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Neil A Rector

Publications and source records attributed to Neil A Rector.

14 recordsLinked to original sources
PubMed2006

Anxiety sensitivity within the anxiety disorders: disorder-specific sensitivities and depression comorbidity.

The tendency to perceive anxious states as aversive and harmful is hypothesized to confer vulnerability to the development of anxiety disorders. The most commonly used measure of anxiety sensitivity, the Anxiety Sensitivity Index [ASI; Reiss, S., Peterson, R.A., Gursky, D.M., & McNally R.J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behavior Research and Therapy, 24, 1-8], is composed of multiple lower-order factors, assessing fear of physical symptoms, fear of publicly observable anxious symptoms, and fear of cognitive dyscontrol. This study examined the convergent validity of the lower-order anxiety sensitivity dimensions in DSM-IV diagnosed anxiety disorders. Participants with primary diagnoses of panic disorder with agoraphobia, social phobia, and generalized anxiety disorder (GAD) completed the ASI and measures of anxiety and depression severity. Support was found for the convergent validity of all ASI dimensions in reference to thematically related anxiety disorders and in the identification of patients presenting with and without secondary major depressive disorder (MDD). The ASI-fear of cognitive dyscontrol dimension displayed strong and nonredundant associations with GAD, dimensional depression scores, and secondary diagnoses of MDD. The conceptual implications of the shared importance of fear of cognitive dyscontrol in GAD and MDD are discussed.

Adult↗
PubMed2005

Dysfunctional belief-based obsessive-compulsive disorder subgroups.

An attempt was made to identify obsessive-compulsive disorder (OCD) subgroups based on differences in OCD related beliefs. OCD patients (N=367) were assessed with the Obsessional-Beliefs Questionnaire prior to treatment. Individuals' scores on measures of inflated personal responsibility and the tendency to overestimate threat, perfectionism and intolerance of uncertainty, and over-importance and over-control of thoughts were subjected to cluster analysis. Support for both a simple and complex subgroup model was found (2-subgroup and 5-subgroup taxonomies). A low-beliefs subgroup was identified in both taxonomies. The low-beliefs subgroups reported scores on belief measures equivalent to scores reported for non-OCD comparison groups in earlier studies. Additional analyses were conducted to determine relations between belief-based and symptom subgroups. Significant relationships were found (e.g., Symmetry symptom subgroup membership was associated with membership in the Perfectionism/Certainty beliefs subgroup), although the shared variance was modest. Implications for understanding OCD heterogeneity and for cognitive theory are discussed.

Adult↗
PubMed2005

Ruminative coping and post-event processing in social anxiety.

Cognitive models of social anxiety implicate various factors in the initiation and maintenance of socially anxious states, including anticipatory processing, self-focused attention and post-event processing. The present study focused on post-event processing, which is a post-mortem analysis following a social event that is described as ruminative in nature and serves to maintain social anxiety. Participants (N=112; 64 women, 48 men) were presented with vignettes that involved making mistakes in public and were instructed to record their thoughts to allow for the examination of the content of post-event processing. Ruminative coping and distraction were assessed via self-report. Results indicated that participants high in social anxiety (n=55) were more likely to ruminate and less likely to distract when faced with socially anxious stressors compared to those low in social anxiety (n=57). Further, as hypothesized, participants high in social anxiety recorded more negative thoughts and more upward counterfactual thoughts ('if only' type thoughts on how things could have been better; associated with negative affect) compared to those low in social anxiety. These results are discussed in terms of cognitive models of social anxiety.

Adaptation, Psychological↗
PubMed2005

The impact of personality on symptom expression in obsessive-compulsive disorder.

Previous research conducted on the five-factor model of personality (FFM) in obsessive-compulsive disorder (OCD) has demonstrated that community and clinical participants score significantly higher than controls on the domains and facets of neuroticism and extraversion and selective facets of agreeableness and conscientiousness. However, studies have yet to examine the extent to which personality traits, as assessed by the FFM, are associated with the specific symptoms of OCD. The purpose of this study was to examine further the personality predictors of obsessive-compulsive symptoms in clinical participants using the facets of the FFM. Patients with a DSM-IV diagnosis of OCD (N = 56) completed the Revised NEO Personality Inventory, the Yale Brown Obsession Compulsion Scale, and the Beck Depression Inventory. Lower scores on openness to ideas were uniquely associated with greater obsession severity, whereas lower openness to actions was uniquely associated with greater compulsive severity. In contrast with past research that has emphasized the association between neuroticism and extraversion and dimensionally rated obsessive-compulsive symptoms, this study demonstrates the specific associations between selective facet traits of openness and clinical obsessions and compulsions. Whereas tendencies toward negative affectivity may confer a nonspecific vulnerability to the development of OCD, facets of openness may impact on the particular expression and severity of obsessive-compulsive symptoms.

Adult↗
PubMed2005

The negative symptoms of schizophrenia: a cognitive perspective.

Recent reports of improvement in the negative symptoms of schizophrenia following targeted cognitive interventions have prompted interest in the cognitive underpinnings of these symptoms. This review integrates current experimental research with the phenomenological accounts of patients participating in cognitive therapy for these specific symptoms. We propose that, in addition to the well-established role of neurobiological factors in their development and maintenance, specific cognitive appraisals and beliefs play a role in the expression and persistence of negative symptoms. This cognitive model of negative symptoms is based on a diathesis-stress formulation: a continuum of predispositional traits from the premorbid personality to the full-blown negative symptomatology, the incorporation of negative social and performance attitudes within these traits, and low expectancies for pleasure or success in goal-oriented activities. We suggest that negative symptoms represent, in part, a compensatory pattern of disengagement in response to threatening delusional beliefs, perceived social threat, and anticipated failure in tasks and social activities. A psychological aspect of this motivational and behavioural inertia appears to be the patient's perception of limited psychological resources--a perception that motivates patients to conserve energy by minimizing investment in activities requiring effort.

Affect↗
PubMed2004

Lifetime rates of alcoholism in adults with anxiety, depression, or co-morbid depression/anxiety: a community survey of Ontario.

BACKGROUND: Separate lines of research have demonstrated strong associations linking alcohol misuse with major depression on the one hand, and anxiety disorders on the other. In the current study we examined the possible confounding and/or additive effects of co-morbid depression/anxiety in understanding these relationships. METHODS: A total of 7195 individuals in Ontario, aged 15-64, were interviewed using the CIDI. Based on lifetime diagnoses, we compared rates of alcohol abuse/dependence in four groups consisting of normal controls, individuals with unipolar major depression but no anxiety disorders, individuals with one or more anxiety disorders without depression, and individuals with co-morbid major depression and anxiety. Age of onset of alcoholism in the four study groups was also compared. RESULTS: In both genders, there were significantly higher rates of alcoholism in all three psychiatric groups relative to controls. In females only, there was also a significantly higher rate of alcoholism in the depressed/anxious group than in the pure anxious group. The age of onset of alcoholism was the same across all four study groups. LIMITATIONS: Due to limitations related to sample size, we combined subjects with various anxiety disorders into a single anxiety group and concurrent and sequential co-morbidity were not distinguished. CONCLUSIONS: Both gender effects and depression/anxiety co-morbidity may be important considerations in the design and interpretation of studies on alcohol misuse. This may be particularly relevant when considering the strength of the association between alcoholism and anxiety disorders in women. Depression and anxiety do not appear to influence the age of onset of alcoholism. Furthermore, no single temporal pattern of onset was identified in individuals with all three disorders, suggesting no obvious cause-effect relationship among them.

Adolescent↗
PubMed2003

Cognitive therapy for schizophrenia: a preliminary randomized controlled trial.

BACKGROUND: The aim of the current study was to assess whether patients with a DSM-IV diagnosis of schizophrenia and experiencing persistent positive and negative symptoms improve with the addition of cognitive-behavioural therapy to enriched standard treatment. METHODS: A controlled study was completed with 42 patients randomized to either cognitive-behavioural therapy plus enriched treatment-as-usual (CBT-ETAU) (n = 24) or enriched treatment-as-usual only (ETAU) (n = 18). Enriched treatment-as-usual comprised comprehensive treatment within specialised schizophrenia treatment services. Cognitive-behavioural therapy was conducted on an individual basis for 6 months (20 sessions). Clinical assessments were done at pretreatment, posttreatment and at 6-month follow-up by raters blind to group allocation. RESULTS: Significant clinical effects were observed for positive, negative and overall symptom severity for patients treated in CBT-ETAU, although there were no statistically significant differences between the treatment groups at posttreatment. The most pronounced effect of CBT-ETAU in comparison to ETAU in this study was in the reduction of negative symptoms at follow-up. CONCLUSION: These results show promise for the impact of CBT on negative symptoms when explicitly targeted in treatment.

Adult↗
PubMed2003

Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: issues of co-morbidity and specificity.

It has been well established that early adversity is a major risk factor for depression and for anxiety disorders in various populations and age groups. Few studies have considered the relative strength of these associations and the possible role of co-morbid depression/anxiety in understanding them. Using data from a large community sample of Ontario, Canada, we examined the relative strength of the associations between early physical abuse, sexual abuse, and/or parental strain with depression alone, anxiety alone, and co-morbid depression/anxiety. The current sample consisted of 6,597 individuals 15-64 years of age who were interviewed using the World Health Organization Composite International Diagnostic Interview (CIDI). Using a multivariate design, we compared early adversity scores across four diagnostic study groups including normal controls, individuals with major depression but no anxiety disorders, individuals with one or more anxiety disorders without major depression, and individuals with co-morbid major depression and anxiety. Individuals with past disorders were considered separately from those with current disorders. For both past and current disorders, highly significant differences in early adversity scores were found across the four study groups. A novel and robust finding, consistent across all analyses, was a marked association between early sexual abuse and co-morbid depression and anxiety but not the "pure" disorders. A strong association between early parental strain and major depression (independent of anxiety) was also found. The overall pattern of results suggest that there may be unique relationships linking particular adversities to particular manifestations of depression and anxiety disorders later in life. A particularly strong association between early sexual abuse and co-morbid depression/anxiety was found.

Adolescent↗
PubMed2003

Quality of life in OCD: differential impact of obsessions, compulsions, and depression comorbidity.

OBJECTIVE: An anxiety disorder severely affects the sufferer's quality of life (QOL), and this may be particularly true of those with obsessive-compulsive disorder (OCD). This study examines the differential impact of obsessions, compulsions, and depression comorbidity on the QOL of individuals with OCD. METHOD: Forty-three individuals diagnosed with OCD according to DSM-IV criteria and experiencing clinically significant obsessions and compulsions completed measures of QOL, obsessive-compulsive symptom severity, and depression severity. RESULTS: Obsession severity was found to significantly predict patient QOL, whereas the severity of compulsive rituals did not impact on QOL ratings. Comorbid depression severity was the single greatest predictor of poor QOL, accounting for 54% of the variance. CONCLUSIONS: Given the importance of these symptoms, treatments that directly target obsessions and secondary depression symptoms in OCD are warranted. However, replication of these findings in a prospective cohort study is required, because although the the current study's cross-sectional design allows for the examination of the associations among obsessions, depression, and QOL, it cannot establish their temporal framework (that is, causal relations).

Adolescent↗
PubMed2002

A clinical review of cognitive therapy for schizophrenia.

Major advances have been made in the cognitive understanding and treatment of the symptoms of schizophrenia, including delusions, hallucinations, and emotional withdrawal. Experimental studies on the psychologic aspects of schizophrenia demonstrate the importance of information processing biases, such as cognitive biases and distortions, that are functionally related to the maintenance of symptoms. Understanding the aspects of schizophrenia in cognitive terms provides a framework for psychotherapeutic intervention with the adaptation of the cognitive strategies proven effective in the treatment of mood and anxiety disorders. The authors of this paper first outline the cognitive conceptualization and strategies employed by cognitive therapists to treat positive and negative symptoms, and conclude with a summary of the empiric status of cognitive therapy for schizophrenia. Cognitive therapy has been shown to be an important adjunct to standard treatments of schizophrenia.

Affect↗
PubMed2002

Cognitive therapy for schizophrenia: from conceptualization to intervention.

OBJECTIVES: To outline the cognitive understanding of symptoms of schizophrenia, such as delusions, hallucinations, and emotional withdrawal, and to review the cognitive therapy approach to ameliorating these symptoms. METHOD: We identified studies examining cognitive factors associated with symptoms of schizophrenia by electronic search (using Medline and Psycinfo). This paper integrates experimental findings and clinical treatment. RESULTS: Recent studies focusing on the psychological aspects of schizophrenia demonstrate the importance of common cognitive biases and distortions that are functionally related to the maintenance of symptoms. Understanding the disorder in cognitive terms provides a framework for psychotherapeutic intervention. Adapting cognitive strategies successfully used in cognitive therapy of depression and anxiety provides an important adjunct to standard treatment of schizophrenia. CONCLUSION: Given that the outcome of current treatment for schizophrenia remains poor, attention to therapist training in psychological approaches is essential.

Cognitive Behavioral Therapy↗