Fear Of Catastrophe Research Articles

Bridging the gap: Utilizing insights from exposure therapy in the innovation of chronic musculoskeletal pain treatment.

For some time, the gold standard treatment for anxiety disorders has been exposure therapy, defined as the repeated approach of anxiety-inducing situations, memories, or physiological sensations. Existing treatments to target fear and avoidance of pain can be augmented by innovations from exposure research in the anxiety disorders, including greater emphasis on safety learning, the utilization of imaginal exposure to catastrophic fears, and exposure to contrasting emotions. Given that treatments to target core, maintaining mechanisms of anxiety, including imaginal exposures, can be administered as self-directed treatments without therapist involvement, they represent important avenues for ensuring the millions of people with chronic musculosketal pain can gain access to psychosocial treatment and reduce the interference of pain in their lives. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Central psychological symptoms from a network analysis of patients with anxiety, somatoform or personality disorders before psychotherapy

BackgroundCross-sectional network analysis examines the relationships between symptoms to explain how they constitute disorders. Up to now, research focuses mostly on depression, posttraumatic stress disorder, and rarely assesses larger networks of various symptoms measured with instruments independent of classifications. Studies on large groups of psychotherapy patients are also rare. MethodsAnalyzing triangulated maximally filtered graph (TMFG) networks of 62 psychological symptoms reported by 4616 consecutive nonpsychotic adults in 1980–2015. ResultsCase-dropping and nonparametric bootstrap proved the accuracy, stability and reliability of networks in patients' sex-, age-, and time of visit divided subgroups. Feeling that others are prejudiced against the patient was the most central symptom, followed by catastrophic fears, feeling inferior and underestimated. Sadness, panic, and sex-related complaints were less central than we expected. All analysed symptoms were connected, and we found only small sex-related differences between subsamples' networks. No differences were observed for time of visit and age of patients. LimitationAnalyses were cross-sectional and retrospective, not allowing examination of directionality or causality. Further, data are at the between-person level; thus, it is unknown whether the network remains constant for any person over time. One self-report checklist and building binary network method may bias results. Our results indicate how symptoms co-occured before psychotherapy, not longitudinally. Our sample included public university hospital patients, all White-Europeans, predominantly females and university students. ConclusionsHostile projection, catastrophic fears, feeling inferior and underestimated were the most important psychological phenomena reported before psychotherapy. Exploring these symptoms would possibly lead to enhancement of treatments.

Parenthood after severely endangered pregnancy and delivery of a prematurely born child: An interview study with fathers and mothers

This study aims to gain insight into the development of parenthood six months after delivery of a preterm infant due to the mother’s preeclampsia or HELLP syndrome. In this qualitative interview study, we conducted individual interviews with the Working Model of the Child Interview to tap into the subjective experiences of parents who went through preterm delivery due to preeclampsia or HELLP. The interview data were analyzed using thematic analysis. From February up to and including December 2017, parental couples were included of whom the mother had suffered from severe preeclampsia or HELLP, and whose child had been born at a gestational age of less than 32 weeks. Parents also filled out a depression, an anxiety and a bonding questionnaire. Five parental couples, five fathers and five mothers, were interviewed. Many statements made clear that these parents are undergoing a distinctive development. Fear of losing the baby was still central to all parents and they were afraid of being a parent or forming a loving bond. Importantly, both fathers and mothers described loss of control, recurring memories and catastrophic fears. Psychological support should help parents regulate the shock, process traumatic experiences and integrate the frightening life event into parenthood development. Therefore, proper monitoring of parenthood development is necessary to detect problems, intervene and prevent adverse consequences.

Associations between Insomnia Symptoms and Anxiety Symptoms in Adults in a Community Sample of Southeastern Pennsylvania, USA.

Although insomnia is reliably associated with anxiety symptoms, aspects of insomnia may differentially relate to one anxiety symptom versus another. Therefore, treatment for insomnia comorbidity with anxiety might be individually tailored to optimize treatment response. Working from this hypothesis, we analyzed data from a survey of 1007 community-dwelling adults. Insomnia was measured using the Insomnia Severity Index (ISI), categorizing items as nighttime disturbances, daytime dysfunction, or self-perceived dissatisfaction. Anxiety symptoms were measured with the Generalized Anxiety Disorder 7-item questionnaire (GAD-7). Linear and binomial logistic regression were used and adjusted for covariates. Post hoc forward stepwise analyses determined which components of the insomnia contributed to individual anxiety symptoms. Significant associations between nighttime disturbance (β = 0.88 [0.44, 1.3]), daytime dysfunction (β = 1.30 [0.81, 1.80]), dissatisfaction (β = 1.20 [0.60, 1.7]) and total GAD-7 score were maintained after adjusting for covariates. Nighttime disturbance was associated with excess worrying, restlessness, irritability, and fear of catastrophe. Daytime dysfunction was associated with all symptoms except for fear of catastrophe, and self-perceived dissatisfaction was associated with all symptoms except irritability. Stepwise analyses revealed that daytime dysfunction and dissatisfaction were most consistently related to anxiety symptoms.Greater attention should be paid to daytime dysfunction in patients with insomnia and anxiety, as improving daytime functioning may improve anxiety.

Darkness on the Edge: Revisionary Black Radicalism in the Depression Era

Darkness on the Edge: Revisionary Black Radicalism in the Depression Era

Elders With Anticipatory Trauma

Chronic institutionalized elders may be iatrogenically misdiagnosed as psychotic when their traumatic fears of present and future bring about a dysfunctional retreat into their past experience. Once physical causes are ruled out, a psychogenic approach for these patients may be indicated, particularly in group settings designed to reverse anticipatory trauma by confronting and resolving catastrophic fears of death and disability. These groups may be intensive, daily, and cover many months. Success will be followed by careful discharge planning with post-discharge support and follow-up. Research and replication on the re-introduction of this intervention holds promise for current 21st-century practice, particularly for these elder patients and their valuable memories. They have much of post-trauma value to contribute.

Cognitive Behavioral Therapy Treatment for a Woman with Bowel and Bladder Obsession

Changes in autonomic function which results from anxiety can lead to an urge to defecate or urinate. In some patients, an exaggeration in visceral sensations can be accompanied by obsession and catastrophic fears that the patient may imminently lose control of their bladder or bowel functioning. The condition, known as bowel/bladder control anxiety (henceforth BBCA) disorder can hurt the social quality of life. In this paper, a case of a woman with bowel/bladder control anxiety disorder is presented. The patient was treated using cognitive behavioral therapy (henceforth CBT) to manage her anxiety about the imminent loss of control of her bowel, which had pushed her to avoid traveling outside of her house. Treatment consisted of six sessions of CBT. At the end of the therapy, the patient reported increased confidence to go outside her home, suggesting that CBT could be useful in the management of bowel/bladder control anxiety disorders.

Maladaptive beliefs in relationship obsessive compulsive disorder (ROCD): Replication and extension in a clinical sample

Obsessive-compulsive symptoms focusing on interpersonal relationships may include obsessive doubts and preoccupation centered on the relationship (i.e., relationship-centered) or the relationship partner (i.e. partner-focused). Although general obsessive beliefs have been associated with relationship obsessive-compulsive disorder (ROCD), perfectionism and catastrophic relationship beliefs may particularly relevant to the maintenance and development of such symptoms. We assessed the unique contributions of specific perfectionism dimensions and catastrophic relationship beliefs to relationship-centered and partner-focused ROCD symptoms. Participants included 124 individuals recruited online reporting that they had received a diagnosis of ROCD by a qualified clinician completed a battery of questionnaire tapping maladaptive beliefs previously associated with obsessive-compulsive disorder (OCD), multidimensional perfectionism and catastrophic relationship beliefs. Perfectionistic concern over mistakes and doubts about actions, catastrophic beliefs regarding being in the wrong relationship and of being alone were found to be unique predictors of relationship-centered ROCD symptoms over and above mood symptoms. Only catastrophic fears of being in the wrong relationships predicted partner-focused ROCD symptoms. Perfectionistic tendencies as well as specific relationship-related beliefs may be more strongly implicated than OCD-related maladaptive beliefs in the development and maintenance of relationship-centered ROCD symptom. More research is needed to identify more specific beliefs associated with partner-focused ROCD symptoms.

“Bring Them Back Alive!”: Fear and the Macabre in US Automobile Tire Advertising

Abstract: Tire companies consistently distinguished themselves by preying upon fears of catastrophe. Ads regularly referred to flat tires and blowouts, and even more surprisingly, alluded to people being maimed and killed. No other companies so directly linked their products to the dangers inherent in traveling by car. The target for these ads was generally men, even when they appeared in women’s magazines, with the industry expectation that men were the principal decision makers and purchasers of this type of car component.

Health Risks Associated with Oil Pollution in the Niger Delta, Nigeria.

Background: Although there is considerable public concern about the environmental impacts of oil pollution in the Niger Delta of Nigeria, actual evidence on the pathological and psychological effects in the health of local communities is minimally known. We sought to associate the perspective measures of exposure to oil pollution with health outcomes (inventory of health symptoms and functional capacity limitations) and determine how emotional reactions to environmental risks moderate these health outcomes. Method: The study was conducted with 600 participants selected from five local government areas in Akwa Ibom State where oil pollution is rampant. A structured questionnaire was used to collect the data on the respondents’ exposure to oil pollution, self-rated health and disease symptoms, perception of risk of exposure and emotional reactions to local oil pollution. Results: Most of the participants lived in areas with visible oil pollution and/or near gas flaring facilities and regularly suffered direct exposure to oil in their environment. High level of emotional distress was a part of everyone's life for the study population. Risk perception in the study area was mediated, to a large extent, by dreaded hazards (catastrophic fears of pipeline explosions and oil spill fire), visual cues (gas flares and smoke stacks) and chemosensory cues (off-flavor in drinking water). The exposure metrics were found to be significant predictors of the health effects and influencing factors (emotional reactions). Multi-levels models suggest that at the individual level, the demographic variables and direct contact with oil pollution were important mediators of functional capacity limitation. At the community level, emotional distress from fear of the sources of exposure was an important mediator of the health symptoms. Conclusions: This study documents high levels of disease symptoms and environmental distress (worry, annoyance and intolerance) associated with oil pollution in the Niger Delta areas of Nigeria. It highlights the need for some intervention to ameliorate the psychological distress associated with living under such environmental adversity.

An imagery-based road map to tackle maladaptive motivation in clinical disorders.

There is now a widespread recognition of the importance of mental imagery in a range of clinical disorders (1). This provides the potential for a transdiagnostic route to integrate some aspects of these disorders and their treatment within a common framework. This opinion piece argues that we need to understand why imagery is such a central and recurring feature, if we are to progress theories of the origin and maintenance of disorders. This will aid us in identifying therapeutic techniques that are not simply targeting imagery as a symptom, but as a manifestation of an underlying problem. As papers in this issue highlight, imagery is a central feature across many clinical disorders, but has been ascribed varying roles. For example, the involuntary occurrence of traumatic memories is a diagnostic criterion for PTSD (2), and it has been suggested that multisensory imagery of traumatic events normally serves a functional role in allowing the individual to reappraise the situation (3), but that this re-appraisal is disabled by extreme affective responses. In contrast to the disabling flashbacks associated with PTSD, depressed adults who experience suicidal ideation often report “flash forward” imagery related to suicidal acts (4), motivating them to self-harm. Socially anxious individuals who engage in visual imagery about giving a talk in public become more anxious and make more negative predictions about future performance than others who engage in more abstract, semantic processing of the past event (5). People with Obsessive Compulsive Disorder (OCD) frequently report imagery of past adverse events, and imagery seems to be associated with severity (6). The content of intrusive imagery has been related to psychotic symptoms (7), including visual images of the catastrophic fears associated with paranoia and persecution. Imagery has been argued (8) to play a role in the maintenance of psychosis through negative appraisals of imagined voices, misattribution of sensations to external sources, by the induction of negative mood states that trigger voices, and through maintenance of negative schemas. In addiction and substance dependence, Elaborated Intrusion (EI) Theory (9, 10) emphasizes the causal role that imagery plays in substance use, through its role in motivating an individual to pursue goals directed toward achieving the pleasurable outcomes associated with substance use. In this opinion piece, we would like to put forward the proposition that the motivating role that imagery plays in behavior may be a key reason for its presence in this wide range of psychopathologies, and that understanding its motivating role can help us identify common features in disorders and their treatments. It has already been recognized that the link between imagery and affect gives imagery a causative role in affective disorders (11), with the emotional amplifier hypothesis suggesting that in bipolar and anxiety disorders, state-congruent imagery leads to further affective responses, in a vicious cycle. Within EI Theory, the affective consequences of imagery are also used to explain why a cycle of elaboration follows an initial intrusive thought. The intrusive thoughts themselves are seen as the product of associative processes relating to both environmental cues and cognitions. Previous work on EI Theory focused initially on desires, and then on motivation in general. Our suggestion here moves a step further, highlighting its potential relevance to dysfunctional motivational imagery in multiple disorders.

Despair and hope: on some varieties of countertransference and enactment in the psychoanalysis of ASD (autistic spectrum disorder) children

This article attempts to deal with the feelings of despair and hope in the analyses of autistic spectrum disorder (ASD) children. The analyst’s therapeutic despair and hope might reflect both the child’s split-off and fragmented primitive unconscious phantasies regarding traumatic breakdown, as well as his or her hidden search for reparation. This autistic reparation involves the phantasised acquisition of bodily and mental coverage and containing forms. These phantasies are deposited in the analyst and are manifested in various, sometimes hallucinatory, states of body and mind. The analyst’s ability to move freely between states of despair and hope is thus a crucial factor in maintaining mental space, in reaching for a better understanding of the child and in promoting his development. Using clinical material drawn from two analyses of a young girl and a male adolescent, the article describes the analyst’s countertransference reactions of somatic hallucinations and the phantasies regarding ‘the virtual child’. These represent both the child’s attempts to use the analyst’s mind in order to get rid of catastrophic fears of breakdown and change as well as to convey various means of phantasised autistic reparation and hopes for a benign psychological birth. All these are part of the process of ‘mantling’, in which the child acquires advanced forms of psychic coverage replacing previous autistic objects and autistic sensation shapes. In addition, an attempt is made to differentiate between false and true hope in the process of emergence from autistic encapsulation.

The explosion of the present and the encapsulation of time: Transference phenomena in the analysis of a psychotic patient

The paper deals with some basic problems concerning the experience of time and space in the psychoanalytic treatment of psychotic patients. Whereas borderline patients tend to distort the experience of time and space under emotional pressure, the concepts of time and space seem to dissolve in acute psychotic states of mind. Sometimes this manifests itself in an explosion of the present, where the past is ubiquitous and the future is perceived as the end of all times.The case of a 48 year‐old patient with the external diagnosis of ‘paranoid–hallucinatory schizophrenia’ is presented to illustrate that the main task is to recreate a structure to contain the experience of space and time. Such a development may occur if primitive psychotic anxieties can be taken up and metabolized. A near‐psychotic decompensation before the first break and the development of a transference psychosis in the second year of the analysis are depicted in detail. Subsequently some developments became visible which helped the patient to better tolerate catastrophic fears of loss. This included the formation of a structure which the patient called ‘hibernation’ enabling her to psychically survive without falling apart. By retreating into her ‘time capsule’ she managed to overcome breaks and to delay her fears of fragmentation until they could be taken up and worked through in the transference. The creation of a structure like the patient's ‘time capsule’ is considered to be an attempt to construct the experience of time and space. It prevented a collapse of her internal space thereby enabling further steps towards thinking and symbolization. In conclusion, some theoretical and clinical aspects are discussed including the role of the countertransference.

A New 'Risky' World Order: Unstable Risk Premiums: Implications for Practice

Investors have to be offered risk premiums to invest in risky assets. These risk premiums take different forms in different asset markets: equity risk premiums (ERP) in stock markets, default spreads in bond markets and real asset premiums in other asset markets. These premiums have their roots in fundamentals and will vary as a function of uncertainty about the economy, the risk aversion of investors, information uncertainty and fear of catastrophe, among other factors. In practice, analysts in developed markets have generally looked backwards to estimate risk premiums, using historical data to arrive at their estimates. Implicitly, they assume that historical averages are not only precise but also that risk premiums are stable and revert back quickly to historical norms. In this paper, we present evidence that risk premiums in equity, bond and real asset markets are not only imprecise, but are also unstable and linked across markets. We present estimation approaches that are more in line with dynamic, shifting risk premiums. We argue that the resulting estimates can help use make more informed asset allocation and asset valuation judgments in portfolio management and better investment, financing and dividend decisions in corporate finance.

Reflections on catastrophic change

Bion asserted that the possibility of change inherent in emotional growth and development was inevitably linked to fears of catastrophe. Did he intend this to apply to all patients and parts of the mind, or only to psychotic areas of functioning? Does subsequent clinical experience substantiate the universality of this assertion? These questions will be taken up from a general theoretical perspective in an attempt to understand what Bion had in mind when he proposed this view, and a clinical case will be presented to illustrate and examine the link between catastrophe and change.

Commentary: Education and the Arts: The Windows of Imagination

This article focuses upon the significance of art experiences at moments of pervasive unease and uncertainty in the society surrounding the schools. Concerned more with a loss of expectation and a sense of futility than actual fear of catastrophe, I turn towards encounters with the several arts to activate imagination which, as Emily Dickinson wrote, may "light the slow fuse of possibility." The sense of possibility, of what might be, what ought to be, what is not yet--seems to be essential in moving the young to learn to learn. It may be nurtured, not only through art education as ordinarily understood, but also through aesthetic education, moving people by means of participation, to awaken to the wonders of authentic appreciation.

Fear of Catastrophe, Fear of Movement, Fear of Back Pain

Fear of Catastrophe, Fear of Movement, Fear of Back Pain

Diagnostic categories of dental anxiety: a population-based study

This study aimed to use a population-based sample to assess the psychological validity of the Seattle system for diagnosing dentally anxious individuals. This system consists of four diagnostic types in which such individuals are categorized according to the main source of their fear regarding dental treatment. Subjects were 1420 randomly selected adults aged 18 years and over who took part in a two-stage mail survey. The questionnaires contained measures of dental anxiety and standardized measures of general anxiety and fearfulness. Allocation to the Seattle categories was based on responses to four diagnostic items. Overall, 16.4% of the sample were dentally anxious. Their distribution across the four Seattle types was as follows: type I (simple conditioned phobia) – 49.6%; type II (fear of catastrophe) – 7.8%; type III (generalized anxiety) – 19.4% and type IV (distrust of dentists) – 9.9%. The remaining 13.3% could not be categorized. Judging by their scores on measures of dental anxiety, these subjects were borderline cases. Scores on the measures of anxiety and fearfulness indicated that the diagnostic system was valid and identified sub-groups of the dentally anxious population which were internally consistent. However, all subjects indicated extreme fear of dental treatment and were broadly similar in terms of their cognitive and behavioral responses to dental care. Of particular interest was the distribution of diagnoses according to age. Younger subjects were more likely to be categorized as type I, while older subjects were more likely to be categorized as type III. Overall, the results indicate that dental anxiety is a complex fear with a number of components.

Dental Hygiene Fear: Gender and Age Differences

Studies aimed at examining gender and age differences as they relate to dental anxiety have begun to appear in the literature. The purpose of this investigation was to explore fear and anxiety in a dental hygiene setting and evaluate gender and age differences among four sub-scales of dental hygiene fear. The Dental Hygiene Fear Survey (DHFS) was developed to address patient reaction to dental hygiene treatment. The University of Washington Dental Fears Model was the theoretical model used for it identifies four domains of dental fear: fear of specific stimuli, generalized anxiety, fear of catastrophe, and distrust. Males and females respond differently to dental hygiene treatment with women reporting significantly (p<.05) greater fear overall than males. Examination of the four dental hygiene fear sub-scales show that females report greater fear (p<.05) in relation to specific fear and generalized anxiety. There were no significant differences across age categories on total fear scores or within any of the sub-scales. Characterization of the dental hygiene fear patient along with knowledge of procedures that elicit anxiety can assist the practitioner in recognizing dental hygiene-related fear. With this foundation, the practitioner can then develop management strategies specific to this phenomenon.

The Modernity of Ethnic Identity and Conflict

Widespread apprehension and fear of catastrophe pervade the world at the close of the twentieth century. The Cold War finale, paradoxically, has not brought an end to history or opened an era of universal peace and democratic capitalism. Instead, we see violent conflicts between weakened states and rebellious ethnonational communities. An explanation cannot be found in primordialist theories or current expediency—instead, we must look to historical forces rooted in modernity and the rise and fall of industrial empires. From their ashes a host of newer states and mobilizing ethnic nations have arisen, all hoping to experience the fruits of modernization: notably industrialization, democracy and nationalism.