Faculty Bibliography

Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' (n = 14) performance was compared to that of matched normal controls (n = 14) while in Study 2 social phobic subjects (n = 24) were compared to matched normal controls (n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes

Used H. Levenson's (1973) Locus of Control Scales to assess perceptions of control in 14 individuals with panic disorder and 14 with social phobia, compared with 14 normal controls. Both anxiety disorder groups (ADGs) showed a lower sense of internal control compared with the controls. The 2 ADGs showed contrasting externality orientations. Panic-disordered Ss viewed events as proceeding in a random and uncontrollable way, while social phobics viewed events as controlled by powerful others. Partial correlations confirmed the unique relationship between each disorder and a particular externality orientation and indicated that low internal perceptions of control were strongly influenced by the presence of beliefs in chance and powerful others.

14 individuals with panic disorder and 14 normal controls performed 2 memory tasks: a high-speed recognition task that measured perceptual memory and a free recall task that measured semantic memory. Ss' memory for threatening, positive, and neutral words was evaluated. In contrast to normal controls, panic disorder Ss showed better perceptual memory and better semantic memory for threat words compared to positive and neutral words. Results suggest that panic disorder Ss engaged in preferential processing of threat information at both a perceptual and semantic level of analysis. The results do not support a 'cognitive avoidance' hypothesis, which predicts the inhibition of more elaborate and meaningful processing of threat stimuli in anxious Ss.

There is a lack of information about the precise strength of the relationship between chronic pain and depression. In a prior study, women with temporomandibular pain and dysfunction syndrome (TMPDS) had much higher scores than did controls on a measure of nonspecific psychological distress. The question arose as to whether rates of clinical depression are also unusually high in TMPDS patients. Their former treating clinician rates cases for likely lifetime presence or absence of depression. A subset of those rated as likely depressed then had their diagnoses verified independently through a structured clinical interview by a psychiatrist and clinical psychologist. Results revealed a minimum lifetime prevalence rate for major depression of 41%. A rate of this magnitude in TMPDS cases is clearly much higher than would be found for women of similar background in the general population

A cognitive-behavioral treatment program for panic disorder was delivered by staff members of a psychiatric center that traditionally uses pharmacological methods. Seven clinicians who were not previously exposed to behavioral techniques were trained by a behavioral psychologist to use a treatment program consisting of breathing control, cognitive restructuring, and exposure to panic-eliciting somatic cues. Of the 24 panic disorder patients treated as part of this training, 14 were panic-free after treatment and 3 showed moderate improvement and decreased frequency of panic. A case example of a 40-yr-old female demonstrates the application of behavioral techniques to individual patients. Discussion focuses on training in behavioral methods and problems in exporting behavioral technology to psychopharmacological treatment centers.

The prevalent use of life event category checklists to facilitate event recall may be one reason that previous studies find that life events play only a small and ambiguous role in the development of health problems. In this study, 136 persons with temporomandibular pain disorder syndrome (TMPDS) and 131 healthy controls reported the occurrence of life events in 10 monthly interviews, using an event category checklist. At the end of the study, they reported retrospectively and in detail about life events over the previous monthly periods. Only one quarter of the event categories appeared in both the monthly interviews and retrospective report for the same period. Detailed analyses revealed problems of inaccuracy inherent in checklists that exacerbate problems of recall. The findings indicate that checklist category approaches should not be used when the goal is to understand the role of stress in adverse health outcomes. Suggestions are made about more adequate methods

Some forms of anxiety and affective disorder, such as panic disorder and major depression, appear distinct, while other forms, such as generalized anxiety disorder and chronic depression or dysthymia, may lie on a continuum and blend with each other. However, even panic disorder and major depression have many common features. Moreover, for reasons not yet clear, they occur together frequently, and their combined occurrence in the same patient has been associated with greater severity and chronicity, decreased treatment responsiveness, and, possibly, increased familial prevalence of anxiety and/or depression. Finally, studies of primary care patients suggest the frequent occurrence of a mixed anxiety-depressive disorder that may often be subsyndromal by DSM-III-R criteria but is nevertheless associated with prominent distress and/or impairment