Cognitive behaviour therapy
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Comparative Study
Associations between dimensions of anxiety sensitivity and PTSD symptom clusters in active-duty police officers.
Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. ⋯ Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.
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Fear of movement/(re)injury is assumed to contribute to the development and maintenance of chronic low back pain (CLBP) in a subgroup of patients. Studying fear of movement/(re)injury with implicit attitude measures, without the awareness of the patient, might be a valuable addition to self-report questionnaires. The aims of the current study were to investigate whether CLBP patients demonstrate more implicit fear of movement/(re)injury than healthy controls, and whether 2 implicit measures are related to each other, and to an explicit self-report measure of fear of movement/(re)injury. ⋯ In general, no associations were found between the EAST and the GNAT, or between implicitly measured and self-reported fear of movement/(re)injury. One major caveat in drawing inferences from these findings is the poor reliability of these implicit measures. Research towards the psychometric properties of these measures should first be expanded before modifying, and applying, them to more complex domains such as fear of movement/(re)injury.
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Inter-rater reliability and accuracy are measures of rater performance. Inter-rater reliability is frequently used as a substitute for accuracy despite conceptual differences and literature suggesting important differences between them. The aims of this study were to compare inter-rater reliability and accuracy among a group of raters, using a treatment adherence scale, and to assess for factors affecting the reliability of these ratings. ⋯ The additional resources needed for a composite rating, a rating based on the average score of paired raters, may be justified by improved accuracy over individual ratings. The additional time required to arrive at a consensus rating, a rating generated following discussion between 2 raters, may not be warranted. Further research is needed to determine whether these findings hold true with other raters and treatment adherence scales.
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Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain-related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. ⋯ Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF-MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain-related fear as a mediating variable between AS and increased perceived pain intensity.
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Randomized Controlled Trial
The role of anxiety sensitivity in subjective and physiological responses to social and physical stressors.
This study examined the specificity of the relationship between anxiety sensitivity (AS), a measure of catastrophizing about arousal-related sensations, and pain responses, by examining the effect of AS on responses to stressors of a physical and social nature. Healthy men and women (n = 129) between the ages of 18 and 25 years were recruited from the community to participate in a study examining subjective, cognitive and behavioural responses to different types of stressors. Participants were randomly assigned to one of 3 groups: (i) a neutral condition in which they sat quietly and read a popular magazine; (ii) a social stress condition in which they anticipated having to give a self-disclosing speech; and (iii) a physical stress condition in which they were presented with 3 countdown to shock trials where a mild electrical shock was administered on the non-dominant arm. ⋯ Furthermore, AS was not shown to be directly associated with exaggerated subjective or physiological reactions to the physical stressor. These results indicate that the role of AS in pain responses may be mediated through a global effect on anxiety, and limited to the anticipatory stage of the pain experience. If future studies yield similar findings in pain patients, then they would suggest that interventions for helping individuals high in AS should focus on catastrophic thinking in anticipation of stressors in general, rather than on pain-specific stressors.