anxiety

A 64-year-old male who met criteria for social and generalised anxiety was treated
using a brief behavioural activation (BA) approach. The intervention was delivered
in twelve weekly 60-minute individual sessions. The effects of the intervention
were assessed using a simple A-B-C phase change with repeated measurement
design. Change in reported anxiety was recorded across phases. Decreased scores
in self-reported anxiety measures were obtained and significant clinical improvement
was maintained during a 4-month no treatment maintenance phase. This
preliminary investigation suggests BA could be an efficient and effective treatment
for anxiety and that replications are warranted.

This investigation seeks to establish the psychometric properties of an adapted measure of experiential avoidance (EA) in the parenting context by assessing its relation to other parenting constructs and psychosocial correlates of child anxiety in a clinical sample. Participants were 154 children (90 female, 64 male) diagnosed with anxiety disorders and their parents (148 mothers, 119 fathers). The newly developed Parental Acceptance and Action Questionnaire (PAAQ) was administered to parents along with self-report measures of adult experiential avoidance, parental psychopathology, affective expression, and parental control behaviors. A subsample of participants, n = 35, were re-administered the PAAQ to assess temporal stability. Factor analysis of the PAAQ yielded a two-factor solution with factors labeled Inaction and Unwillingness. Temporal stability of the PAAQ was found to be moderate, r = .68–.74. Internal consistency was fair across subscales of the PAAQ, a = .64–.65. Correlational analysis of the PAAQ and parent-report measures support the criterion validity of the PAAQ, suggesting that the PAAQ correlates with parent-report measures of parental locus of control, affective expression, and controlling parental behaviors as well as child psychopathology symptoms. Finally, the clinical applicability of the PAAQ is indicated by the PAAQ’s ability to predict a significant amount of variance in parent- and clinician-rated levels of child anxiety and related psychopathology.

This investigation seeks to establish the psychometric properties of an adapted measure of experiential avoidance (EA) in the parenting context by assessing its relation to other parenting constructs and psychosocial correlates of child anxiety in a clinical sample. Participants were 154 children (90 female, 64 male) diagnosed with anxiety disorders and their parents (148 mothers, 119 fathers). The newly developed Parental Acceptance and Action Questionnaire (PAAQ) was administered to parents along with self-report measures of adult experiential avoidance, parental psychopathology, affective expression, and parental control behaviors. A subsample of participants, n = 35, were re-administered the PAAQ to assess temporal stability. Factor analysis of the PAAQ yielded a two-factor solution with factors labeled Inaction and Unwillingness. Temporal stability of the PAAQ was found to be moderate, r = .68–.74. Internal consistency was fair across subscales of the PAAQ, a = .64–.65. Correlational analysis of the PAAQ and parent-report measures support the criterion validity of the PAAQ, suggesting that the PAAQ correlates with parent-report measures of parental locus of control, affective expression, and controlling parental behaviors as well as child psychopathology symptoms. Finally, the clinical applicability of the PAAQ is indicated by the PAAQ’s ability to predict a significant amount of variance in parent- and clinician-rated levels of child anxiety and related psychopathology.

Research has shown that emotional avoidance and anxiety sensitivity are associated with more self-reported fear and distress in response to laboratory fear challenge procedures. The present study aimed to expand upon this work and examined how emotional avoidance and anxiety sensitivity are related to emotional and physiological responses to an observational fear challenge procedure. To accomplish this aim, a carefully screened, nonclinical sample (N = 43) was administered the Acceptance and Action Questionnaire (AAQ), a measure of emotional avoidance, and the Anxiety Sensitivity Index (ASI). Participants then engaged in an observational fear challenge paradigm. During the fear challenge, participants watched mock panic attacks while emotional (e.g., fear, panic) and skin conductance levels were assessed. Consistent with expectation, emotional avoidance and anxiety sensitivity were positively associated with more self-reported fear and more severe panic symptoms to the challenge procedure. However, anxiety sensitivity was more highly associated with self-reported fear and panic symptoms in response to the challenge procedure than emotional avoidance. Emotional avoidance and anxiety sensitivity were not associated with levels of physiological arousal to the observational fear challenge procedure. Discussion focuses on the interplay between emotional avoidance, anxiety sensitivity, and the development of vicarious fear responses and how these constructs may contribute to the pathogenesis of anxiety disorders.

Research has shown that emotional avoidance and anxiety sensitivity are associated with more self-reported fear and distress in response to laboratory fear challenge procedures. The present study aimed to expand upon this work and examined how emotional avoidance and anxiety sensitivity are related to emotional and physiological responses to an observational fear challenge procedure. To accomplish this aim, a carefully screened, nonclinical sample (N = 43) was administered the Acceptance and Action Questionnaire (AAQ), a measure of emotional avoidance, and the Anxiety Sensitivity Index (ASI). Participants then engaged in an observational fear challenge paradigm. During the fear challenge, participants watched mock panic attacks while emotional (e.g., fear, panic) and skin conductance levels were assessed. Consistent with expectation, emotional avoidance and anxiety sensitivity were positively associated with more self-reported fear and more severe panic symptoms to the challenge procedure. However, anxiety sensitivity was more highly associated with self-reported fear and panic symptoms in response to the challenge procedure than emotional avoidance. Emotional avoidance and anxiety sensitivity were not associated with levels of physiological arousal to the observational fear challenge procedure. Discussion focuses on the interplay between emotional avoidance, anxiety sensitivity, and the development of vicarious fear responses and how these constructs may contribute to the pathogenesis of anxiety disorders.

Generalized anxiety disorder (GAD) is a chronic anxiety disorder, associated with comorbidity and impairment in quality of life, for which improved psychosocial treatments are needed. GAD is also associated with reactivity to and avoidance of internal experiences. The current study examined the efficacy of an acceptance-based behavioral therapy aimed at increasing acceptance of internal experiences and encouraging action in valued domains for GAD. Clients were randomly assigned to immediate (n = 15) or delayed (n = 16) treatment. Acceptance-based behavior therapy led to statistically significant reductions in clinician-rated and self-reported GAD symptoms that were maintained at 3- and 9-month follow-up assessments; significant reductions in depressive symptoms were also observed. At posttreatment assessment 78% of treated participants no longer met criteria for GAD and 77% achieved high end-state functioning; these proportions stayed constant or increased over time. As predicted, treatment was associated with decreases in experiential avoidance and increases in mindfulness.

Generalized anxiety disorder (GAD) is a chronic anxiety disorder, associated with comorbidity and impairment in quality of life, for which improved psychosocial treatments are needed. GAD is also associated with reactivity to and avoidance of internal experiences. The current study examined the efficacy of an acceptance-based behavioral therapy aimed at increasing acceptance of internal experiences and encouraging action in valued domains for GAD. Clients were randomly assigned to immediate (n = 15) or delayed (n = 16) treatment. Acceptance-based behavior therapy led to statistically significant reductions in clinician-rated and self-reported GAD symptoms that were maintained at 3- and 9-month follow-up assessments; significant reductions in depressive symptoms were also observed. At posttreatment assessment 78% of treated participants no longer met criteria for GAD and 77% achieved high end-state functioning; these proportions stayed constant or increased over time. As predicted, treatment was associated with decreases in experiential avoidance and increases in mindfulness.

Arch and Craske (2008) examine the similarities and differences between cognitive behavioral therapy and acceptance and commitment therapy for the anxiety disorders and suggest that the two treatment approaches have as many similarities as differences. We agree and believe that there is merit in this conclusion—it brings us together in common purpose and helps move us toward improved approaches to reducing client suffering. Our discussion focuses on the similarities that we think about most positively and the differences of which we should be mindful.

Arch and Craske (2008) examine the similarities and differences between cognitive behavioral therapy and acceptance and commitment therapy for the anxiety disorders and suggest that the two treatment approaches have as many similarities as differences. We agree and believe that there is merit in this conclusion—it brings us together in common purpose and helps move us toward improved approaches to reducing client suffering. Our discussion focuses on the similarities that we think about most positively and the differences of which we should be mindful.