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B J Cox

Publications and source records attributed to B J Cox.

99 records · Page 6Linked to original sources
PubMedDate not supplied

The symptom structure of panic attacks.

Panic attack symptomatology was investigated in 212 panic disorder patients (60 men, 152 women) using the Panic Attack Questionnaire, Feelings of helplessness and thoughts of escape had the highest mean severity ratings, but are not currently listed in the DSM-III-R. The DSM-III-R symptoms labeled choking or smothering sensations, paresthesias, nausea, and chest pain had low severity ratings. Evidence was obtained for a three-factor model of panic symptomatology consisting of dizziness-related symptoms, cardiorespiratory distress, and cognitive factors. These results provide only limited support for the current DSM-III-R symptom structure, and support the notion that panic disorder is a heterogeneous condition.

Adult↗
PubMedDate not supplied

Alexithymia in panic disorder and social phobia.

Two recent studies have found that small samples of panic disorder patients appear to have elevated levels of alexithymia and raised the possibility that panic patients may constrict emotional experience. An alternate hypothesis is that there is conceptual and measurement overlap between alexithymia and cognitive aspects of panic disorder, and panic patients may in fact score high on only one dimension of alexithymia. One hundred panic disorder patients and 46 social phobics completed the revised 20-item Toronto Alexithymia Scale (TAS) and several anxiety-related measures. Thirty-four percent of panic patients and 28.3% of social phobics were classified as alexithymics, a nonsignificant difference. However, the alexithymia dimension related to difficulties in identifying and differentiating emotions and physical sensations was significantly elevated as compared with the alexithymia dimension related to external-oriented thinking. The former dimension was also significantly correlated with anxiety measures. The apparent finding that a sizeable proportion of panic patients are alexithymic may be an artifact of conceptual and psychometric overlap with cognitive aspects of panic disorder, specifically the interoceptive focus and sensitivity often associated with panic attacks.

Adult↗
PubMedDate not supplied

Does the Beck Anxiety Inventory measure anything beyond panic attack symptoms?

The Beck Anxiety Inventory (BAI) has become a popular measure in anxiety assessment and the BAI does not overlap in content with measures of depression. There is also some factor analytic evidence to support this distinction. However, an inspection of the BAI's content indicates that many of its items resemble, or are identical to, the symptoms of panic attacks listed in the DSM-IV. Further empirical support for this suspicion is provided from the results of a factor analysis of the BAI items and the individual DSM-IV panic symptoms contained in the Panic Attack Questionnaire, using data from a sample of 157 panic disorder patients. A three-factor model (dizziness related, catastrophic cognitions/fear, cardiorespiratory distress) emerged that replicated a three-factor model of panic symptoms identified in earlier work with another panic disorder sample. All but one of the BAI items loaded highly on the three panic symptom clusters and no separate BAI factor was obtained. The BAI appears to be confounded with, or actually measures, panic attacks rather than anxiety in general. Several implications of this finding are discussed.

Adult↗
PubMedDate not supplied

Is self-criticism unique for depression? A comparison with social phobia.

BACKGROUND: This study further examined the diagnostic specificity of the self-critical personality dimension, as measured by the Depressive Experiences Questionnaire (DEQ; Blatt et al., 1976. The Depressive Experiences Questionnaire. Yale University Press, New Haven). METHODS: Patients with major depression (n=26) were compared to social phobia patients (n=32). RESULTS: Depressed patients scored significantly higher on the DEQ Self-Criticism dimension. However, when current level of depressed mood was controlled for, self-criticism was not a significant predictor of diagnostic status. Further, the level of DEQ self-criticism reported by patients with social phobia was almost three times greater than the level reported in an earlier diagnostic specificity study with panic disorder patients [Bagby et al., 1992. Diagnostic specificity of the dependent and self-critical personality dimensions in major depression. J. Affect. Disord. 26, 59-64]. LIMITATIONS: Only one measure of self-criticism was used in this study, and the research design was cross-sectional rather than prospective. CONCLUSIONS: Self-criticism is not unique to major depression, and this personality dimension may be implicated in other forms of psychopathology [Blatt, 1991. A cognitive morphology of psychopathology. J. Nerv. Ment. Dis. 179, 449-458]. Some cognitive features believed to play an important role in depression may also be salient in persons with social phobia.

Adult↗
PubMedDate not supplied

Psychopathological correlates of anxiety sensitivity: evidence from clinical interviews and self-report measures.

Most research on anxiety sensitivity (AS) and its relation to psychopathology has examined the Anxiety Sensitivity Index (ASI) in various clinical samples. The present study was the first to investigate psychopathological correlates of AS using self-report measures, the anxiety, somatoform, and substance use disorders sections of the Structured Clinical Interview for the DSM-IV (SCID), and open-ended interview questions about the subjective meaning and origins of AS. A college student sample (N=317) was used for the correlational analysis, and subsamples of high-AS (n=44) and low-AS (n=41) participants completed the interviews. Despite having an ASI score (Mean=35.0) that was equivalent to that observed in panic disorder samples, the screening questions in the clinical interview indicated that only 55% of high-AS participants had panic attacks and the diagnostic assessment indicated that only 30% met criteria for an anxiety disorder. Several findings suggested that AS, at least as measured by the ASI, was strongly related to anxiety disorder symptoms and diagnoses, although there was substantial variation within the anxiety disorder classifications. There was also evidence that AS might extend to a broader catastrophic style concerning bodily symptoms and health that go beyond anxiety symptoms per se. The subjective meaning of AS derived from the interview data stressed the need for a formal, structured interview of AS.

Adult↗
PubMedDate not supplied

An expanded anxiety sensitivity index: evidence for a hierarchic structure in a clinical sample.

Anxiety sensitivity (AS) is the fear of anxiety-related sensations. According to Reiss's (e.g., Reiss, 1991) expectancy theory, AS amplifies fear and anxiety reactions, and plays an important role in the etiology and maintenance of anxiety disorders, particularly panic disorder. Recent evidence suggests that AS has a hierarchical structure, consisting of multiple lower order factors, loading on a single higher order factor. If each factor corresponds to a discrete mechanism (Cattell, 1978), then the results suggest that AS arises from a hierarchic arrangement of mechanisms. A problem with previous studies is that they were based on the 16-item Anxiety Sensitivity Index, which may not contain enough items to reveal the type and number of lower order factors. Also, some of the original ASI items are too general to assess specific, lower order factors. Accordingly, we developed an expanded measure of AS--the ASI-R--which consists of 36 items with subscales assessing each of the major domains of AS suggested by previous studies. The ASI-R was completed by 155 psychiatric outpatients. Factor analyses indicated a four-factor hierarchical solution, consisting of four lower order factors, loading on a single higher factor. The lower order factors were: (1) fear of respiratory symptoms, (2) fear of publicly observable anxiety reactions, (3) fear of cardiovascular symptoms, and (4) fear of cognitive dyscontrol. Each factor was correlated with measures of anxiety and depression, and fear of cognitive dyscontrol was most highly correlated with depression, which is broadly consistent with previous research. At pretreatment, patients with panic disorder tended to scored highest on each of the factors, compared to patients with other anxiety disorders and those with nonanxiety disorders. These findings offer further evidence that Reiss's expectancy theory would benefit from revision, to incorporate the notion of a hierarchic structure of AS.

Adult↗
PubMedDate not supplied

Levels of anxiety sensitivity in relation to repressive and self-deceptive coping styles.

Levels of anxiety sensitivity (AS) were investigated in relation to self-deception and repression in 296 university students. It was hypothesized that a low level of AS, rather than constituting "normal" functioning, would be associated with more general response biases. Scores on the Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1987, 1992) were negatively and significantly correlated with measures of self-deception and denial. Individuals with low AS were significantly more likely to meet an operational definition of repression (i.e., low anxiety and high defensiveness), compared to mid AS and high AS groups. When confronted with a hypothetical health problem, individuals with low AS were less likely to choose a task-oriented response and more likely to choose denial and self-deceptive responses, compared to the other groups. These findings support the observations of Shostak and Peterson (1990) that low AS represents an extreme group that may not be indicative of normal functioning.

Adaptation, Psychological↗
PubMedDate not supplied

Future directions in anxiety disorders: profiles and perspectives of leading contributors.

Eight of the most influential clinicians and researchers in the study and treatment of anxiety disorders were identified by polling professional members of the Anxiety Disorders Association of America. These eight individuals are (in alphabetical order): James C. Ballenger, David H. Barlow, Aaron T. Beck, David M. Clark, Edna B. Foa, Rick G. Heimberg, Donald F. Klein, and Isaac M. Marks. Each offered their thoughts on a set of questions concerning the current and future status of the anxiety disorders field. Profiles and perspectives of these individuals are presented.

Anxiety Disorders↗