Biomedical subjects

Todd B Kashdan

Publications and source records attributed to Todd B Kashdan.

At least 19 recordsLinked to original sources

PubMed2007

Social anxiety spectrum and diminished positive experiences: theoretical synthesis and meta-analysis.

Until recently, there has been limited recognition that diminished positive psychological experiences are important to understanding the nature of social anxiety. Meta-analytic techniques were used to evaluate the strength, consistency, and construct specificity of relations between the social anxiety spectrum with positive affect and curiosity. The social anxiety spectrum had significant inverse relations with positive affect (r=-.36; 95% CI: -.31 to -.40) and curiosity (r=-.24; 95% CI: -.20 to -.28). Relations between social anxiety and positive affect were stronger in studies sampling from clinical populations. Specificity findings (e.g., statistically controlling for depressive symptoms and disorders) further confirmed negative associations with positive affect (r=-.21; 95% CI: -.16 to -.26) and curiosity (r=-.21; 95% CI: -.08 to -.32). The literature on social rank, self-presentation concerns, self-regulatory resources, and experiential avoidance is reviewed and integrated to elaborate a framework of how, why, and when social anxiety may be inversely related to positive experiences. The specificity of theory and data to social interaction anxiety is supported by an examination of existing work on social performance/observation fears and other anxiety conditions. Overall, these findings highlight the importance of diminished positive psychological experiences in understanding excessive social anxiety.

Affect↗

PubMed2007

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD.

We used structural equation modeling with 174 treatment-seeking military trauma survivors evaluated for posttraumatic stress disorder (PTSD) at a VA Medical Center PTSD clinic to examine relationships among lifetime mental health service use, PTSD symptom severity and medical problems (from self-report), as well as prospective (1-year) mental health and medical care use visit counts extracted from medical records. We discovered an adequate statistical fit to a hypothesized model of previous and prospective health service use, and current PTSD severity and health-related problems. Previous inpatient mental health treatment was significantly related to PTSD severity and prospective outpatient mental health use. However, PTSD severity was unrelated to prospective use of mental health or medical services. Health problems were related to prospective medical service use. Clinical and administrative implications in predicting health care use among trauma survivors are discussed.

Adult↗

PubMed2006

Social anxiety and romantic relationships: the costs and benefits of negative emotion expression are context-dependent.

In general, expressing emotions is beneficial and withholding emotions has personal and social costs. Yet, to serve social functions there are situations when emotions are withheld strategically. We examined whether social anxiety influenced when and how emotion expressiveness influences interpersonal closeness in existing romantic relationships. For people with greater social anxiety, withholding the expression of negative emotions was proposed to preserve romantic relationships and their benefits. We examined whether social anxiety and emotion expressiveness interacted to predict prospective changes in romantic relationship closeness over a 12-week period. For people with less social anxiety, relationship closeness was enhanced over time when negative emotions were openly expressed whereas relationship deterioration was found for those more likely to withhold emotions. The reverse pattern was found for people with greater social anxiety such that relationship closeness was enhanced over time for those more likely to withhold negative emotions. Related social anxiety findings were found for discrepancies between desired and actual feelings of closeness over time. Findings were not attributable to depressive symptoms. These results suggest that the costs and benefits of emotion expression are influenced by a person's degree of social anxiety.

Adolescent↗

PubMed2006

Social anxiety, depressive symptoms, and post-event rumination: affective consequences and social contextual influences.

Using a self-presentation perspective, we hypothesized that during social interactions in which social attractiveness could be easily appraised by others, more socially anxious individuals would be more prone to ruminate and rumination would have more adverse emotional consequences. After assessing social anxiety and depressive symptoms, unacquainted college students participated in 45-min structured social interactions manipulated to induce personal self-disclosure or mimic superficial, small-talk. Affective experiences were assessed immediately after and 24h after social interactions. Results found that social anxiety was associated with negative post-event rumination more strongly among those with elevated depressive symptoms. Further, at higher levels of social anxiety, post-event rumination was associated with increases in NA following personal disclosure interactions and decreases in NA following small-talk interactions. Individuals with more depressive symptoms experienced increases in NA following small-talk interactions, but not personal disclosure interactions. Contrary to expectation, positive relations between social anxiety and rumination were not mediated by self-presentation concerns during interactions. Fitting with relevant theory, findings implicated symptom and social contextual variables that moderate the affective consequences of rumination.

Adult↗

PubMed2006

Mental health service use among American Red Cross disaster workers responding to the September 11, 2001 U.S. terrorist attacks.

In this article, we explored 1) the extent of mental health (MH) service use by American Red Cross disaster relief workers, both before (lifetime) and 1 year after the September 11, 2001 terrorist attacks, and 2) demographic, disaster and MH variables predicting (1-year) post-September 11 MH service use in this population. A sample of 3015 Red Cross disaster workers was surveyed 1 year after the attacks, regarding demographic characteristics, MH service use before and since the attacks, and posttraumatic stress disorder (PTSD) symptoms. Findings revealed that while 13.5% used MH services before the attacks, 10.7% used services after. Variables increasing the likelihood of MH service use after the attacks included the following: no previous MH treatment, younger age, being divorced/widowed, and higher PTSD intrusion or hyperarousal symptoms. Findings support other recent research on MH service use after the September 11 attacks.

Disasters↗

PubMed2006

A prospective investigation of the impact of attachment style on stress generation among clinically depressed individuals.

The present study sought to determine if attachment style contributed to the generation of stressful life events among clinically depressed individuals during the course of treatment. Participants (N=68) were interviewed about life stressors experienced during a 3-month treatment protocol using a contextual approach (Life Events and Difficulties Schedule; [Brown, G. W., & Harris, T. O. (1978). Social origins of depression: A study of psychiatric disorder in women. New York: Free Press]). Results suggested interactive effects between severity of depression and attachment style on stress associated with future sociotropic and dependent life events. Mildly depressed individuals who reported a dismissing attachment style (higher levels of avoidant attachment and lower levels of anxious attachment) or preoccupied style (lower levels of avoidant attachment and higher levels of anxious attachment) experienced higher levels of stress associated with sociotropic events. Likewise, a dismissing attachment style predicted stress associated with dependent events among mildly depressed individuals. These effects were not present among our more severely depressed participants.

Adult↗

PubMed2006

Fragile self-esteem and affective instability in posttraumatic stress disorder.

Temporal fluctuations in self-esteem and affect are prominent features of several clinical conditions (e.g., depression), but there is an absence of empirical work examining their role in posttraumatic stress disorder (PTSD). Individuals who experience large fluctuations in self-evaluations and affect are considered more vulnerable to psychopathology than individuals able to adequately modulate their self-image and emotional responses. We examined the relevance of self-esteem and affective instability to PTSD. Veterans with and without PTSD completed 14 daily ratings of self-esteem, positive affect, negative affect, and gratitude. Compared to veterans without PTSD, veterans with PTSD exhibited more temporal fluctuations in self-esteem, negative affect, and gratitude, with a smaller effect for positive affect. For all veterans, self-esteem and negative affective instability was associated with diminished well-being. Except for self-esteem instability, most findings were substantially reduced after accounting for variance attributable to PTSD diagnoses and mean intensity levels over the 14-day monitoring period. These data suggest self-esteem instability is important in understanding the lives of veterans with and without PTSD.

Affect↗

PubMed2006

Gratitude and hedonic and eudaimonic well-being in Vietnam war veterans.

Little information exists on the contribution of psychological strengths to well-being in persons with post-traumatic stress disorder (PTSD). Data from other populations suggest that gratitude, defined as the positive experience of thankfulness for being the recipient of personal benefits, may have salutary effects on everyday functioning. We investigated whether dispositional gratitude predicted daily hedonic and eudaimonic well-being in combat veterans with and without PTSD. We also examined associations between daily gratitude and daily well-being across time. Veterans with PTSD, compared to those without PTSD, exhibited significantly lower dispositional gratitude; no differences were found on daily gratitude. Dispositional gratitude predicted greater daily positive affect, percentage of pleasant days over the assessment period, daily intrinsically motivating activity, and daily self-esteem over and above effects attributable to PTSD severity and dispositional negative and positive affect in the PTSD group but not the non-PTSD group. Daily gratitude was uniquely associated with each dimension of daily well-being in both groups. Although preliminary, these results provide support for the further investigation of gratitude in trauma survivors.

Affect↗

PubMed2006

Social anxiety disorder in veterans affairs primary care clinics.

To examine the prevalence and correlates of social anxiety disorder (SAD) in veterans, 733 veterans from four VA primary care clinics were evaluated using self-report questionnaires, telephone interviews, and a 12-month retrospective review of primary care charts. We also tested the concordance between primary care providers' detection of anxiety problems and diagnoses of SAD from psychiatric interviews. For the multi-site sample, 3.6% met criteria for SAD. A greater rate of SAD was found in veterans with than without post-traumatic stress disorder (PTSD) (22.0% vs. 1.1%), and primary care providers detected anxiety problems in only 58% of veterans with SAD. The elevated rate of comorbid psychiatric diagnoses and suicidal risk associated with SAD was not attributable to PTSD symptom severity. Moreover, even after controlling for the presence of major depressive disorder, SAD retained unique, adverse effects on PTSD diagnoses and severity, the presence of other psychiatric conditions, and suicidal risk. These results attest to strong relations between SAD and PTSD, the inadequate recognition of SAD in primary care settings, and the significant distress and impairment associated with SAD in veterans.

Adult↗

PubMed2006

Anhedonia and emotional numbing in combat veterans with PTSD.

We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales. In primary analyses, anhedonia had a unique positive relationship with PTSD's emotional numbing symptoms and minimal relationships with other PTSD symptoms. Upon examining the incremental validity of appetitive functioning (i.e., anhedonia, emotional numbing) over and above aversive functioning (i.e., re-experiencing, avoidance, and hyper-arousal PTSD symptoms) variables, greater emotional numbing increased the likelihood of being diagnosed with a major depressive disorder, and greater anhedonia increased the likelihood of being diagnosed with additional anxiety disorders and to a lesser extent, psychotic disorders. Results were consistent with research on the distinction of appetitive and aversive functioning, providing insight into the nature of PTSD.

Adult↗

PubMed2006

Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies.

Extending previous work, we conducted two studies concerning the toxic influences of experiential avoidance (EA) as a core mechanism in the development and maintenance of psychological distress, and disruption of pleasant, engaging, and spontaneous activity. Of particular interest was whether EA accounted for relationships between coping and emotion regulation strategies on anxiety-related pathology (Study 1) and psychological distress and hedonic functioning over the course of a 21-day monitoring period (Study 2). In Study 1, EA mediated the effects of maladaptive coping, emotional responses styles, and uncontrollability on anxiety-related distress (e.g., anxiety sensitivity, trait anxiety, suffocation fears, and body sensation fears). In Study 2, EA completely mediated the effects of two emotion regulation strategies (i.e., suppression and reappraisal) on daily negative and positive experiences and was associated with diminished daily positive affective experiences and healthy life appraisals, diminished frequency of positive events and more frequent negative life events, and greater negative affective experiences. The present data show that cognitive reappraisal, a primary process of traditional cognitive-behavior therapy, was much less predictive of the quality of psychological experiences and events in everyday life compared with EA. Further consideration of experiential avoidance as a generalized diathesis and toxic process will be useful in improving our understanding of the etiology, phenomenology, and treatment of anxiety conditions, general human suffering, and disruptions in hedonic capacity.

Adaptation, Psychological↗

PubMed2006

Expanding the topography of social anxiety. An experience-sampling assessment of positive emotions, positive events, and emotion suppression.

The relation between social anxiety and hedonic activity remains poorly understood. From a self-regulatory perspective, we hypothesized that socially anxious individuals experience diminished positive experiences and events on days when they are unable to manage socially anxious feelings adequately. In this 21-day experience-sampling study, we constructed daily measures of social anxiety and emotion regulation. Greater dispositional social anxiety was associated with less positive affect and fewer positive events in everyday life. Among individuals defined as socially anxious from their scores on a global self-report measure of social anxiety, the number of positive events was lowest on days when they both were more socially anxious and tended to suppress emotions and highest on days when they were less socially anxious and more accepting of emotional experiences. Irrespective of dispositional social anxiety, participants reported the most intense positive emotions on the days when they were both least socially anxious and most accepting of emotional experiences. Possible clinical implications are discussed.

Adult↗

PubMed2005

Social anxiety and posttraumatic stress in combat veterans: relations to well-being and character strengths.

There are few studies examining the relationship between psychopathology and positive experiences and traits. Although initial studies suggest persons with posttraumatic stress disorder (PTSD) are at increased risk for excessive social anxiety, there have been no studies to date evaluating how these conditions might interact to affect positive experiences and traits. Using self-report scales, informant ratings, and experience-sampling methodologies, we examined the association of social anxiety with well-being and character strengths in veterans with and without PTSD. Controlling for PTSD and trait negative affect, social anxiety was negatively related to global ratings of well-being and character strengths. Social anxiety also accounted for incremental variance in day-to-day well-being (i.e., daily affect balance, percentage of pleasant days, positive social activity, self-esteem, gratitude) over a 14-day assessment period. Although veterans with PTSD reported lower levels of global and daily well-being and character strengths than veterans without PTSD, a diagnosis of PTSD failed to exhibit unique relationships with these constructs. Building on a growing body of work, these data suggest that social anxiety is uniquely associated with disturbances in positive experiences, events, and traits. Our findings support the value of directly addressing social anxiety in the study and treatment of PTSD.

Anxiety Disorders↗

PubMed2005

Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A survey of traumatic stress professionals.

We report findings from a Web-based survey of the International Society for Traumatic Stress Studies' members (n = 227) regarding use of trauma exposure and posttraumatic assessment instruments. Across clinical and research settings, the most widely used tests included the Posttraumatic Stress Diagnostic Scale, Trauma Symptom Inventory, Life Events Checklist, Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale, PTSD Checklist, Impact of Event Scale-Revised, and Trauma Symptom Checklist for Children. Highest professional degree, time since degree award, and student status yielded no differences in extent of reported trauma assessment test use.

Adult↗

PubMed2005

Substance use in young adults: associations with personality and gender.

We examined relationships among personality (i.e., negative affectivity and conscientiousness), and use of licit and illicit substances in a sample of 421 college-aged social drinkers (52.7% women, 47.3% men). Results indicated significant relationships between personality and substance use as well as gender differences. Negative affectivity was related to greater illicit substance use, but not alcohol use or smoking. Conscientiousness was related to less alcohol use and smoking, which fully mediated relationships between conscientiousness and with less use of marijuana and other illicit substances. For women, conscientiousness was associated with less alcohol and smoking, compared to men. For men, alcohol use and smoking were more likely to lead to marijuana use, compared to women. Our findings support differential pathways from personality to substance use, and gender appears to be an important moderating factor.

Adolescent↗

PubMed2005

Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder.

BACKGROUND: There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers. AIMS: To verify combat exposure history for a relevant sample through objective historical data. METHOD: Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined. RESULTS: Although 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam 'combat' and 'no combat' groups on relevant clinical variables. CONCLUSIONS: A significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system.

Combat Disorders↗

PubMed2004

The neglected relationship between social interaction anxiety and hedonic deficits: differentiation from depressive symptoms.

Depressive symptoms are associated with both the presence of negative subjective experiences and relative absence of positive subjective experiences. A similar affective profile of high negative affect and low positive affect (PA) has been associated with excessive social anxiety (SA). This initial cross-sectional study evaluated the incremental effects of social interaction anxiety on hedonic deficits beyond the effects of depressive and anxiety (i.e., physiological arousal, worry) symptoms. From a sample of 97 college students, a factor analysis on self-report measures of hedonic functioning derived two domains: Positive Subjective Experiences and Curiosity. Social interaction anxiety was uniquely, negatively related to Positive Subjective Experiences and Curiosity after removing variance attributable to various depressive and anxiety symptoms. In contrast, anxious arousal and nonspecific anxiety had near-zero relationships with both domains, and depressive symptoms were negatively related to Positive Subjective Experiences. These data provide some evidence for an association between social interaction anxiety and hedonic deficits that is not attributable to covariance with other internalizing conditions.

Adult↗

PubMed2004

Curiosity and exploration: facilitating positive subjective experiences and personal growth opportunities.

In an effort to expand research on curiosity, we elaborate on a theoretical model that informs research on the design of a new measure and the nomological network of curiosity. Curiosity was conceptualized as a positive emotional-motivational system associated with the recognition, pursuit, and self-regulation of novelty and challenge. Using 5 independent samples, we developed the Curiosity and Exploration Inventory (CEI) comprising 2 dimensions: exploration (appetitive strivings for novelty and challenge) and absorption (full engagement in specific activities). The CEI has good psychometric properties, is relatively unaffected by socially desirable responding, is relatively independent from positive affect, and has a nomological network consistent with our theoretical framework. Predicated on our personal growth facilitation model, we discuss the potential role of curiosity in advancing understanding of various psychological phenomena.

Adult↗