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Worry and Anxiety: Is There a Causal Relationship?
Abstract
The aim of this study was to examine the relationship between worry and anxiety and depression. Path analysis was used to estimate a nonrecursive model which describes the reciprocal causal relation between worry and anxiety. The final model fits the data well and leads to the conclusion that the association between these two constructs is not bidirectional. Indeed, we observed a significant positive effect of worry on anxiety, but no effect in the opposite direction. This result provides a supporting argument for researchers wishing to distinguish these two constructs. Moreover, depression is not directly affected by worry, but is indirectly affected through anxiety.
... Specifically, Liao et al. (2014) reported that "anticipated worry", "experienced worry" and "current worry" specific to H1N1 risk predicted the frequency of protective behaviors, whereas state anxiety made no significant contribution. These results are consistent with theoretical positions suggesting that worry and anxiety are two different facets of emotional processing (Borkovec, Ray, and Stober 1998;Gana, Martin, and Canouet 2001;Zebb and Beck 1998). We thus expected that the predictors of state anxiety should be at least partially different from the predictors of risk and worry measures. ...
... Second, to provide a better understanding of the emotional consequences of the pandemic, measures of experienced worry and state anxiety were also included in the survey. Based on previous evidence (Liao et al. 2014) and the hypothesis that worry and anxiety should be regarded as two different facets of emotional processing (Borkovec, Ray, and Stober 1998;Gana, Martin, and Canouet 2001;Zebb and Beck 1998), we expected to find a partial dissociation in the way in which psychological predictors related to these constructs. ...
... A second aim of our study was to determine whether experienced worry and anxiety were predicted by different variables. According to previous studies, worry can be viewed as a construct separate from anxiety and depression (Gana, Martin, and Canouet 2001;Meyer et al. 1990;Stöber and Joormann 2001). In particular, worry is related to adaptive, problem-focused coping strategies and an information-seeking cognitive style, whereas anxiety is typically associated with poor psychological outcomes (i.e., poor problem-solving confidence, poor perceived personal control, avoidance coping strategies, etc.) (Davey et al. 1992;Davey 1994). ...
The present study examined the psychological predictors of four measures assessing the cognitive and emotional reactions to the COVID-19 pandemic in a sample of Italian respondents (N = 497). Using a snowball sampling strategy, an online questionnaire was disseminated through various social media between 29th April and 29th May 2020, that is at the end of the period of national lockdown. Correlational and regression analyses indicated that a) cognitive risk was higher for participants who were younger and had direct experience with the virus; b) affective risk was higher for participants who were female, followed COVID-19-related information closely, and thought that the restrictive measures adopted by the Italian government were not sufficient; c) experienced worry was higher for participants who were female, had higher levels of prosociality and thought that the risks of COVID-19 were exaggerated; and d) state anxiety was higher for participants who were female, younger and had lower levels of prosociality. Taken together, these results support the notion that the cognitive and affective dimensions of risk perception should be analyzed as separate variables and that worry can be regarded as a construct partially independent of anxiety.
... feeling of fear, dread, or danger toward an unknown source, worry is cognition-oriented, representing ones' negative thoughts toward uncertain events (Broeren et al., 2011;Gana et al., 2001). Cognitive behavior theory and emotional ABC theory suggest that, in response to an activating event (a), individuals first generate a series of false understandings and evaluations toward the event at the cognitive level, such as overestimation of threat, underestimation of coping ability, and negative anticipation of possible outcomes. ...
... These cognitive biases are also called false beliefs (b), which subsequently trigger an emotional consequence (c) in the individual, such as anxiety (Ellis, 1962). Based on this framework, several researchers have proposed that worry could be a form of cognitive bias characterized by a tendency to negatively anticipate the possible outcomes of uncertain events, which, like other forms of cognitive bias, can trigger negative emotional consequences for the individual, such as anxiety (Borkovec et al., 2004(Borkovec et al., , 1998Gana et al., 2001). Such a causal relationship between worry and anxiety has also been supported by a range of empirical studies (Parmentier et al., 2019;Ryum et al., 2017), which suggests an association between parental worry and child anxiety. ...
Despite recent studies on parents' worries and children's anxiety, little is known about the mechanisms linking parental worry to childhood anxiety. In a nonclinical sample of 302 preschool children and both parents from Chinese two-parent families, this 1-year longitudinal study examined how maternal and paternal worry predict child anxiety through the mediating role of maternal and paternal anxious rearing behaviors. Structural equation modeling revealed that after controlling for child anxiety (T1): (a) maternal worry (T1) significantly and positively predicted child anxiety (T2) through maternal anxious rearing behaviors (T1), but not through paternal anxious rearing behaviors (T1); and (b) paternal worry (T1) significantly and positively predicted child anxiety (T2) through maternal anxious rearing behaviors (T1), but not through paternal anxious rearing behaviors (T1). These findings suggest that both maternal and paternal worry are related to maternal anxious rearing behaviors, which increase child anxiety. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... On the basis of Borkovec' Cognitive Avoidance Theory of Worry (Sibrava & Borkovec, 2006), Gana and colleagues (2001) found a causal and unidirectional relationship between worry and anxiety that is worry causes anxiety, and a difference between the two constructs, that were shown to be separated, especially for the somatic aspects belonging to anxiety. there were some controversies about similarities and differences between worry and anxiety (Gana et al., 2001;Zebb & Beck, 1998). Worry has been conceptualized as a cognitive construct while anxiety was referred to an emotional arousal including unpleasant feeling of fear, dread or danger of something unknown, a visceral somatic activation (sympathetic and parasympathetic nervous system) and to behavioral responses such as avoidance and escape (Gana et al., 2001;Zebb & Beck, 1998). ...
... there were some controversies about similarities and differences between worry and anxiety (Gana et al., 2001;Zebb & Beck, 1998). Worry has been conceptualized as a cognitive construct while anxiety was referred to an emotional arousal including unpleasant feeling of fear, dread or danger of something unknown, a visceral somatic activation (sympathetic and parasympathetic nervous system) and to behavioral responses such as avoidance and escape (Gana et al., 2001;Zebb & Beck, 1998). Worry and anxiety were highly correlated, being the two main constructs of Generalized Anxiety Disorder (GAD; DSM-5, 2014), but worry may work through different paths and processes than anxiety (Zysberg & Zisbergs, 2020). ...
Background: The COVID-19 outbreak forced Italian citizens into a generalized quarantine from March to May 2020. The quarantine is a successful measure to reduce the virus’s spread through physical and social distancing, but it can also have negative psychological consequences on the population. People experience high levels of worry and anxiety and have to cope with the consequences of the health emergency. The aim of this study was to preliminarily assess the causal relations among coping, worry and state anxiety at the time of COVID-19 first wave, and the mediation role of worry between coping and state anxiety.
Methods: During March 2020, 1273 Italian citizens completed an ad-hoc online survey composed of socio-demographic and preoccupation-related questions, and standardized self-report questionnaire (Brief COPE, Penn State Worry Questionnaire and State-Trait Anxiety Inventory-State form). Three separate mediation models were performed.
Results: The relationship between coping strategies (i.e.: problem-focused coping, emotion-focused coping and dysfunctional coping) and state anxiety resulted to be mediated by worry. Dysfunctional and problem-focused coping had a negative effect on anxiety scores and this effect was amplified by high levels of worry. Emotion-focused coping reduced state anxiety scores through its effect on reducing the levels of worry, which in turn was related to a reduction in anxiety.
Conclusion: The present study offers first evidence for the mediation role of worry in the relation between coping and anxiety during quarantine caused by COVID-19 pandemic. It supports the clinical importance of investigating people’s coping strategies along with the levels of (cognitive) worry and their long-term effects on the psychological well-being during the outbreak, in order to deliver adequate personalized interventions. Psychological support should enhance emotion-focused coping strategies that have a protective effect on both worry and anxiety.
... Usually, a model is proposed on the basis of theoretical and empirical knowledge about the relationships. Path analysis provides a confirmatory approach (i) to test the congruence between the hypothesized model and the covariances of observed variables, (ii) to examine the direct, indirect, and overall effects of variables on other variables in the hypothesized model, and (iii) to generate hypotheses (Gana et al., 2001). For example, Wright (1921Wright ( , 1934 originated and developed path analysis to study causal and non-causal components of systems of variables measured for guinea pigs. ...
... Nonrecursive multi-equation models allow for both patterns of reciprocal causation among variables and assumptions of one or more error terms in the model having nonzero correlations (Berry, 1984). A nonrecursive model can be used to evaluate different models of causation, with the aims of separating cause from effect and proposing a recursive model once the relevant cause has been determined (e.g., Gana et al., 2001). By means of nonrecursive models, the path analysis can be used to determine whether or not the experimental variables are related in a reciprocal way. ...
Core Ideas
Path analysis reveals multidirectional causal relationships in systems of variables.
Variable selection and model modification result in plausible path diagrams.
Softwood biochar water‐extractable components enhance corn P uptake and root length.
Biochar water and nutrient holding capacities positively affect corn N and Ca uptake.
WEBC and WNHC directly affect corn dry weight and K content, in opposite ways.
Searching for statistically significant and biologically relevant relationships in complex datasets is generally a difficult task, in many fields including agronomy. Path analysis is an accessible, graphical, and inferential method for multivariate data exploration, which allows for more than unidirectional causal relationships between the measured variables. Here, data from experimental rooting media, and from corn plants grown in a greenhouse experiment, are used to introduce the theory and methodology of path analysis. Block‐recursive path diagrams are hypothesized for each set of variables measured from the rooting media and the plants. A path model is hypothesized for the union of the two sets of variables. Several reciprocal relationships between rooting medium and plant variables are pointed out, which challenge the usual assumption of unidirectional causality. Besides other relationships between experimental variables, modeling the union set of variables led to the conclusion that the measurement of any of the variables from this experimental system gives information about all of the other experimental variables. The diagrams that are presented include covariances between disturbance terms, which suggest the presence of shared unmeasured causes of variation. In some other cases, such covariance indicates shared variation due to the measurement of variables with the same machine.
... As previously mentioned, our rumination measure's items may align with features of worry as well as rumination, and this may account for the heightened influence of rumination on anxiety within this sample. Considering that worry constitutes a fundamental aspect of anxiety ( [60]), it follows logically that elevated levels of worry could impede perinatal women's capacity to cultivate self-compassion as a means of mitigating anxiety symptoms. Importantly, future research could better understand how rumination predicts perinatal anxiety by using a measure of worry (e.g., the Penn State Worry Questionnaire, [61]) and a comprehensive rumination scale. ...
Objectives: This study examined how self-compassion and emotional regulation strategies have influenced perinatal anxiety, depression, and social anxiety during COVID-19. Methods: A probabilistic sample, determined by convenience criteria of 265 Australian perinatal women completed an online survey containing measures of depression, anxiety, social anxiety, COVID-19 experiences, self-compassion, and emotional regulation strategies. Results: As hypothesised, correlation analyses showed that self-compassion and adaptive emotional regulation strategies were negatively related to anxiety, depression and social anxiety, and maladaptive strategies were positively related. Contrary to predictions, COVID-19-related experiences showed little relationship with mental health outcomes. Parallel mediation analyses showed that self-compassion negatively predicted depression and anxiety and was partially mediated by specific emotional regulation strategies. For social anxiety, self-compassion was fully mediated by emotional regulation strategies. Different emotional regulation strategies were significant mediators of the relationship between self-compassion and each mental health outcome. Conclusions: The findings suggest that reinforcing self-compassion and addressing certain emotional regulation deficits is important in alleviating mental health symptoms among perinatal women.
... For example, although worry is considered the cognitive component of anxiety, empirical evidence supports its distinction as an independent construct. Research suggests a unidirectional relationship between worry and anxiety, with a strong positive effect of worry on anxiety but no effect in the opposite direction 47 . ...
Psychological characteristics are associated with varying dementia risk and protective factors. To determine whether these characteristics aggregate into psychological profiles and whether these profiles differentially relate to aging health, we conducted a cross-sectional investigation in two independent middle-aged (51.4 ± 7.0 years (mean ± s.d.); N = 750) and older adult (71.1 ± 5.9 years; N = 282) cohorts, supplemented by longitudinal analyses in the former. Using a person-centered approach, three profiles emerged in both cohorts: those with low protective characteristics (profile 1), high risk characteristics (profile 2) and well-balanced characteristics (profile 3). Profile 1 showed the worst objective cognition in older age and middle age (at follow-up), and most rapid cortical thinning. Profile 2 exhibited the worst mental health symptomology and lowest sleep quality in both older age and middle age. We identified profile-dependent divergent patterns of associations that may suggest two distinct paths for mental, cognitive and brain health, emphasizing the need for comprehensive psychological assessments in dementia prevention research to identify groups for more personalized behavior-change strategies.
... As a psychological consequence of worry, anxiety is intensively researched as an emotional state that reflects negative sentiments derived from unfavorable life events and outcomes (Spielberger, 2013). A plethora of previous studies has provided empirical evidence to support the impact of worry on anxiety (e.g., Gana et al., 2001;Ryum et al., 2017). In addition, while worry as a thought process will repetitively provoke negative emotions, psychological symptoms may also have a reciprocal effect on metacognitive beliefs in the long run (Clark & Beck, 2011). ...
What happens when a tourist is stranded at a destination and prevented from returning home? We refer to such an individual as the “castaway tourist,” who is experiencing the above situation due to border/city lockdown or other extenuating circumstances. This inquiry builds upon control theory to unpack a homesickness remedy process under severe environmental duress. It draws on a multiwave design with data from three periods to identify a process in which castaway tourists experience psychological uneasiness, leading to travel homesickness and regret. Findings further reveal that place attachment moderates the relationships between COVID worries and subsequent homesickness and travel regret. Together, this study presents a timely examination of homesickness-induced tourism attributed to mega crises. It brings nuanced insights into the literature by introducing the notion of castaway tourists, while uncovering how adverse travel circumstances could turn into motivational forces that promote future home-province/state travel opportunities in turbulent times.
... We conceptualised different life domains as antecedents of worry by relying on Bronfenbrenner's bio-ecological theory 38 . It is worth anticipating that worry can be considered as a construct independent from anxiety 39,40 : The first is focused on cognitive aspects while the latter on affective ones. Bronfenbrenner's model distinguishes contexts in terms of, among the others, three systems-(a) a microsystem, i.e., circumstances in which individuals are directly involved (e.g., pertaining to students' education); (b) a macrosystem, i.e., elements characterising a culture such as values, traditions, and sociocultural characteristics (e.g., regarding global macroeconomics issues); and (c) a chronosystem, i.e., the set of historical and social events having an impact on the other systems (e.g., such as current historical events like the Ukraine war). ...
Trauma scientists have raised the alarm about the devastating consequences of the Ukraine war on mental health. We examined how higher education students—as indirect victims—coped with this conflict and how they emotionally reacted during 2022. We involved 2314 students from 16 countries through an online survey. A structural equation model indicated significant relations between war-related worry about military and macroeconomics domains and two coping strategies (opposition, support giving), in turn significantly linked with six emotions. The model was strongly invariant across gender, study field, and geographic area. The most frequent emotions were anger and anxiety, followed by two future-centred emotions (hopelessness and hope). Emotions were more frequent for females and students of the countries geographically close to the war region. Our findings call for evidence-based policy recommendations to be implemented by institutions to combat the negative short and long-term psychological sequelae of being witnesses of armed conflicts.
... Also, anxiety was directly linked to depression, while worry does not directly impact depression. Instead, the relationship between worry and depression is mediated by anxiety [19]. ...
Objectives: To examine knowledge, worry, anxiety, and vaccine acceptance for mpox among UAE adults.
Methods: An online survey, advertised on academic and social media platform in June 2022 collected data from 959 participants (aged 18 and above) on mpox beliefs, risks, knowledge, worry, anxiety, COVID-19 infection, vaccination, and willingness to receive the mpox vaccine. Bivariate and logistic regression analysis identified associations and predictors between variables.
Results: 56% had optimal knowledge of mpox transmission and symptoms. 54% were worried, and 27% experienced anxiety related to the outbreak. Knowledge scores were higher among women, healthcare workers, and those with reliable information sources. High perceived infection risk, changes in precautionary measures, and belief in difficult treatment predicted more worry and anxiety. Higher worry and two or more doses of the COVID-19 vaccine predicted higher likelihood of taking the mpox vaccine.
Conclusion: The UAE population showed low knowledge and high worry and anxiety during the global mpox outbreak. Increasing public awareness through targeted educational campaigns is vital. Promoting better understanding of infectious diseases, addressing concerns, and encouraging vaccine uptake can prepare for future outbreaks.
... Also, anxiety was directly linked to depression, while worry does not directly impact depression. Instead, the relationship between worry and depression is mediated by anxiety [19]. ...
... Finally, one can say that emotional responses and perceptions like worry and concern about heart trauma lead to exacerbation of anxiety that is the source of anxiety disorders, such as PTSD. 28 Moreover, the findings of the present study showed that women were more likely than men to experience more severe symptoms of PTSD. The lifetime prevalence of PTSD is about 10%-12% in women, while 5%-6% of men develop PTSD symptoms in a lifetime. ...
Background:
Given the role of post-traumatic stress disorder (PTSD) in morbidity and mortality of cardiac patients, the present study was conducted to determine the relationship between the perception of heart disease and severity of PTSD symptoms.
Methods:
Sampled using simple random sampling, 202 cardiovascular patients (50.5% women) were selected and included in this cross-sectional study. The patients admitted to a hospital from January to May 2017 in western Iran were selected and asked to complete the self-report demographic and cardiac risk factors inventory, Brief Illness Perception Questionnaire (Brief-IPQ), and National Stressful Events Survey PTSD Short Scale (NSESSS) checklist. The results were analyzed using the Pearson correlation coefficient and multiple regression analysis.
Results:
The mean age of patients was 53.5 ± 11.9 years. The results of the correlation coefficient showed a significant relationship between all the components of illness perception, except personal and treatment control, with PTSD (P < 0.05). The regression model could predict 22.5% of PTSD variance and the greatest role was for the emotional representation (P = 0.002) and female sex (P = 0.008).
Conclusion:
The perception of cardiovascular patients of the cognitive and emotional components of the disease, especially in women, plays a significant role in experiencing the symptoms of PTSD. Thus, health professionals have to monitor all these components, especially the patient's perceptions and emotional reactions, and to come up with proper and timely interventions for patients at risk to control the adverse effects of PTSD after cardiovascular events.
... Another pathway may link worry, defined as "an aversive emotional experience that arises alongside repetitive unpleasant thoughts about the future" (Sweeny & Dooley, 2017) with anxiety, of which it is often conceived as a cognitive component (Borkovec, 1985). More specifically, some research has shown that worry predicts anxiety (Gana et al., 2001), and that (social) anxiety predicts loneliness (Lim et al., 2020). ...
Worry about crime has been linked to several detrimental outcomes including worse mental health. However, there has been little research on the association between worry about crime and loneliness, even though loneliness is increasingly being recognised as a serious public health issue. To address this deficit, this study examined the association between worry about crime and loneliness in nine countries of the former Soviet Union (FSU - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine), using data from 18,000 respondents aged 18 and above that were collected during the Health in Times of Transition (HITT) survey in 2010/11. Results from a pooled logistic regression analysis showed that compared to those who reported no worry about crime, individuals with a high level of worry had significantly higher odds of loneliness (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.17–1.75). Sex- and age-stratified analyses further showed that the association was observed in women with a mid (OR: 1.37, 95%CI: 1.10–1.71) and a high level (OR: 1.70, 95%CI: 1.33–2.17) of worry about crime but not in men, and that a high level of worry about crime was linked to loneliness in adults aged 35–59 (OR: 1.39, 95%CI: 1.02–1.91) and 60 and above (OR: 1.64, 95%CI: 1.12–2.40) but not in those aged 18–34. High levels of worry about crime are associated with loneliness in the FSU countries. Reducing crime and its associated worries may have important public health benefits in these countries.
... This may be due to activation of fear circuitry in the brain [63], which then leads to the maintenance of ruminative processes such as ongoing fear and worry. Data suggest these thought patterns can lead to anxiety [64] and motivated avoidance to reduce this anxiety [65]: health protective behaviors may serve as an active coping method to alleviate this fear-related distress [66]. ...
We examined media exposure, psychological fear and worry, perceptions of risk, and health protective behaviors surrounding the 2014 Ebola virus outbreak in a probability-based, representative, national sample of Americans (N = 3447). Structural equation models examined relationships between amount (hours/day) and content (e.g., graphic images of dead bodies) of media exposure and counts of self-reported health protective behaviors that participants performed or would perform if Ebola spread to their community. Ebola-related risk perceptions and fear and worry were potential mediators. Greater total hours and more graphic media exposure positively correlated with more fear and worry; greater total hours of media exposure also positively correlated with higher perceived risk. Higher risk perceptions were associated with more health protective behaviors performed and intended. Greater fear and worry were associated with more behaviors performed. Amount and content of media exposure exhibited indirect effects on behaviors performed; amount of media exposure had indirect effects on intentions. Media may help promote health protective behaviors during public health threats; the amount and content should be congruent with threat to minimize distress and maximize resources.
... concern (Borkovec, 1985;Borkovec & Inz, 1990), pointing out that concern can increase anxiety but not the other way around (Gana et al., 2001). ...
Background
The health crisis caused by the COVID-19 pandemic has led to a considerable increase in the psychopathology of COVID-19 patients and among the general population. This study aims to conduct the psychometric analysis of the scale of concern about COVID-19 in the Spanish population and to estimate the level of concern and dysfunctional anxiety present one year after the lockdown measures in Spain aimed at resisting the spread of the viral disease among the population.
Methods
The factorial structure of the instrument, its reliability for the general population and for COVID patients, and its construct validity have been analyzed, and measurements of dysfunctional concern have been obtained from a sample of 502 adults.
Results
The scale of concern about COVID-19 showed optimal results of reliability and validity for the Spanish population, confirming that it is an ideal instrument for estimating the concern regarding coronavirus contagion.
Limitations
This study used a cross-sectional design and thus, could not compare the changes in the incidence of anxiety symptoms before and after the COVID-19 outbreak. Furthermore, the use of mental health services prior to the COVID-19 restrictions was not assessed in this study, and therefore, no comparisons between the two time points could be made.
Conclusions
After a year of the confinement measures that was instilled to avoid further spread of the disease, the Spanish population presented levels of concern and anxiety that may require clinical attention, with a significant percentage of participants meeting the requirements to be diagnosed with generalized anxiety disorders.
... One possible explanation for this unexpected finding is that experiences in the parenting centers, either during parenting training sessions or group activities, may have led mothers to develop new worries regarding the quality of their parenting. Indeed, worry can lead to disordered or maladaptive anxiety and stress (Clark, 1999;Gana et al., 2001). Because parenting centers educate caregivers on appropriate parenting practices, mothers may perceive direct or implied criticism about their parenting, either from other mothers or from parenting trainers who do not use esteem-enhancing instruction. ...
This study conducts an exploratory analysis of the impacts of a center‐based early childhood development intervention on the mental health of caregivers, using data from a cluster‐randomized controlled trial of 1664 caregivers (Mage = 36.87 years old) of 6‐ to 24‐month‐old children in 100 villages in rural China. Caregivers and children in 50 villages received individual parenting training, group activities and open play space in village parenting centers. The results show no significant overall change in caregiver‐reported mental health symptoms after 1 year of intervention. Subgroup analyses reveal heterogeneous effects by caregiver socioeconomic status and identity (mother vs. grandmother). Findings suggest that early childhood development interventions without targeted mental health components may not provide sufficient support to improve caregiver mental health.
... Finally, one can say that emotional responses and perceptions like worry and concern about heart trauma lead to exacerbation of anxiety that is the source of anxiety disorders, such as PTSD. 28 Moreover, the findings of the present study showed that women were more likely than men to experience more severe symptoms of PTSD. The lifetime prevalence of PTSD is about 10%-12% in women, while 5%-6% of men develop PTSD symptoms in a lifetime. ...
BACKGROUND: Given the role of post-traumatic stress disorder (PTSD) in morbidity and mortality of cardiac patients, the present study was conducted to determine the relationship between the perception of heart disease and severity of PTSD symptoms.
METHODS: Sampled using simple random sampling, 202 cardiovascular patients (50.5% women) were selected and included in this cross-sectional study. The patients admitted to a hospital from January to May 2017 in western Iran were selected and asked to complete the self-report demographic and cardiac risk factors inventory, Brief Illness Perception Questionnaire (Brief-IPQ), and National Stressful Events Survey PTSD Short Scale (NSESSS) checklist. The results were analyzed using the Pearson correlation coefficient and multiple regression analysis.
RESULTS: The mean age of patients was 53.5 ± 11.9 years. The results of the correlation coefficient showed a significant relationship between all the components of illness perception, except personal and treatment control, with PTSD (P < 0.05). The regression model could predict 22.5% of PTSD variance and the greatest role was for the emotional representation (P = 0.002) and female sex (P = 0.008).
CONCLUSION: The perception of cardiovascular patients of the cognitive and emotional components of the disease, especially in women, plays a significant role in experiencing the symptoms of PTSD. Thus, health professionals have to monitor all these components, especially the patient's perceptions and emotional reactions, and to come up with proper and timely interventions for patients at risk to control the adverse effects of PTSD after cardiovascular events.
... This may be due to activation of fear circuitry in the brain [63], which then leads to the maintenance of ruminative processes such as ongoing fear and worry. Data suggest these thought patterns can lead to anxiety [64] and motivated avoidance to reduce this anxiety [65]: health protective behaviors may serve as an active coping method to alleviate this fear-related distress [66]. ...
... Positive and negative anticipatory emotions are defined as the affective reactions to the prospects of positive and negative outcomes in the future and are conceptually construed as broad families composed of specific emotional states (hopeful, optimistic, confident, worried, anxious, nervous). While there is evidence for distinguishing these anticipatory emotional states (e.g., Bryant & Cvengros, 2004;Gana et al., 2001;Worthy et al., 2014;Zebb & Beck, 1998), the discrete perspective was especially critical for anticipated emotions. For the example of positive anticipated emotions, disentangling the occurrence of positive events (e.g., satisfaction or happiness) from the disconfirmation of negative events (e.g., relief) or from the perceived praiseworthiness of one's actions (e.g., pride) is critical to investigate positive anticipated emotions. ...
Most future educational and career transitions represent major life events that individuals anticipate to a considerable extent, possibly with multiple emotions at the same time. However, few studies have examined the emotions that individuals experience when they anticipate a future educational or career transition, imagine how it will occur, the consequences it will have for them, and visualize their coping efforts. The aims of the present dissertation are fourfold. First, we explore individuals’ combinations of multiple future-oriented emotions at the prospect of three major educational and career transitions: (a) the transition from high school to higher education, (b) the transition from higher education to the job market, and (c) the transition from unemployment to employment. Due to the rather exploratory nature of our first research question, our second objective pertains to the replication of these combinations and the investigation of similarities between several groups of individuals based on (a) gender, (b) institutional context, and (c) the temporal distance before the transition. Third, we examine several antecedents of individuals’ combinations of future-oriented emotions. These antecedents ranged from career-related constructs such as career decidedness and career adaptability to affective mechanisms such as cognitive appraisals, trait affect, and emotion regulation. Finally, we examine the behavioral effects of future-oriented emotions in terms of anticipated vocational planning and effort. Overall, the present dissertation brings several implications in highlighting the combinations of future-oriented emotions that individuals experience when anticipating important vocational transitions, a research strand that is scarce both in vocational and emotion research. From a practical point of view, the evidence of several combinations—and the differences and similarities among several groups or contexts—carries practical implications for designing and implementing career-related interventions. Finally, examining antecedents and outcomes of future-oriented emotions combinations underlines the importance of taking emotional anticipation processes into account when individuals prepare for and cope with major educational and career transitions.
... 40 Anxiety towards engaging with one's personal finance has a negative impact on retirement planning and savings behaviour and, as a result of this, in retirement confidence. 41 Specifically, financial anxiety decreases retirement savings, even after controlling for financial goals and financial motivation. 42 There is also research suggesting that financial anxiety deteriorates health and well-being which, in turn, might lead to poor retirement confidence. ...
Older workers who are confident about the changes accompanying retirement report higher well-being. We have developed an index to measure retirement confidence – the Retirement Confidence Index (RCI). A six-stage approach was used to develop the index items, including (i) a literature review to catalogue retirement confidence components; (ii) a consultation with a panel of experts to review the proposed indicators and combine components according to their meaning; (iii) normalisation of the selected components to make them comparable; (iv) weighting of the top-level dimensions using experts’ judgement; (v) linear aggregation of the dimension scores according to their corresponding relative weight; and (vi) correlation of the composite score with a self-report measure of retirement confidence. Based on the review of the literature, a list of nine sub-components (financial literacy, financial attitude and behaviour, financial control, financial anxiety, physical health, mental health, social connectedness, goal setting for retirement and future uncertainties) was compiled. Subsequently, these components were grouped into four broad dimensions. Correlations between these dimensions (social, financial awareness and skills, health and well-being, and retirement awareness and planning dimensions) and the corresponding self-reported measures were as high as r = 0.555, r = 0.603, r = 0.591 and r = 0.569, reflecting 30.8%, 36.3%, 34.9% and 32.3% shared variance with the corresponding self-reported indices, respectively. The Retirement Confidence Index provides the foundation for future research to measure retirement confidence, with the aim of identifying deficient RCI dimensions and directing efforts to targeted policies to ensure older workers are confident about retirement.
... Worry is a risk factor for depression and related negative emotional symptoms (Muris et al., 2005). Among young adults, higher levels of worry are associated with increased depression (Zvolensky et al., 2019), anxiety (Gana et al., 2001), and stress (Roussis & Wells, 2008;Wells & Carter, 2001). Emerging work investigating COVID-19 related worry (i.e., worry that is rooted in the uncertainty that surrounds the trajectory and consequences of has shown that worry about the pandemic is associated with poorer mental health Wang et al., 2020) and greater substance use . ...
Background
Young adults are overrepresented in terms of adverse mental health problems related to COVID-19. Emerging work has identified worry about the consequences and trajectory of COVID-19 and loneliness as important factors in mental health during the pandemic. However, the main and interactive effects of worry about COVID-19 and loneliness have not been explored in one overarching model in relation to mental health problems among young adults.Methods
The present study therefore evaluated loneliness and COVID-19 related worry in terms of anxiety, stress, and depression among young adults (209 college students, 76.1% female, Mage = 22.99 years, SD = 5.25) recruited to participate in an online survey study.ResultsResults indicated a significant interaction between COVID-19 worry and loneliness for each criterion variable (depression: b = .01, SE = .003, t = 2.86, p = .01; anxiety: b = .01, SE = .002, t = 2.36, p = .02; stress: b = .01, SE = .003, t = 2.54, p = .01), such that worry was more strongly related to each mental health outcome among those that endorsed higher levels of loneliness.Conclusion
The current findings suggest loneliness is related to negative mental health symptoms among young adults experiencing COVID-19 related worry. The current findings provide initial empirical evidence for the impact of COVID-19 worry on mental health among young adults experiencing loneliness. Future research may benefit from exploring how COVID-19 worry and loneliness interplay over time.
... On the other hand, worry and anxiety should also be considered as separate constructs (50). While worry is related to problem-focused and adaptive coping strategies, anxiety is associated with negative affect (51). ...
The resurgence of COVID-19 could deepen the psychological impacts of the pandemic which poses new challenges for mental health professionals. Among the actions that should be prioritized is the monitoring of the groups that have shown greater psychological vulnerability during the first stage of the pandemic. The first aim of our study is to explore the fear reactions to COVID-19 between genders during the second wave of the outbreak in Cuba. Second, establish possible predictors of fear of COVID-19 in relation to gender. Specifically, we will evaluate how anxiety related to COVID-19, health self-perception, and worry about the resurgence of COVID-19 predict fear reactions among women and men in the Cuban population. A cross-sectional online study was designed. The research was conducted between August 16 and October 18, 2020. A total of 373 people completed the online survey. A socio-demographic questionnaire, the Fear of COVID-19 Scale and the Coronavirus Anxiety Scale were used. An independent-samples t-test was conducted to compare the fear, worry, anxiety and self-perceived health scores, between genders. The relationship between those variables and fear of COVID-19, was investigated using Pearson correlation coefficient. Finally, multiple linear regression was used to evaluate the possible associations (predictors) related to fear of COVID-19. In our study, women, compared to men, presented greater fear reactions, greater concern about resurgence of COVID-19 and poorer self-perceived health. Anxiety reactions in our sample showed no differences between genders. In women, anxiety of COVID-19, worry about resurgence of COVID-19, and self-perceived health are associated with fear reactions to COVID-19. In the case of men, the self-perceived health showed no associations with fear reactions. Our results confirm the results of several related investigations during the first wave of the pandemic where women have shown greater psychological vulnerability compared to men. However, we cannot rule out that the real impact of the pandemic on mental health in men is much greater than that described by the studies conducted to date. Additional studies are needed on the psychological impact of COVID-19 on men.
... Worry is understood as a cognitive phenomenon that occurred when the individual experiences a threat concerning possible future events and is often accompanied by feelings of anxiety [DGL01] [MWB91] [SJ01]. Both theoretically and empirically, worry shows a substantial relationship with procrastination and a significant positive causal effect on anxiety [SJ01] [GMC01]. ...
... Additionally, both pain intensity and pain-related interference were statistically significantly associated with all other variables. Further, to provide evidence of construct validity of the COVID-19-specific psychological factors, bivariate relations suggest that COVID-19 worry and fear share approximately 56% of variance with each other, which is expected given previous work showing the relationship between worry and fear (Gana et al., 2001). Examining the relationships of COVID-19 worry and fear with the other assessed constructs, all correlations suggest that less than 30% of variance is shared between measures and providing evidence for construct independence. ...
The 2019 novel SARS-CoV2 disease causing COVID-19 has had a devastating impact on the world, and those with pain conditions may be at heightened risk for these negative consequences. Given COVID-19 limitations, including social distancing and stay-at-home orders, pain is likely largely going untreated, leading to greater pain and associated consequences. Mental health symptoms, which have been found to be elevated due to COVID-19, may contribute to elevated pain experience, but little work has examined how COVID-19-specific mental health factors may be associated with pain. Therefore, the current study examined (1) how COVID-19-specific psychological factors and general mental health symptoms differ between those with pain and without, and (2) among those with pain, which psychological factors were most strongly associated with pain experience. Results from a national (U.S. based) online sample of 174 adults (42.5% female, Mage = 37.80 years, SD = 11.30, 88 with pain) collected between April and May 2020 indicated that, compared to those individuals reporting no pain, those with pain reported significantly higher values on all variables. Additionally, COVID-19 fear and sleep problems were associated with pain intensity, and for pain-related interference, fear, sleep problems, and depression were significantly associated. These results highlight the potential importance of COVID-19-specific psychological factors in pain experience.
... Although common also for other diseases (such as fear of cancer) (Consedine, Magai, Krivoshekova, Ryzewicz, & Neugut, 2004), these conceptual inconsistencies are surprising because psychological literature defines these terms as closely related but independent concepts. For example, concerns and fear are defined as emotional reactions, varying in intensity, to a perceived threat or danger, while worry is defined as a cognitive phenomenon to an uncertain, negative event (Gana, Martin, & Canouet, 2001), and anxiety includes both emotional and cognitive responses, in addition to physiological reactions (as conceptualized in the Diagnostic and Statistical Manual of Mental Disorders; period American Psychiatric Association, 2013). ...
Purpose:
The combination of a growing population of older adults and increasing prevalence and awareness of dementia diagnoses suggests that dementia worry may also intensify. As a relatively new area of investigation, the dementia worry literature is growing, but variability in definitions and measurement continue. A scoping review was conducted to gather and examine existing research, as well as assist in guiding future studies in this area. The review focused on characterizing the conceptualization, measurement, and correlates of dementia worry.
Methods:
Using PubMed, CINAHL, AgeLine, and PsycINFO, a search of literature concerning dementia worry was completed.
Results:
A total of 45 articles examining dementia worry fulfilled the inclusion criteria. Most studies were cross-sectional (n = 39), quantitative (n = 38), and conducted in the United States (n = 22). Inconsistencies in the conceptualization, measurement, and correlates examined make it difficult to determine the meaning and true levels of dementia worry.
Conclusions:
Recent attention to dementia worry has increased awareness of the basic concept and its correlates. However, the lack of unity in the definition and measurement of dementia worry impedes advancement in this research area, as well as in establishing its clinical significance.
... Worries are then further exacerbated by three cognitive processes (i.e., positive beliefs about worry, negative problem orientation, and cognitive avoidance of feared mental imagery). Research has offered some support for IUM in both adult samples [32][33][34][35][36][37] and samples of youth as young as 7 years old [14,[38][39][40][41][42]. Interestingly, although some findings suggest that IUM is more applicable to adolescents than children, IU remains the strongest predictor of worry frequency in both age groups when compared with both cognitive avoidance and positive beliefs about worry [43]. ...
Purpose of review:
After reviewing predictors of differential outcomes of cognitive behavioral therapy (CBT) for pediatric anxiety, we identify and discuss recent evidence for the role of (a) intolerance of uncertainty (IU) and (b) parental accommodation as meaningful targets for personalized intervention.
Recent findings:
Few studies to date have identified promising, theory-driven predictors of differential CBT outcomes. Recent findings suggest that increased IU and high levels of parental accommodation are associated with a poorer response to CBT. Several adaptations of CBT and new interventions targeting either IU or parental accommodation have been developed and found to be efficacious in preliminary studies. IU and parental accommodation are promising constructs for personalizing intervention, both in the identification of who will respond to treatment and in the development of targeted intervention. We recommend that future work test if individuals high in IU and/or parental accommodation will respond more optimally to treatments that specifically target these constructs. The results of this future work may help to move the field closer to personalized intervention.
... Accordingly, based on the literature, three direct pathways were added to the model. [31][32][33][34] The second model exhibited significant improvement in model fit indices [ Table 3]. The results of bootstrapping clarified the different relationship pathways between the variables [ Table 4]. ...
Background:
There is a close association between problematic Internet use (PIU), sleep quality, and mental health problems. To evaluate which mental health problem is more associated with coexistence of both PIU and poor sleep quality, we hypothesized a model in which PIU influences sleep quality directly and also through the mediation of three different mental health problems.
Methods:
A total of 402 medical students completed the Persian versions of the Internet Addiction Test, 21-item Depression Anxiety Stress Scale, and Pittsburgh Sleep Quality Index. A maximum likelihood structural equation model was used to assess the hypothesis. For assessment of the indirect effects, bootstrapping was conducted.
Results:
PIU predicted poor sleep quality through indirect pathways by the mediation of mental health problems (P < 0.001). Poor sleep quality were associated with depressive symptoms (P < 0.001), anxiety (P = 0.035), and stress (P < 0.001); however, the direct pathways from stress and anxiety to poor sleep quality were not statistically significant (P > 0.05).
Conclusion:
Findings extend our previous knowledge about the interrelationships between PIU, sleep disturbances, and mental health problems by unveiling the key role of depressive symptoms.
... Worry and anxiety are separable, with worry relating more to other cognitive vulnerability factors such as difficulty with problem solving than anxiety does (Zebb and Beck 1998). Elevated levels of worry are causally linked to the development of anxiety (Calmes and Roberts 2007) and this relation is not bidirectional (Gana et al. 2001). ...
Though early fearful temperament is a robust predictor of anxiety disorder symptoms it remains unclear what links these two factors. Cognitive theories of anxiety have recently implicated individual differences in attentional control and worry as mediators of this relation; however, this pathway remains largely untested in youth. The current study examined the associations between fearful temperament, attentional control, worry, and anxiety during a period critical for the development of attentional control and worry. Participants were 152 parent-child dyads between the ages of 7 and 12 years old. Parents completed measures of child temperament and executive function, and children completed measures of worry and anxiety symptoms. A serial multiple mediator analysis was conducted with PROCESS for SPSS to examine a cognitive pathway between temperament and anxiety in this cross-sectional sample. Overall the data supported the study hypotheses. Attentional control and worry serially mediated the relation between temperament and anxiety, with worry mediating the relation between attentional control and anxiety. The study also tested two reversed mediational models and found that the directionality in the proposed model was unique. These findings suggest that children who are more fearful are less able to control their attention. Among these children, worry may emerge as a low effort cognitive process, which contributes to increased anxiety.
... Worry is in part a cognitive experience, incorporates negative affect, and is reflective of uncertainty about future events, such as development of a health condition (MacLeod, Williams, & Bekarian, 1991). Anxiety is often conceptualized as a more diffuse and long-term somatic experience (Borkovec, Shadick, & Hopkins, 1991) that incorporates feelings of dread (Gana, Martin, & Canouet, 2002). Importantly, worry is associated with problem solving (e.g., Davey, Hampton, Farrell, & Davidson, 1992;Zebb & Beck, 1998) whereas anxiety is associated with avoidance-coping strategies and negative emotional outcomes (Davey, Hampton, Farrell, & Davidson, 1992;Zebb & Beck, 1998). ...
A common criticism of social cognitive models predicting health behavior is their exclusion of affect—an important component of individual-level decision processes for behavior change. Yet the role of affect, and its interaction with cognitions, is complex. We provide an overview of affect and pathways through which it is proposed to influence outcomes. Then, we discuss several common social cognitive models of health behavior change. Next, we highlight specific affect-laden constructs (those that incorporate affective and cognitive components) related to health behavior change. We aim to provide clarity on terminology and measurement of the affect-laden constructs and evidence associating them with health behavior. Finally, we discuss strategies for incorporating these constructs within popular cognitive-based theories and provide suggestions for future work.
... Unexpectedly, although the amelioration of insomnia mediated the decrease in anxiety, this change failed to mediate the improvement of excessive worry. Worry has been described as a cognitive phenomenon that occurs at times of anxiety or in anxiety disorders [33,34], while anxiety has been defined as ''a vague, uncomfortable feeling of fear, dread, or danger from an unknown source'' [35], and is seen to represent a situational response as opposed to a cognitive mechanism. While worry and anxiety are highly correlated with each other [18,33,36], research has demonstrated that worry and anxiety have different structures and should therefore be considered and treated as separate constructs [37]. ...
The present study examined whether improvements in insomnia affect symptoms of worry, anxiety, depression, and impaired social functioning after transdiagnostic treatment for excessive worry. Forty-nine participants with clinical excessive worry were randomized to either a behavioral activation for worry (BAW) treatment group or a waitlist control group. BAW treatment was administered over the course of eight weekly group-based treatment sessions that included the following components: psychoeducation, self-monitoring, functional assessments of worry, activity scheduling, and relapse prevention. After treatment, 64% of patients in the BAW treatment group no longer met the criterion for insomnia, as compared to 17% of patients in the control group. In addition, the BAW treatment group had significantly smaller changes in Insomnia Severity Index (ISI) scores from pre-treatment to post-treatment (ΔISI) compared to the control group. Furthermore, ΔISI scores significantly affected changes in anxiety, depression, and impaired social functioning scores, but had no effect on the pathological worry score. Our results showed that insomnia had a full mediation effect on anxiety and impaired social functioning, and a partial mediation effect on depression. Despite the small sample size, our findings suggest that the amelioration of insomnia may decrease anxiety, depressive symptoms, and social dysfunction in patients with anxiety or depression.
... When a parent creates the impression about the other parent's beliefs, actions, and worthiness that are not consistent with the child's actual experience, the child may feel confused as to what is real and what isn't. Moreover, PA behaviors cause moral dilemmas for children who are asked to go against their values and beliefs (i.e., spy on or keep secrets from the other parent) which can also result in heightened worry, which is predictive of anxiety directly and depression indirectly (Gana, Martin, & Canouet, 2001). ...
This study examined associations between exposure to parental alienation behaviors (PA) and anxiety and depression in a community sample of Italian adults. Data were examined by the gender of the alienating parent and the gender of the respondent/adult child. Five hundred nine adults were administered the Baker Strategy Questionnaire (BSQ), the State-Trait Anxiety Inventory (STAI-Y); and the Beck Depression Inventory (BDI-II). Results revealed that exposure to PA was associated with higher ratings of anxiety and depression. The data add to the growing body of knowledge regarding the long-term negative impact of exposure to parental alienation.
Introduction: Since the COVID-19 epidemic, numerous studies have shown an increase in mental health problems. According to the findings, women are more likely than men to be concerned about the spread of the disease. This study aimed to investigate the effectiveness of dialectical behavior therapy in worry, anxiety, and intolerance of uncertainty in women with COVID-19-induced anxiety.
Material & Methods: This single-case quasi-experimental study was conducted with multiple baseline, continuous assessment, and three-month follow-up. Three female patients were purposefully selected from the statistical population based on the criteria set for entering the study and were treated upon dialectical behavior therapy protocol. These individuals were assessed by completing the Corona Disease Anxiety Scale, Penn State Worry Questionnaire, and Intolerance of Uncertainty Scale. Data were analyzed by graph, recovery percentage, and reliable change index.
(Ethic code: IR.IAUDAMGHAN.REC.1399.025)
Findings: The overall recovery values of participants after treatment (follow-up) were 25% (34%) in terms of anxiety, 56% (57%) in terms of COVID-19-induced anxiety, and 49% (52%) in terms of intolerance of uncertainty, which is statistically significant at 95% confidence level. The results show that participants' worry and intolerance of uncertainty have improved in the three-month follow-up, and the enhancement of their COVID-19-induced anxiety has been stabilized.
Discussion & Conclusion: In general, dialectical behavior therapy is effective in improving anxiety, worry, and intolerance of uncertainty in women with COVID-19-induced anxiety.
Background
The network analysis method emphasizes the interaction between individual symptoms to identify shared or bridging symptoms between depression and anxiety to understand comorbidity. However, the network analysis and community detection approach have limitations in identifying causal relationships among symptoms. This study aims to address this gap by applying Bayesian network (BN) analysis to investigate potential causal relationships.
Method
Data were collected from a sample of newly enrolled college students. The network structure of depression and anxiety was estimated using the Patient Health Questionnaire‐9 (PHQ‐9) and the Generalized Anxiety Disorder (GAD‐7) Scale measures, respectively. Shared symptoms between depression and anxiety were identified through network analysis and clique percolation (CP) method. The causal relationships among symptoms were estimated using BN.
Results
The strongest bridge symptoms, as indicated by bridge strength, include sad mood (PHQ2), motor (PHQ8), suicide (PHQ9), restlessness (GAD5), and irritability (GAD6). These bridge symptoms formed a distinct community using the CP algorithm. Sad mood (PHQ2) played an activating role, influencing other symptoms. Meanwhile, restlessness (GAD5) played a mediating role with reciprocal influences on both anxiety and depression symptoms. Motor (PHQ8), suicide (PHQ9), and irritability (GAD6) assumed recipient positions.
Conclusion
BN analysis presents a valuable approach for investigating the complex interplay between symptoms in the context of comorbid depression and anxiety. It identifies two activating symptoms (i.e., sadness and worry), which serve to underscore the fundamental differences between these two disorders. Additionally, psychomotor symptoms and suicidal ideations are recognized as recipient roles, being influenced by other symptoms within the network.
Bu çalışmanın amacı, yaşlılık, ödemeler, sağlık ve
eğitimden kaynaklanan dört yaygın finansal kaygı
biçimine ek olarak bunların tümünü içeren toplam
finansal kaygı ve COVID-19 kaynaklı finansal kaygıların
muhtemel nedenlerinin Türkiye örneklemi için
araştırılmasıdır. Aile Kaynak Yönetim Modeli
çerçevesinde ele alınan ve açıklanan finansal davranış,
finansal dayanıklılık, sosyal yardımlar ve sosyoekonomik
faktörlerin ampirik dayanakları ise 2021 Global Findex
veri setinden, sıralı logit model kullanılarak elde
edilmiştir. Elde edilen bulgular, Türkiye’de finansal
kaygıların azaltılmasının yalnızca gelir artışıyla değil
finansal kaynak yönetimini de gerektiren finansal
davranışlar ve dayanıklılıkla da ilişkili olduğunu
göstermektedir.
Introduction: While increasing awareness of climate change is needed to address
this threat to the natural environment and humanity, it may simultaneously
negatively impact mental health. Previous studies suggest that climate-specific
mental health phenomena, such as climate anxiety and worry, tend to be especially
pronounced in youth. To properly understand and address these issues, we need
valid measures that can also be used in non-Anglophone samples. Therefore, in
the present paper, we aimed to validate Slovenian versions of the Climate Anxiety
Scale (CAS) and the Climate Change Worry Scale (CCWS) among Slovenian youth.
Method: We conducted an online survey in which 442 young individuals (18–
24 years) from Slovenia filled out the two central questionnaires and additional
instruments capturing other relevant constructs (e.g., general anxiety, neuroticism,
and behavioral engagement).
Results: The confirmatory factor analyses results supported the hypothesized
factorial structure of the CAS (two factors) and the CCWS (one factor). Both scales
also demonstrated great internal reliability. Moreover, the analyses exploring both
constructs’ nomological networks showed moderate positive associations with
similar measures, such as anxiety and stress (convergent validity), and very weak
associations with measures they should not be particularly related to, such as
narcissism (discriminant validity). Lastly, we found that the CAS and, even more so,
the CCWS have unique predictive value in explaining outcomes such as perceived
threat, support for climate policies, and behavioral engagement (incremental
validity).
Discussion: Overall, Slovenian versions of the CAS and the CCWS seem to be valid,
reliable, and appropriate for future studies tackling young individuals’ responses
to climate change. Limitations of the study and areas for future research are
discussed.
Purpose The purpose of this study was to determine the mediating role of psychological resilience in the relationship between worry and stress coping strategies used by young people. Method The study involved 404 individuals aged 15–20 years (M = 18.23, SD = 1.29). In order to assess worry, we used the Penn State Worry Questionnaire for Children (PSWQ-C) by Chorpita. Psychological resilience was measured with the Polish SPP-18 scale by Ogińska-Bulik and Juczyński, and stress coping was assessed by means of the “How do you cope?” Scale (JSR) by Juczyński and Ogińska-Bulik. Results The results obtained suggest that resilience is a significant predictor of a correlation between worry and stress coping strategies, where mediation takes the form of suppression in relation to the strategies of active coping and social support seeking; for the emotion-focused strategy a partial mediation is observed. Conclusion Psychological resilience mediates the correlation between worry and stress coping, but the nature of this mediation is complex, and it varies depending on different coping strategies.
Cel Celem podjętych badań było ustalenie mediacyjnej roli prężności psychicznej w relacji między martwieniem się a strategiami radzenia sobie ze stresem u młodzieży. Metoda Przebadano 404 osoby w wieku 15‒20 lat (M = 18,23; SD = 1,29). Do oceny martwienia się wykorzystano Kwestionariusz martwienia się (PSWQ-C) Chorpity, do pomiaru prężności psychicznej Skalę pomiaru prężności (SPP-18) Ogińskiej-Bulik i Juczyńskiego, a radzenie sobie ze stresem oceniono za pomocą skali „Jak sobie radzisz?” (JSR) Juczyńskiego i Ogińskiej-Bulik. Wyniki Uzyskane wyniki wskazują, że prężność jest istotnym mediatorem w relacji między martwieniem się a strategiami radzenia sobie ze stresem, przy czym w odniesieniu do strategii Aktywnego radzenia sobie i Poszukiwania wsparcia społecznego mediacja ma charakter supresji, natomiast w relacji ze strategią Koncentracji na emocjach występuje mediacja częściowa. Konkluzja Prężność psychiczna mediuje zależność między martwieniem się a radzeniem sobie ze stresem, przy czym charakter tej mediacji jest złożony i zróżnicowany w odniesieniu do różnych strategii zaradczych.
Background
People living with HIV (PLWH) experience multiple psychological symptoms. Few studies have provided information on central and bridge psychological symptoms among PLWH. This information has implications for improving the efficiency and efficacy of psychological interventions. Our study aimed to identify the central and bridge psychological symptoms of PLWH and to explore the interconnectedness among symptoms and clusters.
Methods
Our study used data from the HIV-related Symptoms Monitoring Survey, a multisite, cross-sectional study conducted during 2017–2021. We used R to visualize the network of 16 symptoms and analyzed the centrality and predictability indices of the network. We further analyzed the bridge symptoms among the three symptom clusters.
Results
A total of 3,985 participants were included in the analysis. The results suggested that sadness had the highest strength (rS = 9.69) and predictability (70.7%) compared to other symptoms. Based on the values of bridge strength, feeling unsafe (rbs = 0.94), uncontrollable worry (rbs = 0.82), and self-abasement (rbs = 0.81) were identified as bridge symptoms. We also found a strong correlation between sadness and self-abasement (r = 0.753) and self-loathing and self-blame (r = 0.744).
Conclusion
We found that sadness was the central psychological symptom of PLWH, indicating that sadness was the center of the psychological symptom network from a mechanistic perspective and could be a target for intervention. Deactivating bridge symptoms, including “feeling unsafe,” “self-abasement,” and “uncontrollable worry,” could be more effective in preventing symptom activation from spreading (e.g., one symptom activating another).
Objective: Although parental threatening behaviors are associated with poor mental health outcomes among college students, the underlying mechanisms of this relationship are understudied. This investigation examined the underlying role of perceived anxiety control in the association between childhood exposure to maternal threatening behaviors and depression, worry, and attention/deficit hyperactivity disorder (attention-deficit/hyperactivity disorder) symptoms. Participants: Participants (N = 862; Mage = 18.75 years, SD = 1.04, age range = 18–24) were recruited from a large state university in the northeast. Methods: Participants completed a battery of self-report questionnaires. Results: Tests of indirect effects indicated that greater childhood exposure to maternal threats was associated with lower perceived anxiety control, which in turn was associated with more severe depression, worry, and ADHD symptoms, respectively. Conclusions: Childhood exposure to maternal threatening behaviors may contribute to college students’ low perceived anxiety control, which in turn increases the risk for these symptom clusters.
This study investigated the relationship between perceived worry and self-efficacy, with particular attention to job role in Australian school counsellors working in the New South Wales (NSW) Department of Education. Ninety-eight school counsellors ( N = 98, M age = 44.97, SD age = 10.89; 92% female) comprised the sample group, stratified across three job roles: Senior Psychologist Education, School Counsellor, and School Counselling in Training. Data collection tools were the Penn State Worry Questionnaire and the Psychologist and Counsellor Self-Efficacy Scale. Data were analysed using the Pearson product-moment correlation and a multivariate analysis of variance (MANOVA). We found a weak negative association between perceived worry and self-efficacy of significance ( p = .018). Findings demonstrated a significant effect ( p < .001) of job role on the combined dependent variables although the effect was small. Examination of the between-subjects effects demonstrated that role had a significant effect for self-efficacy, but not for worry. Post-hoc analyses showed that individuals in roles of seniority reported higher self-efficacy and lower perceived worry when compared with counsellors in training. Future studies would likely benefit from a more comprehensive consideration of demographic data to ascertain other variables that may be contributing to levels of worry and self-efficacy.
Past research has primarily focused on the main effect of perfectionism on worry among children and neglected potential moderating processes. The purpose of the present study is to examine the moderating effects of mothers’ parenting styles (authoritative, authoritarian and permissive parenting styles) in the association between self-oriented perfectionism and worry among children in Hong Kong. This study adopted a cross-sectional survey design. A total of 292 children (142 female, 48.6%) aged between 8–12 years (M = 9.60, SD = 0.68) completed a self-report questionnaire. The results of a hierarchical moderated regression analysis revealed that mothers’ authoritative and permissive parenting styles significantly moderated the relationship between self-oriented perfectionism and worry. Specifically, mothers’ authoritative parenting exhibited a buffering effect while mothers’ permissive parenting exhibited a strengthening effect. No significant moderating effect was found for mothers’ authoritarian parenting. These findings suggest that interventions targeting authoritative parenting practices may be effective in ameliorating the impact of children’s self-oriented perfectionism on worry.
Chinese parents tend to exhibit a high level of worry about their children during the preschool years, which may adversely influence children's mental health. Few studies have investigated the content and intensity of parental worry about children among Chinese parents of preschool children. This study developed and validated the Parental Worry About Children Scale (PWCS) for Chinese parents of preschool children. A pool of 70 items was created after an open-ended questionnaire survey of 1069 Chinese parents of preschool children and an Internet-content analysis, followed by an assessment for content validity by eight experts. Exploratory factor analysis was then conducted with 680 Chinese parents of preschool children, resulting in the formal PWCS consisting of 40 items in four dimensions: physical well-being, psychological well-being, learning/living abilities, and future/uncertain risks. With a sample of 1548 Chinese parents of preschool children, the PWCS demonstrated good structural validity, internal consistency reliability, measure invariance across mothers and fathers, and criterion-related validity. The PWCS may help elucidate the characteristics and antecedents of parental worry about children and the mechanisms underlying its influence on children's mental health in the Chinese context. In clinical practice, this new instrument may facilitate the emergence of effective intervention strategies for alleviating parental worry about children and its negative impact on children's mental health.
Background: Anticipatory Anxiety (AA) is defined as a course of thoughts, feelings, and actions occurring just and only "before" an anxiety-provoking event. In order to explore this construct, the Anticipation Anxiety Inventory (AAI) was developed and its psychometric properties have been investigated in two studies. Methods: Study 1 used an Exploratory Factor Analysis approach to determine the factor structure of the items of the scale. In study 2, a Confirmatory Factor Analysis was performed to assess the scale structure, the validity of the factor solution, and convergent and discriminatory validity. Results: Exploratory factor analysis from study 1 suggested 13 items across four factors for the AAI: Emotional Hypersensitivity, Physical responses to AA, Dysfunctional Cognitions, and Daily Functioning. In study 2, the Confirmatory Factor Analysis indicated that the 4-factor solution of the AAI had an acceptable fit, excellent internal consistency (α= 0.92), and displayed good convergent and discriminatory validity. Conclusion: The AAI could be proposed as a useful valid and reliable tool to investigate AA. For future implications, more research is needed regarding the utility of this measure in experimental designs or clinical settings.
Mask‐wearing has been one of the most prominent, conflicted, and deeply divided issues in the United States during the COVID‐19 pandemic. Across two studies, we seek to understand how beliefs and behaviors around mask‐wearing are associated with the relationship between anxiety about the coronavirus and feelings of control over one’s health outcomes during the pandemic. In Study 1, we find that beliefs in the response efficacy of mask‐wearing moderate the relationship between anxiety and control. Study 2 extends these results by investigating the underlying process. Specifically, we find that the relationship between anxiety and control is mediated by self‐reported mask‐wearing behavior and that the relationship between anxiety and mask‐wearing behavior is moderated by consumers’ perceived marketplace influence. These findings have important public policy and marketing implications in the context of physical, emotional, and economic well‐being.
People vary in the frequency with which they worry and there is large variation in the degree to which this worry disrupts their everyday functioning. Heightened tendency to experience disruptive worry is characterised by an attentional bias towards threat. While this attentional bias is often considered maladaptive, it can be adaptive when it concerns threat cues signalling dangers that can be mitigated through personal action. In this case, the resulting worry may increase the likelihood of this action being taken, with beneficial rather than disruptive consequences for everyday functioning. Thus, depending on its focus, attentional bias to threat could potentially drive worry that is high or low in disruptiveness. The current study addressed this possibility, by testing the novel hypothesis that the degree to which worry is disruptive is a function of the degree to which this attentional bias concerns all threat cues, rather than being restricted to threat cues signalling controllable dangers. Participants completed a novel probe task assessing their attention to threat cues signalling a future danger that could be controlled on some blocks, but not on others. Thus, the task revealed the degree to which their selective attention to threat cues was ‘aligned’ with danger controllability, by being more evident on blocks that permitted participant control of the danger signalled by the threat cues. The results indicate, contradicting the hypothesis under test, participants who reported high levels of disruptive worry demonstrated alignment of attentional bias to variations in danger controllability, whereas this was not the case for participants who reported high levels of non-disruptive worry. While caution is needed in the interpretation of the results due to methodological limitations, this study provides a new conceptual and methodological framework for future research on the attentional basis of individual differences in the tendency to experience disruptive vs non-disruptive worry.
Objectives：We developed a Korean version of the Brief Measure of Worry Severity(BMWS), and examined its reliability, validity, and factor structures. We also explored the associations of pathological worry with depression and anxiety. Methods：Three hundreds fifty-two subjects including community population and college students completed the BMWS, and 27 subjects repeated the scale three weeks later. Reliability was assessed by Cronbach's coefficient α and test-retest correlation. The external validity was examined by the correlation of the BMWS score with the scores of Beck Depression Inventory(BDI), Patient Health questionnaire-2(PHQ-2), State Anxiety Inven-tory(SAI), and Trait Anxiety Inventory(TAI). And principal component analysis was performed to evaluate the construct validity. The associations of pathological worry with depression and anxiety were explored using partial correlation analysis. Results：Cronbach's coefficient α for the BMWS was 0.904 and test-retest correlation was 0.56(P＜0.01). The Spearman correlation coefficients of the BMWS score with the scores of BDI, PHQ-2, SAI, and TAI were 0.60(P＜0.01), 0.42(P＜0.01), 0.36(P＜0.01), and 0.59(P＜0.01), respectively. The BMWS showed unifactorial construct. When controlling for TAI score, the correlation coefficient between the BMWS score and the BDI score was 0.357(P＜0.01), and when controlling for BDI score the correlation coefficient between the BMWS score and the TAI score was 0.446(P＜0.01). Conclusion：The Korean version of the BMWS was found to be a reliable and valid questionnaire for measuring pathological worry. And we could identify the associations of the pathological worry with depression as well as anxiety. KEY WORDS : Worry scale ㆍPathological worry ㆍReliability ㆍValidity.
Objective: To examine the construct of illness perception (IP) as measured by the Brief Illness Perception Questionnaire (BIPQ) using network analysis in patients with rheumatic diseases (RD) and with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS).
Design: Cross-sectional and multicentre survey.
Main Outcome Measures: The BIPQ and the Hospital Anxiety and Depression Scale.
Results: BIPQ network structures did not differ between patients with RD and HIV/AIDS. Community analysis identified two clusters: one comprised consequences, timeline, identity, concern and emotional response; and the other consisted of personal control, treatment control and comprehensibility. Centrality indices indicate that concern, consequences and emotional response are central dimensions of the BIPQ. Directed acyclic graph analysis revealed that concern was a dominant network item, activating emotional response, consequences, identity and comprehensibility. Emotional response and consequences were bridging items linking IP to anxiety and depression.
Conclusion: Perceived impact of illness on life and emotion and illness concern are central dimensions of the BIPQ that link IP to anxiety and depression in patients with RD and HIV/AIDS. Care of patients with RD and HIV/AIDS may benefit from addressing IP, particularly concern, emotional response and consequences to prevent clinical anxiety and depression.
The evidence supporting the relationship between intolerance of uncertainty (IU), a cognitive construct well established in the anxiety literature, and depression is mixed. Some research has demonstrated a direct association between IU and depression, whereas other studies suggest that IU is either unrelated or indirectly related to depression through other pathways, including anxiety. The present study aimed to further elucidate the relationship between IU and depression in an undergraduate sample (N = 221). We posited a model in which worry and anxiety account for unique variance in the association between IU and depression. Results supported this hypothesis. Worry and trait anxiety significantly accounted for unique variance in the relationship between IU and depression. Furthermore, the model that best fit the data included two additional direct paths, from IU to anxiety and from worry to depression, and excluded the direct path from IU to depression. Our findings support the notion that IU and depression are indirectly related through worry and anxiety. Limitations and future directions are discussed.
The objective of this study was to examine the organization of emotion coping strategies that reflect positive emotional self-regulation through the contrast of four theoretical models, as well as the relationship between such strategies and resilience. With this aim, the Positive Emotional Self-regulation Questionnaire (PEMSR-Q) for adolescents was developed. A total of 336 secondary school students formed the sample. In order to analyse model fit, four confirmatory factor analyses were realized (a one-factor model/a-three factors model/a hierarchical model/a bifactor model), as well as correlation and regression analyses to determine its concurrent validity. Results have shown that the bi-factor model has the best fit. Besides, the combination of positive self-regulation strategies and problem-focused strategies is associated with better resilience. These results underlie the importance of helping adolescents to develop and use positive self-regulation strategies to increase their resilience.
The Temperament and Character Inventory (TCI) has been developed by Cloninger in order to assess the seven dimensions of his psychobiological model of personality : novelty seeking, harm avoidance, reward dependence, persistence, self-directedness, cooperation, and self-transcendence. The TCI is a 226-item self-questionnaire, generally completed in 30-40 minutes. We report in this paper the first validation studies of the French version of the TCI : a study on its factorial structure carried out in a clinical sample of 242 psychiatric in- and out-patients, two studies on the test-retest stability of the TCI in clinical and nonclinical samples, and a validation study of a computerized version in psychiatric patients. The TCI can be used in various clinical and research domains, including anxiety, affective, and addictive disorders.
Research on worry during the past 15 years has revealed a remarkable amount of knowledge about this pervasive human phenomenon. Worry involves a predominance of verbal thought activity, functions as atype of cognitive avoidance, and inhibits emotional processing. Worry also produces not only anxious experience but depressive affect as well. Recent evidence suggests that the very private experience of worry is developmentally connected to enmeshed childhood relationships with the primary caregiver and is currently associated with significant interpersonal problems, especially those involving tendency to be overly nurturing to others. At the physiological level, worry is characterized peripherally by parasympathetic deficiency and autonomic rigidity and centrally by left-frontal activation.
The goal of this study was to explore the specificity of the relationship between intolerance of uncertainty and worry in a nonclinical sample. Three hundred and forty-seven university students completed measures of worry, obsessions/compulsions, and panic sensations. They also completed measures of process variables known to be associated with worry (intolerance of uncertainty), obsessions/compulsions (responsibility), and panic sensations (anxiety sensitivity). The results show that intolerance of uncertainty was highly related to worry, moderately related to obsessions/compulsions, and weakly related to panic sensations. Further, the relationship between intolerance of uncertainty and worry remained strong after shared variance with other study variables was removed. The findings are discussed in terms of their implications for understanding worry and preventing generalized anxiety disorder.
Gender differences in anxiety were examined in a large sample of adolescents that included 1,079 who had never met criteria for any disorder, 95 who had recovered from an anxiety disorder, and 47 who had a current anxiety disorder. Participants were examined on a wide array of psychosocial measures. There was a preponderance of females among current and recovered anxiety disorder cases, but not among those who had never experienced an anxiety disorder. The female preponderance emerges early in life, and retrospective data indicate that at age 6, females are already twice as likely to have experienced an anxiety disorder than are males. Psychosocial variables that were correlated with both anxiety and gender were identified. Statistically controlling for these variables did not eliminate the gender differences in prevalence or anxiety symptom means.
This experiment examines one component of worry, elevated subjective probabilities of negative events, and attempts to elucidate the cognitive processes on which this is based. The results suggest that the pessimistic subjective probabilities shown by chronic worriers can be understood using general theories of judgment, specifically, by the use of the availability heuristic (Tversky & Kahneman, 1973). However, it is the availability of a particular pattern of cognitions--an increased accessibility of explanations for why a negative event would occur, combined with a reduced accessibility of explanations for why it would not--that is important. The results are integrated within a description of the worry process, and possible clinical applications through the use of reason-generation techniques are discussed.
The Tridimensional Personality Questionnaire is a self-report personality inventory measuring three major personality dimensions: Novelty Seeking, Harm Avoidance, and Reward Dependence. Normative data, based on a U.S. national probability sample of 1,019 adults, are presented and the psychometric properties of the questionnaire are discussed.
Literature on temperament, personality, and mood and anxiety disorders is reviewed. The review is organized primarily around L. A. Clark and D. Watson's (1991b) tripartite model for these disorders, but other influential approaches are also examined. Negative affectivity (or neuroticism) appears to be a vulnerability factor for the development of anxiety and depression, indicates poor prognosis, and is itself affected by the experience of disorder. Positive affectivity (or extraversion) is related more specifically to depression, may be a risk factor for its development, suggests poor prognosis, and also may be affected by the experience of disorder. Other personality dimensions (e.g., anxiety sensitivity, attributional style, sociotropy or dependence, autonomy or self-criticism, and constraint) may constitute specific vulnerability factors for particular disorders. More longitudinal and measurement-based research that jointly examines anxiety and depression is needed.
Structural equation modeling is a comprehensive, flexible approach to research design and data analysis. Although in recent years there has been phenomenal growth in the literature on technical aspects of structural equation modeling, relatively little attention has been devoted to conceiving research hypotheses as structural equation models. The aim of this article is to provide a conceptual overview of clinical research hypotheses that invite evaluation as structural equation models. Particular attention is devoted to hypotheses that are not adequately evaluated using traditional statistical models.
This study investigated the convergence of temperament dimensions with constructs from C. R. Cloninger's (1987a) theory using data from a sample of 949 adolescents (M age = 13.6 years). Substantial convergence was found, and both types of constructs were related in predicted ways to self-regulation variables and adolescent substance use. Structural modeling procedures tested a mediational model for substance use; results showed mediation through self-control, academic competence, negative life events, and deviant peer affiliations. Interactions indicated that substance use could be predicted from a balance of systems for good control and poor control. Poor self-control was present for dimensions implicated in both externalizing and internalizing disorders. Results are discussed with reference to self-regulation models of substance use and the comorbidity of substance abuse and mental disorder.
The similarities and distinctions between the constructs of worry and anxiety were examined in a sample of 189 university students. Three worry scales and four measures of anxiety were compared in relation to measures of negative affect, personal control, and problem-solving style. Although measures of worry and anxiety were highly correlated, negative affect (e.g. depression, confusion) tended to be more closely related to anxiety than to worry, whereas problem-solving style tended to be more closely related to worry than to anxiety. Personal control did not show a differential relationship to anxiety or worry. When the definition of anxiety was restricted to somatic anxiety, however, negative affect, perceived problem-solving abilities, and personal control were more strongly related to worry than to anxiety. Implications of these results are discussed in light of current definitions and measurement of these constructs.
Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487-495.] for weekly assessment of worry was evaluated in a brief treatment study. Cognitive restructuring techniques were taught to 28 nonclinical high-worriers, 14 of whom served as a control group in a lagged waiting-list design. Results showed that the Penn State Worry Questionnaire-Past Week (PSWQ-PW) was highly reliable and substantially valid in the assessment of both (a) weekly status of worry and (b) treatment-related changes in worry: average Cronbach's alpha was 0.91; average convergent correlation with a past-week adaptation of the Worry Domains Questionnaire [Tallis, F., Eysenck, M. W. and Mathews, A. (1992). A questionnaire for the measurement of nonpathological worry. Personality and Individual Differences, 13, 161-168.] was 0.63 and pre-post improvement on PSWQ-PW showed a 0.71 correlation with the Questionnaire of Changes in Experiencing and Behavior [Zielke, M. and Kopf-Mehnert, C. (1978). Veränderungsfragebogen des Erlebens und Verhaltens. Weinheim, Germany: Beltz Test Gesellschaft.]. It is concluded that the PSWQ-PW is a useful instrument for monitoring pathological worry in experimental and applied settings.
This article presents a comprehensive conceptualization of the structure of worry and the relation of worry to mental health and well-being. It is assumed that worries have two facets, namely, the object of a worry (e.g., self, close others, society, the world) and the domain of a worry (the field of life with which it is concerned). The object of a worry is presumed to be more important than its domain in determining the impact of worries on mental health. Only worries concerned with self and close others (micro worries) are expected to be related to poor mental health, whereas worries about society or the entire world (macro worries) are expected to be positively related to mental health. An instrument is introduced to study worries in accordance with the proposed structure. Its validity is tested by two confirmatory techniques (similarity structure analysis and confirmatory factor analysis) in samples from Israel, West Germany, and (the former) East Germany. Worry scores are also related to five mental health indicators. Results show that across samples micro and macro worries can validly be distinguished. Micro worries are strongly related to poor mental health, whereas macro worries are unrelated to mental health or relate marginally to positive well-being.
Scales of the Minnesota Multiphasic Personality Inventory-2 were correlated to identify which measures predicted depression among 219 women and 115 men. Despite prevalence data indicating that dysphoria is more common among females than males, sex did not predict MMPI-2 Depression scores in this sample. Masculine Gender Role was negatively predictive of depression for both sexes. High scores on Feminine Gender Role were slightly predictive of depression among men but not among women. An effective strategy for coping with depression involves managing stress causing circumstances as opposed to managing the feelings that result from stress. Persons of either sex who score high on Masculine Gender Role endorse traits that are compatible with the better strategy.
This study compares two self-report instruments--the Dutch version of Cloninger's Temperament and Character Inventory (TCI) and the Questionnaire on Personality Traits (VKP)--in a Dutch sample of 148 people in a healthy population. The aims of this study are to create a norm group for the Dutch TCI, to investigate the psychometric properties of the TCI, and to examine the relationship between temperament, character (as measured by the TCI), and personality disorders (as measured by the VKP). The Dutch TCI has a good internal consistency. Some scales do intercorrelate. Seven factors can be identified with principal components analysis. T-tests show differences between the mean score of this Dutch population and Cloninger's community sample. According to the results of correlations and multiple regression of the TCI and the VKP, the self-directedness scale can predict the presence or absence of a personality disorder. Other scales might predict the type of personality disorder. It is concluded that the TCI can be a useful aid in the assessment of personality disorders.
Gender differences in anxiety were examined in a large sample of adolescents that included 1,079 who had never met criteria for any disorder, 95 who had recovered from an anxiety disorder, and 47 who had a current anxiety disorder. Participants were examined on a wide array of psychosocial measures. There was a preponderance of females among current and recovered anxiety disorder cases, but not among those who had never experienced an anxiety disorder. The female preponderance emerges early in life, and retrospective data indicate that at age 6, females are already twice as likely to have experienced an anxiety disorder than are males. Psychosocial variables that were correlated with both anxiety and gender were identified. Statistically controlling for these variables did not eliminate the gender differences in prevalence or anxiety symptom means. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Background: Depression affects more women than men and often aggregates in families. Using a communitybased sample of twins, we examined the contributions of genetic and environmental factors to the risk of developing major depressive disorder and the effect of sex and different definitions of depression on the relative contributions of genetic and environmental effects. Sex differences in genetic effects were also studied. Methods: A volunteer sample of Australian twins (2662 pairs) was interviewed using an abbreviated version of the Semi-Structured Assessment for the Genetics of Alcoholism, a semi-structured lay interview designed to assess psychiatric disorders. Depression was defined using 3 different criteria sets: DSM-III-R major depressive disorder, DSM-IV major depressive disorder, and severe DSM-IV major depressive disorder. Genetic and environmental contributions to the liability to develop depression were estimated using genetic model fitting. Results: Lifetime prevalences were 31% in women and 24% in men for DSM-III-R major depressive disorder, 22% in women and 16% in men for DSM-IV major depressive disorder, and 9% in women and 3% in men for severe DSM-IV major depressive disorder. In women, the simplest model to fit the data implicated genetic factors and environmental factors unique to the individual in the development of depression, with heritability estimates ranging from 36% to 44%. In men, depression was only modestly familial, and thus individual environmental factors played a larger role in the development of depression. For DSM-III-R major depressive disorder, there were statistically different estimates for heritability for men vs women. For both sexes, the relative contributions of genetic and environmental factors were stable using different definitions of depression. Conclusions: There was moderate familial aggregation of depression in women and this primarily was attributable to genetic factors. In men, there was only modest familial aggregation of depression. For both men and women, individual environmental experiences played a large role in the development of depression. Major depressive disorder as defined by DSM-III-R was more heritable in women as compared with men. The relative contributions of genetic and environmental factors in the development of depression were similar for varying definitions of depression, from a broad definition to a narrow definition. Arch Gen Psychiatry. 1999;56:557-563
It is suggested that worry has not been given serious academic attention due to problems of definition, and a prevailing belief that it is an unnecessary addition to the theorists vocabulary given the term “anxiety”. However, an increasing awareness of the importance of cognitive factors in emotional disorders makes the study of worry a necessary endeavour. Furthermore, inclusion of worry in DSM III-R as the principle diagnostic index of Generalised Anxiety Disorder has given the term clinical credibility. Three theoretical approaches to the subject of worry are considered: the test anxiety literature, which has focused on the effects of worry on performance, and two largely clinical accounts, a tripartite theory of worry and anxiety proposed by Borkovec, Metzger, and Pruzinsky (1986), and the model of anxious apprehension proposed by Barlow (1988). All approaches are critically evaluated, and suggestions made for future formulations.
In recent years there has been increased interest into the nature of worry. While closely related to neuroticism, worry is considered to be a separate construct. However, few studies have been conducted which investigate the combination of factors, in addition to neuroticism, that best predict worry. Using a hierarchical regression procedure, the present study attempted to determine which factors best predict worry after differences in levels of neuroticism have been taken into consideration. One hundred twenty-five adults completed the Worry Domains Questionnaire, Eysenck Personality Questionnaire, Spheres of Control scale, Self-consciousness scale and the Cognitive Failures Questionnaire. Interpersonal control, public self-consciousness and number of cognitive failures were found to add significantly to the prediction of worry. The implications of these results are discussed in light of current theories of worry and future research.
This article examines the adequacy of the “rules of thumb” conventional cutoff criteria and several new alternatives for various fit indexes used to evaluate model fit in practice. Using a 2‐index presentation strategy, which includes using the maximum likelihood (ML)‐based standardized root mean squared residual (SRMR) and supplementing it with either Tucker‐Lewis Index (TLI), Bollen's (1989) Fit Index (BL89), Relative Noncentrality Index (RNI), Comparative Fit Index (CFI), Gamma Hat, McDonald's Centrality Index (Mc), or root mean squared error of approximation (RMSEA), various combinations of cutoff values from selected ranges of cutoff criteria for the ML‐based SRMR and a given supplemental fit index were used to calculate rejection rates for various types of true‐population and misspecified models; that is, models with misspecified factor covariance(s) and models with misspecified factor loading(s). The results suggest that, for the ML method, a cutoff value close to .95 for TLI, BL89, CFI, RNI, and Gamma Hat; a cutoff value close to .90 for Mc; a cutoff value close to .08 for SRMR; and a cutoff value close to .06 for RMSEA are needed before we can conclude that there is a relatively good fit between the hypothesized model and the observed data. Furthermore, the 2‐index presentation strategy is required to reject reasonable proportions of various types of true‐population and misspecified models. Finally, using the proposed cutoff criteria, the ML‐based TLI, Mc, and RMSEA tend to overreject true‐population models at small sample size and thus are less preferable when sample size is small.
ABSTRACT– A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
Symptom covariation and lack of symptom specificity have proven to be complicating factors in research on the emotional, cognitive, and physiologic characteristics of anxiety and depression. Numerous attempts have been made to investigate the unique and overlapping features of anxiety and depression. Of interest in the present study were potential distinctions among proposed types of anxiety and depression. A variety of self-report measures were administered to 783 college students. Correlational analyses and confirmatory factor analyses converged in suggesting that anxious arousal (somatic anxiety) and anxious apprehension (worry) represent distinct affective dimensions that can be distinguished from depression and negative affect.
The purposes of this report are: (1) to investigate the association between sleep disturbances and depressive symptomatology in older adults; (2) to evaluate the degree to which gender serves to mediate this relationship; and (3) to determine whether several predefined covariates help to explain the association between sleep disturbance and depressive symptoms. This is a retrospective and cross-sectional analysis of baseline data from 485 elderly adults enrolled in three of the eight clinical sites participating in the Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) trials. FICSIT was a linked series of randomized clinical trials which evaluated the impact of various exercise interventions on several measures of frailty in older adults. Women reported more depressive symptoms and more sleep disturbances than men. Sleep disturbances were independently associated with depressive symptoms, bodily pain, a history of falling, limited education, being married, and being female. Gender interactions suggest that, although women reported more depressive symptoms and more chronic health conditions than men, both may be more important predictors of sleep disturbance in men. By contrast, being married may be more predictive in women. Finally, the data suggest a stronger relationship between sleep disturbance and depressive symptoms in men than in women.
This paper reports the results of two studies using a nonselected population to investigate the nature of the internal statements which are reported as characterising bouts of catastrophic worrying. Study 1 used a factor analysis procedure to identify four theoretically coherent sets of statements which related respectively to problem-specific pessimism, personal inadequacy/incompetence, personal despair/hopelessness and need to analyse the problem. Study 2 found that three of the four catastrophising strategies were significantly associated with measures of anxiety, depression and poor problem-solving confidence. Measures of beliefs in the positive effects of worrying predicted use of all four sets of statements independently of measures of anxiety, depression and poor problem-solving confidence. These findings are consistent with theoretical accounts of catastrophic worrying which allude to the role of poor problem-solving confidence and beliefs about personal inadequacy in exacerbating the catastrophising process and to the role of dysfunctional beliefs about the utility of worrying in generating and maintaining pathological worry.
This series of three studies investigated some of the characteristics of worrying which are independent of related constructs such as trait anxiety. The results from all three studies suggested that worry and anxiety can be considered as separate constructs, each with their own unique sources of variance. Worrying was associated with adaptive problem-focussed coping strategies and an information-seeking cognitive style. Trait anxiety was independently associated with psychological processes that are normally considered to result in poor psychological outcomes, including (i) poor problem-solving confidence, (ii) poor perceived personal control, (iii) responsibility for negative but not positive outcomes, (iv) the tendency to define events as threats and (v) avoidance or emotion-focused coping strategies. The results also suggested ways in which pathological worrying might be generated, especially where adaptive worrying is thwarted or where processes characteristic of adaptive worrying interact with psychological phenomena associated with high levels of anxiety.
Work conducted under the auspices of the Pennsylvania State University Worry Project suggests that worriers show retarded responding when attempting to categorise ambiguous figures. Recent research has yielded similar findings. These effects might be attributed to a characteristic elevated evidence requirement in high worriers. In the following, an experiment is reported which supports this notion. Further, a correlational analysis is reported which reveals a systematic association between evidence requirements and everyday worry frequency. A model of worry is suggested, in which elevated evidence requirements are given a central role.
The present report describes the development of the Penn State Worry Questionnaire to measure the trait of worry. The 16-item instrument emerged from factor analysis of a large number of items and was found to possess high internal consistency and good test-retest reliability. The questionnaire correlates predictably with several psychological measures reasonably related to worry, and does not correlate with other measures more remote to the construct. Responses to the questionnaire are not influenced by social desirability. The measure was found to significantly discriminate college samples (a) who met all, some, or none of the DSM-III-R diagnostic criteria for generalized anxiety disorder and (b) who met criteria for GAD vs posttraumatic stress disorder. Among 34 GAD-diagnosed clinical subjects, the worry questionnaire was found not to correlate with other measures of anxiety or depression, indicating that it is tapping an independent construct with severely anxious individuals, and coping desensitization plus cognitive therapy was found to produce significantly greater reductions in the measure than did a nondirective therapy condition.
Indirect evidence suggests that worry primarily involves thought, rather than imaginal, activity, a distinction within cognitive process that is potentially crucial to some theories of anxiety maintenance and modification. The present study contrasted the frequencies of reporting the presence of thoughts and images among generalized anxiety disorder clients and matched, nonanxious control subjects during a self-relaxation period and a worry period. Repetition of the assessment was conducted with clients after they completed 12 sessions of therapy. Sampling of mentation during these periods revealed that (a) during relaxation, nonanxious subjects reported a predominance of imagery whereas clients show equal amounts of thought and imagery, (b) nonanxious subjects shifted to a predominance of thought during worry, and (c) clients showed a normalization of thought and image frequencies after successful therapy. This combination of results suggests that worry is principally thought-like in content. The speculation is offered that worry may function as motivated avoidance of emotional imagery and its attendant somatic sensations.
The present paper reports two questionnaire studies and an experimental investigation of worrying. Worry correlated more highly than general tension reports with a variety of affect scales and was characterized by: (a) feelings of anxiety, tension and apprehension; (b) moderate awareness of somatic cues including muscle tension and upset stomach; and (c) concerns over future rather than past or present situations. Self-labeled worriers were most distinguished from non-worriers by their reported uncontrollability of cognitive intrusions once worrying was initiated. In the experimental study, worriers and non-worriers were assessed for their ability to focus their attention on a monotonous (breathing) stimulus before and after 0, 15 or 30 min of worrying. Worriers reported significantly higher anxiety. depression and hostility, a lower frequency of focused attention and a greater frequency of negative thought intrusions than did non-worriers prior to the worry period. For both worriers and non-worriers. 15 min of worry resulted in an apparent incubation of negative cognitive intrusions on the subsequent attention-focusing task.
This study investigated the relationship between worrying and two features of social problem solving: problem-solving ability and confidence. However, while levels of worrying were significantly related to both poor problem-solving confidence and poor perceived control over the problem-solving process, worrying was unrelated to problem-solving ability per se. The failure to find a relationship between worrying and social problem-solving skills was found separately at both low and high levels of worrying, and also when levels of trait anxiety had been controlled for. These results provide no support for the hypothesis that chronic worrying results from poor social problem-solving abilities, but the results are consistent with the belief that worrying is primarily an anxiety-related phenomenon with any problem-solving deficits occurring at the level of solution implementation rather than solution generation.
This paper describes a study comparing three worry questionnaires; The Worry Domains Questionnaire (WDQ), The Penn State Worry Questionnaire (PSWQ), and The Student Worry Scale (SWS). The results suggested that (i) scores on two out of the three questionnaires exhibited sources of variance that were independent of trait anxiety, (ii) content-based questionnaires (the WDQ and SWS) appeared to capture features of task-oriented constructive worrying, whereas the PSWQ did not, and (iii) all three questionnaires indicated that worriers were characterized by an information-seeking, monitoring cognitive style and a tendency to indulge in avoidance coping behaviours. The implications of these findings for the development of a clinically useful diagnostic instrument are discussed.
More than 200 published studies from most medical settings worldwide have reported experiences with the Hospital Anxiety and Depression Scale (HADS) which was specifically developed by Zigmond and Snaith for use with physically ill patients. Although introduced in 1983, there is still no comprehensive documentation of its psychometric properties. The present review summarizes available data on reliability and validity and gives an overview of clinical studies conducted with this instrument and their most important findings. The HADS gives clinically meaningful results as a psychological screening tool, in clinical group comparisons and in correlational studies with several aspects of disease and quality of life. It is sensitive to changes both during the course of diseases and in response to psychotherapeutic and psychopharmacological intervention. Finally, HADS scores predict psychosocial and possibly also physical outcome.
The aim of this study is to describe gender differences in depressive symptomatology among an elderly Spanish population and to see whether women are more at risk than men and whether the effects of known risk factors for depression differ between the genders. Data come from the study Envejecer en Leganés (Growing Old in Leganés), where a representative sample of community residing elderly was screened by an at-home interview for high depressive symptomatology using the Center for Epidemiologic Studies Depression Scale (CES-D). Sociodemographic characteristics, health status, Activities of Daily Living and Instrumental Activities of Daily Living, disability, social support, and locus of control were measured as possible correlates of depressive symptoms. Screening was completed in 1116 subjects. The prevalence of high depressive symptomatology varied, being 19.6% for men and 46% for women (OR = 3.4; 95% CI = 2.6; 4.5). In addition to gender, comorbidity, low emotional support from children, lack of a confidant, few social activities, and a sense of lack of control were independently associated with high levels of depressive symptoms. None of the interactions of gender by the known risk factors of depression was significant. Although the prevalence of depressive symptomatology is higher in women than in men, the known risk factors do not totally explain the difference between genders in this population of Spanish elderly. This difference could be due to the cultural definitions of gender roles that have affected them throughout their lives.
The Temperament and Character Inventory (TCI) is a self-report personality questionnaire based on Cloninger's psychobiological model of personality, which accounts for both normal and abnormal variation in the two major components of personality, temperament and character. Normative data for the Swedish TCI based on a representative Swedish sample of 1,300 adults are presented, and the psychometric properties of the questionnaire are discussed. The structure of the Swedish version replicates the American version well for the means, distribution of scores, and relationships within the between scales and subscales. Further, the Swedish inventory had a reliable factor structure and test-retest performance. The results of this study confirm the theory of temperament and character as a seven-factor model of personality.
Using a conceptual and nontechnical approach, the meaning of structural equation modeling (SEM) and the similarities to, and differences from, more commonly used procedures such as correlation, regression, path analysis, and factor analysis are explained. Application of the statistical technique is presented using data from a study of the relationships among stresses, strains, and physical health in a random sample of 492 community-dwelling elders aged 65 and older. Advantages of each statistical procedure are described. Theoretical issues related to the use of each procedure are presented with emphasis on the need for a sound theoretical model and match between the statistical procedure and the aims of the analysis.
Personality assessment may allow reliable measurement of risk of mood disorders.
A group of adults (804) representative of the general population were assessed by questionnaire. Personality types were measured by the Temperament and Character Inventory (TCI).
Specific TCI configurations define personality types that can be described as hyperthymic, cyclothymic, irritable, and depressive. Each type had a unique profile of emotions, suicide attempts, and hospitalization.
TCI traits are associated with mood disorders.
Different ways of measuring Kraepelinean subtypes may disagree. Whether differences in personality cause psychopathology, or vice versa, remains uncertain.
Personality profiles help in assessing suicidality and planning treatment.
The prevalence of major psychiatric disorders in the general population is difficult to pinpoint owing to widely divergent estimates yielded by studies employing different criteria, methods, and instruments. Depressive disorders, which represent a sizable mental health care expense for the public purse, are no exception to the rule.
The prevalence of depressive disorders was assessed in a representative sample (n = 4972) of the U.K. general population in 1994. Interviews were performed over the telephone by lay interviewers using an expert system that tailored the questionnaire to each individual based on prior responses. Diagnoses and symptoms lists were based on the DSM-IV.
Five percent (95% confidence interval = 4.4-5.6%) of the sample was diagnosed by the system with a depressive disorder at the time of the interview, with the rate slightly higher for women (5.9%) than men (4.2%). Unemployed, separated, divorced, and widowed individuals were found to be at higher risk for depression. Depressive subjects were seen almost exclusively by general practitioners (only 3.4% by psychiatrists). Only 12.5% of them consulted their physician seeking mental health treatment, and 15.9% reported being hospitalized in the past 12 months.
The study indicates that mental health problems in the community are seriously underdetected by general practitioners, and that these professionals are highly reluctant to refer patients with depressive disorders to the appropriate specialist.
This study tested the hypothesis that female subjects may exhibit a higher prevalence than male subjects of depression associated with somatic symptoms but not a higher prevalence of depression not associated with these other symptoms.
The author reanalyzed research interview data on major depression from the National Comorbidity Survey, dividing respondents into those who met overall criteria for major depression and exhibited fatigue and appetite and sleep disturbance ("somatic depression") and those who met overall criteria but did not exhibit these somatic criteria ("pure depression").
Female subjects exhibited a higher prevalence than male subjects of somatic depression but not a higher prevalence of pure depression. Somatic depression was associated with a high prevalence of anxiety disorder and, among female subjects, with body aches and onset of depression during early adolescence.
The gender difference in depression may result from a difference in a specific subtype of anxious somatic depression.
Although several studies have assessed the relationships between the temperament dimensions of the Cloninger model of personality and depression, little is known about the role played by the character dimensions proposed by the seven-factor model of Cloninger in depression. In this study, the relationships between the Temperament and Character Inventory (TCI) and depression were examined in a sample of 40 major depressive patients and 40 healthy controls. Depressed patients exhibit higher harm avoidance and self-transcendence scores as well as lower self-directedness and cooperativeness scores as compared to healthy controls. However, the three other dimensions do not differ between depressive patients and controls. Among the depressive group, harm avoidance, self-directedness and cooperativeness dimensions are related to the severity of depression as assessed by the Hamilton scale. This study confirms the state dependence of the harm avoidance dimension and suggests a relationship between the character dimensions of the Cloninger model and depression.
Structural equation modeling (SEM) has dominated causal analysis in the social and behavioral sciences since the 1960s. Currently, many SEM practitioners are having difficulty articulating the causal content of SEM and are seeking foundational answers. Recent developments in the areas of graphical models and the logic of causality show potential for alleviating such difficulties and thus for revitalizing structural equations as the primary language of causal modeling. This paper summarizes several of these developments, including the prediction of vanishing partial correlations, model testing, model equivalence, parametric and nonparametric identifiability, control of confounding, and covariate selection. These developments clarify the causal and statistical components of structural equation models and the role of SEM in the empirical sciences. 1 INTRODUCTION 1.1 Causality in Search of a Language The word cause is not in the vocabulary of standard probability theory. It is an embarr...