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Parental problem drinking and anxiety disorder symptoms in adult offspring: Examining the mediating role of anxiety sensitivity components

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Abstract

Preliminary studies have implicated childhood exposure to parental problem drinking as a possible factor in the development of anxiety sensitivity (AS). The present retrospective study was designed to examine the role of exposure to distressing parental problem drinking behaviors, over and above the role of parental alcoholism, in the development of various AS components (psychological, physical, and social concerns) in the offspring. We also examined the possible mediating role of AS components in explaining relations between parental drinking problems and anxiety-related symptoms in the adult offspring. A sample of 213 university students provided retrospective reports of both distress related to parental drinking [Children of Alcoholics Screening Test (CAST)] and parental alcoholism [maternal and paternal forms of the Short Michigan Alcoholism Screening Test (SMAST)]. Participants also reported on their own current AS levels [AS Index (ASI)], general anxiety symptoms [State-Trait Anxiety Inventory-Trait subscale (STAI-T)], and lifetime history of uncued panic attacks [Panic Attack Questionnaire-Revised (PAQ-R)]. Scores on the CAST predicted AS psychological and physical concerns (but not social concerns) over and above participant gender and parental alcoholism measured by the SMASTs. Moreover, AS psychological concerns proved a consistent modest mediator of the relations between parental problem drinking on the CAST and both general anxiety and uncued panic outcomes in the offspring. Thus, exposure to distressing parental problem drinking behavior may be one factor that contributes to elevated AS psychological concerns in the child, which in turn may contribute to the development of anxiety disorder symptoms in the offspring.

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... n childhood exposure to parental dyscontrol and the development of anxiety disorder symptoms in young adulthood. It was hypothesized that AS psychological concerns, in particular, would mediate the expected association between exposure to parental loss of control related to drinking, and both general anxiety and panic symptoms in the offspring (cf. MacPherson et al., 2001). ...
... range from 20 to 80. Considerable evidence supports the good psychometric properties of the STAI-T including high reliability and good construct validity in predicting anxiety in response to stressors (see review by Spielberger et al., 1983). The STAI-T was included in the present study as a measure of the frequency of general anxiety symptoms (cf. MacPherson et al., 2001). ...
... The sample produced means of 1.11 (SD = 0.72), 0.68 (SD = 0.74), and 1.84 (SD = 0.73) on the physical , psychological, and social concerns subscales of the ASI, respectively. These subscale scores are highly similar to those reported for previously tested samples of university students (e.g., MacPherson et al., 2001; Stewart et al., 1997). Overall, 33% (n = 153) of the sample reported at least one panic attack in his/her lifetime. ...
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This retrospective study investigated the relationship between childhood exposure to parental dyscontrol (i.e., loss of control behaviors) and levels of anxiety sensitivity (AS) components in early adulthood. Four-hundred-and-sixty-five undergraduate students completed self-report measures including the Dyscontrol Experiences Questionnaire. Specificity emerged between AS components and particular dyscontrol experiences. Although exposure to parental dyscontrol related to negative emotional states was significantly positively correlated with all AS dimensions, exposure to parental dyscontrol related to drinking was significantly positively correlated with psychological concerns only. Mediator regression analyses showed AS psychological concerns to play a significant mediating role between parental dyscontrol related to anger and drinking and both general and panic-related anxiety symptoms in the adult offspring. Results suggest that specific parental behaviors may be etiologic in the development of AS, and acquired AS may help explain relations between childhood learning experiences and the development of psychopathological symptoms in young adulthood.
... Researchers have demonstrated that alcohol-abusing fathers appear less sensitive (Cavell, Jones, Runyan, Constantin-Page, & Velasquez, 1993;Eiden, Edwards, & Leonard, 2002) and more rejecting (Cavell et al., 1993;MacPherson, Stewart, & McWilliams, 2001) than non-alcohol-abusing fathers. As a result, alcohol-abusing parents may be less able to provide the nurturance and consistency necessary to form parent-child bonds that promote security, low anxiety, and positive self-image (Latham & Napier, 1992). ...
... Bowlby (1969Bowlby ( , 1980 suggested that interactions with caregivers contribute to the development of internal working models about the world. During periods of active abuse, alcohol-abusing parents may be inconsistent, insensitive, angry, and rejecting (MacPherson et al., 2001;Tweed & Ruff, 1996). The inconsistent behavior displayed by some alcohol-abusing parents may convey to their children that they are unworthy. ...
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Gender of the alcohol-abusing parent was examined in relation to general and romantic attachment (as measured by the Experiences in Close Relationships—Revised and the Relationship Scales Questionnaire) in female adult children of alcoholics (ACOAs; as indicated by the Children of Alcoholics Screening Test) as compared to non-ACOAs. As compared to non-ACOAs, ACOAs reported more anxious and avoidant behaviors in their romantic relationships. Female participants who suspected their mother of alcohol abuse reported significantly greater avoidance within romantic relationships as compared to those who suspected neither parent of having an alcohol problem. No differences emerged in relation to general attachment.
... CAST scores predicted anxiety sensitivity over and above participant gender and parental alcoholism per se. The measure employed by MacPherson et al. (2001), however, was specific to parental uncontrolled behavior due to alcohol intake (i.e., the CAST) and did not allow for the assessment of general parental uncontrolled behaviors due to other reasons (e.g., anger), leaving open the possibility that exposure to uncontrolled behavior from any source (not just parental drinking) would cause elevated anxiety sensitivity levels in the child (cf. Scher & Stein, in press). ...
... nge from 20 to 80. Considerable evidence supports the good psychometric properties of the STAI-T including high reliability, and good construct validity in predicting anxiety in response to stressors (see review by Spielberger et al., 1983 ). The STAI-T was included in the present study as a measure of the frequency of general anxiety symptoms (cf. MacPherson et al., 2001). Beck, Steer, & Brown, 1996) The BDI-II is a 21-item self-report instrument for measuring the severity of depression in adults and adolescents (aged 13 years and older) consistent with the DSM-IV (American Psychiatric Association [APA], 1994). The BDI-II reflects both cognitive and affective, as well as somatic and vegetative symptoms ...
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This paper describes development of a retrospective measure of childhood exposure to parental dyscontrol related to specific conditions such as a parent's drinking, anger, or other negative emotional states (e.g., stress, anxiety, depression). A 45-item questionnaire, the Dyscontrol Experiences Questionnaire (DEQ), was designed to assess individuals' childhood experiences with parental loss of control. Two student samples (n = 465 and n = 536) completed a battery of self-report measures. Responses were used to examine the psychometric properties of the DEQ. Factor analysis revealed three lower-order factors accounting for 54.4% of the variance in DEQ item scores. Cronbach's coefficient alphas indicated acceptable internal consistency. Moderate intercorrelations with two other retrospective measures of childhood experiences suggested construct validity. Moderate intercorrelations with two measures of psychological distress suggested predictive validity. In summary, initial psychometric testing of the DEQ suggests it is a reliable and valid tool for investigating an important developmental antecedent of adult psychological distress.
... This would create an apparent association between AS and alcohol abuse in the offspring, which is actually accounted for by both variables' association with parental alcoholism (the third variable). One study included in this series (MacPherson, Stewart, & McWilliams, 2001, this issue) is among the first to systematically evaluate the role of a putative common variable (genotypic alcoholism) as a confounding variable in the oft-reported association between AS and alcohol misuse. More attention should be paid to controlling such third variables in future research. ...
... The present special issue of Addictive Behaviors consists of a series of eight empirical studies covering current issues in the area of AS and addictive behaviors. Studies span populations of adolescents (Comeau et al., 2001, this issue) to adults (e.g., MacPherson et al., 2001, this issue). The samples have been drawn from both clinical (Kushner et al., 2001, this issue) and nonclinical (e.g., Zvolensky et al., 2001, this issue) sources. ...
Article
Anxiety sensitivity (AS) is a cognitive, individual difference variable characterized by a fear of arousal-related bodily sensations due to beliefs that such sensations are signs of impending catastrophic physical, psychological, or social outcomes. AS has been linked to increased risk for the development and maintenance of panic attacks and anxiety disorders, and more recently has been related to risk for other psychopathological conditions including those related to substance misuse. This article introduces a special issue of Addictive Behaviors focusing on cutting edge findings on the relations of AS to substance use and abuse. We set the stage for the following series of eight novel empirical papers by providing a review of background on the ways in which AS has been hypothetically linked to increased risk for the development of substance abuse and addiction. We also consider whether AS might be differentially related to risk for abuse of specific classes of drugs with different pharmacological effects (e.g., depressants vs. stimulants). Finally, we consider how AS might be related to substance use disorder maintenance or relapse risk through its putative effects in increasing drug withdrawal severity and in lowering tolerance for withdrawal symptoms. Our overriding goal in writing this Introduction was to provide an organizational template for integrating the featured studies and to recommend promising directions for future work into the association of AS and substance use-related problems.
... Research has identified several mechanisms involved in transmitting the risk of problem drinking from parents to their offspring-genetics, physiological sensitivity to the effects of consumption ( Kaplan et al., 1988), psychosocial factors such as modelling substance misuse by parents, family dysfunction, negative affect, anxiety sensitivity, availability of alcohol, and poor parental monitoring ( Hussong et al.,1998;MacPherson et al., 2001). An alternative explanation of problem drinking in adolescents, including the children of parents with alcohol problems, relates to psychological motivations to use alcohol and expectancies about its effects (Cooper, 1994). ...
... Behaviours such as these, if left unchecked, have the potential to develop into more serious problems with alcohol use in adulthood. Parental influences on adolescents' drinking behaviour may be mediated by biological mechanisms that govern physiological sensitivity to alcohol (Kaplan et al., 1988), psychological factors such as anxiety sensitivity, negative affect, and modelling the misuse of alcohol (Eiden and Leonard, 1996;MacPherson et al., 2001), or environmental factors such as availability of alcohol, inadequate parenting, or family dysfunction ( Hussong et al., 1998;Newlin et al., 2000). All these dimensions of parental alcohol problems, in combination with adolescents' tendencies to engage in risky behaviour, might have contributed to the frequent and heavy use of alcohol, which was reported by children of parents with alcohol problems. ...
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To study the influences of parental alcohol problems on adolescents' alcohol consumption and motivations to drink alcohol. A community sample of 1744 adolescents from schools in South Wales completed the 6-item Children of Alcoholics Screening Test, Drinking Motives Questionnaire, and survey measures of alcohol consumption. Children of parents with alcohol problems constituted almost one-fifth of the sample group and were found to drink more frequently, more heavily, and more often alone than children of parents without alcohol problems. Parental alcohol problems were also related to internal motives to drink (e.g. coping) in their adolescent children. Across the entire sample, internal motives to drink interacted with parental alcohol problems in predicting alcohol consumption and drinking frequency. Parental alcohol problems appeared to co-exist with an asocial pattern of alcohol consumption in adolescents that involves drinking alone and drinking to feel intoxicated or to forget about problems. In addition to the external, social motives to drink, which are shared by most adolescents, nearly one in five of the adolescents studied reported salient internal motives to drink that tended to coexist with alcohol problems in their parents.
... These studies also showed that the acquired fear of arousal-related sensations, particularly, puts high AS individuals at risk for the development of panic, whereas the acquired fear of bodily sensations more generally puts high AS individuals at risk for the development of health anxiety. We have also shown that childhood/adolescent exposure to parental loss of control (e.g., due to anger or alcohol intoxication) may contribute to AS development, particularly AS cognitive concerns (MacPherson et al., 2001;Watt & Stewart, 2003). Overall, it appears that both heredity and learning experiences contribute to the development of global AS and its components. ...
Article
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Le présent article résume notre programme de recherche sur la sensibilité à l’anxiété (SA) – un facteur dispositionnel cognitif et affectif impliquant des craintes de sensations liées à l’anxiété en raison de croyances selon lesquelles ces sensations entraînent des conséquences catastrophiques. La SA et ses dimensions d’ordre inférieur sont considérées comme des facteurs transdiagnostiques de risque ou de maintien des troubles émotionnels et des troubles addictifs. La compréhension des mécanismes par lesquels la SA exerce ses effets peut révéler des cibles d’intervention clés pour les programmes de prévention et de traitement axés sur la SA. Dans le présent article, je passe en revue les recherches fondamentales que nous avons menées pour comprendre les mécanismes qui relient la SA à ces troubles et à leurs symptômes. Je décris également les interventions transdiagnostiques ciblées sur la SA et j’illustre la manière dont la recherche fondamentale a permis d’orienter le contenu de ces interventions. Enfin, je passe en revue les projets en cours dans mon laboratoire et je souligne les orientations futures importantes dans ce domaine. Bien que des progrès considérables aient été réalisés au cours des trois dernières décennies et que la recherche ait considérablement fait avancer notre compréhension de la SA en tant que facteur transdiagnostique, de nombreuses questions restent en suspens. Les réponses devraient nous aider à affiner les interventions afin d’en faire bénéficier au maximum les personnes qui ont une grande peur d’avoir peur.
... So weisen sie oftmals Defizite in einer Vielzahl von sozialen, kognitiven und emotionalen Entwicklungsbereichen sowie ein erhöhtes Risiko für die Entwicklung einer eigenen Suchterkrankung oder anderen psychischen Störung auf [3,12]. Im Vergleich zu Kindern von Eltern ohne Suchtproblematik treten bei betroffenen Kindern und Jugendlichen häufiger affektive Störungen [13,14] sowie externalisierende Verhaltenstendenzen auf [15,16]. Kinder und Jugendliche aus suchtbelasteten Familien weisen damit einhergehend eher Symptome wie mangelndes Mitgefühl mit anderen, verminderte soziale Leistungen und zwischenmenschliche Anpassung, geringes Selbstwertgefühl und mangelnde Kontrolle über die Umgebung auf [17]. ...
Article
Zusammenfassung Hintergrund Eltern mit einer Drogenabhängigkeit sind häufig in ihren elterlichen Kompetenzen eingeschränkt. Die Lebenswelt von Kindern, die in suchtbelasteten Familien aufwachsen, ist oft prekär, insbesondere wenn diese von der Drogensubkultur geprägt ist. Gleichzeitig stehen für Mütter und Väter mit Drogenproblemen in Deutschland keine evidenzbasierten, standardisierten Interventionen zur Verfügung. Methode Mit SHIFT PLUS wurde ein modularisiertes Gruppenprogramm für drogenabhängige Eltern mit Kindern bis 8 Jahren entwickelt, welches ihre Elternkompetenzen und die Familienresilienz stärken sowie ihre Bereitschaft bzw. Fähigkeit zur Abstinenz fördern soll. Das Training basiert auf dem bestehenden „SHIFT“-Elterntraining für Crystal Meth-konsumierende Eltern und wurde für den gesamten Bereich der Abhängigkeit von illegalen Substanzen erweitert sowie um Module für Angehörige ergänzt. Die Umsetzung des Programms erfolgte an acht Praxisstandorten im Bundesgebiet in Kooperation von Sucht- und Jugendhilfeeinrichtungen mit N=87 teilnehmenden Eltern. Zur Evaluation der kurzzeitigen Wirkeffekte wurde ein quasi-experimentelles Forschungsdesign mit Interventions- und Wartekontrollgruppe zu zwei Messzeitpunkten realisiert. Ergänzend wurden Akzeptanz und Praktikabilität durch Teilnehmende und Trainer/innen bewertet. Ergebnisse Das SHIFT PLUS-Elterntraining zeigte sich als praktikabel und hoch akzeptiert von teilnehmenden Müttern und Vätern, die berichteten familiäre Herausforderungen subjektiv besser bewältigen zu können. Die Wirksamkeitsevaluation zeigte zudem eine signifikante Reduktion depressiver Symptome in der IG sowie einen signifikant besseren Umgang mit dem Thema Sucht in der Familie. Ergänzend verbesserten sich beide Gruppen hinsichtlich psychischer Belastungen, Substanzkonsum und Elternkompetenz. Schlussfolgerung Die Intervention bietet eine innovative Ergänzung zur evidenzbasierten Unterstützung suchtbelasteter Familien in Deutschland. Sie ermöglicht eine systematische Förderung elterlicher Fähigkeiten und familiärer Resilienz unter Berücksichtigung einer kooperativen Versorgung durch Jugend- und Suchthilfe. Der direkte Einbezug von Angehörigen in das Training gestattet dieser Zielgruppe zudem einen direkten, niedrigschwelligen Zugang zum Hilfesystem.
... They also face a higher risk of early substance use involvement as well as mental health problems [4,5]. For instance, anxiety disorder [6], depression [7,8], attention-deficit/hyperactivity disorder [9,10] and also disturbed social behaviour [11,12] were more common in the children and adolescents of parents with substance use disorder (SUD) compared with the offspring of parents without SUD. ...
... Besides prenatal substance exposure that can have negative physical and developmental consequences [1,3,4], psychological effects may additionally impair the affected children's development. For example, children and adolescents affected by parental substance use show and conduct higher rates of emotional disorders, such as anxiety disorders and depression [5][6][7], social behaviour disorders [8,9], or hyperactivity disorders [10,11]. ...
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Background Children of substance-abusing parents are at a substantial risk of developing substance-use and other mental disorders. Children involved in substance abuse – not diagnosed with substance-use problems but integrated in psychiatric treatment or youth welfare services – constitute a particular high-risk group that is in need of substance use prevention. Emerging evidence indicates that self-regulatory determinants of substance use and other mental disorders, particularly stress reactivity, are modifiable by mindfulness-based interventions, such as mindfulness-based stress reduction. Methods In this ongoing cluster randomised-controlled trial, a mindfulness-augmented version of the modularised evidence-based “Trampoline” programme for children affected by parental substance use problems is evaluated in a sample of 420 children who are from substance-involved families, aged from 8 to 12 and receiving non-substance-specific care in psychiatric or youth welfare services. Larger effects on adaptive stress-coping strategies (primary outcome), internalising and externalising problem behaviours and distress due to parental substance use are expected compared to the standard “Trampoline”-programme version. Mindfulness components will be added and regularly practiced for 30 min in each validated “Trampoline” module. Moreover, the feasibility of mindfulness-based interventions in psychiatric care and youth welfare services for children suffering from emotional and behavioural problems will be investigated in this study. Discussion Despite recruitment challenges, this study provides a unique opportunity to develop and test a promising addiction-specific, mindfulness-based intervention for a target group at risk, i.e. children from substance-involved families. Trial registration The trial was registered in the German Clinical Trials Register on July 16th 2018 (trial registration number (TRN): DRKS00013533). Any important protocol modifications are to be reported immediately. Protocol version v.2.1, 15th April 2019.
... Furthermore, both cocaine (e.g., Parrott et al. 2003;Roozen et al. 2011) andalcohol (e.g., Eckhardt 2007;Giancola et al. 2002) administration studies have documented increases in negativity and hostility. Moreover, adult children of alcoholics (ACOAs) are more likely than non-ACOAs to report their parents as hostile, uncontrolled, and rejecting (MacPherson et al. 2001). It is possible that the overt hostile style of interparental conflict described by Ahrons (1981) and Camara and Resnick (1988) depicts many substance-abusing couples and may impact children's internalizing symptoms (Buehler et al. 2007;Denham et al. 2000). ...
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The present study examined whether emotional reactivity mediated the association between interparental violence, parental hostility, and children’s worrying among 90 youth living with substance-abusing parents. Children completed measures of security and anxiety. Mothers and fathers’ completed measures of violence perpetrated toward their partners and general hostility. Results of a Bayesian mediation model revealed indirect effects such that after controlling for other variables in the model, fathers’ hostility was associated with greater emotional reactivity, which in turn was associated with children’s reports of worrying. The indirect effects of mothers’ hostility, parents’ interparental violence, and child age on children’s reports of worrying via children’s emotional reactivity were not statistically significant. Results suggest that fathers’ hostility is associated with children’s reports of worrying among children residing with a substance-abusing parent via associations with children’s emotional reactivity to parental conflict.
... Familial alcoholism has been found to be significant in the background of those who later develop eating problems (Coniglio, 1993), raising a further possible explanation for the co-prevalence. Coniglio has pointed out that the environment in families where alcohol is a problem is often " chaotic, unpredictable, and inconsistent " (1993, p. 236; cf.MacPherson et al., 2001). As a result, the needs of children in such families may not be adequately met or even recognized, leaving them vulnerable to alternative efforts to meet their emotional needs later in life. ...
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Although the precise rates of substance use problems among people with disordered eating have varied across studies, one consistent finding is elevated rates of alcohol problems (Wilson, 1993). Up to 55 per cent of women presenting for treatment of bulimia nervosa have met the diagnostic criteria for alcohol abuse (Wilson, 1993). Although most research has focused on the co-prevalence of eating disorders and alcohol problems,women with eating disorders also appear to be at increased risk for abusing a variety of substances other than alcohol, including amphetamines, barbiturates, marijuana, tranquilizers and cocaine (Holderness et al., 1994). Across studies, about one-quarter of women with bulimia report a past or current history of using drugs other than alcohol (Frank et al., 1991;Weiss & Ebert, 1983). Typically, the greatest association between substance use problems and eating disorders has been found among women with bulimia nervosa or the binge-eating/purging subtype of anorexia nervosa, rather than women with the restricting subtype of anorexia (Garfinkel et al., 1980; Garner et al., 1985). Not only have high rates of substance use problems been observed in samples of women with eating disorders, but the converse is also true: high rates of disordered eating have been reported among groups of women with substance use disorders(Holderness et al., 1994; Wilson, 1993). For example, Taylor et al. (1993) found that women with alcohol problems are more likely to experience eating disorders than women in the population at large. About 30 to 40 per cent of women being treated for an alcohol problem report a history of disordered eating. There are advantages to conceptualizing both drinking and eating problems as part of a continuous—as opposed to categorical—framework. Drinking has been posited to lie on a continuum, with non-drinkers at one end and people with severe alcohol dependence at the other (Sobell & Sobell., 1993a, b). Similarly, Garner and his colleagues (1983) have characterized eating problems as occurring on a continuum, with anorexia and bulimia representing the extreme end of the spectrum of preoccupation with weight that is ubiquitous among women in our culture (see also Brown, 1993). Adopting this perspective acknowledges that most women who struggle with problem eating and alcohol use fall outside clinical definitions of these problems—and are therefore usually excluded from research on the topics. Their subsequent invisibility in co-prevalence research means that evidence-based health service planning does not respond to the needs of women at all levels of risk. Similarly, research would benefit substantially by changing the focus from scrutinizing rates of co-occurring diagnoses to examining the mechanisms that account for the overlap of eating problems and substance use problems at all levels of severity.
... Of note, adolescent COAs report more parental hostility, less parental attachment and warmth, more adolescent-parent conflict, and fewer interactions with their parents in comparison to non-COAs (Barnow et al., 2002). Because of the negative behaviors associated with parental problem drinking (e.g., neglect, abuse, rejection) (MacPherson, Stewart, & McWilliams, 2001), youth with a substance abusing parent simply may be less attached to that parent and therefore, may experience less separation anxiety in relation to that parent. Simply put, some youth may need to feel emotionally close to and attached to a parent for the development of separation anxiety disorder. ...
Article
This study examined the effects of both paternal problem drinking and maternal problem drinking on adolescent internalizing problems (depression and anxiety symptomatology). Surveys were administered to 566 10th and 11th grade students from the Mid-Atlantic region of the U.S. in the spring of 2007 and again in the spring of 2008. Although significant main effects were not observed, significant interactions were found between paternal problem drinking and maternal problem drinking for internalizing problems, especially for boys. In general, these interactions indicated that when paternal problem drinking was high, depression symptomatology and anxiety symptomatology were lower if maternal problem drinking was low. Findings from this study highlight the need to consider both paternal and maternal problem drinking when examining the effects that parental problem drinking may have on adolescent adjustment. Copyright © 2015 Elsevier Ltd. All rights reserved.
... The effects of living with a substance-using parent has been found to contribute to social and emotional problems, including social isolation, difficulties developing relationships with adults and peers, academic difficulties, and negative emotions, such as shame, guilt, fear, anger, and embarrassment (Council of Australian Governments, 2009;Velleman & Templeton, 2007). Children of parents with SUDs are at an increased risk of earlier onset of substance use, developing a SUD, and developing internalizing (e.g., anxiety and depression) and externalizing (e.g., conduct disorder and aggression) disorders (Chassin, Pitts, Delucia & Todd, 1999;Johnson & Leff, 1999;Kilpatrick et al., 2000;Lander, Howsare & Byrne, 2013;MacPherson, Stewart & McWilliams, 2001;Merikangas et al., 1998;Pears, Capaldi & Owen, 2007;Reich, Earles, Frankel & Shayka, 1993). ...
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Parental substance use disorders (SUDs) for Māori, the indigenous people of Aotearoa/New Zealand and an ethnic minority, are considered to be contributors to adverse effects on outcomes for their children. This article offers a review of international and Aotearoa literature in regard to key considerations for Māori parents with SUDs who present to an Alcohol and Drug specialist for assessment and treatment. Factors to increase positive outcomes for Māori children of parents with SUDs are promoted. Effective adult AoD services provide support to parents with SUDs through comprehensive assessment and intervention plans that consider both individual and familial risk and protective factors. In this context, it is imperative that possible child welfare issues are identified early to ensure prevention or intervention. The AoD workforce must have the knowledge and skills to facilitate access to other relevant sectors, such as education, employment, and housing. An AoD workforce that is effective with Māori must not only have these abilities, but also have at least some basic knowledge and skills in Whānau Ora philosophy and Whānau-centered best practice. To address these processes, AoD specialist services need to acquire a set of knowledge and skills. These include increasing the knowledge and skills associated with the realities of lifestyles centered in low socioeconomic communities and co-occurring issues that contribute to poor health outcomes. To assist Māori, several key processes are proposed. This includes working in a Whānau-centered approach with Whānau as a collective entity, based on Māori foundations; understanding intergenerational dynamics; and endorsing a group capacity for self-determination. Research and training in Whanau ora philosophy and Whānau-centered best practices will be essential for developing an appropriate AoD workforce, which would provide the foundations for improving AoD service delivery for Māori parents with SUDs.
... 77 In college they are found to suffer more from stress than their peers do. 78 They are then more likely as adults to go on to develop anxiety disorders 79 . According to a literature review done by John Baer in 2002 very little research on the genetics of alcoholism has focused specifically on college students as a clinical population. ...
... This is similar with the result of the study by Moos and Billings,26) reporting that there is a significant possibility that children with parental drinking problems will have emotional problems. MacPherson et al. 27) also stated that a parent's drinking problem is one of the factors that aggravates their children's anxiety. ...
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It has been reported that children with parental drinking problems are at increased risk of drinking problems or psychiatric diseases in adulthood. The present study was conducted to examine the psychiatric characteristics of high school students according to paternal drinking problems. The subjects were 950 high school students (390 male and 560 female). The paternal drinking problems were assessed by using the Father-Short Michigan Alcoholism Screening Test. The Alcohol Use Disorders Identification Test, Beck's depression inventory, and Beck's anxiety inventory were used to evaluate the drinking behavior, depression, and anxiety of high school students. While male students with paternal drinking problems showed significantly increased risk of anxiety (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.05 to 4.63), female students with paternal drinking problems showed significantly increased risk of depression (OR, 1.84; 95% CI, 1.24 to 2.74) according to the results of logistic regression analysis with adjustments for participants' age, whether they live together with parents, their religion, club activities, and smoking habits on the basis of students without paternal drinking problems. The above results suggest that paternal drinking problems lead to unstable mentalities in both male and female students, and that a family physician should address the mental state of teenagers with paternal drinking problems during clinical encounters.
... An additional finding is the prediction of ASl scores through the frequency of exposure to parental uncontrolled behavior due to drunkenness andlor anger, as well as the report by individuals with elevated anxiety sensitivity of significantly more episodes of exposure (Watt et aI., 1998). Initial evidence has also been provided that anxiety sensitivity levels in young adulthood were related to retrospectively reported childhood exposure to parental problem-drinking behaviors (MacPherson, Stewart, & McWilliams, 2001). This finding adds to the growing literature suggesting that acquired anxiety sensitivity may playa modest mediating role in explaining relationships between childhood learning experiences and anxiety-related . ...
Article
The psychometric properties of the Anxiety Sensitivity Index (ASI) have been criticized. Although it has been the gold standard in research and assessment, its reliability (i.e., internal consistency) has been questioned. There are doubts about its ability to identify accurately the underlying factors for anxiety sensitivity. To provide a more accurate description of the anxiety sensitivity construct, Taylor and Cox (1998) developed the Anxiety Sensitivity Profile (ASP) and performed analyses based on a sample of 349 university students. The current study utilized a clinical sample to test the hypotheses that the ASP would have convergent validity with the ASI and discriminant validity with the trait version of the State-Trait Anxiety Inventory (STAl). This correlational study was conducted with a clinical sample of 105 adults, 19 to 65 years old, who have an anxiety disorder. Each subject completed the ASP, ASI, STAl, and the computerized version of the SClD-I/P. Results supported the hypotheses. Large correlations at the .01 level were found for the ASP and ASI total scores and ASP subscale scores. Modest correlations were found for the ASI and ASP total and subscale scores and the trait version of the STAl at the .05 level. Reliability (internal consistency) for the ASI total scores and ASP subscales was high. Therefore this study provides evidence for convergent validity with the ASI. It also provides necessary, although not sufficient evidence for construct validity for the ASP subscales. Internal consistency reliability cannot be determined for all of the underlying domains of the ASI, because one of the domains consists of only one item. This evidence implies that the ASP is psychometrically superior to the ASI for research and treatment. Instead of the three underlying factors of the ASI, six factors are implied. Evidence is provided through convergent validity and internal consistency reliability found for the six ASP subscales. It is speculated that utilization of the ASP will support improved consistency in research through the use of congruence (i.e., matching the symptoms caused by a provocation task and the symptoms a person fears). Furthermore the ASP will support accurate identification of the domains underlying anxiety sensitivity that contribute to its association with all anxiety disorders. Finally, there are applied implications. These include the fact that those at risk can be identified and given brief cognitive-behavioral therapy as a preventive intervention. Also, treatment can target congruent cognitions, and elevated anxiety sensitivity at the end of treatment can be targeted for further interventions.
... Thus, one direction for future research is the examination of potential specificity in the relationships of various learning experiences related to pain and anxiety with particular AS and IS lower-order dimensions. Previous research (e.g., MacPherson, Stewart, & McWilliams, 2001; Watt & Stewart, 2003) has found that exposure to parental loss of control experiences due to drinking has a specific association with AS-Psychological (vs. Physical or Social) Concerns. ...
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Health anxiety refers to the preoccupation with and fear of bodily sensations arising from catastrophic misinterpretations about the significance of these sensations (Hadjistavropoulos, Asmundson, & Kowalyk, 2004). Constructs theoretically relevant to the development of both health anxiety and chronic pain are two of the putative "fundamental fears" identified by Reiss (1991)—anxiety sensitivity (AS) and illness/injury sensitivity (IS) (Cox, Borger, & Enns, 1999; Vancleef, Peters, Roelofs, & Asmundson, 2006). The learning history origins of AS have been examined in a series of studies (Stewart et al., 2001; Watt & Stewart, 2000; Watt, Stewart, & Cox, 1998); however, no studies have examined the learning history antecedents of IS. The present retrospective study compared the relative specificity of learning experiences related to the development of AS and IS in a sample of 192 undergraduates (143 women and 49 men). Structural equation modeling supported nonspecific paths from both anxiety-related and aches/pains-related childhood learning experiences to AS and a more specific path from aches/pain-related childhood learning experiences to IS. Results suggest that the developmen-tal antecedents of IS are more specific to learning experiences around aches and pains, whereas the developmental origins of AS are more broadly related to learning experiences around bodily sensations.
... Anxiety sensitivity is a stimulus-outcome expectancy that reflects individual differences in the propensity to experience fear in response to one's arousal-based bodily sensations (Reiss & McNally, 1985). Individual differences in anxiety sensitivity arise from both genetic predispositions (Stein, Jang, & Livesley, 1999) and adverse learning experiences (MacPherson, Stewart, & McWilliams, 2001;Stewart, Taylor, et al., 2001;Watt & Stewart, 2000;Watt, Stewart, & Cox, 1998). There is a variety of evidence that indicates anxiety sensitivity may be a risk factor for panic pathology. ...
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An integrated theoretical conceptualization of the cooccurrence of panic disorder and smoking (PDSM) is presented. First, the nature and prevalence of this apparently costly, yet largely unrecognized, co-occurrence of health care problems is described. Second, a theoretical analysis regarding how smoking may negatively impact panic disorder is described. Third, the negative impact of panic disorder on smoking outcomes is discussed. Finally, primary implications of this conceptualization for the research and treatment of individuals with PDSM are elaborated, including the need to assess for smoking among persons with panic disorder and the potential need for specialized treatment approaches.
... These results support and extend previous research on college student ACOAs that found ACOAs reported lower quality of relationships to their mothers and fathers on the IPPA-R (which assesses trust, communication and alienation; Kelley et al., 2010). Prior research has shown that alcohol-abusing fathers are less sensitive (Cavell, Jones, Runyan, Constantin-Page, & Velasquez, 1993) and more rejecting (Cavell et al., 1993;MacPherson, Stewart, & McWilliams, 2001) than non-alcohol-abusing fathers. Similarly, Gallant et al. (1998) found 90% of parents who took part in residential treatment for alcohol abuse reported inappropriate parenting (e.g., parental-child role reversal). ...
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... As hypothesized, ACOAs also reported less positive relationships (i.e., less trust, poorer communication, and greater alienation) to mothers, fathers, and peers. These results are not surprising given that alcohol-abusing fathers appear less sensitive (Cavell, Jones, Runyan, Constantin-Page, & Velasquez, 1993;Eiden et al., 2002), more rejecting (Cavell et al., 1993;MacPherson, Stewart, & McWilliams, 2001), and report more negative responses to child misbehavior (Fals-Stewart, Kelley, Fincham, Golden, & Logsdon, 2004) than non-alcohol-abusing fathers. Moreover, Kelley et al. (2007) found that ACOA women, whose fathers were typically reported as the substanceabusing parent, reported poorer quality of affective relationships and less support from their fathers. ...
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... Baron and Kenny (1986) noted that any degree of reduction in the relationship between the criterion and the predictor is evidence of partial mediation; ALCOHOL, CARDIOVASCULAR REACTIVITY AND AGGRESSION 89 however, objective rules to what amount of reduction is theoretically noteworthy are not readily available. Two recent studies in the alcohol literature (Kushner et al., 2001;MacPherson et al., 2001) recommended two objective criteria: first, that the relation between the predictor and the criterion loses statistical significance when the mediator is controlled for, and secondly, that the magnitude of the relationship between the predictor and the criterion is diminished by at least 30% when the mediator is controlled for. Our mediation analyses met both objective criteria. ...
... 52 Internalising child behaviour problems may also be related to specific child temperament characteristics, 53 or to aspects of parent-child interaction not focused in the present study, such as parental hostile, uncontrolled and rejecting behaviour. 54 Previous studies have indicated that maternal depression is an important predictor of internalised problems in children of alcohol abusing fathers. 3,12,35 In the present study, however, additional analyses showed no association between internalised child behaviour problems and the mothers' scores on the SCL-90 depression scale. ...
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This study examines possible risk factors associated with child adjustment in a sample of children with alcohol abusing fathers in Norway (N = 37). Factors included are socio-economic status, severity of the fathers' alcohol abuse, parental psychological problems, and family functioning. Children of alcohol abusing fathers were found to have more adjustment problems assessed by CBCL compared to a general population sample. The findings further suggest that child adjustment in families with paternal alcohol abuse is the result of an accumulation of risk factors rather than the effects of the paternal alcohol abuse alone. Both general environmental risk factors (psychological problems in the fathers, family climate, family health and conflicts) and environmental factors related to the parental alcohol abuse (severity of the alcohol abuse, the child's level of exposure to the alcohol abuse, changes in routines and rituals due to drinking) were related to child adjustment. The results indicate the need to obtain both parents' assessments of child adjustment, as the fathers' assessment was associated with different risk factors compared to the mothers'.
... Endler, & Norton, 1994;Whittal, Suchday, & Goetsch, 1994), the association of panic attacks and dispositional risk factors such as anxiety sensitivity (Cox, Endler, Norton, & Swinson, 1991;Deacon & Valentiner, 2001;Donnell & McNally, 1990;Watt, Stewart, & Cox, 1998;Zvolensky & Raulin, 1999), as well as the incidence of panic attacks in other conditions, particularly Substance Use Disorders (e.g., MacPherson, Stewart, & McWilliams, 2001;Norton, Block, & Malan, 1991;Norton, Malan, Cairns, Wozney, & Broughton, 1989). Despite its popularity, several researchers have rightly cautioned the potential limits of the instrument in regard to sensitivity and specificity (Brown & Cash, 1989;Wilson, Sandler, Asmundson, Larsen, & Ediger, 1991). ...
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Since its development in the mid-1980s, the Panic Attack Questionnaire (PAQ) has been one of the more, if not the most, commonly used self-report tools for assessing panic attacks. The usage of the instrument, however, has come amid potential concerns that instructions and descriptions may lead to an over-estimate of the prevalence of panic attacks. Furthermore, the instrument has not been revised since 1992, despite changes in DSM-IV criteria and more recent developments in the understanding of panic attacks. As a result, this paper describes a revision of the PAQ to improve the instruction and descriptive set, and to fully assess features of panic derived from recent conceptualizations. Students meeting DSM-IV panic attack criteria and those endorsing panic attacks, but not meeting criteria, showed few differences with the exception that those not meeting DSM-IV criteria typically reported a longer onset-to-peak intensity time than did Panickers. Results were cross-validated and extended using an independent Community Sample. A full descriptive phenomenology of panic attacks is described, and future directions for studying panic attacks using the PAQ are presented.
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Das Versorgungssystem für Menschen mit alkoholbezogenen Störungen in Deutschland umfasst eine Vielzahl von differenzierten Angeboten, ist jedoch aufgrund historisch gewachsener Strukturen und den spezifischen Zuständigkeiten der Leistungsträger stark fragmentiert. Zu unterscheiden sind die speziell für Menschen mit Störungen durch Alkoholkonsum (SdA) ausgerichteten Systeme der Suchtberatung, der suchtmedizinischen, suchtpsychiatrischen, suchttherapeutischen, und suchtrehabilitativen Behandlung einerseits, von Hilfesystemen mit anderen Schwerpunkten in der Aufgabenstellung, Kompetenz und Verantwortung, wie z. B. medizinische Versorgung (durch niedergelassene ÄrztInnen und Allgemeinkrankenhäuser), die ambulante psychotherapeutische Versorgung, die Altenhilfe, die Jugendhilfe, die Wohnungslosenhilfe, das System der Arbeitslosenhilfen (z. B. Jobcenter, Agenturen für Arbeit) usw. andererseits (DHS, 2019).
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Background Parental substance misuse is reported to endanger the health and psychological development of children and adolescents. The aim of the present study was to address conceptual and methodological problems in estimating the number of children affected by parental substance misuse (CaPSM) and offer a novel approach based on survey data. Methods Data came from the 2018 German Epidemiological Survey of Substance Abuse (ESA) among 18- to 64-year-olds (n = 9267) and from population statistics. DSM-IV diagnostic criteria were used to assess substance use disorder (SUD) related to tobacco, alcohol, cannabis, cocaine or amphetamine. Based on the number of household members, the number of children below age 18 years and the information on SUD status of the respondent living in this household, the number of children currently living in households with at least one member with SUD was estimated. Results In 2018, there were 13,597,428 children younger than 18 years living in Germany. Of these, 6.9–12.3% (935,522–1,673,103) were estimated to currently live in households where at least one adult had a tobacco use disorder, 5.1–9.2% (688,111–1,257,345) in households where at least one adult had an alcohol use disorder and 0.6–1.2% (87,817–158,401) in households where at least one adult had a disorder related to the use of illicit drugs. The total number of children currently living with SUD adults in their household was estimated at 11.2–20.2% (1,521,495–2,751,796). Conclusions Available estimates are difficult to interpret and to compare due to a lack of clear case definitions and methodological approaches with various biases and limitations. Future estimates need to provide precise case definitions and standard approaches.
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Background Parental substance misuse is reported to endanger the health and psychological development of children and adolescents. The aim of the present study was to estimate the number of children currently affected by substance use disorders (SUDs) of any adult living in the same household. Methods Data came from the 2018 German Epidemiological Survey of Substance Abuse (ESA) among 18-64-year-olds (n = 9,267) and from population statistics. DSM-IV diagnostic criteria were used to assess SUD (abuse or dependence) related to tobacco, alcohol, cannabis, cocaine or amphetamine. Based on the number of household members, the number of children below the age 18 years and the information on SUD status of the respondent living in this household, the number of children in households with at least one member with SUD was estimated. Results In 2018, there were 13,597,428 children younger than 18 years living in Germany. Of these, 5.2–7.9% (686,482–696,279) were estimated to live in households where at least one adult had an alcohol-related disorder, 5.0–7.4% (674,065–690,792) in households where at least one adult was tobacco dependent and 0.38–1.05% (93,229–142,141) in households where at least one adult had a disorder related to the use of illicit drugs. The total number of children in close contact with SUD adults was estimated at 7.4–11.2% (1,000,725–1,522,667). Conclusions The large number of children affected by adults with SUD has implications for identification and prevention. Substantial variation in estimates, resulting from differences in methods, definition of exposure and exposure to whom, calls for international standardization in order to make estimates comparable.
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This study was aimed to investigate the relation between codependency and mental health and to get a idea dealing with social worker`s codependency for their healthy and professional caring, which is an important factor between social worker and client in social work practice. The subjects of this study consisted of 290 social workers working in social welfare facilities of Gangwon-do. The data were collected through self-reported questionnaires from Jun. to Oct., 2013. Results indicated that codependency showed over 50% of social workers were moderate-severe level and there were the significant correlation between codependency and mental health. Implications of findings of this study were discussed.
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In Germany little empirical research exists on interventions for children from substance-affected families and their regional distribution. In the course of developing and evaluating a modularized prevention program for affected children (project "Trampoline") a questionnaire study was conducted, surveying 48 institutions with outpatient programs for this target group. Results reveal that institutions mainly offer consecutive group interventions and individual counseling for children from substance-affected families. In contrast fixed-term, manualized and evidence-based programs are still scarce in Germany. Children are usually recruited via their substance-using parents in treatment centers or upon referral from a cooperating institution. Both an extension of existent cooperating networks and the use of innovative recruitment channels are recommended.
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Diese qualitative Studie untersucht den Zusammenhang zwischen dem Aufwachsen in einer alkoholbelasteten Familie und der Entstehung von psychischen Erkrankungen. Auf der Basis narrativer biographischer Interviews mit jungen Erwachsenen aus alkoholbelasteten Familien wurden in der Auswertung belastende biographische Kategorien erhoben. Daraus wurde ein fünfstufiges Modell der Angstentstehung abgeleitet. Die Ergebnisse ermöglichen ein vertieftes Verständnis für die therapeutische Arbeit mit Betroffenen und können auch für präventive Maßnahmen und Empowerment herangezogen werden.
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An integrated theoretical conceptualization of the cooccurrence of panic disorder and smoking (PDSM) is presented. First, the nature and prevalence of this apparently costly, yet largely unrecognized, co-occurrence of health care problems is described. Second, a theoretical analysis regarding how smoking may negatively impact panic disorder is described. Third, the negative impact of panic disorder on smoking outcomes is discussed. Finally, primary implications of this conceptualization for the research and treatment of individuals with PDSM are elaborated, including the need to assess for smoking among persons with panic disorder and the potential need for specialized treatment approaches.
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Familial alcoholism is associated with various types of psychopathology in offspring, yet most studies do not differentiate maternal from paternal alcoholism. The purpose of this study was to examine the influence of maternal and paternal alcoholism and gender on alcohol consumption, an alcohol-related self-cognition, and four types of psychopathologic symptoms in young adults. Data were drawn from a study designed to examine the role of the self-concept in alcoholism and recovery. The sample included young adults with a current DSM-IV diagnosis of alcohol dependence (n = 25), those with a history of DSM-IV alcohol dependence who were abstinent for at least 12 months (n = 18), and nonalcoholic controls (n = 23). Regression analyses showed that 1) alcoholism on the paternal side of the family independently predicted drinking behavior and symptoms of social phobia over and above the effects of current alcohol dependence, 2) neither alcoholism on the maternal nor paternal side of the family predicted the alcohol-related self-cognition score, and 3) alcoholism on the maternal side of the family predicted symptoms of major depression, generalized anxiety disorder, and obsessive-compulsive disorder, with women having more major depressive symptoms, and men with alcoholism on the maternal side having more anxiety symptoms. These findings suggest that maternal and paternal alcoholism may confer different risks to the offspring, and that risk may vary depending on the gender of the offspring. Results highlight the importance of examining the effects of maternal and paternal alcoholism separately in research, and have important implications for assessing risk for high levels of alcohol consumption and psychopathology.
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This study replicated and extended the work of C. F. Weems, S. L. Berman, W. K. Silverman, and E. T. Rodriquez (2002) by investigating relations between anxiety sensitivity (AS) and attachment dimensions in a sample of young adults. Two hundred and twenty-six undergraduate students completed self-report measures including the Anxiety Sensitivity Index and the measure of adult romantic attachment used by C. F. Weems et al. (2002). In order to investigate the association between AS and a different domain of attachment, a measure of adult attachment referring to close relationships was included. As defined by both measures, insecurely attached individuals, specifically those classified as preoccupied and fearful (i.e., those with negative Models of Self), reported significantly higher levels of AS than those with secure and dismissing attachment styles (i.e., those with positive Models of Self). Results indicated that across both measures the Model of Self attachment dimension accounted for unique variance in AS levels beyond that contributed by trait anxiety. The Model of Others attachment dimension had a more limited association with AS.
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The eight articles in this special issue on anxiety sensitivity (AS) and substance abuse provide provocative new information on the relationships, or lack of relationships, between AS and several types of substance use and abuse. The eight articles provide data that extend our understanding of the role of AS in substance abuse with younger people, people who use substances other than alcohol, people who have disorders comorbid with substance use disorders, and people who experience chronic headaches. In addition, one of the articles attempts to determine how AS develops in relationship to parental substance abuse. Finally, several of the studies show that the three Anxiety Sensitivity Index (ASI) subscales (physical concerns, social concerns, and psychological concerns) are uniquely associated with different aspects of substance use/abuse. Each of the articles is discussed as to its merits and potential domains that may require additional research. Finally, several general suggestions are provided for new directions that research on the relations of AS and substance use/abuse should take.
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Decreased sensitivity to alcohol has been demonstrated to be a predictor of alcoholism in humans, and variation in the gene-linked polymorphic region of the serotonin transporter (5-HTTLPR) is associated with the response to the motor-impairing effects of alcohol. In a nonhuman primate model of excessive alcohol intake, we have shown that decreased serotonin turnover is associated with both lower initial sensitivity to alcohol and higher prospective alcohol consumption using rhesus macaques. In addition, we have demonstrated that macaques separated from their mothers and reared in peer-only groups are more likely to consume alcohol as adults. To examine the relationship between serotonin transporter genotype, early rearing experience, and initial sensitivity to alcohol, peer- and mother-reared, adolescent, alcohol-naive rhesus macaques (n = 123) were rated for intoxication after intravenous administration of ethanol (2.2 g/kg and 2.0 g/kg for males and females, respectively) during two testing periods. Serotonin transporter (rh5-HTTLPR) genotype was determined using polymerase chain reaction followed by gel electrophoresis, and data were analyzed using ANOVA and the Mann-Whitney U test. Our analyses demonstrate an effect of serotonin transporter gene variation on ethanol sensitivity, such that animals homozygous for the l allele exhibited decreased sensitivity to the ataxic and sedating effects of alcohol. This effect remained after correction for blood ethanol concentrations and birth cohort. When animals were segregated according to rearing condition, serotonin transporter gene variation predicted intoxication scores among peer-reared animals. As in some human reports, this study demonstrates a diminution in the response to alcohol in animals homozygous for the l rh5-HTTLPR allele. The phenotypic expression of this genotype in l/s animals, however, is environmentally dependent.
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In the present study, the relationships among parental drinking, family environment, and child adjustment is investigated in a community sample of 207 10-14-year-olds. Multiple aspects of perceived family environment (e.g., cohesion, organization, conflict) as well as multiple indicators of adjustment (e.g., negative affect, feelings of competence, self-esteem) are taken into consideration. Parental alcohol problems are found to be associated with low family cohesion, poor family organization, and low global self-worth of the child. A mediational analysis reveals that the relation between parental drinking and low global self-worth is mediated by family cohesion.
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Expectancy theory posits that anxiety sensitivity may serve as a premorbid risk factor for the development of anxiety pathology (S. Reiss, 1991). The principal aim of the present study was to determine whether anxiety sensitivity acts as a specific vulnerability factor in the pathogenesis of anxiety pathology. A large, nonclinical sample of young adults (N = 1,401) was prospectively followed over a 5-week highly stressful period of time (i.e., military basic training). Anxiety sensitivity was found to predict the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety. Approximately 20% of those scoring in the upper decile on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1987) experienced a panic attack during the 5-week follow-up period compared with only 6% for the remainder of the sample. Anxiety sensitivity also predicted anxiety symptomatology, functional impairment created by anxiety, and disability. These data provide strong evidence for anxiety sensitivity as a risk factor in the development of panic attacks and other anxiety symptoms.
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Anxiety sensitivity (AS) is the fear of anxiety sensations which arises from beliefs that these sensations have harmful somatic, social, or psychological consequences. Over the past decade, AS has attracted a great deal of attention from researchers and clinicians with more than 100 peer-reviewed journal articles published. In addition, AS has been the subject of numerous symposia, papers, and posters at professional conventions. Why this growing interest? Theory and research suggest that AS plays an important role in the etiology and maintenance of many forms of psychopathology, including anxiety disorders, depression, chronic pain, and substance abuse. Bringing together experts from a variety of different areas, this volume offers the first comprehensive state-of-the-art review of AS--its conceptual foundations, assessment, causes, consequences, and treatment--and points new directions for future work. It will prove to be an invaluable resource for clinicians, researchers, students, and trainees in all mental health professions.
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The present study examines the relationship of familial and personality risk factors for alcoholism to individual differences in sensitivity to the positively and negatively reinforcing properties of alcohol. Sixteen sons of male alcoholics with multigenerational family histories of alcoholism (MFH) and 11 men who self-report heightened sensitivity to anxiety (HAS) were compared with 13 age-matched family history negative, low anxiety sensitive men (FH-LAS) on sober and alcohol-intoxicated response patterns. We were interested in the effects of alcohol on specific psychophysiological indices of “stimulus reactivity,” anxiety, and incentive reward. Alcohol significantly dampened heart rate reactivity to aversive stimulation for the MFH and HAS men equally, yet did not for the FH-LAS group. HAS men evidenced idiosyncrasies with respect to alcohol-induced changes in electrodermal reactivity to avenive stimulation (an index of anxiety/fear-dampening), and MFH men demonstrated elevated alcohol-intoxicated resting heart rates (an index of psychostimulation) relative to the FH-LAS men. The results are interpreted as reflecting a sensitivity to the “stimulus reactivity-dampening” effects of alcohol in both high-risk groups, yet population-specific sensitivities to the fear-dampening and psychostimulant properties of alcohol in the HAS and MFH groups, respectively.
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Anxiety sensitivity (AS; the fear of anxiety-related sensations) has been proposed as a risk factor for the development of panic disorder. The present study involved a conceptual replication of Ehlers' (1993, Behaviour Research and Therapy, 31, 269–278) study on childhood learning experiences and panic attacks, but also extended her work by investigating the relationship between early learning experiences and the development of AS, in a non-clinical sample. A sample of 551 university students participated in a retrospective assessment of their childhood and adolescent instrumental and vicarious learning experiences with respect to somatic symptoms (i.e. anxiety and cold symptoms, respectively) using an expanded version of Ehler's (1993) Learning History Questionnaire. AS levels were assessed using the Anxiety Sensitivity Index, and panic history was obtained using the Panic Attack Questionnaire, Revised. Contrary to hypotheses, the learning experiences of high AS individuals were not found to be specific to anxiety symptoms, but involved parental reinforcement of sick-role behavior related to somatic symptoms in general. High AS subjects reported both more anxiety and cold symptoms prior to age 18 than individuals with lower levels of AS. In addition, both cold and anxiety symptoms elicited more special attention and/or instructions from parents for high AS individuals to take special care of themselves. These findings are contrasted with the results for self-reported panickers who reported more learning experiences (modeling and parental reinforcement) specific to anxiety-related symptoms, than the non-panickers. The results suggest that higher-than-normal levels of AS may arise from learning to catastrophize about the occurrence of bodily symptoms in general, rather than anxiety-related symptoms in particular.
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A sample of 253 children of alcoholics (COAs) and 237 children of nonalcoholics (non-COAs) were compared on alcohol and drug use, psychopathology, cognitive ability, and personality. COAs reported more alcohol and drug problems, stronger alcohol expectancies, higher levels of behavioral undercontrol and neuroticism, and more psychiatric distress in relation to non-COAs. They also evidenced lower academic achievement and less verbal ability than non-COAs. COAs were given Diagnostic Interview Schedule alcohol diagnoses more frequently than non-COAs. The relation between paternal alcoholism and offspring alcohol involvement was mediated by behavioral undercontrol and alcohol expectancies. Although gender differences were found, there were few Gender X Family History interactions; the effects of family history of alcoholism were similar for men and women. When gender effects were found, they showed greater family history effects for women.
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In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
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Three potential sources of error in retrospective reports of childhood experiences are documented: low reliability and validity of autobiographical memory in general, the presence of general memory impairment associated with psychopathology, and the presence of specific mood-congruent memory biases associated with psychopathology. The evidence reviewed suggests that claims concerning the general unreliability of retrospective reports are exaggerated and that there is little reason to link psychiatric status with less reliable or less valid recall of early experiences. Nevertheless, it is clear that steps must be taken to overcome the limitations of retrospective reports and enhance their reliability.
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Expectancy theory posits that anxiety sensitivity may serve as a premorbid risk factor for the development of anxiety pathology (S. Reiss, 1991). The principal aim of the present study was to determine whether anxiety sensitivity acts as a specific vulnerability factor in the pathogenesis of anxiety pathology. A large, nonclinical sample of young adults (N = 1,401) was prospectively followed over a 5-week highly stressful period of time (i.e., military basic training). Anxiety sensitivity was found to predict the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety. Approximately 20% of those scoring in the upper decile on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1987) experienced a panic attack during the 5-week follow-up period compared with only 6% for the remainder of the sample. Anxiety sensitivity also predicted anxiety symptomatology, functional impairment created by anxiety, and disability. These data provide strong evidence for anxiety sensitivity as a risk factor in the development of panic attacks and other anxiety symptoms.
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The present study examines the relationship of familial and personality risk factors for alcoholism to individual differences in sensitivity to the positively and negatively reinforcing properties of alcohol. Sixteen sons of male alcoholics with multigenerational family histories of alcoholism (MFH) and 11 men who self-report heightened sensitivity to anxiety (HAS) were compared with 13 age-matched family history negative, low anxiety sensitive men (FH-LAS) on sober and alcohol-intoxicated response patterns. We were interested in the effects of alcohol on specific psychophysiological indices of "stimulus reactivity," anxiety, and incentive reward. Alcohol significantly dampened heart rate reactivity to aversive stimulation for the MFH and HAS men equally, yet did not for the FH-LAS group. HAS men evidenced idiosyncrasies with respect to alcohol-induced changes in electrodermal reactivity to aversive stimulation (an index of anxiety/fear-dampening), and MFH men demonstrated elevated alcohol-intoxicated resting heart rates (an index of psychostimulation) relative to the FH-LAS men. The results are interpreted as reflecting a sensitivity to the "stimulus reactivity-dampening" effects of alcohol in both high-risk groups, yet population-specific sensitivities to the fear-dampening and psychostimulant properties of alcohol in the HAS and MFH groups, respectively.
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Review of book, Kenneth J. Sher (Au.) Children of Alcoholics: A Critical Appraisal of Theory and Research. Chicago: University of Chicago Press, 1991, 256 pp., ISBN 0-87630-604-0. Reviewed by Ken C. Winters.
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The arrival of a book for review usually gives rise to pleasant anticipation, and whatever criticisms have to be made, it is that almost always possible to find some pleasant things to say. But finding praise for this tome is a problem — it is a volume too far. It is to be hoped that the authors
Article
Reviewed 23 studies with 18,627 Ss to explore 5 areas of the literature on nonclinical panickers (NCPs): (1) prevalence of panic attacks (PATs) and factors affecting prevalence rates, (2) panic symptom profile, (3) measures of psychopathology, (4) family history of PATs, and (5) psychophysiological responses to challenge tasks. Results suggest that (1) reported prevalence of PATs depends on the way PATs are defined and measured; (2) the symptom profile of nonclinical panic is consistent; (3) levels of associated depressed and anxious mood are consistent and show that the scores of NCPs fall between those of nonpanickers and clinical panickers; (4) NCPs, compared with nonpanickers, report a higher prevalence of family members experiencing PATs; and (5) psychophysiological responses to challenge tasks show both similarities and differences to those of nonpanickers and clinical patients. The requirement that nonclinical panic be spontaneous in nature is not valid. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
151 college students to whom the Anxiety Sensitivity Index (ASI) was administered in 1984 were retested in 1987 for anxiety sensitivity and tested for panic attacks, state-trait anxiety, and anxiety disorder history. ASI scores in 1984 predicted the frequency and intensity of panic attacks in 1987. Compared to Ss with low 1984 ASI scores, Ss with high 1984 ASI scores were 5 times more likely to have an anxiety disorder during the period 1984 to 1987. Test-retest reliability for the ASI across 3 yrs was .71. Data provide evidence for the stability of anxiety sensitivity over time and that the concept of anxiety sensitivity should be considered a personality variable. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Evaluated a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences), the Child Anxiety Sensitivity Index (CASI), in 76 7th–9th graders and 33 emotionally disturbed children (aged 8–15 yrs). The CASI had sound psychometric properties for both samples. The view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children was supported. The CASI correlated with measures of fear and anxiety and accounted for variance on the Fear Survey Schedule for Children—Revised and the State-Trait Anxiety Inventory for Children (Trait form) that could not be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorder in children is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A problem confronting the search for psychopathology-related genes concerns the difficulty identifying gene carriers. Psychiatric diagnosis provides imperfect identification of affected individuals, and unaffected gene carriers go undetected. Psychophysiological measures may assist molecular genetic investigations by indicating genetic susceptibility for psychopathology, thus increasing the probability of identifying affected and unaffected gene carriers. Research strategies based on these premises are applied to the study of psychoactive substance use disorders and schizophrenia. Data are presented illustrating (1) that individual differences in inhibitory control involving autonomic and antisaccade eye movement measures and the P3 component of the event-related potential may be sensitive to susceptibility for substance use disorders, and (2) that eye tracking variables may identify genetic risk for schizophrenia.
Article
Anxiety sensitivity (AS) is the fear of anxiety-related sensations arising from beliefs that these sensations have harmful physical, psychological, or social consequences. AS is measured using the Anxiety Sensitivity Index (ASI), a 16-item self-report questionnaire. Little is known about the origins of AS, although social learning experiences (including sex-role socialization experiences) may be important. The present study examined whether there were gender differences in: (a) the lower- or higher-order factor structure of the ASI; and/or (b) pattern of ASI factor scores. The ASI was completed by 818 university students (290 males; 528 females). Separate principal components analyses on the ASI items of the total sample, males, and females revealed nearly identical lower-order three-factor structures for all groups, with factors pertaining to fears about the anticipated (a) physical, (b) psychological, and (c) social consequences of anxiety. Separate principal components analyses on the lower-order factor scores of the three samples revealed similar unidimensional higher-order solutions for all groups. Gender × AS dimension analyses on ASI lower-order factor scores showed that: females scored higher than males only on the physical concerns factor; females scored higher on the physical concerns factor relative to their scores on the social and psychological concerns factors; and males scored higher on the social and psychological concerns factors relative to their scores on the physical concerns factor. Finally, females scored higher than males on the higher-order factor representing the global AS construct. The present study provides further support for the empirical distinction of the three lower-order dimensions of AS, and additional evidence for the theoretical hierarchical structure of the ASI. Results also suggest that males and females differ on these various AS dimensions in ways consistent with sex role socialization practices.
Article
The purposes of this article are to summarize the author's expectancy model of fear, review the recent studies evaluating this model, and suggest directions for future research. Reiss' expectancy model holds that there are three fundamental fears (called sensitivities): the fear of injury, the fear of anxiety, and the fear of negative evaluation. Thus far, research on this model has focused on the fear of anxiety (anxiety sensitivity). The major research findings are as follows: simple phobias sometimes are motivated by expectations of panic attacks; the Anxiety Sensitivity Index (ASI) is a valid and unique measure of individual differences in the fear of anxiety sensations; the ASI is superior to measures of trait anxiety in the assessment of panic disorder; anxiety sensitivity is associated with agoraphobia, simple phobia, panic disorder, and substance abuse; and anxiety sensitivity is strongly associated with fearfulness. There is some preliminary support for the hypothesis that anxiety sensitivity is a risk factor for panic disorder. It is suggested that future researchers evaluate the hypotheses that anxiety and fear are distinct phenomena; that panic attacks are intense states of fear (not intense states of anxiety); and that anxiety sensitivity is a risk factor for both fearfulness and panic disorder.
Article
It is generally agreed that problems related to alcohol use and anxiety tend to occur within the same individual (“comorbidity”); however, the cause of this association remains controversial. Three prominent perspectives are that anxiety disorder promotes pathological alcohol use, that pathological alcohol use promotes anxiety disorder and that a third factor promotes both conditions. We review laboratory, clinical, family, and prospective studies bearing on the validity of these explanatory models. Findings converge on the conclusion that anxiety disorder and alcohol disorder can both serve to initiate the other, especially in cases of alcohol dependence versus alcohol abuse alone. Further, evidence from clinical studies suggests that anxiety disorder can contribute to the maintenance of and relapse to pathological alcohol use. Relying heavily on pharmacological and behavioral laboratory findings, we tentatively propose that short-term anxiety reduction from alcohol use, in concert with longer-term anxiety induction from chronic drinking and withdrawal, can initiate a vicious feed-forward cycle of increasing anxiety symptoms and alcohol use that results in comorbidity.
Article
The Michigan Alcoholism Screening Test and a shortened 13-item version can reliably be used as self-administered questionnaires.
Article
To the Editor— Although we welcome discussion of the relative merits of different research criteria for Psy chiatric diagnosis, the article by Drs Overall and Hollister in theArchives(36:1198-1205, 1979) "Comparative Evaluation of Research Diagnostic Criteria for Schizophrenia" troubles us for several reasons. First of all, the authors do not address the issue of the different purposes of various sets of research diagnostic criteria. Whereas the purpose of the actuarial approach taken by Drs Overall and Hollister is to simulate competent or expert clinical practice, the purpose of the Washington University criteria, research diagnostic criteria (RDC), and DSMIII criteria is to improve usual clinical practice by incorporating into the criteria distinctions that have been shown by research study to have some validity in terms of such variables as course, response to specific therapy, familial pattern, etc. Given this difference in purpose, it is hardly adequate to approach the evaluation
Article
In previous research adapted versions of the Short Michigan Alcoholism Screening Test (SMAST) have been employed to assess an individual's father's (F-SMAST) and mother's alcohol abuse (M-SMAST). However, to date psychometric information on these forms has been limited. In order to more broadly assess the psychometric properties of these forms, several critical issues in five related studies were addressed. The samples for the five studies were drawn from a college population at a large midwestern university. Overall, the reliability and validity of the adapted SMASTs appears to be quite good. The F-SMAST demonstrated high reliability (from the standpoint of internal consistency, temporal stability, and reliability across siblings) as well as validity (both in respect to convergence with an interview measure and with father's own report on a parallel instrument). Furthermore, shortening both of these instruments to nine-item versions appears to improve their reliability and validity. For researchers and clinicians interested in assessing parental history of alcoholism, the F-SMAST and M-SMAST would appear to be a reliable and valid paper-and-pencil measure.
Article
The issues confronting adult children of alcoholics (ACOA) are well publicized but their empirical basis remains limited. The screening of 250 consecutive psychiatric admissions to a general hospital revealed a significant prevalence of ACOAs across diagnoses. Compared to the other patients, the ACOA group was younger but with no other socioeconomic difference. The diagnoses of substance abuse and phobic disorders were more frequent. The group was psychiatrically hospitalized at an earlier age. The impact of an ACOA status varied with the parental biological relation and gender, and with the premorbid antecedents of parental alcoholism.
Article
Despite the variability in sampling and methodology, the majority of the family, twin and adoption studies suggest that alcoholism is familial, a significant proportion of which can be attributed to genetic factors. However, the specific components of alcoholism that may be inherited have yet to be identified. To date, there are no biological trait markers for which there is evidence for specificity for alcoholism. The three major levels of enquiry regarding possible mechanisms for the transmission of alcoholism and the involvement of genes and gene products in its development are factors related to exposure, metabolism, or pharmacological effects of ethanol. Exposure to ethanol is an obvious precondition for the development of tolerance and/or dependence. Therefore, identification of factors which enhance (or decrease) exposure are important goals of studies of the pathogenesis of alcoholism. It is likely that demographic, cultural and environmental factors (i.e. sex, age, religious affiliation, social group influences, income, availability of alcohol, etc.) play a crucial role in mediating exposure to alcohol. The key to alcoholism is likely to reside in the effects of alcohol on the brain. In contrast to nicotine, the opioids, and catecholamines, no specific receptor for ethanol has been found. Thus, one major focus of current research on possible central nervous system (CNS) mechanisms for the effect of alcohol includes assessment of the role of alcohol in the stimulation of brain reward or reinforcement systems. Alternately, alcohol may produce dependence by normalizing abnormal baseline states such as irritability, hyperexcitability, dysphoria, impulsiveness, or stress/tension level. The results of animal studies have yielded information on the central effects of alcohol including sensitivity of neuronal membranes, proteins, and ion channels to alcohol, and factors related to the binding and release of neurotransmitters and neuromodulators including dopamine, norepinephrine, gamma aminobutyric acid, pro-opiomelanocortin, glutamate receptors and the endorphin system (Institute of Medicine, 1987). In addition to possible genetic explanations for the strong degree of familial aggregation of alcoholism, alternative explanations need to be further evaluated. These include: modelling of parental behaviour; possible changes in the susceptibility of the foetus to alcohol as a result of in utero maternal ingestion of alcohol; results of negligent rearing manifested in dietary deficiency, exposure to toxic substances, or brain trauma, which so often characterize the homes of alcoholic parents; or damage to paternal germ cells from alcohol.
Article
Recent studies of the correlates of having an alcoholic relative have relied heavily upon study participants' reports of the drinking behavior of their parents and other near relatives. These investigations have rarely attempted to validate the reports of familial alcohol problems or report on the reliability of information across other family members. The present study examined the reliability of reports of parental drinking behavior in a sample of 88 sibling pairs on versions of the Short Michigan Alcoholism Screening Test adapted so that subjects endorsed items pertaining to their father's (F-SMAST) or mother's (M-SMAST) drinking behavior. Because of the relative infrequency of offspring reports of maternal problem drinking in this sample, only data from the F-SMAST were suited for analysis. Siblings' reports of specific paternal drinking consequences showed relatively low agreement on items requiring inference (e.g., the presence or absence of guilt) and relatively high agreement on items referring to specific behavioral acts or consequences (e.g., seeking help, being arrested, driving under the influence). Global judgments of paternal alcoholism and overall scores on the F-SMAST showed adequate levels of reliability. It is concluded that, although it is always desirable to validate offsprings' reports of relatives' drinking, such reports tend to agree with those of other siblings, and the use of these reports is reasonable when validation is impossible or unfeasible.
Article
A distinction is proposed between anxiety (frequency of symptom occurrence) and anxiety sensitivity (beliefs that anxiety experiences have negative implications). In Study 1, a newly-constructed Anxiety Sensitivity Index (ASI) was shown to have sound psychometric properties for each of two samples of college students. The important finding was that people who tend to endorse one negative implication for anxiety also tend to endorse other negative implications. In Study 2, the ASI was found to be especially associated with agoraphobia and generally associated with anxiety disorders. In Study 3, the ASI explained variance on the Fear Survey Schedule—II that was not explained by either the Taylor Manifest Anxiety Scale or a reliable Anxiety Frequency Checklist. In predicting the development of fears, and possibly other anxiety disorders, it may be more important to know what the person thinks will happen as a result of becoming anxious than how often the person actually experiences anxiety. Implications are discussed for competing views of the ‘fear of fear’.
Article
The children of Alcoholics Screening Test (CAST) and the Family Environment Scale were administered to 307 adults (M age = 27.6 years, 81% female, 89% White). Internal reliability estimates of the CAST were high (r = .98). Factor analysis of the CAST resulted in a four-factor solution, which accounted for 67% of the variability-Parental Problem Drinking, Personal Distress, Responsibility for Parental Drinking, and Alcoholic Mother. A canonical correlation between measures of family environment and the CAST factors showed that higher levels of conflict and lower levels of cohesion and expressiveness were stronger predictors of Personal Distress in the child than of Parental Drinking Behavior. The results suggest that distress in children of alcoholics may be more a function of an impaired family than of parental drinking behavior itself.
Article
Individuals with panic attacks evaluate physical anxiety symptoms as dangerous and tend to respond to them with fear. In a retrospective questionnaire study, we explored childhood and adolescent learning experiences with respect to somatic symptoms of panickers. Compared to normal controls (N = 61), patients with panic disorder (N = 121), infrequent panickers (N = 86) and patients with other anxiety disorders (N = 38) reported more frequent instances prior to age 18 when they had experienced symptoms like dizziness, shortness of breath, palpitations or nausea, accompanied by special attention from their parents and instructions to restrain from strenuous or social activities. The differences were due to higher symptom frequencies in the anxiety groups. All anxiety groups reported more frequent uncontrolled behavior of their parents than controls. Patients with panic disorder and infrequent panickers reported that their parents had suffered more frequently from physical symptoms typical of anxiety than patients with other anxiety disorders or normal controls. Panickers, but not patients with other anxiety disorders, had observed sick-role behavior related to panic symptoms in their parents more often than controls. Panic attack Ss reported a higher number of household members suffering from chronic illnesses than controls and patients with other anxiety disorders. No group differences were found in the reported behavior of parents when Ss had colds. Overall, the results point to the role of severe illnesses and physical symptoms typical of anxiety in significant others in the history of Ss with panic attacks. These experiences during childhood and adolescence may contribute to their belief that physical symptoms are dangerous. In contrast, there was no specificity for panic with respect to the Ss' own physical symptoms or cold-related symptoms.
Article
Survey data are presented on the associations between retrospectively reported childhood adversities and subsequent onset and persistence of DSM-III-R disorders. Data come from the US National Comorbidity Survey, a large survey of the US household population. Twenty-six adversities were considered, including loss events (e.g. parental divorce), parental psychopathologies (e.g. maternal depression), interpersonal traumas (e.g. rape) and other adversities (e.g. natural disaster). These adversities were consistently associated with onset, but not persistence, of DSM-III-R mood disorders, anxiety disorders, addictive disorders and acting out disorders. Most bivariate associations with onset attenuated in models that controlled for clustering of adversities and for lifetime co-morbidities among psychiatric disorders. Multivariate effects of adversities in logistic models were additive, which means that they have multiplicative effects on probability of disorder onset. Adversities showed little specificity. An analysis of time decay showed that the effects of childhood adversities on disorder onset persist beyond childhood. The existence of strong clustering among childhood adversities and lifetime co-morbidity among adult disorders means that caution is needed in interpreting the results of previous single-adversity single-disorder studies as documenting unique effects of specific childhood adversities on specific adult disorders. Future studies need to assess a broader range of adversities and disorders and to explore the existence and effects of commonly occurring adversity clusters. Replication is needed to verify that the effects of childhood adversities are mostly on first onset rather than on the creation of vulnerabilities that lead to increased risk of persistence.
Article
A problem confronting the search for psychopathology-related genes concerns the difficulty identifying gene carriers. Psychiatric diagnosis provides imperfect identification of affected individuals, and unaffected gene carriers go undetected. Psychophysiological measures may assist molecular genetic investigations by indicating genetic susceptibility for psychopathology, thus increasing the probability of identifying affected and unaffected gene carriers. Research strategies based on these premises are applied to the study of psychoactive substance use disorders and schizophrenia. Data are presented illustrating (1) that individual differences in inhibitory control involving autonomic and antisaccade eye movement measures and the P3 component of the event-related potential may be sensitive to susceptibility for substance use disorders, and (2) that eye tracking variables may identify genetic risk for schizophrenia.
Article
In attempting to explain the familial predisposition to panic disorder, most studies have focused on the heritability of physiologic characteristics (e.g., CO2 sensitivity). A heretofore unexplored possibility is that a psychological characteristic that predisposes to panic-anxiety sensitivity-might be inherited. In this study, the authors examined the heritability of anxiety sensitivity through use of a twin group. Scores on the Anxiety Sensitivity Index were examined in a group of 179 monozygotic and 158 dizygotic twin pairs. Biometrical model fitting was conducted through use of standard statistical methods. Broad heritability estimate of the Anxiety Sensitivity Index as a unifactorial construct was 45%. Additive genetic effects and unique environmental effects emerged as the primary influences on anxiety sensitivity. There was no evidence of genetic discontinuity between normal and extreme scores on the Anxiety Sensitivity Index. This study suggests that one psychological risk factor for the development of panic disorder-anxiety sensitivity-may have a heritable component. As such, anxiety sensitivity should be considered in future research on the heritability of panic disorder.
Article
This review describes the strategy of using elementary phenotypes for neurobiological and genetic linkage studies of schizophrenia. The review concentrates on practical aspects of selecting the phenotype and then understanding the confounds in its measurement and interpretation. Examples from the authors' studies of deficits in P50 inhibition and smooth pursuit eye movement dysfunction are presented. These two phenotypes share considerable similarity in their neurobiology, including a similar response to nicotine. They also appear to co-segregate with the genetic risk for schizophrenia as autosomal co-dominant phenotypes. Although most schizophrenic patients inherit these abnormalities unilinealy, i.e., from one parent, apparent bilineal inheritance produces a more severe illness, observed clinically as childhood-onset schizophrenia. The initial study showing linkage of the P50 deficit to the chromosome 15q14 locus of the alpha 7-nicotinic acetylcholine receptor is an example of the potential usefulness of these phenotypes for combined genetic and neurobiological study of schizophrenia.
Article
the present study investigated childhood learning experiences potentially associated with the development of elevated hypochondriacal concerns in a non-clinical young adult sample, and examined the possible mediating roles of anxiety sensitivity (i.e., fear of anxiety-related symptoms) and trait anxiety (i.e., frequency of anxiety symptoms) in explaining these relationships. 197 university students participated in a retrospective assessment of their childhood instrumental (i.e., parental reinforcement) and vicarious (i.e., parental modeling) learning experiences with respect to arousal-reactive (e.g., dizziness) and arousal-non-reactive (e.g., lumps) bodily symptoms, respectively. Childhood learning experiences were assessed using a revised version of the Learning History Questionnaire (LHQ), anxiety sensitivity levels with the Anxiety Sensitivity Index (ASI), trait anxiety levels with the State-Trait Anxiety Inventory-Trait (STAI-T) scale, and degree of hypochondriacal concerns with the Illness Attitudes Scale (IAS)-Total score. consistent with earlier findings [Watt MC, Stewart SH, Cox BJ. A retrospective study of the learning history origins of anxiety sensitivity. Behav Res Ther 1998; 36: 505-525.], elevated anxiety sensitivity levels were associated with increased instrumental and vicarious learning experiences related to both arousal-reactive and arousal-non-reactive bodily symptoms. Similarly, individuals with elevated hypochondriacal concerns also reported both more instrumental and vicarious learning experiences around bodily symptoms than did students with lower levels of such concerns. However, contrary to the hypothesis, the childhood learning experiences related to hypochondriacal concerns were not specific to arousal-non-reactive symptoms, but instead involved parental reinforcement and modeling of bodily symptoms in general (arousal-reactive and -non-reactive symptoms alike). Anxiety sensitivity, but not trait anxiety, partially mediated the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood. elevated anxiety sensitivity appears to be a risk factor for the development of hypochondriasis when learning experiences have involved both arousal-reactive and arousal-non-reactive bodily symptoms.
Article
We used structural equation modeling (SEM) to test the hypothesis that childhood instrumental and vicarious learning experiences influence frequency of panic attacks in young adulthood both directly, and indirectly through their effects on anxiety sensitivity (AS). A total of 478 university students participated in a retrospective assessment of their childhood learning experiences for arousal-reactive sensations (e.g., nausea, racing heart, shortness of breath, dizziness) and arousal-non-reactive sensations (i.e., colds, aches and pains, and rashes). SEM revealed that learning history for arousal-reactive somatic symptoms directly influenced both AS levels and panic frequency; AS directly influenced panic frequency; and learning history for arousal-non-reactive symptoms directly influenced AS but did not directly influence panic frequency. These results are consistent with the findings of previous retrospective studies on the learning history origins of AS and panic attacks, and provide the first empirical evidence of a partial mediation effect of AS in explaining the relation between childhood learning experiences and panic attacks in young adulthood. Implications for understanding the etiology of panic disorder are discussed.
Article
Anxiety sensitivity (AS), the tendency to interpret feelings of anxiety as dangerous, is a core dispositional trait in a well articulated and extensively studied cognitive model of proneness to anxiety disorder. In recent years, there has been an increasing body of findings that also links AS to the tendency to use alcohol in general and the tendency to use alcohol as a means of coping with negative affect in particular. We expand on this empirical base by proposing and testing a theoretical model in which anxiety symptoms mediate the association between AS and alcohol use. That is, we propose that AS promotes anxiety symptoms, which, in turn, promote alcohol use aimed at coping with anxiety and other negative affect states. Over a 1-year data collection period, we assessed 82 alcohol-dependent individuals shortly after they began an intensive alcoholism treatment program. Self-reported anxiety symptoms associated with distinct anxiety syndromes were obtained with reference to the month period preceding their entry into the treatment program. Other information, including the presence of withdrawal symptoms, was obtained via interview. We found that syndrome-related anxiety symptoms and Trait Anxiety, but not State Anxiety or withdrawal symptoms, mediated the significant association between AS and the self-reported tendency to use alcohol as a means of controlling anxiety symptoms. Demonstrating a similar pattern of findings, but much less robustly so, were tests of these mediator models using alcohol use aimed at coping with negative affect (vs. coping with anxiety per se) as an outcome. In discussing these findings, we attempt to further develop a coherent model that incorporates AS, anxiety symptoms, and drinking motives. Our findings suggest that these relationships may differ for negative affect not specifically related to anxiety. We also discuss the possible associations of AS to withdrawal symptoms implied by our findings.
Article
Anxiety sensitivity (AS) has been implicated in the etiology of anxiety and depressive disorders. Nonetheless, little is known about the developmental antecedents of AS or about its role as a mediator of emotional distress. To investigate these issues, 249 university students completed a battery of self-report measures. Regression analyses and partial correlations were used to evaluate hypotheses. Analyses revealed that exposure to parental threatening, hostile, and rejecting behaviors (1) predicted overall AS and (2) appeared differentially related to AS factors. Additionally, AS acted as a mediator between parenting and both current emotional distress and history of emotional disorder symptoms. These data support the notion that parental behaviors hypothesized as etiologic in the development of emotional disorders may also be etiologic in the development of AS and that AS may serve as a mediator between childhood experience and emotional distress.
Parental symptomatology and child anxiety: the role of trait anxiety and anxiety sensitivity (Summary)
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Hale, L. R., & Calamari, J. E. (1999). Parental symptomatology and child anxiety: the role of trait anxiety and anxiety sensitivity (Summary). Program and abstracts of the 19th National Conference of the Anxiety Disorders Association of America (p. 87). Rockville, Maryland, USA: Anxiety Disorders Association of America
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