Bio

Clinical Focus


  • Cognitive Behavior Therapy
  • Exposure and Response Prevention
  • Psychiatry
  • Obsessive-Compulsive Disorder

Academic Appointments


Professional Education


  • Medical Education:Temple University - Dept of Psychology (2007) PA
  • Fellowship:Stanford University - Dept of Psychiatry (10/31/2008) CA
  • Residency:Palo Alto VA Healthcare System (08/31/2007) CA

Research & Scholarship

Current Research and Scholarly Interests


Clinical Interests: Cognitive and Behavioral Therapies for the treatment of anxiety disorders; Behavior Therapy and Exposure and Response Prevention (ERP) for Obsessive-Compulsive Disorder and other OC Spectrum conditions.

Publications

Journal Articles


  • Content and correlates of checking related to symptoms of obsessive compulsive disorder and generalized anxiety disorder JOURNAL OF ANXIETY DISORDERS Coleman, S. L., Pieterefesa, A. S., Holaway, R. M., Coles, M. E., Heimberg, R. G. 2011; 25 (2): 293-301

    Abstract

    In addition to the central role of compulsive behaviors in obsessive compulsive disorder (OCD), recent data have documented the presence of compulsive behaviors in individuals with generalized anxiety disorder (GAD). However, there is a lack of information about potential similarities and differences with regard to the quality, or content, of checking associated with worry and obsessions. The two studies presented herein are an initial step towards gathering this information. Findings of Study 1, from a large unselected undergraduate sample, showed that symptoms of OCD and GAD were both significantly associated with checking behaviors. However, while OCD symptoms were associated with checking related to both objects and interpersonal situations, GAD symptoms were only significantly associated with interpersonal checking. Findings of Study 2, using a separate sample, suggest links between interpersonal checking and features characteristic of GAD, namely emotion regulation difficulties, and between object checking and a cognitive feature of OCD, namely thought-action fusion. In summary, the current studies add to a growing body of literature suggesting that checking may be important in numerous forms of psychopathology, while also suggesting that the nature and function of checking may differ for various symptom profiles.

    View details for DOI 10.1016/j.janxdis.2010.09.014

    View details for Web of Science ID 000287009100020

    View details for PubMedID 21242055

  • The factor structure and dimensional scoring of the Generalized Anxiety Disorder Questionnaire for DSM-IV ASSESSMENT Rodebaugh, T. L., Holaway, R. M., Heimberg, R. G. 2008; 15 (3): 343-350

    Abstract

    Despite favorable psychometric properties, the Generalized Anxiety Disorder Questionnaire for the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (GAD-Q-IV) does not have a known factor structure, which calls into question use of its original weighted scoring system (usually referred to as the dimensional score). Analyses appropriate to categorical item responses in a large sample of undergraduates were used to establish the scale's factor structure. Analyses indicated that a one-factor structure resulted in good fit. A scoring method based on this one-factor structure was compared with a variety of alternative scoring procedures, and it was found that a method based on factor scores did relatively well but that the previously suggested dimensional score failed to perform better than a simple sum of items. Results support the general unity of the measure but raise doubts regarding its scoring and response options.

    View details for DOI 10.1177/1073191107312547

    View details for Web of Science ID 000258922400008

    View details for PubMedID 18202302

  • Delineating components of emotion and its dysregulation in anxiety and mood psychopathology BEHAVIOR THERAPY Mennin, D. S., Holaway, R. M., Fresco, D. M., Moore, M. T., Heimberg, R. G. 2007; 38 (3): 284-302

    Abstract

    Two studies sought to elucidate the components of emotion and its dysregulation and examine their role in both the overlap and distinctness of the symptoms of 3 highly comorbid anxiety and mood disorders (i.e., generalized anxiety disorder, major depression, and social anxiety disorder). In Study 1, exploratory factor analyses demonstrated that 4 factors--heightened intensity of emotions, poor understanding of emotions, negative reactivity to emotions, and maladaptive management of emotions--best reflected the structure of 4 commonly used measures of emotion function and dysregulation. In Study 2, a separate sample provided support for this 4-factor model of emotion dysregulation. Poor understanding, negative reactivity, and maladaptive management were found to relate to a latent factor of emotion dysregulation. In contrast, heightened intensity of emotions was better characterized separately, suggesting it may relate more strongly to dispositional emotion generation or emotionality. Finally, the 4 components demonstrated both common and specific relationships to self-reported symptoms of generalized anxiety disorder, major depression, and social anxiety disorder.

    View details for Web of Science ID 000257418600008

    View details for PubMedID 17697853

  • Robust dimensions of anxiety sensitivity: Development and initial validation of the anxiety sensitivity index-3 PSYCHOLOGICAL ASSESSMENT Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., Abramowitz, J. S., Holaway, R. M., Sandin, B., Stewart, S. H., Coles, M., Eng, W., Daly, E. S., Arrindell, W. A., Bouvard, M., Cardenas, S. J. 2007; 19 (2): 176-188

    Abstract

    Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because the original measure--the Anxiety Sensitivity Index (ASI)--was not designed to be multidimensional. Subsequently developed multidimensional measures have unstable factor structures or measure only a subset of the most widely replicated factors. Therefore, the authors developed, via factor analysis of responses from U.S. and Canadian nonclinical participants (n=2,361), an 18-item measure, the ASI-3, which assesses the 3 factors best replicated in previous research: Physical, Cognitive, and Social Concerns. Factorial validity of the ASI-3 was supported by confirmatory factor analyses of 6 replication samples, including nonclinical samples from the United States and Canada, France, Mexico, the Netherlands, and Spain (n=4,494) and a clinical sample from the United States and Canada (n=390). The ASI-3 displayed generally good performance on other indices of reliability and validity, along with evidence of improved psychometric properties over the original ASI.

    View details for DOI 10.1037/1040-3590.19.2.176.supp

    View details for Web of Science ID 000247083900002

    View details for PubMedID 17563199

  • Examination of the known-groups validity of the liebowitz social anxiety scale DEPRESSION AND ANXIETY Heimberg, R. G., Holaway, R. M. 2007; 24 (7): 447-454

    Abstract

    We examined the known-groups validity of the Liebowitz Social Anxiety Scale (LSAS) by comparing the scores of patients with social anxiety disorder (n=46), generalized anxiety disorder plus an additional diagnosis of social anxiety disorder (n=15), generalized anxiety disorder without social anxiety disorder (n=12), and nonanxious controls (n=34). The LSAS total score discriminated significantly among all pairs of groups. Similar analyses were conducted on the original LSAS subscales and additional subscales derived from the factor-analytic work of Safren et al. [1999]. Original subscales showed a pattern substantially similar to that of the total score, but subscale intercorrelations and total score-subscale correlations were extremely high, suggesting that these subscales do not provide much unique information beyond that provided by the total score. Factor-analytically derived subscales were less highly correlated with each other or with the LSAS total score. Although the pattern of differences was more variable across subscales, the factor-analytically derived subscales, in conjunction with the total score, may provide more nonredundant information of clinical relevance than the original subscales. Limitations and future directions for research on the LSAS are discussed.

    View details for DOI 10.1002/da.20277

    View details for Web of Science ID 000250661200001

    View details for PubMedID 17120297

  • A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder JOURNAL OF ANXIETY DISORDERS Holaway, R. M., Heimberg, R. G., Coles, M. E. 2006; 20 (2): 158-174

    Abstract

    Intolerance of uncertainty has been defined as the unwillingness to tolerate the possibility that negative events may occur in the future, no matter how low the probability [Personality Individual Differences 17 (1994), 791-802]. Previous research suggests that intolerance of uncertainty may be more specific to worry and generalized anxiety disorder (GAD) than to other anxiety disorders [e.g., Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143-163). New York: Guilford Press]. However, Tolin et al. [J. Anxiety Disorders 17 (2003), 233-242] argued that intolerance of uncertainty may also play a central role in obsessive-compulsive disorder (OCD). Therefore, the current study compared intolerance of uncertainty in individuals with analogue GAD and/or OCD. Intolerance of uncertainty was strongly related to pathological worry, GAD symptoms, and OCD symptoms; however, neither worry nor GAD was found to be more strongly associated with intolerance of uncertainty than OCD. Further, individuals with analogue GAD or OCD reported more intolerance of uncertainty than controls, but they did not differ significantly from each other. These findings suggest that intolerance of uncertainty may be a central theme in a number of the anxiety disorders.

    View details for DOI 10.1016/j.janxdis.2005.01.002

    View details for Web of Science ID 000235765600003

    View details for PubMedID 16464702

  • The treatment of social anxiety disorder CLINICAL PSYCHOLOGY REVIEW Rodebaugh, T. L., Holaway, R. M., Heimberg, R. G. 2004; 24 (7): 883-908

    Abstract

    We review the available treatments for social anxiety disorder, focusing primarily on psychotherapeutic interventions for adults, but also giving briefer summaries of pharmacological treatments and treatments for children and adolescents. The most well-researched psychosocial treatments for social anxiety disorder are cognitive-behavioral therapies (CBTs), and meta-analyses indicate that all forms of CBT appear likely to provide some benefit for adults. In addition, there are several pharmacological treatments with demonstrated efficacy, and cognitive-behavioral interventions have some demonstrated efficacy for children and adolescents. We outline a number of concerns regarding this literature, including the questions of what influences treatment response and what role combinations of CBT and medication might have. Clearly, although a number of treatments appear well-established in regard to their effects on social anxiety disorder, a number of opportunities for future research remain, including the search for predictors of who will benefit from which treatment.

    View details for DOI 10.1016/j.cpr.2004.07.007

    View details for Web of Science ID 000224928600007

    View details for PubMedID 15501560

  • Scoring error of social avoidance and distress scale and its psychometric implications DEPRESSION AND ANXIETY Hofmann, S. G., DiBartolo, P. M., Holaway, R. M., Heimberg, R. G. 2004; 19 (3): 197-198

    Abstract

    An error in the scoring instructions of the Social Avoidance and Distress Scale (SAD), one of the most popular instruments to measure social anxiety, is discussed.

    View details for DOI 10.1002/da.10142

    View details for Web of Science ID 000221664200009

    View details for PubMedID 15129423

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