Peter J Norton

Peter J Norton
University of Houston | U of H, UH · Department of Psychology

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134
Publications
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Publications

Publications (134)
Article
Nicotine has acute pain-relieving properties, and tobacco smokers often report using cigarettes to cope with pain. The proportion of smokers using menthol cigarettes has increased in recent years, and there is reason to suspect that menthol may enhance the analgesic effects of nicotine. Up to 90% of African American smokers report using menthol cig...
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Samples in prior studies examining attachment theory in the military have been predominantly composed of male combat veterans. Given the rates of sexual trauma among female veterans and differences in the association between attachment and posttraumatic stress disorder (PTSD) severity for sexual trauma survivors, it was necessary to consider the at...
Article
Background Transdiagnostic group cognitive behavioral therapy for anxiety (TGCBT) has demonstrated effectiveness in improving comorbid conditions, including depression. Mediators of change in reductions in comorbid depression have yet to be established following this anxiety-focused treatment. Negative affect (NA) and intolerance of uncertainty (IU...
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It is widely recognized that smoking is related to abdominal pain and discomfort, as well as gastrointestinal disorders. Research has shown that visceral sensitivity, experiencing anxiety around gastrointestinal sensations, is associated with poorer gastrointestinal health and related health outcomes. Visceral sensitivity also increases anxiety sym...
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Individuals with anxiety disorders experience decrements in quality of life (QoL), though it is seldom assessed as an outcome in treatment studies. This study examined QoL as an outcome following transdiagnostic group cognitive-behavioral therapy (TGCBT) for anxiety. Treatment-seeking adults (N = 129; Mage = 33.1; 47.4% female) with social phobia,...
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Persons living with HIV/AIDS (PLHIV) are able to live full lifespans after infection, however, rates of anxiety disorders among this population are elevated compared to national samples. Importantly, these anxiety symptoms and disorders have a negative effect on medication adherence, quality of life and other psychological disorders, such as depres...
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Disproportionately more smokers report low-income and mental health problems relative to non-smokers. Low-income smokers may use smoking to alleviate negative emotional states resulting from exposure to multiple stressors. Yet, little work has been devoted to elucidating mechanisms that may explain the association between negative emotional states...
Article
Neuroticism has been implicated in many forms of psychopathology. Additional transdiagnostic factors such as shame, psychological inflexibility, and emotion dysregulation may explain the association between neuroticism and anxiety. While past work has, to some degree, evaluated these factors that cut across diagnostic categories, no study has evalu...
Article
Background: Recent evidence suggests intolerance of uncertainty (IU) is a transdiagnostic variable elevated across anxiety disorders. No studies have investigated IU's response to transdiagnostic group CBT for anxiety (TGCBT). This study evaluated IU outcomes following TGCBT across anxiety disorders. Methods: 151 treatment-seekers with primary d...
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Homework assignments have been shown to produce both causal and correlational effects in prior meta-analytic reviews of Cognitive Behavior Therapy (CBT), but this research area has been characterized by a focus on the amount of compliance (i.e., quantity), and little is known about the role of skill acquisition (i.e., quality). A landmark study by...
Article
Background: Norton and Robinson [2010. Development and evaluation of the anxiety disorder diagnostic questionnaire. Cognitive Behaviour Therapy, 39(2), 137-149. doi: 10.1080/16506070903140430 ] developed the Anxiety Disorder Diagnostic Questionnaire (ADDQ) as a transdiagnostic assessment of fear and anxiety to address problems in using diagnosis-s...
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Veterans returning from Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) display high rates of noncompletion from posttraumatic stress disorder (PTSD) treatment. The present study included 282 male OEF/OIF/OND Veterans and examined predictors of noncompletion from inpatient evidence-based treatment (EBT)...
Article
Objective: Little is known about the temporal variability of the alliance-symptom change and cohesion-symptom change relationships over the course of group therapy. These questions were examined in a sample of 373 clients receiving a transdiagnostic cognitive behavior therapy (tCBT), which culled the principle research-supported mechanisms of chan...
Article
The article by Pfeifer and Strunk on psychotherapy process research offers a highly thoughtful review on the state of psychotherapy process research in cognitive therapy for depression, and the inherent challenges in establishing causal relationships between process and outcomes. In this commentary, I argue that the goal of internal validity in psy...
Article
Background: Negative affectivity (NA) has been linked to anxiety and depression (DEP). Identifying the common factors between anxiety and DEP is important when explaining their overlap and comorbidity. However, general factors such as NA tend to have differential relationships with different disorders, suggesting the need to identify mediators in o...
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Treatment noncompletion is common among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans obtaining treatment for posttraumatic stress disorder (PTSD). The present study examined causes of inpatient PTSD evidence-based treatment (EBT) discontinuation among 69 male OEF/OIF/OND veterans. Findings r...
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Increasing awareness of cross-cultural issues in psychology has led many to question the validity and utility of instruments in nonmajority ethnic and racial groups. The Mood and Anxiety Symptom Questionnaire (MASQ; Clark & Watson, 1991) is a widely used measure of anxious and depressive symptoms. However, some of the most-cited investigations into...
Article
Emetophobia is defined as a specific phobia of vomiting, currently diagnosed as specific phobia "other" type in DSM-5 (American Psychiatric Association, 2013). Though there is a dearth of research conducted on emetophobia and its treatment, there is limited data from case studies (Hunter & Antony, 2009; Maack, Deacon, & Zhao, 2013) and one open tri...
Article
Mental health professionals have long been concerned with describing and proscribing a structure around the myriad variations of psychological and emotional distress that are deemed to be disordered. This has frequently been characterized as a conflict between so-called “lumpers” and “splitters” – those who advocate broad categorizations based on o...
Article
. The construct of anxiety sensitivity (AS) – the fear of anxiety-related symptoms – has been highly influential in current conceptualizations of anxiety disorders in general, and panic disorder specifically. However, given documented associations between AS and both non-anxiety psychological disorders as well as medical/health conditions, the exte...
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Anxiety disorders represent a prevalent and impairing class of disorders. Although individual and group cognitive–behavioral interventions have been efficacious in treating anxiety, this research typically looks at individuals or study condition as the unit(s) of analysis. Thus, an understudied area in group therapy is in the investigation of outco...
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The cognitive model of panic (Clark, 1988) suggests that panic attacks result from the catastrophic misinterpretation of bodily sensations rather than the sensations themselves. Anxiety sensitivity (AS) is fear of anxious bodily sensations (Reiss, 1991) and has implications in panic development, maintenance, and severity. Although previous work has...
Article
We offer a critical and constructive appraisal of the conclusions provided by the Interdivisional (American Psychological Association [APA] Divisions 12 & 29) Task Force on Evidence-Based Therapy Relationships. We highlight problems in overlapping terminology and definitions, as well as problems in the conduct of its meta-analyses (i.e., duplicatio...
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Between-session interventions, or homework, are crucial to a range of psychological therapies, including cognitive behavior therapy (CBT). Therapeutic interventions often involve experiencing emotions and situations, or examining strongly held views about their problems, that clients can find distressing. Hence, the clinician faces a particular cha...
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Background: One of the primary differences between Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for anxiety is the approach to managing negative thoughts. CBT focuses on challenging the accuracy of dysfunctional thoughts through cognitive restructuring exercises, whereas ACT attempts to foster acceptance of such t...
Article
Despite findings indicating that anxiety disorders are more likely to co-occur with each other than occur in isolation, little research has explored precise areas of overlap and differentiation among comorbid pairs of anxiety disorders. Furthermore, many studies comparing phenomena across anxiety disorders define comparison groups based on principa...
Article
Abstract Limited work has examined worry, or apprehensive anticipation about future negative events, in terms of smoking. One potential explanatory factor is the tendency to respond inflexibly and with avoidance in the presence of smoking-related distress (smoking-specific experiential avoidance). Participants (n = 465) were treatment-seeking daily...
Article
Background: Studies on adolescents and adults show that romantic love (RL) is associated with favorable emotional states. However, data on these associations are scarce for adults. The aim of the present study was, therefore, to explore the associations between RL, symptoms of depression, anxiety, hypomania (bright side and dark side), and sleep i...
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Anxiety sensitivity (AS), the fear of anxious cognitive and physiological experiences, is multidimensional and adds incrementally to the prediction of relationships of panic and relevant phenomenology. Many agree upon the content of the dimensions, but there is less agreement about the factor structure of the anxiety sensitivity index (ASI), a wide...
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High rates of attrition occur in outpatient and inpatient evidence-based treatments (EBTs) targeting newly returning veterans from Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) with posttraumatic stress disorder (PTSD). Traditionally, research has examined attrition as a dichotomous variable (i.e., non...
Article
Objective This study examines discontinuation of psychotherapy from a consumer decision-making perspective. Two plausible predictors, the level of illness and rate of progress from where the patient started, were examined as predictors of treatment discontinuation.Method Using data from 139 patients (45.5% women; mean age = 32.18 years) participati...
Article
Background: Functional analytic psychotherapy (FAP) is a contextual behavior therapy that targets idiographic behaviors relevant to interpersonal functioning. FAP often targets issues with intimacy, defined as behavior exchanges that are vulnerable to interpersonal punishment. While existing measures examine similar constructs to FAP’s conceptualiz...
Article
Research examining the impact of therapist experience on client outcomes has yielded mixed findings. The current study aimed to improve upon previous research by examining the impact of global trainee therapists' experience, as well as treatment protocol-specific experience, on client outcomes. Data were obtained based on 319 clients being treated...
Chapter
In the most recent publication, DSM-IV-TR, 12 distinct diagnoses are listed under the heading of anxiety disorders. Evidence from multiple realms supports the assertion that anxiety disorders are not distinct pathological entities, but are manifestations of a homogeneous construct. This chapter provides an overview of the theoretical and practical...
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Background: Falling in love is a universal human behavior. Studies indicate that both adolescents and adults experience romantic love (RL) and emotional states of joy and happiness. However, there is evidence that among adolescents RL is also associated with symptoms of depression and anxiety, but no data on these associations are available for ad...
Article
Current conceptualizations for anxiety disorders focus heavily on cognitive and behavioral aspects of anxiety and address other emotions to a far lesser extent. Studies have demonstrated that negative appraisals of anxiety and fear (e.g., anxiety sensitivity) are elevated in each of the anxiety disorders and depressive disorders. Much less is known...
Article
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Background: Smoking cessation for individuals with depressive disorders represents an important clinical issue. It often has been hypothesized that smoking cessation worsens negative affect as part of the withdrawal process in this population. However, studies examining the impact of smoking cessation on changes in affect in smokers with depressio...
Article
Objective(s): Treatment credibility and client satisfaction have received relatively little research attention, but extant findings indicate that some clients and therapists differ in their perceptions of what is helpful about therapy, with greater divergence related to poorer outcomes. This study examined relationships between treatment credibili...
Article
Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179-186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group t...
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The present study examines the effectiveness of a 12-week transdiagnostic cognitive-behavioral group in reducing comorbid diagnoses. Data from 79 treatment completers (60.8% women; M age = 32.57 years) during three previous trials of transdiagnostic cognitive behavior therapy (CBT) were examined to compare treatment effects between those with and w...
Article
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Transdiagnostic cognitive-behavioral treatments for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, research on transdiagnostic anxiety treatments has, to date, relied on open trials, or comparisons to waitlist conditions, published benchmarks, or relaxation-based interventions. The current...
Article
Transdiagnostic cognitive-behavioral treatments (CBT) for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, all of the research on transdiagnostic anxiety treatments to date have either not used a control condition, or have relied on no-treatment or delayed-treatment controls, thus limiting i...
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Abstract Research suggests that test anxiety is associated with a number of maladaptive factors. The majority of test anxiety research includes the Test Anxiety Inventory (TAI) as a primary outcome variable. However, the TAI was normed on college undergraduates in 1980. The academic landscape has altered in a variety of ways in the past 30 years, w...
Article
Interest in transdiagnostic approaches to the cognitive-behavioral treatment (CBT) ofemotional disorders has been increasing over the past decade. The purpose of this paper was toreview the rationale behind transdiagnostic treatment models, describe one such group-based treatmentprotocol in detail, and report on the building evidence base to date....
Article
The cognitive factor of Anxiety Sensitivity (AS; the fear of anxiety and related bodily sensations) is theorized to play a role in cannabis use and its disorders. Lower-order facets of AS (physical concerns, mental incapacitation concerns, and social concerns) may be differentially related to cannabis use behavior. However, little is known about th...
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Research has shown that although intrusive thoughts occur universally, the majority of individuals do not view intrusive thoughts as being problematic (Freeston, Ladouceur, Thibodeau, & Gagnon, 1991; Rachman & de Silva, 1978; Salkovskis & Harrison, 1984). Thus, it is not the presence of intrusive thoughts that leads to obsessional problems but rath...
Article
Individuals with anxiety often report greater smoking and drinking behaviors relative to those without a history of anxiety. In particular, smoking and alcohol use have been directly implicated among individuals experiencing panic attacks, diagnosed with panic disorder, or high on panic-relevant risk factors such as anxiety sensitivity. Less is kno...
Article
Previous exposure therapy research has suggested potential differences in emotional processing at different points in treatment (Hayes, Hope, & Heimberg, 2008). For example, indicators of emotional processing may be more related to outcome during the later exposure sessions than during the initial session. This is consistent with a growing body of...
Article
Research and clinical literatures are replete with examples that psychological disorders are related to drug use, abuse, and dependence. The preponderance of scientific work addressing relations among psychopathological processes and drug use, abuse, and dependence has been focused primarily on psychotic disorders, major depression, antisocial pers...
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Sudden gains in psychotherapy are characterized by large and relatively stable decreases in psychiatric symptoms and have been associated with cognitive shifts in clients and shown to predict superior treatment outcomes in studies of depression and, to a lesser extent, anxiety disorders. The purpose of this study was to examine prevalence and impac...
Article
While there is general agreement that, across cultures, panic disorder appears to be characterized by sudden onset of bodily sensations, such as dizziness and heart palpitations, followed by catastrophic misinterpretations of these symptoms, there remains a need for research investigating ethnic/cultural differences in the experience of panic attac...
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The Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV) is a self-report diagnostic measure of generalized anxiety disorder. Previous studies have established the psychometric properties of the GAD-Q-IV, revealing excellent diagnostic specificity and sensitivity as well as good test-retest reliability and convergent and discriminant validity (...
Chapter
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Social anxiety, social withdrawal, and social skills are intertwined, but distinct, constructs that can mutually and independently have a significant impact on social functioning. Comprehensive definitions and descriptions of social skills are provided elsewhere in this volume; however, social anxiety is defined as a fear of negative evaluation by...
Chapter
Evidence generally supports a situationally specific view of social skill competence. This perspective contends that behavior is specific to a particular situation, and therefore deficits in social skills are transient depending on the situational context (Meier & Hope, 1998). Therefore, when assessing social skill competency it is important to not...
Chapter
As noted in Chapter 6, empirically based measures for assessing social skills in adults have primarily utilized self-report and analogue observational assessment approaches. Meier and Hope (1998) have described a sample clinical interview approach to assessing social skills but, to date, no data have been collected supporting the reliability or val...
Chapter
Full-text available
In assessing the social skills of adults, many of the same factors in assessing social skills among children and adolescents will influence the resulting data. Issues such as single versus multiple prompts, standardized or individualized scenarios, and molar versus molecular ratings all impact the use and validity of social skills assessments with...
Article
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most commonly used instrument for assessing OCD in clinical trials, but little information is available regarding its appropriateness with patients of diverse racial and ethnic backgrounds. We examined the factor structure and measurement invariance of this widely used measure, across indivi...
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The transition from elementary to middle or junior high school is commonly regarded as a period of stress and turmoil for young adolescents, and has been associated with changes in anxiety and other psychological problems. However, less is known about risk and resilience factors that may predict these changes. This study examined changes in anxiety...
Article
The following instructions are suggestions ONLY, designed to give you a sense of how the researchers have presented this questionnaire in the past. It is anticipated that teachers will present the questionnaire in a manner they feel is appropriate for their own unique classroom situation.
Chapter
The extent to which scores on a target measure can be used to predict an individual’s score on a measure of performance collected at the same time as the target measure.
Book
Social skills are at the core of mental health, so much so that deficits in this area are a criterion of clinical disorders, across both the developmental spectrum and the DSM. The Practitioner’s Guide to Empirically-Based Measures of Social Skills gives clinicians and researchers an authoritative resource reflecting the ever growing interest in so...
Article
A model of anxiety that emphasizes a single common pathology across diagnostic categories is gaining support and influencing nosological and treatment approaches of anxiety disorders. As research in this area continues to grow, a need exists for an assessment tool of the theorized single anxiety pathology that is unbiased toward any particular anxi...
Article
Full-text available
We propose a cognitive model of social anxiety-related submission based upon psycho-evolutionary accounts of social anxiety and depression and present results of two studies supporting this model. We tested a confirmatory factor model consisting of three latent lower-order factors (fear of negative evaluation, fear of positive evaluation, and depre...
Article
The suppression of unwanted thoughts appears to contribute to the development and maintenance of emotional disorders. This report tested the thought suppression paradigm in relation to suicidal ideation. Based on the ironic process theory, we hypothesized that the suppression of unwanted thoughts, especially suicidal thoughts, would associate with...
Article
Full-text available
Interest in the assessment of quality of life in the anxiety disorders is growing. The present study examined quality of life impairments in individuals with generalized anxiety disorder (GAD), social phobia, and panic disorder. Results showed that individuals with these disorders reported less satisfaction with their quality of life than non-anxio...
Article
Established and emerging cognitive models of social anxiety have provided researchers and clinicians with a solid foundation for understanding and treating this phenomenon. Much of the support for these models, however, has been derived from predominantly Caucasian samples. While the evidence supports the concept of socioevaluative fears as being u...
Article
Theory and evidence relating to biological and psychological vulnerabilities, comorbidity, latent structure, cognitive and behavioral maintaining factors, and treatment outcome suggest that commonalities across emotional disorders may outweigh the differences. Thus, researchers have recently begun evaluating transdiagnostic (or unified) treatment p...
Article
Recent evidence suggests that social anxiety disorder is best characterized as having a dimensional latent structure. In this study, we examined the latent structure of two cognitive components of social anxiety, fear of negative evaluation (FNE) and fear of positive evaluation (FPE), in a large undergraduate sample. Two taxometric procedures (MAMB...
Conference Paper
One of the features of the consumption of mental health services is that they are often consumed as a series of individual therapy sessions that are spread over time but are collectively required to achieve the therapeutic goal. As a result, patient drop-out is a significant risk in psychotherapy treatment regimes, with some studies reporting it to...
Article
Transdiagnostic models of anxiety, and cognitive-behavioral treatments based on these models, have been gaining increased attention in recent years. Preliminary efficacy studies generally suggest strong treatment effects, although few of these studies have examined to what extent treatment effects are similar across clients with different anxiety d...
Article
Since its development in the mid-1980s, the Panic Attack Questionnaire (PAQ) has been one of the more, if not the most, commonly used self-report tools for assessing panic attacks. The usage of the instrument, however, has come amid potential concerns that instructions and descriptions may lead to an over-estimate of the prevalence of panic attacks...
Article
Clark and Watson's (1991)70. Watson , D. and Clark , L. A. 1991. The Mood and Anxiety Symptom Questionnaire (MASQ) Unpublished manuscript, University of Iowa (Iowa City) View all references tripartite model is commonly viewed as the preferred model for examining the relationship between anxiety and depression. The tripartite model proposes that t...
Article
Much has been written about the applicability of cognitive-behavioral group treatments for anxiety disorders using a transdiagnostic model. These studies generally support the efficacy of such treatments, although concern is apparent regarding the impact on therapeutic processes by including individuals with different DSM-IV anxiety disorder diagno...
Article
The current study was conducted to assess courage, defined as behavioral approach despite the experience of fear, in an effort to better understand its relationship with anxiety, fear, and behavioral approach. Thirty-two participants who completed a measure of courage and reported elevated spider fears during an earlier screening participated in a...
Article
The Yale-Brown Obsessive-Compulsive Scale and the Padua Inventory Washington State University Revision are commonly used measures of obsessive-compulsive disorder. They have been shown to be reliable and valid with both clinical and nonclinical samples. However, their psychometrics have primarily been assessed using homogenous white samples. This i...