Jeremy Tyler

Obsessive-compulsive disorder (OCD) is a chronic and often debilitating psychiatric condition affecting approximately 2–3% of the population (Ruscio et al., 2010). OCD is associated with substantia...

Objectives: Different aspects of emotion dysregulation (ED) have been found to be broadly associated with various anxiety‐related disorders (ADs), but the mechanism underlying these transdiagnostic associations is largely unknown. There are at least two possible hypotheses. The generality hypothesis suggests that the associations are better explained by the link between a general ED factor and the general vulnerability factor derived from various ADs. The specificity hypothesis posits that specific ED facets make a unique contribution beyond the general ED factor.Methods: In a treatment‐seeking sample of 351 patients with a primary diagnosis of an AD, we simultaneously examined both the general and facet‐specific effects of ED, as assessed by the Difficulties in Emotion Regulation Scale (DERS), on the general vulnerability factor underlying ADs over the course of treatment using a bifactor latent change modelling approach.Results: Supporting the generality hypothesis, we found decreases in the general DERS factor were associated with symptoms reduction and improvement in life functioning. Except for emotional clarity, specific DERS factors had limited effects beyond the general factor.Conclusions: Our findings suggested that the well‐documented broad associations between ED and various ADs are best explained by the relationship between the general ED factor, rather than specific facets, and the general vulnerability factor to ADs. Thus, assessing overall ED, rather than focusing on specific facets, may be more effective for screening individuals at risk for ADs and monitoring therapeutic progress in the treatment of ADs.

Perfectionistic cognitions are thinking patterns that reflect excessive striving and are associated with emotional disorders in nonclinical samples. Despite literature connecting trait perfectionism with psychological disorders, much remains unknown about how perfectionistic cognitions relate to anxiety disorder symptoms in clinical populations. This is the first study to our knowledge that investigates how symptoms of anxiety and related symptoms are influenced by the frequency of perfectionistic cognitions when controlling for well documented correlates of anxiety. Perfectionistic cognitions, depressive symptoms, emotion regulation, anxiety sensitivity, and anxiety symptom severity were assessed prior to starting treatment in 356 treatment-seeking patients diagnosed with an anxiety or anxiety-related disorder at a specialty anxiety clinic. Perfectionistic cognitions were significantly correlated with all anxiety symptom measures as well as measures of depression, emotion regulation and anxiety sensitivity (range of rs =.22-.68). Hierarchical regression analyses revealed that when controlling for depressive symptoms, anxiety sensitivity, and emotion regulation, perfectionistic cognitions significantly and uniquely contribute to the variance of GAD (p <.01) and PTSD (p <.05) symptoms but not other anxiety-related symptoms (all ps >.05). Regardless of specific diagnoses, treatment-seeking individuals reporting frequent perfectionistic thoughts are more likely to report more severe symptoms of PTSD and GAD.

Objective/Background: Few studies have examined the relationship between insomnia and anxiety treatment outcomes in naturalistic settings. Furthermore, prior studies typically examine insomnia within a single anxiety diagnosis without accounting for the high overlap between disorders. Here we investigate the association between insomnia and multiple anxiety disorders over a course of cognitive behavioral treatment (CBT) in a naturalistic treatment setting. Participants: Insomnia was assessed in 326 patients seeking treatment at a clinic specializing in CBT for anxiety. Methods: Multilevel modeling was used to investigate whether insomnia moderated reductions in anxiety symptoms. A cross-lagged analysis tested for bidirectional effects between insomnia and anxiety. Multiple regression was used to investigate the relationship between insomnia and anxiety while controlling for the other anxiety disorders and depression. Results: While there was a significant reduction in insomnia during treatment in all anxiety disorders, the majority of the most severe patients remained in the clinical range at post-treatment. Baseline insomnia did not significantly moderate anxiety outcomes, suggesting that patients with high or low levels of insomnia will do equally well in CBT for anxiety. The bidirectional effect between insomnia and anxiety did not reach significance. Additionally, posttraumatic stress disorder, generalized anxiety disorder, and panic disorder were associated with the greatest endorsement of insomnia, after controlling for the overlap between disorders. Conclusions: Sleep problems may persist after anxiety treatment, suggesting that CBT for insomnia may be warranted during or after a course of CBT for anxiety. Importantly, baseline insomnia does not impede anxiety reduction during CBT.

The purpose of this study was to identify whether maladaptive perfectionism predicts elevated symptoms of anxiety in a sample of primarily Puerto Rican middle school students. Participants included students (N = 128) from Grades 6 through 8 (48% male; average age = 11.9 years) who attended an urban, bilingual, public, charter school. Results suggested both general and specific links between maladaptive perfectionism and anxiety disorder symptoms. More specifically, socially-prescribed perfectionism (SPP) uniquely predicted symptoms of panic whereas self oriented perfectionism (SOP) uniquely predicted symptoms of social anxiety across the sample. These findings provide support for the previously established connection between various anxiety symptoms and perfectionism and demonstrate that such a connection exists in Latino adolescents. Given the strong relationship between different types of maladaptive perfectionism and anxiety, theoretical and cultural considerations should be considered to help better understand the nature of how perfectionism is linked to anxiety disorder manifestations. Future studies implementing more control and longitudinal designs may be useful to better understand how perfectionism may function as a transdiagnostic mechanism in the development and maintenance of anxiety in adolescents, and specifically those who identify as Latino.