The past decade witnessed considerable debate over the factor structure of the Anxiety Sensitivity Index (ASI), with an eventual consensus emerging that supported a hierarchically organized factor structure. The present study attempted to replicate and examine the overall stability and utility of the hierarchical ASI factor pattern using a large sample of outpatients participating in an ongoing longitudinal study of anxiety disorders. Results supported a hierarchical factor structure for the ASI consisting of three lower-order factors measuring physical concerns, mental incapacitation concerns, and social concerns, all of which loaded significantly on a single second-order factor. Correlational analyses show good test-retest reliability and consistent patterns of intercorrelation for these factor-derived subscales across a 10-month time frame. Additional analyses provide support for the discriminant validity of the ASI subscales with regard to individuals with specific anxiety disorders. The theoretical implications of these findings for future evaluations of anxiety sensitivity are discussed.

This study contrasted the effects of intimate partner and nonpartner sexual assault on women's mental health among a sample (N=835) of low-income, ethnically diverse community women. Compared to sexual assault by a previous partner or by a non-intimate partner, sexual assault by a current partner was the strongest predictor of PTSD, stress, and dissociation. Non-intimate partner sexual assault was only a significant predictor of PTSD and only for African American women. These findings suggest that the victim-offender relationship is important when considering the impact of sexual assault. Specifically, sexual assault perpetrated by an intimate partner may be especially traumatic.

Emotion regulation is widely studied in many areas of psychology and the number of publications on emotion regulation has increased exponentially over the past few decades. Additionally, interest in the relationships between emotion dysregulation processes and psychopathology has drastically increased in recent years. The Emotion Regulation Questionnaire (ERQ) was developed to measure two specific constructs related to emotion control: reappraisal and suppression (Gross & John, 2003). In its initial validation study and subsequent analyses, the instrument was shown to possess sound psychometric properties, but, to date, inquiry regarding the measure's characteristics has been limited. Factor analytic examinations of commonly used instruments are recommended to validate the properties of a given measure and increase researchers understanding of the measured constructs. The current study examined the psychometric properties of the ERQ in a sample of 1,188 undergraduates through confirmatory factor analysis. Additionally, tests of measurement invariance were employed in order to examine potential structural differences based on gender and ethnicity. The current study supported the original structure of the measure with all demographic groups and exceptional fit was demonstrated. Additional normative data for gender and ethnic groups are included. Results support the use of the instrument in future research.

To expound on the nature of emotional deficits in PTSD, the current study investigated the relationships among emotion content and process variables and PTSD symptomatology in a sample of 85 veterans with military-related trauma. Alexithymic externally oriented thinking and negative affectivity emerged as the most consistent predictors of PTSD symptoms; however, depression was the only variable associated with emotional numbing. Theoretical and clinical implications of these findings are discussed, as well as future research directions including the collateral and clinician assessment of emotional functioning, use of other process measures, and inclusion of various control groups.

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The present study examined the course of posttraumatic stress disorder (PTSD) in a sample of 84 primary care patients. More specifically, this study investigated the role of Axis I comorbidity, psychosocial impairment, and treatment participation in the maintenance of an episode of chronic PTSD and whether patients at follow-up met criteria for PTSD (full remission) or continued to exhibit residual PTSD symptoms and impairment (partial PTSD). Diagnostic structured interviews established all clinical diagnoses and information on the course of anxiety disorder symptoms, psychosocial functioning, and treatment status. Using a prospective, longitudinal design, this study found that during the first 2 years of follow-up, the probability of no longer meeting full DSM-IV criteria for PTSD was .69, and .18 for full remission from PTSD. The number of comorbid anxiety disorders and degree of psychosocial impairment at intake were significantly related to remission status (i.e., full and partial PTSD). This study suggests that, in a primary care setting, PTSD is a persistent illness, and that many subjects who have recovered from PTSD continue to suffer from subthreshold symptoms of PTSD.

The current study examined the naturalistic course of generalized anxiety disorder (GAD) in a sample of 113 primary care patients across a 2-year period. Initial diagnoses were established using structured clinical interviews according to DSM-IV diagnostic criteria. Results indicated that the majority of patients meeting DSM-IV diagnostic criteria for GAD were still symptomatic to some degree after 2 years of follow-up. Rates of full and partial recovery from GAD, however, were found to be higher than those reported for previous studies of GAD in psychiatric patients. Diagnostic comorbidity, severity of psychosocial impairment, and gender were found to be significantly associated with achieving full or partial recovery from GAD. Psychiatric treatment was not found to be associated with time to full or partial recovery from GAD symptoms, likely due to a treatment-biasing effect. These results underscore that GAD is a chronic and persistent illness in primary care patients. KeywordsGAD; psychiatric treatment; GAD course; anxiety; primary careGeneralized anxiety disorder (GAD) is a highly prevalent mental illness with 1-year and lifetime prevalence rates in the general population at 3.1% and 5.1%, respectively . As many researchers have noted (e.g., Culpepper, 2002), GAD represents a particular problem in the primary care field, where GAD patients are frequently encountered but often unrecognized (Fifer et al., 1994; Niesenson et al., 1998;Wittchen et al., 2002). Anxiety disorder patients in general, and GAD patients in particular, are also among the highest utilizers of medical services (Greenberg et al., 1999;Katon et al., 1990;Rice and Miller, 1998;Roy-Byrne and Katon, 1997). Thus, studying GAD specifically within the primary care population is particularly timely and relevant. Despite the prevalence of GAD, few studies have examined the illness's natural course. Most of the data currently available on the course of GAD are retrospective and have come from epidemiological studies (e.g., Kessler et al., 1999;Wittchen et al., 1994) and/or from short-term follow-ups of patients involved in treatment studies (e.g., Mancusco et al., 1993;Rickels and Schweizer, 1993). One of the only naturalistic, prospective studies of the course of GAD conducted to date found low rates of recovery from GAD among psychiatric outpatients, with high rates of subsequent recurrence among those who do recover (Yonkers et al., 1996(Yonkers et al., , 2000. This same study identified better psychosocial functioning in general, and in specific functioning domains (e.g., relationships with spouse, and life satisfaction, etc.) as significant predictors of GAD recovery.While the results of the studies by Yonkers et al. (1996Yonkers et al. ( , 2000 provide important insights into the naturalistic course of GAD, several aspects of that study's sample need to be considered when interpreting the course findings. First, recruiting the GAD sample from psychiatric treatment settings may represent a significant departure from the typical GAD pat...