Rorschach assessment of annihilation anxiety and ego functioning.

This work illustrates the development, validation, and application of the Rorschach Content Scale (RCS; M. Hurvich et al; see record 1994-15961-001) for annihilation anxiety. Annihilation anxiety is defined here as the fear of one's impending psychic or physical destruction. Results reflected adequate RCS interrater reliability, content validity, construct validity, criterion validity, and divergent validity. Patient groups scored significantly higher on annihilation anxiety measures than did controls. Findings also demonstrated that certain aspects of RCS annihilation anxiety appeared more frequently than did others and may be more central to the construct. Results supported the contention that annihilation anxiety is associated with compromised ego functioning, when both are measured on the Rorschach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Annihilation anxiety in schizophrenia: Metaphor or dynamic?

Chronic high levels of disruptive anxiety (terror) related to annihilation fears have been observed as a pathognomonic finding in schizophrenia. It has been hypothesized that annihilation anxiety in schizophrenia is related to early traumatic interpersonal experiences and patterns of relationship that are internalized in the formation of pathological models of the world, the self, and others. The internalized traumatic experiential models of reality lead to a set of conditioned expectations that make internal and external existence painful and terrifying in relation to others. The dynamics of the compulsive schizophrenic's suicidal intent are considered in relation to helplessness and victimization, persecutory annihilation anxieties, and compliance with and escape from fantasies of annihilation. Case examples illustrating these phenomena are presented. Therapists must establish a protective and gratifying therapeutic relationship to contain the schizophrenic's annihilation anxiety or suicidal intent. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Death and annihilation anxieties in anorexia nervosa, bulimia, and self-mutilation.

Self-starvation, bulimic behavior, and self-mutilation comprise a triad of associated self-harm syndromes that are potentially life threatening, with anorexia nervosa having the highest mortality rate of any psychiatric disorder. They are associated with trauma and are extremely resistant to treatment. These patients present a disturbing lack of anxiety about their own life-threatening behavior, yet are preoccupied with death and anxiety about annihilation. Because dissociation compartmentalizes and separates psychological and somatic aspects of traumatic experience (psychological and somatoform dissociation), it enables these patients to disavow the life-threatening nature of their behavior, which makes the dissociative processes the most destructive factor in this psychopathology. The self-harm symptoms are a presymbolic form of communication that must be decoded and confronted in treatment to make recovery possible. For many patients who starve, purge, or mutilate themselves, the body is speaking of death. They require a treatment that protects their safety, determines their personal construct of death, treats the dissociative pathology and sadomasochism, and builds signal anxiety and other ego functions, especially affect regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nightmares and annihilation anxiety.

Evaluated the relation between self-reported frequency of nightmares, a number of saliency measures of the nightmare experience, and a self-report measure of annihilation anxiety (appended) for 1,357 undergraduates from 2 independent populations. A significant positive relation was found between nightmare frequency and salience and annihilation anxiety. Findings were cross-validated across both samples. Results are discussed within the context of object relations and ego psychology theory utilizing an ego boundary model and are consistent with previous research (e.g., E. Hartmann, 1991) demonstrating boundary impairment in Ss with self-reported frequent nightmares. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive impact of traumatic events

The impact of traumatic experiences on cognitive processes, especially memory, is reviewed. The major psychological sequelae of trauma (reexperiencing, avoidance, hypervigilance) and posttraumatic stress disorder (PTSD) are noted and related to traditional views of fear conditioning. Evidence indicating enhanced memory for the gist of emotional events is reviewed as are psychological and neurophysiological mechanisms underlying this enhancement. This view is updated by introducing the distinction between explicit and implicit memory and its relevance to traumatic memory and PTSD. The central role of "the experiencing ego" in the storage and retrieval of episodic memories is postulated. This leads into discussion of dissociative experiences during traumas and the occasional amnesia for voluntary recall of the trauma accompanied by involuntary, uncontrollable flashbacks of it. The relationship of dissociative experiences to hypnotizability and to pathological reactions to traumas is discussed, although the interpretation of those correlations is questioned. The article concludes by noting that beyond conditioning of fear, traumas often violate and shake the victims' basic assumptions about the benevolence, justice, and meaningfulness of their physical and social worlds. Psychotherapy with trauma victims then needs to attend not only to extinguishing the victims' fear and feelings of extreme vulnerability, but also to rebuilding their basic beliefs about the relative benevolence of the world.     

Pharmacological and anatomical analysis of fear conditioning using the fear-potentiated startle paradigm.

Pharmacological and anatomical analyses of fear conditioning using the fear-potentiated startle paradigm are reviewed. This test measures conditioned fear by an increase in the amplitude of a simple reflex (the acoustic startle reflex) in the presence of a cue previously paired with a shock. This paradigm offers a number of advantages as an alternative to most animal tests of fear or anxiety because it involves no operant and is reflected by an enhancement rather than a suppression of ongoing behavior. Fear-potentiated startle is selectively decreased by drugs such as diazepam, morphine, and buspirone that reduce fear or anxiety clinically. By combining behavioral, anatomical, physiological, and pharmacological approaches, it should soon be possible to determine each neural pathway that is required for a stimulus signaling fear to alter startle behavior. Once the exact structures are delineated, it should be possible to determine the neurotransmitters that are released during a state of fear and how this chemical information is relayed along these pathways so as to affect behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Freud and disability.

Reviewed several books about Freud's work and Psychological Abstracts to provide an analysis of Freud's writings and theories as related to persons with physical disabilities and identify references to disability by Freud and pertinent supportive literature. Although Freud wrote very little about disability per se, many of his ideas can be applied directly to understanding attitudes toward disability and adjustment to disability processes. The relevance of concepts such as castration anxiety, fear of loss of love, ego strength, secondary gain, and the death instinct are specifically discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of annihilation anxiety from projective tests

This report details procedures to measure annihilation anxiety, a concept derived from Freud's 1926 formulation of traumatic anxiety. A 25-item pencil-and-paper inventory administered to patient and to nonpatient samples is described, along with a brief summary of earlier findings. The delineation of nine interrelated experiential components of annihilation anxiety provides the background for the construction of Rorschach and TAT measures of the concept. Findings comparing the pencil-and-paper inventory and the projective test measures are presented as well as examples of responses judged to reflect annihilation anxiety from Rorschach and TAT protocols.     

The vital role of adaptive grandiosity in artistic creativity

The artist needs adaptive grandiosity in order to create. Adaptive grandiosity is an ego-state that derives from primary narcissism and a partial resolution of the positive Oedipus complex, with the ego-ideal merged with the ego. It functions as a manic defense to overcome the artist's annihilation anxiety when confronting the blank canvas or other aspects of creativity which unconsciously represent separation from the maternal introject. Because of it fragile, defensive nature, adaptive grandiosity can readily degenerate into maladaptive grandiosity (omnipotence), which can block creativity. Clinical examples are used to illustrate the differences between adaptive grandiosity and omnipotence.     

Micropsia and testicular retractions

Five episodes of micropsia, which were precipitated by oedipal masturbatory fantasies, are described in the analysis of an adult male. Traumatic visual events and testicular retractions during the oedipal and latency years predisposed the ego functions concerned with visual perception to later involvement in conflict. The micropsia itself is seen as defending against castration anxiety by means of a series of unconscious fantasies of denial. These fantasies cause a regression to an earlier mode of visual perception (and to micropsia) characteristic of latency. The defensive modifications of the functions of the ego itself seen in micropsia are closely allied to those seen in the dèjá vu experience and in depersonalization.     

Narcissistic adolescents' object relations.

This article describes how narcissistic adolescents' needs for admiration and fusion are driven by primitive fears of annihilation and dependency. Freudian, British object relations, and interpersonal views of extreme adolescent narcissism are compared, and a case vignette is presented to emphasize the importance of an active analytic engagement with narcissistic adolescent patients. These adolescents unknowingly fear and seek being held in awe in the analytic relationship. Family psychopathology perpetuates the narcissistic adolescent's defensive reliance on grandiosity, entitlement, and the addiction to being admired. In contrast to the less disturbed adolescent, the severely disturbed narcissistic adolescent uses the admirer to sustain grandiosity and to maintain body image cohesion and ego integrity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptualizations of anxiety sensitivity.

Anxiety sensitivity (fear of anxiety) is thought to play an important role in the development and maintenance of anxiety disorders. One of the most widely used measures of anxiety sensitivity is the Anxiety Sensitivity Index (ASI). The originators of this scale regarded it as a measure of a unidimensional construct (S. Reiss et al, 1986). Recent investigations have challenged this claim, and several 4-factor solutions have been proposed. If the dimension(s) of this scale are to guide theory and research, then it is necessary to determine the most stable factor structure. ASI responses were obtained from 142 spider-phobic college students and 327 psychiatric patients presenting with anxiety or stress-related (psychophysiological) disorders. The results of a series of confirmatory analyses indicated that the ASI is best regarded as unifactorial. The implications for the conceptualization of anxiety sensitivity are considered, and directions for further investigation are set out. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are different parts of the extended amygdala involved in fear versus anxiety?

Although there is a close correspondence between fear and anxiety, and the study of fear in animals has been extremely valuable for understanding brain systems that are important for anxiety, it is equally clear that a richer animal model of human anxiety disorders would include measures of both stimulus-specific fear and something less stimulus specific, more akin to anxiety. Studies in patients with posttraumatic stress syndrome indicate these individuals seem to show normal fear reactions but abnormal anxiety measured with the acoustic startle reflex. Studies in rats, also using the startle reflex, indicate that highly processed explicit cue information (lights, tones, touch) activates the central nucleus of the amygdala, which in turn activates hypothalamic and brain stem target areas involved in specific signs of fear. Somewhat less explicit information, such as that produced by exposure to a threating environment for several minutes or by intraventricular administration of the peptide corticotropin-releasing hormone may activate a brain area closely related to the amygdala, called the bed nucleus of the stria terminalis, which in turn activates hypothalamic and brain stem target areas involved in specific signs of fear or anxiety. Because the nature of this information may be less specific than that produced by an explicit cue, and of much longer duration, activation of the bed nucleus of the stria terminalis may be more akin to anxiety than to fear.     

The psychobiological basis of posttraumatic stress disorder

Posttraumatic stress disorder is a disorder with an identifiable etiological factor (exposure to a traumatic event) and with a complex symptomatology (i.e. intrusive memories, avoidance, hyperarousal) that suggests dysfunction in multiple psychobiological systems. This review considers studies of the neurobiological consequences of acute and chronic stress showing that traumatic experiences can produce long-lasting alterations in multiple neurochemical systems. The role of the locus coeruleus noradrenergic system, prefrontal cortex dopaminergic system, endogenous opiates, hypothalamic-pituitary-adrenal axis, and cortico-releasing factors are reviewed. Several models of PTSD are highlighted, including fear conditioning, kindling, and sensitization. In particular, fear conditioning to explicit and contextual cues is proposed as a model for intrusive memories reactivated by trauma-related stimuli and hyperarousal, respectively. It is argued that the amygdala plays a crucial role in the encoding and retrieval of fear memories activated by specific stimuli that have been associated with aversive events. Association involving more complex environmental stimuli and aversive events may require the involvement of the hippocampus and the bed nucleus of the stria terminalis. Repeated activation of conditioned fear memories may produce a kindling-like process which results in spontaneous intrusive memories.     

The role of the amygdala and dorsal raphe nucleus in mediating the behavioral consequences of inescapable shock

It has been argued that exposure to inescapable shock produces later behavioral changes such as poor shuttle box escape learning because it leads to the conditioning of intense fear, which later transfers to the shuttle box test situation and interferes with escape. Both fear, as assessed by freezing, and escape were measured in Sprague-Dawley rats 24 hr after exposure to inescapable shock. Lesions of the basolateral region and central nucleus of the amygdala eliminated the fear that transfers to the shuttle box after inescapable shock, as well as the fear conditioned in the shuttle box by the shuttle box shocks. However, the amygdala lesions did not reduce the escape learning deficit produced by inescapable shock. In contrast, dorsal raphe nucleus lesions did not reduce the fear that transfers to the shuttle box after inescapable shock, but eliminated the enhanced fear conditioning in the shuttle box as well as the escape deficit. The implications of these results for the role of fear and anxiety in mediating inescapable shock effects are discussed.     

Factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale

In the study of social anxiety, it is common to differentiate between social interaction versus performance anxiety. The Social Interaction Anxiety Scale was designed to assess social interaction anxiety, and the Social Phobia Scale to assess fear of scrutiny by others (Mattick and Clarke, 1989). In common use, these scales are typically administered together and treated as subscales of a larger measure. However, the joint factor structure of these instruments has never been examined; therefore, it is unclear whether or not the items on these scales actually represent distinct aspects of social anxiety. In the present study, a confirmatory factor analysis of the pooled items from the SIAS and SPS failed to adequately fit the data. An exploratory factor analysis yielded three factors: (1) interaction anxiety, (2) anxiety about being observed by others, and (3) fear that others will notice anxiety symptoms. However, hierarchical factor analysis suggested that these factors all load on a single higher-order factor, social anxiety. Relationships of the first-order factors to other measures of social and performance fear and avoidance are examined, and implications of our findings for the assessment of social phobia are discussed.     

Self-enhancing and self-defeating ego orientation: Relations with task and avoidance orientation, achievement, self-perceptions, and anxiety.

Recent research in motivation has identified 2 main goal orientations: task orientation and ego orientation. Two studies of 6th- and 8th-grade Norwegian students tested the prediction that there are different dimensions of ego orientation (self-defeating and self-enhancing), that they may be separated from other goal orientations, and that they relate differently to academic achievement, self-concept, self-efficacy, self-esteem, anxiety, and intrinsic motivation. Results from both studies supported the predictions. The correlation between self-defeating and self-enhancing ego orientation was small, and these constructs had different relations to other variables in the study. Self-defeating ego orientation was associated with high anxiety and was negatively related to achievement and self-perceptions. Self-enhancing ego orientation was positively related to achievement, self-perceptions, and intrinsic motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional processing of fear: Exposure to corrective information.

Contends that emotions are represented by information structures in memory, and anxiety occurs when an information structure that serves as program to escape or avoid danger is activated. Emotional processing (EMP) is defined as the modification of memory structures that underlie emotions. It is argued that some form of exposure to feared situations is common to many psychotherapies for anxiety and that confrontation with feared objects or situations is an effective treatment. Physiological activation and habituation within and across exposure sessions are cited as indicators of EMP, and variables that influence activation and habituation of fear responses are examined. These variables and the indicators are analyzed to yield an account of what information must be integrated for EMP of a fear structure. The elements of such a structure are viewed as cognitive representations of the stimulus characteristic of the fear situation, the individual's responses in it, and aspects of its meaning for the individual. Treatment failures are interpreted with respect to the interference of cognitive defenses, autonomic arousal, mood state, and erroneous ideation with reformation of targeted fear structures. Implications for therapeutic practice and the study of psychopathology are discussed. (2? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety sensitivity and depression: How are they related?

Anxiety sensitivity is the fear of anxiety-related bodily sensations, which arises from beliefs that the sensations have harmful somatic, psychological, or social consequences. Elevated anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI), is associated with panic disorder. The present study investigated the relationship between anxiety sensitivity and depression. Participants were people with panic disorder (n?=?52 ), major depression (n?=?46), or both (n?=?37 ). Mean ASI scores of each group were elevated, compared to published norms. Principal components analysis revealed 3 factors of anxiety sensitivity: (a) fear of publicly observable symptoms, (b) fear of loss of cognitive control, and (c) fear of bodily sensations. Factors 1 and 3 were correlated with anxiety-related measures but not with depression-related measures. Conversely, factor 2 was correlated with depression related measures but not with anxiety-related measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence concerning the construct validity of conceptual level as a personality variable.

100 female 12th graders from Southern Ontario, classified as either high, moderate, or low in conceptual level (CL) by the Paragraph Completion Test, were examined for differences in integrative complexity as well as movement toward interpersonal maturity. Ss completed the Wonderlic Intelligence Test, Rasmussen Ego Identity Scale, and the State-Trait Anxiety Inventory. After controlling for intelligence, the higher CL group exhibited significantly superior performance on the more complex aspects of an impression formation task and higher ego identity and lower anxiety scores. Correlational analysis revealed that CL tended to be related to higher level task measures and to ego identity and anxiety, while intelligence tended to be related to less complex aspects of the impression task. Intelligence itself was unrelated to ego identity and anxiety. Findings support the construct validity of CL as outlined by D. E. Hunt at al (1977). (French summary) (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)