General Educational Development (GED) and Educational Attainment Equivalency for Demographically Adjusted Norms†.

OBJECTIVE: To investigate whether the General Educational Development (GED) certificate should be considered equivalent to a standard 12-year high school education when performing demographic corrections on neuropsychological performance levels. If the GED certificate and high school diploma reflect comparable levels of educational achievement, then performance on the Test of Premorbid Function (TOPF) and selected WAIS-IV indices should not differ between groups. METHOD: Archival neuropsychology data were reviewed to identify patients who either (1) did not complete high school and did not subsequently obtain a GED, (2) did not complete high school but subsequently obtained a GED, or (3) completed high school and did not obtain any further formal education. Most patients were programmatic referrals for epilepsy surgery evaluation, although referrals from the general neurology clinic were also included. The primary dependent measures were the TOPF and WAIS-IV Full Scale IQ (FSIQ). RESULTS: High school graduates obtained higher scores on the TOPF (p < .01, partial η2 = 0.16) and FSIQ (p < .01, partial η2 = 0.14) as compared to both GED subjects and subjects withdrawing from high school with no GED. The non-GED group and the GED group did not differ from each other. CONCLUSIONS: These findings demonstrate that the GED is not equivalent to a standard 12-year high school education when characterizing educational background. Although these data do not address what the appropriate year equivalent should be for the GED when adjusting performance for educational background, using 12 years will likely identify more areas of neuropsychological weakness simply by suggesting higher levels of premorbid ability.

The mediating role of state maladaptive emotion regulation in the relation between social anxiety symptoms and self-evaluation bias.

Although social anxiety symptoms are robustly linked to biased self-evaluations across time, the mechanisms of this relation remain unclear. The present study tested three maladaptive emotion regulation strategies - state post-event processing, state experiential avoidance, and state expressive suppression - as potential mediators of this relation. Undergraduate participants (N = 88; 61.4% Female) rated their social skill in an impromptu conversation task and then returned to the laboratory approximately two days later to evaluate their social skill in the conversation again. Consistent with expectations, state post-event processing and state experiential avoidance mediated the relation between social anxiety symptoms and worsening self-evaluations of social skill (controlling for research assistant evaluations), particularly for positive qualities (e.g. appeared confident, demonstrated social skill). State expressive suppression did not mediate the relation between social anxiety symptoms and changes in self-evaluation bias across time. These findings highlight the role that spontaneous, state experiential avoidance and state post-event processing may play in the relation between social anxiety symptoms and worsening self-evaluation biases of social skill across time.

Correspondence Between Self-Report Measures and Clinician Assessments of Psychopathology in Female Intimate Partner Violence Survivors.

Intimate partner violence (IPV) has potentially severe and long-lasting mental health consequences for survivors, including elevated symptoms and diagnoses of posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD). The current study examined the relationship between three self-report measures of psychological distress and ratings obtained from the corresponding clinician-administered measures in women seeking assessment for mental health problems following IPV ( N = 185). PTSD symptoms were assessed using the self-report Impact of Event Scale-Revised (IES-R) and the interview-based Clinician-Administered PTSD Scale (CAPS). Depression symptoms were assessed using the self-report Beck Depression Inventory-II (BDI-II) and the depressive disorders sections from the clinician-administered Anxiety Disorders Interview Schedule-IV (ADIS-IV). Anxiety symptoms were assessed using the self-report Beck Anxiety Inventory (BAI) and the clinician-administered GAD section from the ADIS-IV. Results indicated that psychological distress was prevalent in the sample, with 27% receiving a PTSD diagnosis, 40% diagnosed with a depressive disorder, and 55% meeting criteria for GAD. Although each self-report measure was significantly and positively correlated with its corresponding clinician-administered measure, rates of diagnostic concordance were mixed. The BDI-II showed a high degree of agreement with the ADIS-IV depression section, but the IES-R and the CAPS were discordant at classifying PTSD. The BAI had acceptable sensitivity but poor specificity in relation to the ADIS-IV GAD section. These findings suggest that multiple assessment modalities should be considered when rating symptoms and estimating the prevalence of diagnoses among survivors of IPV.

Understanding the role of dysfunctional post-trauma cognitions in the co-occurrence of Posttraumatic Stress Disorder and Generalized Anxiety Disorder: Two trauma samples.

This report focuses on the co-occurrence of PTSD-GAD and examines a factor that could operate to maintain both conditions, specifically negative post-trauma cognitions about the self, the world, and self-blame. Two separate help-seeking samples were examined: (a) a mixed gender sample of 301 individuals who had experienced a serious motor vehicle accident (MVA), a single incident, non-interpersonal trauma; and (b) a sample of 157 women who had experienced intimate partner violence (IPV), a recurrent, interpersonal trauma. When examined at the diagnostic level, posttraumatic cognitions for one diagnosis did not vary as a function of whether the other diagnosis was present. In the MVA sample, both diagnosed PTSD and GAD were associated with elevations in negative thoughts about the self. Diagnosed GAD was also significantly associated with negative thoughts about the world. In the IPV sample, diagnosed PTSD was associated with elevations in negative thoughts about the self only. When continuously measured PTSD and GAD were examined, results indicated that negative thoughts about the self showed significant simultaneous associations with PTSD and GAD in both samples. In the MVA sample, negative thoughts about the world and self-blame showed significant associations with PTSD but not with GAD. In the IPV sample, negative thoughts about the world and self-blame were not significantly associated with either PTSD or GAD. Results are discussed in light of current treatment models for these conditions, with emphasis on the potential for addressing transdiagnostic processes as a more effective approach to treating comorbid conditions following trauma.

Physical injury, PTSD symptoms, and medication use: examination in two trauma types.

Physical injury is prevalent across many types of trauma experiences and can be associated with posttraumatic stress disorder (PTSD) symptoms and physical health effects, including increased medication use. Recent studies suggest that PTSD symptoms may mediate the effects of traumatic injury on health outcomes, but it is unknown whether this finding holds for survivors of different types of traumas. The current study examined cross-sectional relationships between injury, PTSD, and pain and psychiatric medication use in 2 trauma-exposed samples, female survivors of motor vehicle accidents (MVAs; n = 315) and intimate partner violence (IPV; n = 167). Data were obtained from participants at 2 trauma research clinics who underwent a comprehensive assessment of psychopathology following the stressor. Regression with bootstrapping suggested that PTSD symptoms mediate the relationship between injury severity and use of pain medications, R(2)  = .11, F(2, 452) = 28.37, p < .001, and psychiatric medications, R(2)  = .06, F(2, 452) = 13.18, p < .001, as hypothesized. Mediation, however, was not moderated by trauma type (ps > .05). Results confirm an association between posttraumatic psychopathology and medication usage and suggest that MVA and IPV survivors alike may benefit from assessment and treatment of emotional distress after physical injury.

Global and local evaluations of public speaking performance in social anxiety.

Differences in the relative use of global and local information (seeing the forest vs. the trees) may explain why people with social anxiety often do not benefit from corrective feedback, even though they pay close attention to details in social situations. In the current study, participants high (n=43) or low (n=47) in social anxiety symptoms gave a series of brief speeches, and then self-rated their speaking performance on items reflecting global and local performance indicators (self-assessment) and also received standardized performance feedback from an experimenter. Participants then completed a questionnaire asking how they thought the experimenter would rate their performance based on the feedback provided (experimenter assessment). Participants completed the self- and experimenter assessments again after 3 days, in addition to a measure of postevent processing (repetitive negative thinking) about their speech performance. Results showed that, as hypothesized, the High SA group rated their performance more negatively than the Low SA group. Moreover, the High SA group's ratings of global aspects of their performance became relatively more negative over time, compared to their ratings of local aspects and the Low SA group's ratings. As expected, postevent processing mediated the relationship between social anxiety group status and worsening global performance evaluations. These findings point to a pattern of progressively more negative global evaluations over time for persons high in social anxiety.

Post-event processing and memory bias for performance feedback in social anxiety.

Despite predictions following from cognitive theories of anxiety, evidence for memory biases in social anxiety has been mixed. This study extends previous research by using stimuli relevant to participants' concerns and allowing time for post-event processing. Participants high (n=42) or low (n=39) in social anxiety symptoms gave speeches and received standardized feedback on their and a confederate's performance. Participants then took recognition and recall tests for the feedback immediately after it was given and after a two-day delay. Results showed no recall biases. However, the hypothesized recognition biases were found: the high social anxiety group remembered the confederate's feedback more positively than their own, remembered their negative feedback as worse than the low group, and diminished positive feedback over time. Moreover, post-event processing mediated the relationship between social anxiety and memory for negative feedback. Results suggest that biased recognition of social feedback is linked to social anxiety.

Imagery and fear influence height perception.

The current study tested whether height overestimation is related to height fear and influenced by images of falling. To assess perceptual biases, participants high (n=65) versus low (n=64) in height fear estimated the vertical extents of two balconies using a visual matching task. On one of the balconies, participants engaged in an imagery exercise designed to enhance the subjective sense that they were acting in a dangerous environment by picturing themselves falling. As expected, we found that individuals overestimated the balcony's height more after they imagined themselves falling, particularly if they were already afraid of heights. These findings suggest that height fear may serve as a vulnerability factor that leads to perceptual biases when triggered by a stressor (in this case, images of falling).

A new mode of fear expression: perceptual bias in height fear.

Emotion and psychopathology researchers have described the fear response as consisting of four main components--subjective affect, physiology, cognition, and behavior. The current study provides evidence for an additional component in the domain of height fear (perception) and shows that it is distinct from measures of cognitive processing. Individuals High (N = 35) and Low (N = 36) in acrophobic symptoms looked over a two-story balcony ledge and estimated its vertical extent using a direct height estimation task (visual matching), and an indirect task (size estimation); the latter task seems to exhibit little influence from cognitive factors. In addition, implicit and explicit measures of cognitive processing were obtained. Results indicated that, as expected, the High Fear group showed greater relative, implicit height fear associations and explicit threat cognitions. Of primary interest, the High (compared to Low) Fear group estimated the vertical extent to be higher, and judged target sizes to be greater, even when controlling for the cognitive bias measures. These results suggest that emotional factors such as fear are related to perception.

Baclofen for alcohol dependence: a preliminary open-label study.

BACKGROUND: Recent preclinical and clinical studies have shown that the gamma-aminobutyric acid-B agonist baclofen may be an effective treatment for reducing alcohol consumption. This preliminary open-label investigation examined the tolerability and effect of a 30-mg daily baclofen dose for reducing drinking, subclinical anxiety and depressive symptoms, and craving in alcohol-dependent subjects. METHODS: Nine men and three women participated in a 12-week trial during which they took baclofen on a 10 mg thrice-daily regimen and received four sessions of motivational enhancement therapy. Each participant received a comprehensive physical and psychiatric screening before being enrolled. At each visit, side effects were monitored with a revised version of the Systematic Assessment of Treatment Emergent Events-General Inquiry, and drinking data were collected via the timeline follow-back interview. Participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, and the Penn Alcohol Craving Scale at each visit. RESULTS: Baclofen was reasonably tolerated. Two participants discontinued because of side effects. No serious adverse events were noted. Six other individuals did not complete the trial. Overall, there were statistically significant reductions in the number of drinks per drinking day and the number of heavy-drinking days, and there was an increase in the number of abstinent days. Significant decreases in anxiety and craving were also shown. CONCLUSIONS: These findings suggest that baclofen is reasonably tolerated in an alcohol-dependent population, although the high dropout rate in the study is of concern. Baclofen may be effective for the reduction of drinking, anxiety, and craving for some alcohol-dependent individuals. A larger-scale placebo-controlled study is needed to further explore these effects and to determine the characteristics of those who respond to this medication.