Psychiatry - Theses
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ItemThe relationship between anxiety vulnerability and stress in the cognitive processing of threat-related information( 2000-03)In order to clarify the relationship between anxiety vulnerability and clinical anxiety, information-processing models have been employed to examine the cognitive biases of anxious individuals for threat-related information. At the core of these models are research findings indicating that anxiety-linked attentional biases render high trait anxious individuals disproportionately vulnerable to the effects of stress. The current research, following the model of Williams, Watts, MacLeod, and Matthews (1988), tested the hypothesis that attention to threat-related information is due to the interaction of trait anxiety and state anxiety. Five comparable studies employed emotional Stroop and probe-detection paradigms to assess the attentional biases of high and low trait anxious individuals to threat-related words in response to elevations of stress. Four of the studies assessed the preconscious and conscious attentional biases of adults and one study investigated the attentional biases of children. This focus allowed developmental comparisons that had not been undertaken previously. The studies were comparable to each other and to previous research. The studies sought to clarify the effects of different forms of stress on the anxiety-linked attentional biases and to assess the effects of these stressors on domain-specific stimuli. The hypotheses were that, in response to elevations in state anxiety, high trait anxious individuals show increased attention to threat and low trait anxious individuals show avoidance of threat. It was expected that these threat-related attentional biases are identified at both preconscious and conscious levels of processing, and more when the stimuli are related to the individuals’ domain of concern. Contrary to expectations, only one study found the predicted pattern and this result occurred at a conscious level of processing. In addition to the lack of support for the hypotheses, a counter-intuitive alternative pattern that was the converse of predictions was identified in four of the five studies. In this pattern, in response to elevated stress, there was a trend for high trait anxious individuals to show decreased attention to threat and low trait anxious individuals to show increased attention to threat. The pattern was identified, in various studies, at conscious and preconscious levels of processing, and more in response to domain-specific stimuli. Adults and children showed similar levels and types of attentional biases. The results of the current studies show some convergence with previous research. The findings are discussed in the context of a proposed model that incorporated aspects of Williams et al’s theories (1988; Williams, Watts, MacLeod, & Mathews, 1977) and Mogg and Bradley’s (1988) theory. This model suggests that high and low trait anxious individuals’ patterns of threat-related attentional biases vary according to their different levels of reactivity to stress, which affects their threat threshold. Due to differences in this threat threshold, high and low trait anxious individuals show divergent attentional responses under the same level of external stress. The model incorporates the avoidance effects identified in previous research and theory. This model may explain both the current counter-intuitive findings and past inconsistencies in the literature. It may also clarify how individuals with different levels of anxiety vulnerability show divergent attentional responses to stress elevations. It is suggested that inclusion of the notion of subjective stimulus threat value into the cognitive processing paradigm may clarify some of the unresolved issues raised in this research.
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ItemPsychosocial mechanisms underlying cultural differences in depressive and anxiety illness symptom reporting and presentation: comparison of Greek-born immigrants and Anglo-Australians( 2003)The current research included three studies: a survey exploring psychological factors that may underly cultural differences in illness reporting and presentation; and a qualitative and a quantitative study exploring cultural differences in illness schemas. The purpose of the work is to examine the importance of a wide variety of factors that may underly cultural differences in the presentation and reporting of depression and anxiety. The total sample of respondents consisted of 221 Greek-born and 239 Anglo-Australian people (mean age 65 yrs). First, Greek-born people reported higher levels of depression (as measured by the Beck Depression Inventory-2, BD1-2) and anxiety (as measured by the State Trait Anxiety Inventory, STAI) and higher levels of stress, trait negative affectivity, illness concern, impression management, self-focused attention and stigma. Hierarchical regression analyses indicated that all explanatory variables were significant unique predictors of at least one BDI-2 and/or STAI measure when controlling for confounding variables such as socio-economic status, age and gender. Overall, Trait Negative Affectivity (TNA) was the most stable and consistent predictor of the BDI-2 and STAI scores for both birthplace groups. Conceptual similarities appear to exist for the causes and important symptoms components of illness schemas between mental and physical problems for the Greek-born. For the Anglo-Australians, similarities exist for the course and development, consequences and therapy components of illness schemas between mental, physical and social problems. The propensity to report particular types of symptoms to a doctor appeared to also be affected by illness schemas. Findings suggest that different presentation of depression and anxiety across cultures may be better understood by the degree to which processes underlying symptom reporting may be salient in different cultures.