Biomedical subjects

J Gayle Beck

Publications and source records attributed to J Gayle Beck.

At least 19 recordsLinked to original sources

PubMed2006

Is the delay discounting paradigm useful in understanding social anxiety?

The delay discounting paradigm was used to examine its utility in understanding motivational factors among socially anxious individuals. Participants (n=88) who reported high and low levels of social anxiety were randomly assigned to either a social threat or non-threat condition and their subsequent rates of discounting were examined. A significant difference in rates of discounting was found between the high and low social anxiety groups within the non-threat condition, with high social anxiety participants showing increased discounting. This study suggests that a modified version of the delay discounting paradigm may be useful in understanding motivational factors in social anxiety.

Adolescent↗

PubMed2006

What factors are associated with the maintenance of PTSD after a motor vehicle accident? The role of sex differences in a help-seeking population.

To investigate potential sex differences in factors that are associated with chronic PTSD, data from 223 participants were examined using logistic regression analyses. Each participant had been involved in a serious motor vehicle accident (MVA), which had occurred at least 6 months earlier (range 6mos-37 years). Although men and women did not differ in the rate of diagnosed PTSD, four variables were found to interact significantly with sex in the prediction of chronic PTSD: peritraumatic experiences of helplessness, danger, and the certainty that one would die during the MVA and lack of employment. Follow up analyses indicated that although the peritraumatic experience variables were statistically significant, no notable differences emerged in the odds ratios of men and of women. In contrast, men who were unemployed were 9.94 times more likely to be diagnosed with PTSD, relative to men who were employed, while unemployed women were 2.85 times more likely to be diagnosed with PTSD, relative to women who were employed. Results are discussed in light of the role of functional limitations and their impact on the maintenance of PTSD in men and women.

Accidents, Traffic↗

PubMed2006

Screening for PTSD in motor vehicle accident survivors using the PSS-SR and IES.

The current study compares the total scores of two potential posttraumatic stress disorder (PTSD) screening tools, the Impact of Event Scale (IES) and the PTSD Symptom Scale, Self-Report (PSS-SR), to the Clinician-Administered PTSD Scale (CAPS) in a large sample of motor vehicle accident (MVA) survivors (N = 229, of whom 43% met criteria for PTSD). For the IES using a cutoff score of 27, sensitivity was .91, specificity was .72, and overall correct classification was .80. For the PSS-SR using a cutoff score of 14, sensitivity was .91, specificity was .62, and overall correct classification was .74. Compared to those in studies of other trauma populations, the identified IES cutoff score is somewhat lower for this population of MVA survivors and the identified PSS-SR cutoff score is consistent with previous findings. These data support the use of the IES and the PSS-SR as PTSD screening tools in MVA samples.

Accidents, Traffic↗

PubMed2006

Rebound effects following deliberate thought suppression: does PTSD make a difference?

This study was designed to examine the effects of deliberate suppression of trauma-related thoughts in 44 individuals who were PTSD+ and 26 individuals who were PTSD- following a motor vehicle accident (MVA). In an effort to resolve discrepancies in the literature, the PTSD- group was selected from the same help-seeking population as the patient group. Measures included the percentage of MVA-related thoughts, mood, perceived controllability of thoughts, and physiological arousal (heart rate, skin conductance, and two measures of facial EMG). Contrary to hypothesis, both PTSD+ and PTSD- groups showed a rebound in trauma-related thoughts following deliberate thought suppression. This rebound was associated with increases in negative affect, anxiety, and distress and diminished perceptions of controllability over thoughts. Examination of the physiological measures did not mirror the pattern noted for trauma-related thoughts, although the data suggest that suppression was associated with higher levels of frontalis EMG and possibly, reduced heart rate. The current study indicates that help-seeking individuals who are distressed about their psychological state following a serious MVA will show a rebound in MVA-related thoughts, irrespective of PTSD diagnosis. Implications for the study of thought suppression as a potential maintaining factor for trauma-related problems are discussed, with suggestions for future research.

Accidents, Traffic↗

PubMed2005

When the heat is on: romantic partner responses influence distress in socially anxious women.

This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed.

Adult↗

PubMed2005

Attentional biases in social anxiety and dysphoria: does comorbidity make a difference?

This study examined whether comorbid symptoms influence the attentional biases associated with social anxiety and dysphoria using the Emotional Stroop Task (EST). Participants were recruited into three groups: a Social Anxiety group, a Dysphoric group, and a Social Anxiety/Dysphoric group. Four types of stimulus words were used: social anxiety threat, depressive threat, neutral words, and positive words. It was hypothesized that the Social Anxiety group would display an attentional bias to emotionally threatening stimuli whereas neither the dysphoric nor the Social Anxiety/Dysphoric group would display an attentional bias. Results found that the Social Anxiety group took longer to color name social threat and depressive words, whereas neither the Dysphoric nor the Comorbid group displayed an attentional bias. These results are discussed in light of their implications for cognitive theories of social anxiety and depression.

Adult↗

PubMed2005

Cognitive aspects of anxiety and depression in the elderly.

Although older adults represent the fastest-growing segment of the population, we have just begun to understand the nature of anxiety and depression in this age group. In this review, current models of anxiety and depression are examined, with consideration of similarities and differences between data drawn from younger and older adults. Studies that look at the content of specific cognitions associated with anxiety, depression, and cognitive processes, such as attention and memory, are examined. Consideration is given to areas for clinical application and future research.

Affect↗

PubMed2005

Is the concept of "repression" useful for the understanding chronic PTSD?

Theories concerning the value of avoiding versus attending to trauma-related thoughts provide mixed support for specific coping strategies such as repression. The goal of this study is to examine the usefulness of the concept of repression in understanding chronic Posttraumatic Stress Disorder (PTSD). One hundred and fifty individuals who had been in a motor vehicle accident were included. Participants were classified into four groups (repressors, low anxious, high anxious, and defensively high anxious) based on methodology introduced by Weinberger et al. [J. Abnormal Psychol. 88 (1979) 369]. These four groups were compared on measures of PTSD symptomatology, anxiety, depression, and where appropriate, perceived pain and disability. Results revealed a fairly consistent pattern of group differences such that repressors reported fewer PTSD symptoms, fewer additional anxiety disorders, less depression, and less physical disability due to pain relative to the high anxious and defensively high anxious groups. Regression analyses examining the separate and interactive effects of anxiety and social desirability to predict PTSD symptomatology showed that the majority of the variance was explained by anxiety. In many respects, these data suggest that repression may not be a useful concept for understanding chronic PTSD.

Accidents, Traffic↗

PubMed2005

Post-traumatic stress disorder symptoms, pain, and perceived life control: associations with psychosocial and physical functioning.

The symptoms of PTSD and pain frequently co-occur following a traumatic event; however, very little is known about how these two conditions are associated with physical and psychosocial functioning. The current study intended to first examine the differential association of co-occurring pain complaints and PTSD symptoms with disability in the domains of psychosocial and physical functioning, and second, to test whether perceived life control is a mediator of these relationships. All participants experienced a motor vehicle accident (MVA) and reported pain due to accident-related injuries (n=183). Structural equation modeling was used to develop two models hypothesizing a relationship between PTSD symptomatology, pain severity, and perceived life control. Separate models were constructed for psychosocial and physical functioning, based on the hypothesis that pain and PTSD would be differentially related to disability in these two domains. Results suggested that more severe PTSD symptoms and greater pain complaints were related to psychosocial impairment, however, only pain was significantly related to impairment in physical functioning. Perceptions of life control were shown to further explain these interrelationships.

Accidents, Traffic↗

PubMed2005

Group Cognitive Behavioral Treatment for PTSD: Treatment of Motor Vehicle Accident Survivors.

Individual cognitive behavioral therapies (CBT) are now considered the first-line treatment for posttraumatic stress disorder (PTSD; Foa, Keane, & Friedman, 2000). As mental health reimbursement becomes more restricted, it is imperative that we adapt individual-format therapies for use in a small group format. Group therapies have a number of advantages, including provision of a natural support group, the ability to reach more patients, and greater cost efficiency. In this article, we describe the development of a group CBT for PTSD in the aftermath of a serious motor vehicle accident (MVA). Issues unique to the group treatment format are discussed, along with special considerations such as strategies to reduce the potential for triggering reexperiencing symptoms during group sessions. A case example is presented, along with discussion of group process issues. Although still in the early stages, this group CBT may offer promise as an effective treatment of MVA-related PTSD.

Journal Article↗

PubMed2004

Quality of life and post trauma symptomatology in motor vehicle accident survivors: the mediating effects of depression and anxiety.

We examined the respective contributions of depression, anxiety, and post-trauma symptoms, as these factors reduce quality of life (QOL) in 111 individuals who had experienced a serious motor vehicle accident. Correlations and structural equation modeling were used to evaluate whether the severity of posttraumatic stress disorder symptoms influences QOL directly, and whether depression and anxiety mediated this relationship. Results indicated that post trauma symptomatology has a negative effect on QOL, which is mediated by depression and anxiety.

Accidents, Traffic↗

PubMed2004

Understanding the pattern of PTSD symptomatology: a comparison of between versus within-group approaches.

This report examines the influence of statistical approach on patterns of Posttraumatic Stress Disorder (PTSD). In this report, 114 women and 51 men were assessed using both the Clinician Administered PTSD Scale (CAPS) and the Posttraumatic Symptom Scale-Self Report measure (PSS-SR). Data were examined using both a between-group and a within-group design. In the between-group approach, three subsamples were formed, representing full syndrome PTSD (fPTSD), partial PTSD (pPTSD), and no PTSD. The fPTSD and pPTSD groups differed on total scores on both PTSD measures, although differences were noted between clinician and self-report measures in specific symptom clusters. In the within-group approach, curve estimation techniques were used to examine linear versus quadratic fit of the data, utilizing the sample as a whole, ranked according to a separate scale of clinical severity. A linear approach was noted for each measure. Results are discussed in light of current design choices in the literature and its impact on the understanding of post-trauma problems.

Adolescent↗

PubMed2004

Psychometric Properties of the Posttraumatic Cognitions Inventory (PTCI): a replication with motor vehicle accident survivors.

This study examined the factor structure, internal consistency, concurrent validity, discriminant validity, and discriminative validity of the Posttraumatic Cognitions Inventory (PTCI; E. B. Foa, A. Ehlers, D. M. Clark, D. F. Tolin, and S. M. Orsillo, 1999) in a sample of 112 individuals who had experienced a serious motor vehicle accident. Results generally supported the 3-factor structure of the PTCI: (a) Negative Cognitions About Self, (b) Negative Cognitions About the World, and (c) Self-Blame. Subscales reflecting negative thoughts of the self and world showed adequate internal consistency, as well as good concurrent, discriminant, and discriminative validity. However, difficulties with the subscale representing self-blame emerged, specifically poor concurrent and discriminant validity. Potential reasons for this finding are discussed. The PTCI seems to be a promising measure of negative and dysfunctional posttrauma cognitions, which deserves continuing attention.

Accidents, Traffic↗

PubMed2003

'Minor GAD': characteristics of subsyndromal GAD in older adults.

Subsyndromal emotional symptoms are common in older adults and are associated with increased disability, health care utilization, and risk for developing psychiatric disorders. The purpose of this study was to examine subsyndromal generalized anxiety disorder (GAD) in older adults. Participants included 30 older adults with diagnosable GAD, 19 with subsyndromal anxiety symptoms [minor GAD; (MGAD)], and 21 normal control volunteers (NC). Participants were assessed using the Anxiety Disorders Interview Schedule for DSM-IV and completed self-report measures of anxiety, worry, depression, and life satisfaction. Excessive worry on more days than not, difficulty controlling worry, and clinically significant distress or impairment were the diagnostic criteria endorsed by MGAD participants least often. Therefore, these criteria may be useful in distinguishing between GAD and subsyndromal GAD. Self-reported anxiety and worry also systematically differed across groups in the expected directions, with a discriminant analysis yielding good classification of the GAD and NC groups based on these measures. Categorization of MGAD participants generally was poor, with most misclassified as GAD patients. Clinical implications of these findings are discussed.

Aged↗

PubMed2003

A preliminary examination of treatment for posttraumatic stress disorder in chronic pain patients: a case study.

Manualized treatments have become popular, despite concern about their use when comorbid diagnoses are present. In this report, the efficacy of manualized posttraumatic stress disorder (PTSD) treatment was examined in the presence of chronic pain. Additionally, the effect of PTSD treatment on chronic pain and additional psychiatric diagnoses was explored. Six female patients with both PTSD and chronic pain following motor vehicle accidents were treated for PTSD using a multiple baseline design. The results indicate that manualized treatment for PTSD was effective in reducing PTSD symptoms in these patients. Although there were no changes in subjective pain, there were pain-related functional improvements and reductions in other psychiatric diagnoses for the majority of patients.

Accidents, Traffic↗

PubMed2003

PTSD and emotional distress symptoms measured after a motor vehicle accident: Relationships with pain coping profiles.

This study explored differences among pain patients classified as Dysfunctional, Interpersonally Distressed, and Adaptive Copers on the Multidimensional Pain Inventory with respect to PTSD symptomatology, anxiety, and depression. Eighty-five patients with pain complaints who had experienced a serious motor vehicle accident (MVA) were classified into these three pain coping categories and assessed using clinician and self-report measures. Results indicated that patients classified as Adaptive Copers (n = 24) showed less PTSD symptomatology, anxiety, and depressed mood, relative to individuals classified as Dysfunctional (n = 36) and as Interpersonally Distressed (n = 25), who did not differ on these dimensions. Emotional responses during the accident (fear, helplessness, danger, perceived control, and certainty that one would die) did not differentiate the groups. Pain profiles contributed to the prediction of self-reported PTSD symptoms, controlling for state anxiety. These data suggest that pain patients with both Dysfunctional and Interpersonally Distressed coping profiles are at elevated risk for a range of post-trauma problems following a serious MVA.

Journal Article↗

PubMed2003

Cognitive-behavioral treatment of late-life generalized anxiety disorder.

This study addressed the efficacy of cognitive-behavioral therapy (CBT), relative to minimal contact control (MCC), in a sample of 85 older adults (age 60 years and over) with generalized anxiety disorder (GAD). All participants completed measures of primary outcome (worry and anxiety), coexistent symptoms (depressive symptoms and specific fears), and quality of life. Results of both completer and intent-to-treat analyses revealed significant improvement in worry, anxiety, depression, and quality of life following CBT relative to MCC. Forty-five percent of patients in CBT were classified as responders, relative to 8% in MCC. Most gains for patients in CBT were maintained or enhanced over 1-year follow-up. However, posttreatment scores for patients in CBT failed to indicate return to normative functioning.

Age Factors↗

PubMed2003

Assessing worry in older adults: confirmatory factor analysis of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model.

The assessment of worry among older adults typically has involved measures designed with younger cohorts. Because of special concerns in assessing older adults, modifications to existing instruments may be necessary. Addressing equivocal factor analytic data on the Penn State Worry Questionnaire (PSWQ) among younger adults, the authors conducted confirmatory factor analyses to evaluate the generalizability of previous models to older adults with generalized anxiety disorder. Data fit poorly with established single- and two-factor models. The single-factor model was modified, resulting in the elimination of 8 items, strong fit indices, high internal consistency, adequate test-retest reliability, and good convergent and divergent validity. Further psychometric work is required to assess whether the revised model is a more parsimonious method to assess late-life anxiety.

Aged↗