Phobic anxiety in 11 nations: part II. Hofstede's dimensions of national cultures predict national-level variations

Hofstede's dimensions of national cultures termed Masculinity-Femininity (MAS) and Uncertainty Avoidance (UAI) (Hofstede, 2001) are proposed to be of relevance for understanding national-level differences in self-assessed fears. The potential predictive role of national MAS was based on the classical work of Fodor (Fodor, 1974). Following Fodor, it was predicted that masculine (or tough) societies in which clearer differentiations are made between gender roles (high MAS) would report higher national levels of fears than feminine (or soft/modest) societies in which such differentiations are made to a clearly lesser extent (low MAS). In addition, it was anticipated that nervous-stressful-emotionally-expressive nations (high UAI) would report higher national levels of fears than calm-happy and low-emotional countries (low UAI), and that countries high on both MAS and UAI would report the highest national levels of fears. A data set comprising 11 countries (N > 5000) served as the basis for analyses. As anticipated, (a) high MAS predicted higher national levels of Agoraphobic fears and of Bodily Injury-Illness-Death fears; (b) higher scores on both UAI and MAS predicted higher national scores on Bodily Injury-Illness-Death fears, fears of Sexual and Aggressive Scenes, and Harmless Animals fears; (c) higher UAI predicted higher national levels of Harmless Animals, Bodily Injury-Illness-Death, and Agoraphobic fears. (C) 2003 Elsevier Ltd. All rights reserved.

Looking beyond the negatives: A time period analysis of positive cognitions, negative cognitions, and working alliance in cognitive-behavior therapy for panic disorder

Time period analysis was used in an international sample of clients ( N = 106) to demonstrate that cognitive - behavioral therapy (CBT) for panic disorder is associated with specific changes in both negative and positive cognitions during the treatment period. In the first 6 weeks of the treatment phase, working alliance failed to predict changes in panic severity, whereas changes in panic self-efficacy and catastrophic misinterpretation of bodily sensations predicted rapid symptom relief. In the last 6 weeks of treatment, higher doses of CBT were associated with further changes in positive and negative cognitions. The findings can be interpreted as suggesting that the role of the working alliance in CBT for panic disorder is to facilitate cognitive change.

Cognitive mediation of panic severity: The role of catastrophic misinterpretation of bodily sensations and panic self-efficacy

This study examined the differential role of negative and positive cognitions in mediating treatment outcome in CBT for Panic Disorder through comparison of a Standard CBT (n = 36) versus a Waitlist Condition (n = 24). Regression analyses indicated that, relative to the Waitlist Condition, patients in the Standard CBT condition reported significantly greater shifts both towards higher panic self-efficacy and lower catastrophic misinterpretation of bodily sensations during treatment, as well as a significantly lower level of panic severity at posttreatment. Changes in catastrophic misinterpretation of bodily sensations and panic self-efficacy contributed significantly more to prediction of panic severity than did assignment to either Standard CB T or a Waitlist Condition. Results are discussed in terms of the importance of including both negative and positive cognitions in demonstrating cognitive mediation.

DESEMPENHO EM TESTES DE ATENÇÃO VISUAL E INTERFERÊNCIA DE ESTÍMULOS AUDITIVOS DE MOVIMENTO EM INDIVÍDUOS COM E SEM MEDO DE ALTURA

Desordens da ansiedade, especialmente a agorafobia e a desordem do pânico foram associadas a anormalidades das funções vestibulares. Evidências de que o controle do equilíbrio pode exigir habilidades atencionais também foram relatadas. Utilizando o medo de altura como modelo clínico onde sintomas ansiosos coexistem com anormalidades com a percepção espacial e controle do equilíbrio, este estudo investigou o desempenho em testes de atenção visual em voluntários normais com altos e baixos escores obtidos do Questionário de Acrofobia. O teste de rastreio visual foi realizado em 30 indivíduos (15 em cada grupo) enquanto ouviam dois tipos diferentes de estímulos auditivos. Na condição volume um som de 900 Hz era apresentado em ambos ouvidos durante 2 segundos seguidos de mais 2 segundos de silêncio. Na condição balanço , o mesmo som era apresentado durante 2 segundos ao ouvido direito seguido por 2 segundos ao ouvido esquerdo. Estímulos auditivos de movimento provocaram maior desconforto em ambos os grupos, mas nos indivíduos com maiores escores de acrofobia estes estímulos foram associados a um pior desempenho no teste visual. Embora muito limitado pela amostra experimental, este estudo sugere que o medo de altura pode estar associado à dependência visual para manutenção do equilíbrio e que poderia piorar o desempenho nos testes visuais devido à competição dos recursos neuro-cognitivos. Implicações experimentais e clínicas destes achados preliminares exigem outras pesquisas.

Comorbid Migraine in Major Depressive Disorder Suggests a Subgroup Related to Bipolar Disorder

Aims: Previous small-scale studies suggest presence of migraine in major depressive disorder (MDD) is associated with specific clinical characteristics that may overlap with those of bipolar disorder. We aimed to compare a broad range of characteristics in participants who have MDD with and without migraine, and to explore possible similarities between those characteristics associated with the presence of migraine in MDD and those in bipolar disorder in a large UK sample. Methods: Lifetime and episodic clinical characteristics and affective temperaments in DSM-IV MDD with (n=134) and without (n=218) migraine were compared. Characteristics associated with the presence of migraine were then compared with a sample of participants with DSM-IV bipolar disorder (n=407). All participants were recruited into the Bipolar Disorder Research Network (www.bdrn.org). Results: The presence of migraine in MDD was associated with female gender (76.9% vs 56.9%, p<0.001), younger age of onset (23 vs 27 years, p=0.002), history of attempted suicide (38.3% vs 22.7%, p=0.002), and more panic/agoraphobia symptomatology (6 vs 4, p<0.001). Female gender (OR=2.44, p=0.006) and younger age of onset (OR=0.97, p=0.013) remained significant in a multivariate model. These clinical characteristics were not significantly different to those of our participants with bipolar disorder. Conclusions: The presence of migraine in MDD delineates a subgroup of individuals with a more severe illness course. The clinical presentation of this subgroup more closely resembles that of bipolar disorder than that of MDD without migraine. The presence of migraine in major depression may be a marker of a specific subgroup that could be useful in future research.