Effects of psychotherapy on comorbid conditions in generalized anxiety disorder.

Comorbid diagnoses were examined in 55 principal generalized anxiety disorder (GAD) clients, and the effect of treatment for the principal disorder on those conditions was evaluated. High rates of comorbid diagnoses were present at pretherapy, with social and simple phobia being most common. The presence of additional diagnoses declined dramatically from pretherapy to follow-up and was significantly greater among clients for whom the GAD therapy had been successful than among clients for whom GAD outcome had been ambiguous. This was generally true regardless of whether clients reported at follow-up that they had received further therapy since the posttherapy assessment.

Women, anger, and cardiovascular responses to stress.

Cardiovascular reactivity (CVR) to stressful stimuli is predictive of future development of cardiovascular disease (CVD). Anger appears to be an important mediator of this relationship. Unfortunately, the majority of research in this area has utilized predominantly male subjects, leaving the relationship between CVD and anger in females largely unexplored. To address the dearth of research among females, the present study examined the relationship between Anger-In, as well as Anger-Out, and CVR to stressors among women. Females reporting moderate levels of Anger-Out exhibited lower blood pressure reactions to a mental arithmetic stressor than females reporting high and low levels of Anger-Out. Females reporting moderate levels of Anger-Out also exhibited lower heart rate reactions than individuals reporting high levels of Anger-Out. Anger-In was not related to CVR in the present study.

Psychopathology correlates of binge eating and binge eating disorder.

The present study examined the psychopathology associated with binge eating disorder (BED), a new diagnostic category proposed for DSM-IV to classify patients with significant binge eating problems in the absence of purging. Self-report measures of psychopathology (e.g., depression, anxiety) and body image disturbance were administered to 72 women who prospectively (1) met criteria for BED (DSM-IV criteria), (2) reported frequent bingeing but did not meet BED criteria, and (3) denied problems with eating. Subjects satisfying BED criteria reported higher levels of psychopathology than normals on all measures and subclinical binge eaters scored between these two groups, but they were closer to subjects without eating problems. The pattern of results was essentially unchanged when corrected for weight. BED subjects and subclinical binge eaters were less satisfied with their bodies than were normal controls. These findings suggest that BED is not only characterized by frequent bingeing, but more importantly is associated with elevated psychopathology. Overall, these results lend support to the diagnostic criteria proposed for BED.

The effects of stress, mood, and coping on blood glucose in NIDDM: a prospective pilot evaluation.

Eight subjects (Ss) with non-insulin-dependent diabetes (NIDDM) monitored their stress, blood glucose (BG), food intake, activity (via pedometer), mood, and coping responses for 8 days. They alternated 2 daily, self-selected ADA food-exchange diets to control for the effects of stress on adherence to diet. BG was significantly higher on high-stress compared to low-stress days. This effect was at least partially mediated by the effect of stress on activity; Ss were significantly less active on high-stress days. Further analyses suggested idiosyncratic relationships between mood and BG, and some evidence was found to suggest a relation between stress, coping, and BG.

Exposure with response prevention and serotonergic antidepressants in the treatment of obsessive compulsive disorder: a review and implications for interdisciplinary treatment.

A comprehensive review of controlled investigations examining the effectiveness of exposure with response prevention (ERP) and clomipramine (CMI), as well as other serotonergic anti-depressants, in the treatment of Obsessive Compulsive Disorder (OCD) was conducted. Overall, findings suggested that ERP is more effective than CMI, particularly in alleviating rituals, but CMI may be more effective in reducing obsessive compulsive behavior among individuals with concomitant severe depression, obsessions only, and overvalued ideation. In addition, the literature favors ERP in terms of side-effects and risks, dropout, and maintenance, while one advantage of drug therapy is that less time and effort are required by the therapist and patient. Directions for interdisciplinary treatment are discussed.

The effect of social support and physical touch on cardiovascular reactions to mental stress.

To examine the effects of social support on cardiovascular reactions to behavioral stress, the present study tested the relative contribution of three elements of social support: the presence of another person in the laboratory; the presence of a person considered to be a friend; and physical touch. Sixty undergraduate females were assigned to one of the following groups: alone (A); friend present-touch (FT); friend present-no touch (FNT); stranger present-touch (ST); and stranger present-no touch (SNT). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) measures were obtained across baseline phases and during presentation of two behavioral challenges (mental arithmetic, mirror-tracing). The findings suggest that neither the presence of a stranger nor physical touch are related to attenuated cardiovascular reactions to stress; rather, if the extent of cardiovascular reactivity is related to social support, the presence of a friend may be the important mediating variable.

Reducing heart rate reactivity to stress with feedback. Generalization across task and time.

Heart rate (HR) reactions to two behavioral stressors (videogame and mental arithmetic) were measured in 8 experimental subjects who received biofeedback training and 8 matched control subjects during three assessment periods: pretraining, posttraining, and one-week follow-up. Experimental subjects exhibited significant reductions in HR following a training session in which they received ongoing HR feedback while playing a videogame. Control subjects, who played the same number of videogames without HR feedback, showed smaller HR reductions. During the training session, all subjects were instructed to reduce HR while maximizing game performance. In comparison to controls, experimental subjects (a) maintained lower HRs during videogame presentations after a one-week period and (b) generalized these HR reductions to the mental arithmetic challenge at follow-up. Performance on the videogame declined from posttraining to follow-up for experimental subjects but not for control subjects. No group difference in mental arithmetic performance was observed.

Assessment of cardiovascular reactivity across laboratory and natural settings.

The purpose of this investigation was to examine the stability of heart rate and blood pressure reactions of individuals across laboratory challenges and a challenge in the natural environment. Undergraduate musicians' heart rates and blood pressures were measured during anticipation and in response to a mental arithmetic challenge and a visual-verbal concepts challenge in the laboratory and anticipation of a musical performance jury in the natural environment. Results revealed that systolic blood pressure reactivity measured in anticipation of laboratory challenges, but not during these tasks, was related to systolic blood pressure levels measured in anticipation to the musical performance jury. Generalization of heart rate and diastolic blood pressure reactivity across settings was not supported. Systolic blood pressure, diastolic blood pressure, and heart rate reactions were stable across laboratory tasks.