Biomedical subjects

Ronald M Rapee

Publications and source records attributed to Ronald M Rapee.

31 records · Page 2Linked to original sources

PubMed2004

The etiology of social phobia: empirical evidence and an initial model.

Research into the etiology of social phobia has lagged far behind that of descriptive and maintaining factors. The current paper reviews data from a variety of sources that have some bearing on questions of the origins of social fears. Areas examined include genetic factors, temperament, childrearing, negative life events, and adverse social experiences. Epidemiological data are examined in detail and factors associated with social phobia such as cognitive distortions and social skills are also covered. The paper concludes with an initial model that draws together some of the current findings and aims to provide a platform for future research directions.

Age of Onset↗

PubMed2004

Predicting who benefits from psychoeducation and self help for panic attacks.

UNLABELLED: Self-help and psychoeducation have been identified as effective methods for delivering treatment, yet not everyone benefits from these brief interventions. Therefore it is clinically and economically useful to identify who is likely to require more intensive assistance. This paper develops a prognostic scale which predicts who will recover from panic attacks and who will require more assistance. METHOD: Random regression models were used to evaluate the relationship between predictive variables, baseline severity, and the rate of improvement in 117 people with DSMIV panic attacks who participated in a trial of a psycho-educational booklet, a self-help workbook, and brief group CBT over a 9-month period. ROC analysis was used to choose cut-off points on a scale made up of significant predictors. RESULTS: Panic disorder and agoraphobia symptom measures were predicted by baseline social anxiety, and general mental health. There was no significant effect on the outcome for baseline depression or anxiety sensitivity. While general mental health (SF12 Mental Component scores) was predicted by the age at first panic attack, neuroticism, panic disorder and/or agoraphobia symptoms and a positive screen for alcohol use disorders. A prognostic scale based on simple additive scoring was equivalent to standard scores and significantly better than chance at predicting who would recover and who required face-to-face therapy. CONCLUSIONS: The prognostic scale may be used to guide the choice of psychoeducation, self-help or face-to-face therapy as the first step in stepped care.

Adult↗

PubMed2004

A parent-report measure of children's anxiety: psychometric properties and comparison with child-report in a clinic and normal sample.

This study examined the psychometric properties of the parent version of the Spence Children's Anxiety Scale (SCAS-P); 484 parents of anxiety disordered children and 261 parents in a normal control group participated in the study. Results of confirmatory factor analysis provided support for six intercorrelated factors, that corresponded with the child self-report as well as with the classification of anxiety disorders by DSM-IV (namely separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, obsessive-compulsive disorder, and fear of physical injuries). A post-hoc model in which generalized anxiety functioned as the higher order factor for the other five factors described the data equally well. The reliability of the subscales was satisfactory to excellent. Evidence was found for both convergent and divergent validity: the measure correlated well with the parent report for internalizing symptoms, and lower with externalizing symptoms. Parent-child agreement ranged from 0.41 to 0.66 in the anxiety-disordered group, and from 0.23 to 0.60 in the control group. The measure differentiated significantly between anxiety-disordered children versus controls, and also between the different anxiety disorders except GAD. The SCAS-P is recommended as a screening instrument for normal children and as a diagnostic instrument in clinical settings.

Adolescent↗

PubMed2004

The structure of negative self-statements in children and adolescents: a confirmatory factor-analytic approach.

The aim of this study was to examine the nature and organization of a range of negative self-statements in children and adolescents, using a structural equations/confirmatory factor-analytic approach. A community sample of 978 children aged 7-16 years completed a questionnaire about the frequency with which they experienced a broad range of negative automatic thoughts. The outcome of comparative modeling provided strongest support for a model in which 4 distinct cognitive factors were all related to a single higher order factor. The 4 lower order factors related to cognitions on social threat, physical threat, personal failure, and hostility. The pattern of results was consistent across age and gender. Results were consistent with assumptions of cognitive specificity models of psychopathology, on the latent structure of automatic thoughts in children and adolescents.

Adolescent↗

PubMed2004

Caregiving representations of mothers of behaviorally inhibited and uninhibited preschool children.

This study examined differences in the caregiving representations of mothers of 3- to 4-year-old behaviorally inhibited and uninhibited children with secure or insecure attachments. Mothers of inhibited children perceived their children as more vulnerable than did mothers of uninhibited children, and they acknowledged difficulties associated with their children's inhibited temperament. However, mothers of insecure inhibited children were less likely than mothers of secure inhibited children to validate their children's emotional experiences and to be aware of their children's internal states and perspectives, and they showed higher levels of boundary violation and defense against negative affect. Implications of the more problematic caregiving representations of mothers of insecure inhibited children for parent-child relationships are discussed.

Adult↗

PubMed2004

Post-event rumination and negative self-appraisal in social phobia before and after treatment.

This study investigated the relationship between self-appraisals of performance, symptom severity and post-event rumination in social phobia, and evaluated the effect of treatment on these variables. A socially phobic group and a nonanxious control group performed an impromptu speech and were told that their performance would be evaluated. Participants appraised their performance immediately after the speech and 1 week later, and the frequency of post-event rumination during the week following the speech was assessed. The socially phobic group maintained the negative appraisals of their speech over the week, whereas the nonclinical group showed increased positivity about their performance The socially phobic group also engaged in more negative rumination than controls. Treatment improved perceptions of performance and reduced negative rumination. These results are discussed in the light of cognitive models of social phobia.

Adult↗

PubMed2004

The relationship between automatic thoughts and negative emotions in children and adolescents: a test of the cognitive content-specificity hypothesis.

The aim of this study was to test the cognitive content-specificity hypothesis in children and adolescents aged 7-16 years. Participants consisted of a community sample of 200 youth and a clinical sample of 160 youth with anxiety, depressive, or disruptive behavior disorders. Participants completed several self-report measures assessing a wide range of negative beliefs and symptoms of internalizing and externalizing problems. Multivariate analyses examining the interrelationships between beliefs and noncognitive symptoms revealed that thoughts on loss or personal failure were the strongest predictors of depressive symptoms, thoughts on social threat were the strongest predictors of anxiety symptoms, and thoughts on hostility or revenge were the strongest predictors of aggression. Results showed clear evidence of cognitive-affective specificity across both internalizing and externalizing problems in youth.

Adolescent↗

PubMed2004

The development and modification of temperamental risk for anxiety disorders: prevention of a lifetime of anxiety?

This review poses the question, is it possible to prevent the development of anxiety disorders through selective interventions? The article begins with a review of the major psychosocial risk factors for anxiety disorders. Evidence is reviewed to support the role of inhibited temperament, parent anxiety, environmental support of avoidant coping, and vicarious and instructional learning of avoidance as risks for anxiety. It is argued that the central focus of these risks is an inhibited temperament and that the other risk factors are likely to be both moderated and mediated by this temperamental style. Thus, a clear option for prevention would be to modify early inhibition. Some preliminary data are presented from the Macquarie University Preschool Intervention Project, a longitudinal study of a brief parent education program for the reduction of inhibited temperament in preschool children. Although there remains considerable room for stronger effects, preliminary results show clear promise that it may be possible to modify early risk for anxiety disorders.

Anxiety Disorders↗

PubMed2002

The effect of situational structure on the social performance of socially anxious and non-anxious participants.

Twenty-six socially anxious and 24 low-anxious female undergraduate students were observed in brief unstructured and structured hetero-social interactions with a confederate. The unstructured interaction was a naturalistic interaction in which participants were observed surreptitiously. The structured interaction was a role-play in which participants were instructed to try and get to know as much as possible about their partner. Videotapes of the interactions were subsequently rated on subjective and objective measures of social skill. The results showed that high socially anxious females performed somewhat worse than low socially anxious females in both situations. However, this difference was far larger in the unstructured social situation and was relatively small in the structured social situation. It appears that socially anxious females do perform more poorly in social interactions than do low-anxious females, but a large component of this poor performance may be a result of avoidance rather than a lack of ability.

Adult↗

PubMed2002

Mother knows best: effects of maternal modelling on the acquisition of fear and avoidance behaviour in toddlers.

The present study was conducted to investigate the influence of parental modelling on the acquisition of fear and avoidance towards novel, fear-relevant stimuli in a sample of 30 toddlers. The toddlers were shown a rubber snake and spider, which were alternately paired with either negative or positive facial expressions by their mothers. Both stimuli were presented again after a 1- and a 10-min delay, while mothers maintained a neutral expression. The children showed greater fear expressions and avoidance of the stimuli following negative reactions from their mothers. This was true for both genders although the degree of modelled avoidance was greater in girls than in boys. The strong observational learning results are consistent with views that modelling constitutes a mechanism by which fear may be acquired early in life.

Anxiety↗

PubMed2002

Parent-child interactions in clinically anxious children and their siblings.

Observed 57 children (37 anxiety-disordered and 20 non-clinic-referred children) and their siblings interacting with their parents while completing a complex puzzle task. Consistent with previous findings, mothers were more involved and more intrusive during the task with their anxiety-disordered child than mothers of non-clinic-referred children. Mothers in the clinic-referred group were also significantly more involved and more intrusive during interactions with the anxious child's sibling than mothers of non-clinic-referred children. Although fathers were more involved during the task than mothers overall, no significant differences in overinvolvement were found between fathers of anxiety-disordered children and fathers of non-clinic-referred children. Both mothers and fathers were equally involved with the anxious child and the sibling of the anxious child. Although this study provides support for the association between maternal overinvolvement and the anxiety disorders, it suggests that overinvolvement does not occur exclusively in the context of relationships with the anxiety-disordered child.

Adolescent↗

PubMed2002

Child-rearing practices and psychological disorders in children: cross-cultural comparison of Korea and Australia.

The present study was designed to explore cultural differences in the relationship between parenting behaviors and psychological adjustment of the child. Mother-son interaction behaviors of 37 Korean boys (11 with Anxiety Disorder, 10 with Externalizing Disorders and 16 Non-clinical boys) and 54 Australian boys (20 with Anxiety Disorder, 17 with Externalizing Disorders and 17 Non-clinical boys) between the ages of 7 and 15 were compared in terms of parental negativity and involvement. The results indicated that Korean mothers displayed more overall negativity and lower overall involvement than Australian mothers. Furthermore, anxiety diagnosis was associated with low maternal involvement in the Korean subjects, while in the Australian subjects, high maternal involvement was associated with clinical status in the child.

Adaptation, Psychological↗