Fear

Anxiety disorders are common in adolescents (ages 12 to 18) and contribute to a range of impairments. There has been speculation that adolescents with anxiety are at risk for being treatment nonresponders. In this review, the authors examine the efficacy of cognitive-behavioral therapy (CBT) for adolescents with anxiety. Outcomes from mixed child and adolescent samples and from adolescent-only samples indicate that approximately two-thirds of youths respond favorably to CBT. CBT produces moderate to large effects and shows superiority over control/comparison conditions. The literature does not support differential outcomes by age: adolescents do not consistently manifest poorer outcomes relative to children. Although extinction paradigms find prolonged fear extinction in adolescent samples, basic research does not fully align with the processes and goals of real-life exposure. Furthermore, CBT is flexible and allows for tailored application in adolescents, and it may be delivered in...

Over the course of natural history, countless animal species have evolved adaptive behavioral systems to cope with dangerous situations and promote survival. Emotional memories are central to these defense systems because they are rapidly acquired and prepare organisms for future threat. Unfortunately, the persistence and intrusion of memories of fearful experiences are quite common and can lead to pathogenic conditions, such as anxiety and phobias. Over the course of the last 30 years, neuroscientists and psychologists alike have attempted to understand the mechanisms by which the brain encodes and maintains these aversive memories. Of equal interest, though, is the neurobiology of extinction memory formation as this may shape current therapeutic techniques. Here we review the extant literature on the neurobiology of fear and extinction memory formation, with a strong focus on the cellular and molecular mechanisms underlying these processes.

O objetivo geral do Diagnóstico da Violência e Criminalidade do Município de
Itabuna é aprofundar a análise dos principais problemas de violência e criminalidade,
bem como a percepção da população sobre os mesmos, buscando identificar os
principais fatores de risco e oportunidades de solução dos problemas enfrentados e
mobilizar os atores governamentais e não-governamentais, facilitando assim a
implementação das estratégias de intervenção propostas pelo projeto. A sua
importância não está apenas na divulgação de dados estatísticos sobre a segurança
pública no município, mas na transformação desses dados estatísticos brutos em algo
que possa servir para orientar ações futuras.

Background and objective: Several cognitive-behavioral factors contribute to the persistence of pain disability in patients with chronic back pain. Fear-avoidance beliefs and fear of movement/(re)injury in particular have been shown to be strong predictors of physical performance and pain disability. Patients reporting substantial pain-related fear might benefit from exposure in vivo to a set of individually tailored, fear-eliciting, and hierarchically ordered physical movements rather than more general graded activity. Patients and interventions: Six consecutive patients with chronic low back pain who reported substantial fear of movement/(re)injury were included in the study. After a no-treatment baseline measurement period, the patients were randomly assigned to one of two interventions. In the first intervention, patients received exposure in vivo first, followed by graded activity. In the second intervention, the sequence of treatment modules was reversed. Before each treatment module, treatment credibility was assessed. Daily measures of pain-related fear, pain catastrophizing, and pain intensity were completed using visual analog scales. In addition, standardized measures of pain disability, pain-related fear, and pain vigilance were taken before and after each treatment module and at the 1-year follow-up. To obtain more objective data on actual activity levels, an ambulatory activity monitor was carried by the patients during 1 week before and after each treatment module. Results: Time series analysis of the daily measures showed that improvements in pain-related fear and pain catastrophizing occurred only during the exposure in vivo and not during the graded activity, irrespective of the treatment order. Analysis of the pretreatment to post-treatment differences also revealed that decreases in pain-related fear also concurred with decreases in pain disability and pain vigilance and an increase in physical activity levels. All improvements remained at the 1-year follow-up.

Ultrasonic vocalization (USV) was found useful for differentiating fear and anxiety in rats. These affective states were established through a Pavlovian conditioning procedure. Danger stimulus, preceding unavoidable tail shock, elicited acute fear. Intertrial situational cues evoked anxiety. A safety signal (SS) indicating the omission of shock inhibited fear. Sustained 22-kHz USV characterized anxiety and was present between trials. A signal of danger resulted in immediate inhibition of vocalization, while a SS reversed this effect. These results are discussed in the context of three theories: Pavlovian, Bollesian and Konorskian. The anxiolytic drugs diazepam and buspirone (1 and 5 mg/kg) suppressed vocalization in the intertrial and SS periods. The reaction to the signal of danger remained complete inhibition of USV. Anxiogenic pentyletetrazole (1 and 5 mg/kg) enhanced intertrial vocalization, but did not affect its reoccurrence during the SS. Anxiogenic FG7142 (5 mg/kg) did not affect intertrial vocalization, but blocked its reappearance on the SS. It is suggested that the behavioral target of both anxiogenic drugs is different */pentyletetrazole supposedly exerts its anxiogenic effect by increasing situational anxiety, whereas FG7142 suppresses inhibition of fear.

Measures of PTSD and comorbidity were obtained at intake and 9-month follow-up. Measures also included potential mediators of therapeutic alliance, social support, problematic/undermining relationships and fear of emotion. Path analyses supported anger as a predictor of treatment outcome, with only fear of anger and alcohol comorbidity accounting for the variance between anger and outcome. To improve treatment effectiveness, clinicians need to assess veterans' anger, aggression, and alcohol use, as well as their current fear of anger and elucidate the relationship between these factors.

The medial prefrontal cortex (mPFC) has emerged as a key structure involved in the modulation of fear behavior over the past few decades. Anatomical, functional and electrophysiological studies have begun to shed light on the precise mechanisms by which different prefrontal regions regulate the expression and inhibition of fear behavior. These studies have established a canonical view of mPFC functions during fear behavior with dorsal regions selectively involved in the expression of fear behavior and ventral regions linked to the inhibition of fear behavior. Although numerous reports support this view, recent data have refined this model and suggested that dorsal prefrontal regions might also play an important role in the encoding of fear behavior itself. The recent development of sophisticated approaches such as large scale neuronal recordings, simultaneous multisite recordings of spiking activity and local field potentials (LFPs) along with optogenetic approaches will facilitate the testing of these new hypotheses in the near future. Here we provide an extensive review of the literature on the role of mPFC in fear behavior and propose further directions to dissect the contribution of specific prefrontal neuronal elements and circuits in the regulation of fear behavior.

Background The levels and experiences of harassment of people with mental health problems in the community compared with those of the general population have not been explored. Aims To measure the levels and experience of harassment experienced by people with mental health problems in the community in Scotland and compare them with the general population. Method Experiences of harassment were collected by interviewing 165 individuals with mental health problems and a control group of 165 people from the general population. Results Harassment in the community was found to be twice as common for individuals with mental health problems (41%) than for those in the general population (15%). The harassment commonly involved verbal abuse referring to the individual's mental health problems and was committed primarily by teenagers and neighbours. Conclusions Harassment has a significantly higher prevalence among individuals with mental health problems living in the community and is beli...

Mutations of the fragile X mental retardation 1 (FMR1) gene are the genetic cause of fragile X syndrome (FXS). The presence of significant socioemotional problems has been well documented in FXS although the brain basis of those deficits remains unspecified. Here, we investigated amygdala dysfunction and its relation to socioemotional deficits and FMR1 gene expression in children and adolescents on the FX spectrum (ie, individuals whose trinucleotide CGG repeat expansion from 55 to over 200 places them somewhere ...

The Meaning Maintenance Model asserts that following a meaning threat, people will affirm any meaning,frameworks,that are available. Three experiments tested 1) whether people affirm alternative meaning,frameworks,after reading absurdist literature; 2) the role of expectations in determining whether absurdities are threatening; 3) whether people have a heightened need for meaning following exposure to absurdist art. In Study 1, participants who

The selective serotonin reuptake inhibitors (SSRIs) are now being employed in the treatment of the full spectrum of anxiety disorders. In comparative trials, the SSRIs are proving to be equal or superior in efficacy to traditional antianxiety medications. Due to their favorable side effect profile, safety, and tolerability, they are rapidly replacing older agents in the treatment of anxiety. Neuroanatomical pathways that may be important in the antianxiety effect of the SSRIs are outline and discussed, followed by a review of the clinical evidence supporting the efficacy of this class of medications in the treatment of anxiety disorders.

This study explored the role of threat and contamination-related associations in spider phobia. Treatment-seeking (n ¼ 60) and non-phobic (n ¼ 30) individuals completed threat and disgustrelated Implicit Association Tests (IATs). Phobic individuals were assessed before and after one session of 2.5 h in vivo exposure. To differentiate actual treatment effects from test-retest effects on the IAT, half of the phobic individuals completed the IAT twice before treatment. Results showed that: (1) threat and contamination associations similarly distinguished between phobic and nonphobic participants on self-reports and IATs; (2) only self-reported threat associations incrementally predicted participants' overt avoidance behavior next to self-reported global affective associations;

One of the major limitations in the use of genetically modified mice for studying cognitive functions is the lack of regional and temporal control of gene function. To overcome these limitations, a forebrain-specific promoter was c o m b i n e d with the tetracycline transactivator system to achieve both regional and temporal control of transgene expression. Expression of an activated calcium-independent form of c a l c i u m -c a l m o d u l i n -d e p e ndent kinase II (CaMKII) resulted in a loss of h i p p o c a m p a l long-term potentiation in response to 10-hertz stimulation and a deficit in spatial memory, a form of explicit memory. Suppression of transgene expression reversed both the physiological and the memory deficit. When the transgene was expressed at high levels in the lateral amygdala and the striatum but not other forebrain structures, there was a deficit in fear conditioning, an implicit m e m o r y task, that also was reversible. Thus, the CaMKII signaling pathway is critical for both explicit and implicit m e m o r y storage, in a manner that is independent of its potential role in development.

The anterior cingulate cortex (ACC) is thought to be the neuroanatomical interface between emotion and cognition. Because effective emotion-cognition interactions are essential to optimal decision making, clarifying how the functionality of the ACC changes in older age using functional imaging holds great promise for ultimately understanding what contributes to the psychological changes occurring in late life. However, the interpretation of functional imaging studies is complicated by the fact that aging is associated with changes in grey matter volume and in the cerebral vasculature. In the present study, we obtained high-resolution structural magnetic resonance (MR) imaging data and quantitative blood flow images to examine the association between aging, blood flow, and grey matter volume in the ACC. Twenty-six healthy individuals between 25 and 79 years of age underwent quantitative [ 15 O]water positron emission tomography (PET) imaging. The ACC was traced onto tissue-classified images derived from T1-and T2-weighted MRIs using previously defined methods. The ACC was divided into dorsal, rostral, and subgenual regions. Age was negatively correlated with blood flow in dorsal and rostral ACC regions. Effects were weaker but in a similar direction for the subgenual ACC. While older age and lower blood flow were both associated with smaller rostral ACC grey matter volumes, mediation analysis revealed that grey matter volume only partially mediated the effect of age on blood flow in the rostral ACC. Neural alterations not detectable on MR images may lead to reduced blood flow due to fewer and/or less metabolically active neurons. Alternatively, lower blood flow may be a cause, rather than a consequence, of smaller grey matter volume in the ACC. M., 2002. Changes in regional cerebral blood flow abnormalities in late-life depression following response to electroconvulsive therapy. Psychiatry Clin. Neurosci. 56, 31-40. Baron, R.M., Kenny, D.A., 1986. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J. Pers. Soc. Psychol. 51, 1173-1182. Bennett, S.A., Tenniswood, M., Chen, J.H., Davidson, C.M., Keyes, M.T., Fortin, T., Pappas, B.A., 1998. Chronic cerebral hypoperfusion elicits neuronal apoptosis and behavioral impairment. NeuroReport 9, 161-166. ., 2001. Hippocampal and anterior cingulate activation deficits in patients with geriatric depression. Am. J. Psychiatry 158, 1321-1323. Denburg, N.L., Recknor, E.C., Bechara, A., Tranel, D., 2006. Psychophysiological anticipation of positive outcomes promotes advantageous decision-making in normal older persons. Int. J. Psychophysiol. 61, 19-25. Devinsky, O., Morrell, M.J., Vogt, B.A., 1995. Contributions of anterior cingulate cortex to behaviour. Brain 118, 279-306.

After reading vignettes, a group of spider-phobic girls (n=18) and a group of nonphobic girls (n=18) rated the subjective probability of spiders entering their private living space, their tendency to approach and make physical contact, and the subjective probability of spiders doing physical harm. In addition, they indicated their eagerness to eat a favorite food item before as well as after it had been shortly contacted by spiders. In support of the idea that spider phobia results from the convergence of spiders’ disgusting properties and the subjective probability of involuntary contact, phobic girls reported relatively high ratings concerning: (a) the probability of spiders entering their room; (b) spiders’ tendency to approach and make physical contact; and (c) spiders’ disgust-evoking status. Finally, regression analysis indicated that spiders’ disgust-evoking status is the single best predictor of spider phobia, whereas the independent contribution of the perceived probability of spiders doing physical harm was found to be negligible. All in all, the present findings strongly support the idea that spider phobia essentially reflects a fear of physical contact with a disgusting stimulus.

The present study investigated the contribution of parental modeling to the fearfulness of children. Forty children (aged 9-12) who were referred to an outpatient treatment centre filled out the trait version of the Spielberger State-Trait Anxiety Inventory for Children (STAIC) and the revised version of the Fear Survey Schedule for Children (FSSC). The parents of the children completed adult versions of the STAI-trait and the FSS. In addition, parents rated to what extent they generally expressed fears to their children. Results showed that trait anxiety in children was positively associated with trait anxiety of both the mother (r = 0.34, P < 0.05) and the father (r = 0.31, P < 0.05). Fearfulness of the children was only related to fearfulness of the mother (r = 0.56, P < 0.001). Most importantly, the data showed that modeling played a role in this relationship. A linear association between FSSC scores and mothers' rating of expressing fears to their children was found. That is to say, children of mothers who never expressed their fears had the lowest FSSC scores, children of mothers who often expressed their fears had the highest FSSC scores, whereas children of mothers who sometimes expressed their fears scored in between.

j Abstract Background The aim of this study was to investigate the prevalence of self-reported social phobia in a community sample of Swedish adolescents in junior high school, at the risk-period for developing social phobia. Of particular interest was to investigate gender differences in prevalence across ages. Prevalence of sub-threshold social phobia was also studied. Methods Students in grades 6-8 (aged 12-14) from seventeen schools in five Swedish municipalities were screened by means of a self-report questionnaire, the social phobia screening questionnaire-for children (SPSQ-C). Results Data from a sample of 2,128 students were analysed and showed a point-prevalence rate of 4.4% (95%CI 3.5-5.2) and a significant gender difference (6.6% girls vs.

"Scototaxis, the preference for dark environments in detriment of bright ones, is an index of anxiety in zebrafish. In this work, we analyzed avoidance of the white compartment by analysis of the spatiotemporal pattern of exploratory behavior (time spent in thewhite compartment of the apparatus and shuttle frequency between compartments) and swimming ethogram(thigmotaxis, freezing and burst swimming in the white compartment) in four experiments. In Experiment 1, we demonstrate that spatiotemporal
measures of white avoidance and locomotion do not habituate during a single 15-min session. In Experiments 2 and 3,we demonstrate that locomotor activity habituates to repeated exposures to the apparatus, regardless of whether inter-trial interval is 15-min or 24-h; however, no habituation of white avoidance was observed in either experiment. In Experiment 4,we confined animals for three 15-min sessions in the white compartment prior to recording spatiotemporal and ethogram measures in a standard preference test. After these forced exposures,white avoidance and locomotor activity showed no differences in relation to non-confined animals, but burst swimming, thigmotaxis and freezing in the white compartment
were all decreased. These results suggest that neither avoidance of thewhite compartment nor approach to the black compartment account for the behavior of zebrafish in the scototaxis test."

On ScienceDirect: http://www.sciencedirect.com/science/article/pii/S0166432810000550

African American women are more likely than other women to be diagnosed with breast cancer at a young age, to be diagnosed at a late stage, and to die from the disease. Yet we see evidence of irregular screening and follow-up. Previous research on psychosocial factors influencing decisions to screen reveals barriers: fear, fatalistic perceptions of cancer, inaccurate perceptions of risk, and associations with stigma. The current qualitative research with, largely, insured African American women ( n = 26), health navigators ( n = 6), and community stakeholders ( n = 24) indicates both positive and negative factors influencing decision making. The women in our sample believe in the value of early detection and are motivated to screen in response to encouragement from health providers. However, they also report several factors that contribute to their decisions to delay or not screen. These include (1) perceptions that the health community itself is confused about the need for screenin...

Pavlovian conditioning is the process by which we learn relationships between stimuli and thus constitutes a basic building block for how the brain constructs representations of the world. We first review the major concepts of Pavlovian conditioning and point out many of the pervasive misunderstandings about just what conditioning is. This brings us to a modern redefinition of conditioning as the process whereby experience with a conditional relationship between stimuli bestows these stimuli with the ability to promote adaptive behavior patterns that did not occur before the experience. Working from this framework, we provide an in-depth analysis of two examples, fear conditioning and food-based appetitive conditioning, which include a description of the only partially overlapping neural circuitry of each. We also describe how these circuits promote the basic characteristics that define Pavlovian conditioning, such as error-correction-driven regulation of learning.

The precise contribution of visual information to contextual fear-learning and discrimination has remained elusive. To better understand this contribution, we coupled the context pre-exposure facilitation effect (CPFE) fear conditioning paradigm with presentations of distinct visual scenes displayed on 4 LCD screens surrounding a conditioning chamber. Adult male Long-Evans rats received non-reinforced context pre-exposure on Day 1, an immediate 1.5 mA foot shock on Day 2, and a non-reinforced context test on Day 3. Rats were pre-exposed to either digital Context (dCtx) A, dCtx B, a distinct Context C, or no context on Day 1. Context A and B were identical except for the visual image displayed on the LCD monitors. Immediate shock and retention testing occurred in dCtx A. Rats pre-exposed dCtx A showed the CPFE with significantly higher levels of freezing compared to learning controls. Rats pre-exposed to Context B failed to show the CPFE, with freezing that did not differ significant...

This international study in 42 countries inquired children’s perception of the coronacrisis, their knowledge on COVID-19 and the role the media play in this. It Shows that children who are better informed about COVID-19 and can identify Fake News are less &quot;very worried&quot; about the corona-Virus.

This study evaluated the causes of declining frequency of voluntary blood donations among educated elites as seen at the blood bank of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria, over the last decade. The number of blood units received from educated elite donors during a 10-year period (1995-2004) at the blood bank were determined and expressed as percentages of total donations collected annually. The reasons for elite donor default were obtained through the use of questionnaires filled by defaulting donors. The proportion of educated elite donations steadily fell from 28% in 1995 to 7% in 2004. Reasons for defaulting from voluntary blood donations included fear for HIV screening in 86.7% of respondents, economic hardship/poor nourishment in 50.6% of respondents, changed address/logistic difficulties in 4.8% of respondents and ill health in 2.4% of respondents. Therefore, the steady fall in the proportion of elite donors over the years was mainly due to fear of HI...

Introduction Although the fear of cancer recurrence (FCR) is to varying degrees almost universal in cancer survivors, few studies have been carried out specifically on this issue partly because of the complexity and the heterogeneity of the phenomenon. Purpose To explore the presence of specific profiles of FCR and to describe the nature of intrusive thoughts associated with FCR.

Aim/Objectives/Background Considerable attention has been paid to assessing the risk factors for the development of disability following neck pain (NP) in the general population, but we still lack knowledge regarding disability in NP patients referred to a specialist level of care. This study investigated the associations among the socio-demographic characteristics, work ability, selfreported pain, emotional distress, fear of movement and disability of NP patients referred to a specialised neck and back outpatient clinic. In total, 221 patients participated in this cross-sectional study, which was conducted from December 2007 to December 2009.

The present study investigated the contribution of parental modeling to the fearfulness of children. Forty children (aged 9-12) who were referred to an outpatient treatment centre filled out the trait version of the Spielberger State-Trait Anxiety Inventory for Children (STAIC) and the revised version of the Fear Survey Schedule for Children (FSSC). The parents of the children completed adult versions of the STAI-trait and the FSS. In addition, parents rated to what extent they generally expressed fears to their children. Results showed that trait anxiety in children was positively associated with trait anxiety of both the mother (r = 0.34, P < 0.05) and the father (r = 0.31, P < 0.05). Fearfulness of the children was only related to fearfulness of the mother (r = 0.56, P < 0.001). Most importantly, the data showed that modeling played a role in this relationship. A linear association between FSSC scores and mothers' rating of expressing fears to their children was found. That is to say, children of mothers who never expressed their fears had the lowest FSSC scores, children of mothers who often expressed their fears had the highest FSSC scores, whereas children of mothers who sometimes expressed their fears scored in between.

The aim of the present study was to compare the subjectively reported and objectively assessed activityrelated characteristics of patients with Chronic Low Back Pain (CLBP) who were classified according to their scores on the Patterns of Activity Measure-Pain (POAM-P) into avoiders, persisters, mixed performers (i.e. high scores on both avoidance and persistence behaviour) or functional performers (i.e. low scores on avoidance and persistence behaviour).

Tamoxifen-induced mutagenesis via the so-called CreER T2 fusion enzyme is a key technology for the inducible gene knockout in the adult murine brain. However, it requires a subchronic transient treatment with high doses of the non-selective estrogen receptor antagonist tamoxifen. It has been shown earlier that acute tamoxifen treatment causes behavioral alterations, while the long-term behavioral effects of tamoxifen in mice are so far unknown. Therefore C57BL/6 male mice, a common strain used for targeted mutagenesis and behavioral analyses, were subjected to a tamoxifen treatment protocol as used for inducible mutagenesis in vivo, and analyzed for effects on general behavior (locomotion, exploration), emotional behavior (anxiety, depression) and on learning and memory after a drug-free interval period of 4 weeks. The results demonstrate that a test for depression-like behavior, i.e. the Forced Swim Test, is affected even more than 4 weeks after tamoxifen treatment. In contrast, in all other tests, tamoxifen treated mice showed unaltered behaviors, indicating that the currently established 5-day protocol of tamoxifen treatment (40 mg/kg bid) for inducible mutagenesis has no or little effects on the behavior of C57BL/6 male mice after a latency period of 4 weeks. These results are important for all studies using tamoxifen-induced mutagenesis since this protocol obviously does not evoke alterations in general behaviors such as locomotion, exploration or anxiety-like behaviors, which might confound more complex behavioral analyses, nor does it affect standard tests for learning and memory, such as Morris Water Maze, contextual and cued Fear Conditioning and T-Maze learning.

Aims: To assess parental attitudes towards type 1 diabetes clinical trials (T1DCTs) and factors that impact willingness to enroll their children with and without diabetes. Methods: A cross-sectional survey of parents of children with type 1 diabetes was administered at an academic clinic and a diabetes educational event. Results: Survey response rate was 36%. Of 166 participating parents, 76% were aware of T1DCTs. More parents reported willingness to enroll children with diabetes (47%) than unaffected children (36%). Only 18% recalled being asked to enroll their children, and of these, 60% agreed to enroll at least some of those times. Less than 30% were comfortable with placebos. Factors predicting willingness to enroll children with diabetes included healthcare provider trust, comfort with consent by proxy, low fear of child being a ''guinea pig,'' and comfort with placebo. Factors predicting willingness to enroll unaffected children were provider trust, comfort with consent by proxy, comfort with placebo, and perceived ease of understanding T1DCT information. Conclusions: Parents report moderate willingness to enroll children in T1DCTs. Willingness is diminished by common trial methodologies. Although most parents recalled receiving trial-related information, significantly fewer recalled being asked to participate. Efforts to optimize effective communication around identified areas of parental concern may increase T1DCT participation.

To develop and test the ability of a screening instrument to identify subgroups among primary healthcare patients with musculoskeletal pain. The Pain Belief Screening Instrument covers pain intensity, disability, self-efficacy, fear avoidance and catastrophizing. Design: Cross-sectional, correlational and comparative study. Subjects: Patients in primary healthcare (n 1 = 215; n 2 = 93) with a pain duration of 4 weeks or more were included. Methods: Items for the Pain Belief Screening Instrument were derived from principal component analyses of: the Self-efficacy Scale, the Tampa Scale of Kinesiophobia and the Catastrophizing subscale in the Coping Strategies Questionnaire. Cluster solutions of scores on the screening instrument and the original instruments were cross-tabulated. The reliability of items in the Pain Belief Screening Instrument was examined. Results: The screening instrument identified 2 groups: highor low-risk profile for pain-related disability. Validity was inbetween moderate and substantial (κ = 0.61, p < 0.001). The reliability of each item in the Pain Belief Screening Instrument in relation to the corresponding item in the original instruments was moderate to high (r s 0.50-0.80, p < 0.01). Conclusion: The screening instrument fairly well replicated subgroups identified by the original instruments. The reliability of items in the screening instrument was acceptable. Further testing of predictive validity for a primary healthcare population is needed.

Drawing from an approach-avoidance perspective, we examine the relationships between subordinates&#39; perceptions of abusive supervision, fear, defensive silence, and ultimately abusive supervision at a later time point. We also account for the effects of subordinates&#39; assertiveness and individual perceptions of a climate of fear on these predicted mediated relationships. We test this moderated mediation model with data from three studies involving different sources collected across various measurement periods. Results corroborated our predictions by showing (a) a significant association between abusive supervision and subordinates&#39; fear, (b) second-stage moderation effects of subordinates&#39; assertiveness and their individual perceptions of a climate of fear in the abusive supervision-fear-defensive silence relationship (with lower assertiveness and higher levels of climate-of-fear perceptions exacerbating the detrimental effects of fear resulting from abusive supervisio...

BackgroundFear of recurrence (FoR) following head and neck cancer (HNC) treatment is a major patient concern but is infrequently discussed in outpatient settings and may cause significant detrimental effect on patient psychological well-being.Fear of recurrence (FoR) following head and neck cancer (HNC) treatment is a major patient concern but is infrequently discussed in outpatient settings and may cause significant detrimental effect on patient psychological well-being.AimThe aim of this paper is to determine longitudinal trends and predictors of significant FoR.The aim of this paper is to determine longitudinal trends and predictors of significant FoR.MethodProspective data collection was obtained in 189 post-treatment HNC patients with 456 clinic attendances from October 2008 to January 2011. All patients completed Patient Concerns Inventory (PCI), University of Washington Quality of Life Questionnaire version 4 and the FoR questionnaires using a combination of paper and touch-screen technology.Prospective data collection was obtained in 189 post-treatment HNC patients with 456 clinic attendances from October 2008 to January 2011. All patients completed Patient Concerns Inventory (PCI), University of Washington Quality of Life Questionnaire version 4 and the FoR questionnaires using a combination of paper and touch-screen technology.ResultsThe prevalence of significant FoR was 35%, which was stable longitudinally. Logistic regression-delineated predictors of significant FoR were young age (<65 years), anxiety/mood and patient-reported FoR. Conventional prognostic factors including standard clinicopathological factors, treatment modality and length of follow-up did not predict significant FoR. Over time, 20% of patients reported significant FoR intermittently, whereas 30% experienced it consistently. The remaining 50% did not experience significant FoR.The prevalence of significant FoR was 35%, which was stable longitudinally. Logistic regression-delineated predictors of significant FoR were young age (<65 years), anxiety/mood and patient-reported FoR. Conventional prognostic factors including standard clinicopathological factors, treatment modality and length of follow-up did not predict significant FoR. Over time, 20% of patients reported significant FoR intermittently, whereas 30% experienced it consistently. The remaining 50% did not experience significant FoR.DiscussionPatient-related characteristics were more important than clinicopathological prognostic factors in predicting significant FoR, potentially creating a mismatch between the doctors' perception of patient's experience of FoR with what patients may experience. In the long term, FoR is expressed across a spectrum extending from ‘normal’ FoR to persistent significant FoR with an intermediate category of intermittent significant FoR. Those patients experiencing intermittent and consistent levels of significant FoR may benefit from psychological support. This study confirmed that self-reported screening FoR using the PCI is a valuable tool in identifying significant FoR. Copyright © 2012 John Wiley & Sons, Ltd.Patient-related characteristics were more important than clinicopathological prognostic factors in predicting significant FoR, potentially creating a mismatch between the doctors' perception of patient's experience of FoR with what patients may experience. In the long term, FoR is expressed across a spectrum extending from ‘normal’ FoR to persistent significant FoR with an intermediate category of intermittent significant FoR. Those patients experiencing intermittent and consistent levels of significant FoR may benefit from psychological support. This study confirmed that self-reported screening FoR using the PCI is a valuable tool in identifying significant FoR. Copyright © 2012 John Wiley & Sons, Ltd.

The present study explores driving skills in a group of 50 media-recruited driving-fearful and 50 control drivers, all of whom were women. Participants completed an on-road practical driving assessment with a professional driving instructor. Diagnostic as well as pre-post self-report and instructor driving assessments were conducted. Fearful drivers made more errors on the driving assessment than controls. However, the pattern of errors was identical for both groups, indicating that fear and anxiety may be associated with the number rather than the type of driving errors made. These differences remained when factors such as driving history, current driving frequency, and diagnosis were controlled using case selection. More research is needed to replicate the findings in more diverse samples. Additional work should also aim to clarify the specific role of driving skills in driving fear, which will facilitate treatment planning for exposure-based treatments and help identify cases where driving skills assessment may be appropriate. r

The amygdala has received great interest as a possible neurophysiological substrate of bipolar disorder (BD). This review summarizes information about the structure and function of the amygdala with attention to its role in experienced emotion and mood. We review the evidence for amygdala pathology in psychiatric conditions and discuss the role of the amygdala in BD during development. There appear to be consistent findings in the neuroimaging literature that suggest an etiological model for BD that involves abnormalities in the structure and function of the amygdala, but also depends on the failure of prefrontal cortical regions to modulate amygdala activity. In addition, evidence is accumulating to suggest that this model has flexible outcomes, depending on factors intrinsic and extrinsic to BD, and may follow several possible paths across the course of maturational development.