Problem drinking during the college years is a significant public health concern. The goal of the current review was to examine the primary psychosocial factors that predict problem drinking in college students. Variables examined included demographic variables, personality, drinking history, alcohol expectancies, drinking motives, stress and coping, activity involvement, and peer and family influence. Evidence from studies of college drinking indicated that the variables associated with college drinking seem to vary at levels dealing with one's personality and coping mechanisms, one's thought processes about drinking, and the environment. It seems that expectancies and drinking motives may serve as explanations for the pathways from certain personality types (i.e., sensation seeking and neurotic) to problem drinking in the college setting. Factors that predicted future drinking problems after college were also examined. Overall, it seems that interventions and prevention programs would need to reach college students at all three levels--the environment, individual personality traits, and cognitive processes. Future research should address the limitations in the previous research as well as test comprehensive models of college drinking.
Background: This article presents results of the acute treatment phase of a 2-site study comparing cognitive behavioral group therapy (CBGT) and treatment with the monoamine oxidase inhibitor phenelzine sulfate for social phobia.
Forty-nine patients participated in a study comparing cognitive-behavioral group treatment (CBGT) for social phobia with a credible placebo control. CBGT consisted of exposure to simulated phobic events, cognitive restructuring of maladaptive thoughts, and homework for self-directed exposure and cognitive restructuring between sessions. Control patients received a treatment package consisting of lecture-discussion and group support that was comparable to CBGT on measures of treatment credibility and outcome expectations. At pretest, posttest, and 3-and 6-month follow-ups, patients completed assessments that included clinician ratings, self-report measures, and behavioral physiological and cognitive-subjective measures derived from a behavioral simulation of a personally relevant phobic event. Both groups improved on most measures, but, at both posttest and follow-up, CBGT patients were rated as more improved than controls and reported less anxiety before and during the behavioral test. At follow-up, CBGT patients also reported significantly fewer negative and more positive self-statements than controls on a thought-listing task following the behavioral test. Regardless of treatment condition, follow-up changes in clinician-rated phobic severity were significantly related to changes on the thought-listing measure.
A revised Stroop color-naming task was used to test hypotheses derived from Beck's cognitive theory of anxiety disorders which proposes that social phobics are hypervigilant to social-evaluative threat cues. Color-naming latencies for social and physical threat words were compared to matched neutral words for both social phobics and individuals with panic disorder. As predicted, social phobics showed longer latencies for social threat words, and panickers had longer latencies for physical threat words. Latency for color-naming social threat words correlated with self-reported avoidance among social phobics. These results are consistent with Beck's notion of self-schemata which facilitate the processing of threat cues. Methodological issues and clinical implications are discussed.
There is scattered but significant psychological and neuropsychological evidence to suggest that mild traumatic brain injury (mild TBI) plays a notable role in the emergence and expression of anxiety. Conversely, there is also empirical evidence to indicate that anxiety may exert a pronounced impact on the prognosis and course of recovery of an individual who has sustained a mild TBI. Although the relationship between mild TBI and anxiety remains unclear, the present body of research attempts to elucidate a number of aspects regarding this topic. Overall, the mild TBI research is rife with inconsistencies concerning prevalence rates, the magnitude and implications of this issue and, in the case of PTSD, even whether certain diagnoses can exist at all. This review obviates the need for greater consistencies across studies, especially between varying disciplines, and calls for a shift from studies overly focused on categorical classification to those concerned with dimensional conceptualization.
Although research from numerous investigations indicates that there is substantial overlap in anxiety and depressive symptoms and comorbid diagnoses in youth, these constructs can be adequately differentiated. Clark and Watson [Clark, L. A. & Watson, D., (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336] proposed a tripartite model to account for the symptom overlap and diagnostic comorbidity between anxiety and depression. This tripartite model posits that anxiety and depression share a common component of negative affect, but can be differentiated by low positive affect associated with depression and high physiological hyperarousal associated with anxiety. The present article reviews initial research which has supported the utility of the tripartite model for explaining the association between anxiety and depression in adult and youth samples. Following that review, more recent investigations which have called into question the applicability of the tripartite constructs for youth are presented. Finally, the paper reviews evidence suggesting that the tripartite factors may not function similarly across all anxiety and depressive disorders. This article concludes by suggesting that more research is necessary with children and adolescents in order to determine the functioning of tripartite constructs across anxiety disorders in youth.
Research on lesbian, gay, and bisexual (LGB) individuals has long examined outness, or openness about one's sexual orientation, as an important predictor of health and well-being. The authors reconceptualized outness as a composite of two related but independent constructs: disclosure and concealment of sexual orientation. This conceptualization guided creation of the Nebraska Outness Scale (NOS), a 10-item measure with a concealment (NOS-C) and disclosure (NOS-D) subscale. The scale and subscales showed good internal reliability, discriminant, convergent, and predictive validity. As hypothesized, concealment showed a stronger relationship to mental health and well-being constructs than disclosure. Disclosure, but not concealment, also differed across sexual orientations with bisexual individuals reporting less disclosure and mostly gay/lesbian and gay/ lesbian individuals reporting successively higher levels. The authors conclude that concealment and disclosure are separate constructs and that concealment may be more relevant to minority stress processes among LGB individuals and may provide a more comparable measure across sexual orientation categories. Further research is needed to validate the scale and to examine the role that outness plays in minority stress among LGB individuals.
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