross-sectional and do not provide evidence of whether deficits are trait-related (antecedent and independent of symptomatology) or state-related (a consequence, dependent on symptomatology).
The nosological status of agoraphobia is controversial. Agoraphobia may be a distinct diagnostic entity or a marker of avoidance severity. The current study examines the latent structure of agoraphobia through the use of taxometric analysis. The latent structure of agoraphobia was examined in two independent samples, one comprising outpatients presenting for treatment for panic disorder (PD) with or without agoraphobia (n=365), and the other comprising community volunteers to a national mental health survey who experienced fear or avoidance of at least one prototypic agoraphobic situation (n=640). Two taxometric procedures were carried out - maximum eigenvalue (MAXEIG) and mean above minus below a cut (MAMBAC) - using indicators derived from questionnaire measures of, and structured diagnostic interviews for, agoraphobia. Results show consistent evidence of dimensional latent structure in both samples. It is concluded that scores on measures of agoraphobia best represent an agoraphobic severity dimension.
In schizophrenia, blunted affect has been argued to reflect difficulties with the amplification of emotion expressive behavior. The aim of the present study was to assess whether ostensibly healthy individuals vulnerable to schizophrenia present with similar difficulties. In the first component of the study, 843 non-clinical participants completed the Schizotypal Personality Questionnaire, of which 27 scoring in the upper 15% (high schizotypy group) and 27 scoring in the lower 15% (low schizotypy group) were asked to watch amusing film clips, whilst engaging in different emotion regulatory strategies, and specifically, amplify the expression of an experienced emotion (amplification) or suppress the expression of an experienced emotion (suppression). The results indicate that highly schizotypal participants present with specific difficulties with the amplification (but not suppression) of emotion expressive behavior. These difficulties are significantly correlated with total negative schizotypy, particularly blunted affect. In the second component of the study, an individual differences approach was used to assess the interrelationship between self-reported use of suppression and schizotypy in an independent sample of 204 community volunteers. The results suggest that, although blunted affect is associated with increased use of suppression, it cannot be regarded as the primary mechanism underpinning this disturbance. Implications for understanding blunted affect in schizophrenia and related disorders are discussed.
Hypersentimentality to possessions has been proposed to play an important role in the development and maintenance of compulsive hoarding. The current study prospectively examined the formation of attachment to a newly acquired object in an OCD sample (n=62) to determine whether specific hoarding symptoms moderated the development of attachment to an object over time. Participants rated their level of attachment to a keychain immediately upon receipt (time 1) and one week later (time 2). We hypothesized that individuals with a tendency to hoard and strong beliefs about the value of possessions would exhibit greater attachment to the object over time. Hierarchical multiple regression analyses revealed that a persons initial attachment to the object was the best predictor of attachment one week later. Although emotional attachment increased similarly for all participants independent of their hoarding symptoms, specific hoarding-related beliefs and behaviors uniquely predicted initial attachment to the keychain.
It is unclear how many people in the community have obsessions and compulsions and associated levels of interference. It is also unknown what variables predict help-seeking for these symptoms, whether they are developmentally stable, and whether they increase the risk of mental disorders.
Increasing emphasis has been placed on the role of socioemotional functioning in models of obsessive-compulsive disorder (OCD). The present study investigated whether OCD symptoms were associated with capacity for theory of mind (ToM) and basic affect recognition. Non-clinical volunteers (N=204) completed self report measures of OCD and general psychopathology, in addition to behavioral measures of ToM and affect recognition. The results indicated that higher OCD symptoms were associated with reduced ToM, as well as reduced accuracy decoding the specific emotion of disgust. Importantly, these relationships could not be attributed to other, more general features of psychopathology. The findings of the current study therefore further our understanding of how the processing and interpretation of social and emotional information is affected in the context of OCD symptomatology, and are discussed in relation to neuropsychological models of OCD.
A defining characteristic of obsessive-compulsive disorder (OCD) is unsuccessful suppression of unwanted thoughts. Recent evidence of individual differences in ability to control intrusive thoughts may inform our understanding of failures of cognitive control associated with OCD symptomatology. The current study investigated characteristics of cognitive style that are potentially associated with OCD symptoms and may influence response to unwanted thoughts, including perceived ability to control thoughts and tendency to ruminate. Undergraduate students (N=166) completed self-report measures of OCD symptoms, perceived thought control, and ruminative thinking. They were then presented with a distressing target thought and completed a standard thought suppression paradigm. Correlational results indicated that, controlling for anxiety and depression, OCD symptoms were positively associated with rumination and inversely associated with perceived thought control ability. In addition, OCD symptoms were associated with higher levels of distress and greater spontaneous efforts to suppress the target thought during a baseline period, while perceived thought control ability predicted frequency of target thoughts during suppression. Finally, results of the experimental manipulation confirmed that participants instructed to suppress experienced more intrusions during the recovery period. Clinical implications and future directions are discussed.
Current social phobia models (e.g., Clark & Wells, 1995; Leary & Kowalski, 1995) postulate that socially anxious individuals negatively appraise their anxiety sensations (e.g., sweating, heart racing, blushing) as evidence of poor social performance, and thus fear these anxiety symptoms will be noticed and judged negatively by others. Consequently, they become self-focused and hypervigilant of these sensations and use them to judge how they appear to others. To test this model, high (N=41) and low (N=38) socially anxious participants were shown false physiological feedback regarding an increase or decrease in heart rate prior to and during an impromptu speech task. Relative to participants who observed a false heart rate decrease, those in the increase condition reported higher levels of negative affect, more negative performance appraisals, and more frequent negative ruminative thoughts, and these effects were mediated by an increase in self-focused attention. The unhelpful effects of the physiological feedback were not specific to high socially anxious participants. The results have implications for current cognitive models as well as the treatment of social phobia.
The emotion of disgust has been implicated in the development and maintenance of contamination-based obsessive-compulsive disorder (OCD). In the present study nonclinical participants with high (n=26) and low (n=28) levels of OCD contamination symptoms were exposed to 2 categories of disgust stimuli (blood injury and body waste) across 4 blocks using standardized disgust images. Self-report disgust and fear were recorded, as well as cardiovascular heart rate. In both groups, an initial primary disgust reaction was observed. Self-report disgust and fear, but not heart rate deceleration, was greater in the high symptom group. The high symptom group showed reductions in heart rate deceleration, whereas the low symptom group did not. Significant differences in self-report changes across time were observed between the groups, with fear increasing to a greater extent for high contamination fearful individuals when viewing body waste images. The implications of these findings for theoretical models and clinical treatment of OCD with prominent contamination symptoms are discussed.
Thought-action fusion (TAF), or maladaptive cognitions regarding the relationship between mental events and behaviours, has been implicated in the development and maintenance of obsessive-compulsive disorder (OCD). As some religions promote TAF-like appraisals, it has been proposed that religiosity may play a role in the transformation of normally occurring intrusive thoughts into clinically distressing obsessions. No research, however, has experimentally investigated the mediating role of TAF on the relationship between religiosity and OC symptoms.
Although selective attention to ones own appearance has been widely documented in studies of body dysmorphic disorder (BDD), little is known about attentional bias toward non-self appearance-related stimuli in BDD. Furthermore, despite reports of heightened experience of disgust in BDD, it is unknown whether these individuals differentially attend to disgusting stimuli and whether disgust is important in processing of unattractive stimuli. We used a dot probe procedure to investigate the relationship between dysmorphic concern, a defining feature of BDD, and selective attention to faces, attractive, unattractive and disgusting images in a female heterosexual student population (N=92). At the long stimulus presentation (1000 ms), dysmorphic concern was positively associated with attention to faces in general and attractive appearance-related images. In contrast, at the short stimulus presentation (200 ms), there was a positive association between dysmorphic concern and disgusting images. Implications for theoretical models of BDD are discussed.
It has been argued that individuals who are anxious are less likely and willing to take perceived risks across multiple behavioral domains (e.g., social, recreational, financial etc.), and that this bias is likely implicated in the etiology of pathological anxiety. While evidence is accumulating, there has been minimal research investigating the characteristics of risk-avoidance across anxiety disorders and across the specific risk-taking domains. The current study investigated risk-avoidance across domains in an anxious treatment-seeking sample. We hypothesized that: (i) individuals with anxiety would be more risk averse across domains relative to healthy controls; and, (ii) risk-avoidance would predict unique variance in anxiety symptoms, above and beyond other vulnerability factors (e.g., neuroticism). Individuals diagnosed with one or more anxiety disorders (n=67) completed measures of risk-taking, anxiety and depression symptoms, personality, and psychological distress. Healthy controls (n=58) completed measures of risk-taking and psychological distress. Results partially confirmed our hypotheses, demonstrating that anxious individuals were significantly more risk averse relative to controls across most domains, even after controlling for age and psychological distress. Furthermore, specific domains were found to account for unique variance in specific anxiety symptoms, as well as symptoms of depression. The results of this study provide novel evidence to suggest that risk-aversion is a possible transdiagnostic factor contributing to anxiety pathology.
Although general emotion coping difficulties are well documented in schizophrenia, there has been limited study of specific regulatory strategies such as suppression, reappraisal, and acceptance. In the present study, clinical and control participants were asked to watch video clips selected to elicit negative affect while engaging in one of these three different emotion regulation strategies (counterbalanced), versus a passive viewing condition. The experiential and expressive components of emotion were quantified using self-report and facial electromyography, respectively. A major finding was that, in contrast to control participants, individuals with schizophrenia did not report a greater willingness to reexperience negative emotion after engaging in acceptance. These data are discussed in the context of evidence highlighting the potentially important role of acceptance in understanding affective abnormalities in clinical conditions such as schizophrenia.
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