Authors:Lindsey M. Collins; Meredith E. Coles Pages: 1 - 5 Abstract: Publication date: Available online 19 March 2017 Source:Behaviour Research and Therapy Author(s): Lindsey M. Collins, Meredith E. Coles Prior research in the treatment of depression and anxiety has demonstrated that a sudden reduction in symptoms between two consecutive sessions (sudden gain) is related to lower post-treatment symptom severity (e.g. Hofmann, Schulz, Meuret, Moscovitch, & Suvak, 2006; Tang & DeRubeis, 1999). However, only one study has examined sudden gains in the treatment of obsessive compulsive disorder (OCD). In that study, one-third of the patients with OCD experienced a sudden gain (I M Aderka et al., 2012). Further, patients who had a sudden gain had lower clinician-rated OCD symptom severity post-treatment (I M Aderka et al., 2012). In replication, the current study examined the frequency, characteristics, and clinical impact of sudden gains in 27 OCD patients during exposure and response prevention (ERP) therapy. Fifty two percent of patients experienced a sudden gain. The mean magnitude of a sudden gain represented, on average, 61.4% of total symptom reduction. Following treatment, individuals who had experienced a sudden gain were rated as less severe on the clinical global impression scale, but they did not experience a greater reduction in OCD symptoms (pre-to post-treatment) than those without a sudden gain. None of the pre-treatment characteristics tested were found to significantly predict whether a patient would have a sudden gain. Additional research examining predictors of, and patterns of, change in OCD symptoms is warranted.
Authors:Charles T. Taylor; Sarah E. Knapp; Jessica A. Bomyea; Holly J. Ramsawh; Martin P. Paulus; Murray B. Stein Pages: 6 - 12 Abstract: Publication date: June 2017 Source:Behaviour Research and Therapy, Volume 93 Author(s): Charles T. Taylor, Sarah E. Knapp, Jessica A. Bomyea, Holly J. Ramsawh, Martin P. Paulus, Murray B. Stein Objective Cognitive behavioral therapy (CBT) is empirically supported for the treatment of anxiety disorders; however, not all individuals achieve recovery following CBT. Positive emotions serve a number of functions that theoretically should facilitate response to CBT – they promote flexible patterns of information processing and assimilation of new information, encourage approach-oriented behavior, and speed physiological recovery from negative emotions. We conducted a secondary analysis of an existing clinical trial dataset to test the a priori hypothesis that individual differences in trait positive emotions would predict CBT response for anxiety. Method Participants meeting diagnostic criteria for panic disorder (n = 28) or generalized anxiety disorder (n = 31) completed 10 weekly individual CBT sessions. Trait positive emotionality was assessed at pre-treatment, and severity of anxiety symptoms and associated impairment was assessed throughout treatment. Results Participants who reported a greater propensity to experience positive emotions at pre-treatment displayed the largest reduction in anxiety symptoms as well as fewer symptoms following treatment. Positive emotions remained a robust predictor of change in symptoms when controlling for baseline depression severity. Conclusions Initial evidence supports the predictive value of trait positive emotions as a prognostic indicator for CBT outcome in a GAD and PD sample.
Authors:Adi Dayan; Andrea Berger; Gideon Emanuel Anholt Pages: 13 - 21 Abstract: Publication date: June 2017 Source:Behaviour Research and Therapy, Volume 93 Author(s): Adi Dayan, Andrea Berger, Gideon Emanuel Anholt Obsessive-compulsive disorder (OCD) is characterized by repeated thoughts and behaviors. This study explored the stages of motor response preparation that precede action performance or inhibition: We investigated whether OCD is related to enhanced action tendencies in response to external stimuli. Response preparation processes were assessed using the event-related potential (ERP) component of the readiness potential (RP). ERPs were recorded while 15 participants with OCD and 16 healthy controls performed a variation of the go/no-go task and the stop-signal task using schematic faces (angry and neutral). The OCD group presented with a greater RP slope gradient and amplitude over bilateral frontoparietal areas corresponding to the motor cortex. The amplitude effect was further enhanced under negative valence, compared to the neutral condition. Results support the hypothesis that stronger readiness for action might characterize OCD, especially in the presence of threatening stimuli. These findings – specifically correlated with OCD and not with anxiety and depression symptoms – may underlie habitual behavior and embodiment tendencies in OCD. This study suggests that early stages of motor preparation might be important to the etiology and maintenance of OCD.
Authors:Rivkah Ginat-Frolich; Zohar Klein; Omer Katz; Tomer Shechner Pages: 29 - 37 Abstract: Publication date: June 2017 Source:Behaviour Research and Therapy, Volume 93 Author(s): Rivkah Ginat-Frolich, Zohar Klein, Omer Katz, Tomer Shechner Generalization is an adaptive learning mechanism, but it can be maladaptive when it occurs in excess. A novel perceptual discrimination training task was therefore designed to moderate fear overgeneralization. We hypothesized that improvement in basic perceptual discrimination would translate into lower fear overgeneralization in affective cues. Seventy adults completed a fear-conditioning task prior to being allocated into training or placebo groups. Predesignated geometric shape pairs were constructed for the training task. A target shape from each pair was presented. Thereafter, participants in the training group were shown both shapes and asked to identify the image that differed from the target. Placebo task participants only indicated the location of each shape on the screen. All participants then viewed new geometric pairs and indicated whether they were identical or different. Finally, participants completed a fear generalization test consisting of perceptual morphs ranging from the CS + to the CS-. Fear-conditioning was observed through physiological and behavioural measures. Furthermore, the training group performed better than the placebo group on the assessment task and exhibited decreased fear generalization in response to threat/safety cues. The findings offer evidence for the effectiveness of the novel discrimination training task, setting the stage for future research with clinical populations.
Authors:Y.J. Daniel Yang; Tandra Allen; Sebiha M. Abdullahi; Kevin A. Pelphrey; Fred R. Volkmar; Sandra B. Chapman Pages: 55 - 66 Abstract: Publication date: June 2017 Source:Behaviour Research and Therapy, Volume 93 Author(s): Y.J. Daniel Yang, Tandra Allen, Sebiha M. Abdullahi, Kevin A. Pelphrey, Fred R. Volkmar, Sandra B. Chapman Autism Spectrum Disorder (ASD) is characterized by remarkable heterogeneity in social, communication, and behavioral deficits, creating a major barrier in identifying effective treatments for a given individual with ASD. To facilitate precision medicine in ASD, we utilized a well-validated biological motion neuroimaging task to identify pretreatment biomarkers that can accurately forecast the response to an evidence-based behavioral treatment, Virtual Reality-Social Cognition Training (VR-SCT). In a preliminary sample of 17 young adults with high-functioning ASD, we identified neural predictors of change in emotion recognition after VR-SCT. The predictors were characterized by the pretreatment brain activations to biological vs. scrambled motion in the neural circuits that support (a) language comprehension and interpretation of incongruent auditory emotions and prosody, and (b) processing socio-emotional experience and interpersonal affective information, as well as emotional regulation. The predictive value of the findings for individual adults with ASD was supported by regression-based multivariate pattern analyses with cross validation. To our knowledge, this is the first pilot study that shows neuroimaging-based predictive biomarkers for treatment effectiveness in adults with ASD. The findings have potentially far-reaching implications for developing more precise and effective treatments for ASD. Graphical abstract
Authors:Inna Arnaudova; Muriel A. Hagenaars Pages: 67 - 77 Abstract: Publication date: June 2017 Source:Behaviour Research and Therapy, Volume 93 Author(s): Inna Arnaudova, Muriel A. Hagenaars Affective films are often used in emotion research and negative films are frequently used as an analogue for trauma (trauma film paradigm). However, different films are used with possibly distinct consequences. We aimed to investigate specific effects of four negative films covering distinct themes (physical, sexual, traffic and food), and tested neutral and positive films with matching content. Self-reported emotional responses and heart rate during the films were examined (immediate responses) as well as intrusions of the films in the subsequent week (delayed responses). Within each theme, negative films were rated as more unpleasant than the positive and neutral counterparts. They also evoked more negative emotions and more intrusive memories. Across themes, the four negative films did not differ in terms of valence and arousal, but clearly differed on immediate (e.g., disgust, embarrassment, heart rate) and delayed (intrusions) effects. Thus, we urge researchers to carefully select negative films for their studies, as different films seem to evoke distinct emotional responses. In addition, using positive films within the same themes is recommended in order to control for effects of arousal. In general, the specific film material should be considered when comparing effects across studies.
Authors:Alina Thompson; Ottmar V. Lipp Pages: 1 - 10 Abstract: Publication date: May 2017 Source:Behaviour Research and Therapy, Volume 92 Author(s): Alina Thompson, Ottmar V. Lipp Extant literature suggests that extinction training delivered during the memory reconsolidation period is superior to traditional extinction training in the reduction of fear recovery, as it targets the original fear memory trace. At present it is debated whether different types of fear memories are differentially sensitive to behavioral manipulations of reconsolidation. Here, we examined post-reconsolidation recovery of fear as a function of conditioned stimulus (CS) fear-relevance, using the unconditioned stimulus (US) to reactivate and destabilize conditioned fear memories. Participants (N = 56; 25 male; M = 24.39 years, SD = 7.71) in the US-reactivation and control group underwent differential fear conditioning to fear-relevant (spiders/snakes) and fear-irrelevant (geometric shapes) CSs on Day 1. On Day 2, participants received either reminded (US-reactivation) or non-reminded extinction training. Tests of fear recovery, conducted 24 h later, revealed recovery of differential electrodermal responding to both classes of CSs in the control group, but not in the US-reactivation group. These findings indicate that the US reactivation-extinction procedure eliminated recovery of extinguished responding not only to fear-irrelevant, but also to fear-relevant CSs. Contrasting previous reports, our findings show that post-reconsolidation recovery of conditioned responding is not a function of CS fear-relevance and that persistent reduction of fear, conditioned to fear-relevant CSs, can be achieved through behavioral manipulations of reconsolidation.
Authors:Rocco Mennella; Elisabetta Patron; Daniela Palomba Pages: 32 - 40 Abstract: Publication date: May 2017 Source:Behaviour Research and Therapy, Volume 92 Author(s): Rocco Mennella, Elisabetta Patron, Daniela Palomba Frontal alpha asymmetry has been proposed to underlie the balance between approach and withdrawal motivation associated to each individual's affective style. Neurofeedback of EEG frontal alpha asymmetry represents a promising tool to reduce negative affect, although its specific effects on left/right frontal activity and approach/withdrawal motivation are still unclear. The present study employed a neurofeedback training to increase frontal alpha asymmetry (right - left), in order to evaluate discrete changes in alpha power at left and right sites, as well as in positive and negative affect, anxiety and depression. Thirty-two right-handed females were randomly assigned to receive either the neurofeedback on frontal alpha asymmetry, or an active control training (N = 16 in each group). The asymmetry group showed an increase in alpha asymmetry driven by higher alpha at the right site (p < 0.001), as well as a coherent reduction in both negative affect and anxiety symptoms (ps < 0.05), from pre-to post-training. No training-specific modulation emerged for positive affect and depressive symptoms. These findings provide a strong rationale for the use of frontal alpha asymmetry neurofeedback for the reduction of negative affect and anxiety in clinical settings.
Authors:Alina Morawska; Amy E. Mitchell; Scott Burgess; Jennifer Fraser First page: 107 Abstract: Publication date: May 2017 Source:Behaviour Research and Therapy, Volume 92 Author(s): Alina Morawska, Amy E. Mitchell, Scott Burgess, Jennifer Fraser
Authors:Emily L. Belleau; Eu Gene Chin; Sonya G. Wanklyn; Laura Zambrano-Vazquez; Julie A. Schumacher; Scott F. Coffey Pages: 43 - 50 Abstract: Publication date: Available online 25 January 2017 Source:Behaviour Research and Therapy Author(s): Emily L. Belleau, Eu Gene Chin, Sonya G. Wanklyn, Laura Zambrano-Vazquez, Julie A. Schumacher, Scott F. Coffey Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35–62% of individuals drop out of trauma-focused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes. The current study explored pre-treatment predictors of early termination from PE treatment in a sample of 85 individuals receiving concurrent treatment for PTSD and a SUD in a residential treatment facility as part of a randomized controlled trial. The results indicated that less education and more anxiety sensitivity uniquely predicted PE treatment dropout. Demographic variables, PTSD severity, SUD severity, mental health comorbidities, and emotion regulation difficulties did not predict treatment dropout. These results suggest that adding pre-treatment interventions that address anxiety sensitivity, and promote social adjustment and cognitive flexibility, could possibly improve PE retention rates in clients with high anxiety or low education.
Authors:Sabine Baker; Matthew R. Sanders; Karen M.T. Turner; Alina Morawska Pages: 78 - 90 Abstract: Publication date: April 2017 Source:Behaviour Research and Therapy, Volume 91 Author(s): Sabine Baker, Matthew R. Sanders, Karen M.T. Turner, Alina Morawska Objective This randomized controlled trial examined the efficacy of Triple P Online Brief, a low-intensity online positive parenting program for parents of children with early onset disruptive behavior problems. Method Two hundred parents with 2–9-year-old children displaying early onset disruptive behavior difficulties were randomly assigned to either the intervention condition (n = 100) or a Waitlist Control group (n = 100). Results At 8-week post-assessment, parents in the intervention group displayed significantly less use of ineffective parenting strategies and significantly more confidence in dealing with a range of behavior concerns. These effects were maintained at 9-month follow-up assessment. A delayed effect was found for child behavior problems, with parents in the intervention group reporting significantly fewer and less frequent child behavior problems at follow-up, but not at post-assessment. All effect sizes were in the small to medium range. There were no significant improvements in observed negative parent and child behavior. No change was seen for parents' adjustment, anger, or conflict over parenting. Consumer satisfaction ratings for the program were high. Conclusions A brief, low-intensity parenting program delivered via the Internet can bring about significant improvements in parenting and child behavior.
Authors:Inna Arnaudova; Merel Kindt; Michael Fanselow; Tom Beckers Abstract: Publication date: Available online 19 April 2017 Source:Behaviour Research and Therapy Author(s): Inna Arnaudova, Merel Kindt, Michael Fanselow, Tom Beckers Avoidance is a key symptom of anxiety disorders. Maladaptive avoidance impairs general functioning acutely and maintains chronic anxiety. A better understanding of the mechanisms that elicit and maintain excessive avoidance might provide opportunities to improve treatment. Here, we discuss pathways through which avoidance might get amplified in the context of anxiety disorders: 1) increased threat appraisal; 2) enhanced threat avoidance tendencies; 3) impaired regulation of avoidance; 4) habitual avoidance; and 5) attempts at increasing psychological distance. Novel strategies for reducing avoidance are considered. These include memory reconsolidation interference, retraining of avoidance tendencies, mindfulness training and habit disruption approaches. Throughout the paper, we highlight a number of suggestions for future research on avoidance and how to achieve lasting behavior change.
Authors:Keisuke Takano; Jun Moriya; Filip Raes Abstract: Publication date: Available online 19 April 2017 Source:Behaviour Research and Therapy Author(s): Keisuke Takano, Jun Moriya, Filip Raes Studies on autobiographical memory retrieval highlight the prominence of rapid and direct access to a specific event memory. Because it has been believed that autobiographical memory retrieval mostly relies on an effortful generative process, there is little empirical evidence on the early stage of information processing that contributes to autobiographical memory specificity (AMS). Therefore, we investigated the associations between AMS and automatic activation of information stimulated by rapid presentation of emotional words. Study 1 involved a visual search task to assess activation of various distractors in working memory. Participants with reduced AMS showed a tendency to activate distractors that were not semantically associated with preceding cues. In Study 2, we manipulated the levels of AMS by using a computerized version of Memory Specificity Training (c-MeST) to observe the changes in the activation of distractors. Results showed that increases in AMS were associated with decreases in activation of cue-unassociated distractors. These findings suggest that reduced AMS can be characterized by dispersed activation spreading over semantically unassociated distractors in automatic information selection of working memory. Because we also found an association between depressive symptoms and AMS, the role of automatic information processing in the relation between reduced AMS and depression is discussed.
Authors:Eric Stice; Sonja Yokum; Harm Veling; Eva Kemps; Natalia Lawrence Abstract: Publication date: Available online 19 April 2017 Source:Behaviour Research and Therapy Author(s): Eric Stice, Sonja Yokum, Harm Veling, Eva Kemps, Natalia Lawrence Elevated brain reward and attention region response, and weaker inhibitory region response to high-calorie food images have been found to predict future weight gain. These findings suggest that an intervention that reduces reward and attention region response and increases inhibitory control region response to such foods might reduce overeating. We conducted a randomized pilot experiment that tested the hypothesis that a multi-faceted food response and attention training with personalized high- and low-calorie food images would produce changes in behavioral and neural responses to food images and body fat compared to a control training with non-food images among community-recruited overweight/obese adults. Compared to changes observed in controls, completing the intervention was associated with significant reductions in reward and attention region response to high-calorie food images (Mean Cohen's d = 1.54), behavioral evidence of learning, reductions in palatability ratings and monetary valuation of high-calorie foods (p = 0.009, d's = 0.92), and greater body fat loss over a 4-week period (p = 0.009, d = 0.90), though body fat effects were not significant by 6-month follow-up. Results suggest that this multifaceted response and attention training intervention was associated with reduced reward and attention region responsivity to food cues, and a reduction in body fat. Because this implicit training treatment is both easy and inexpensive to deliver, and does not require top-down executive control that is necessary for negative energy balance obesity treatment, it may prove useful in treating obesity if future studies can determine how to create more enduring effects.
Authors:Shehzad Ali; Laura Rhodes; Omar Moreea; Dean McMillan; Simon Gilbody; Chris Leach; Mike Lucock; Wolfgang Lutz; Jaime Delgadillo Abstract: Publication date: Available online 18 April 2017 Source:Behaviour Research and Therapy Author(s): Shehzad Ali, Laura Rhodes, Omar Moreea, Dean McMillan, Simon Gilbody, Chris Leach, Mike Lucock, Wolfgang Lutz, Jaime Delgadillo Background Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT). Method This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics. Results Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months post-treatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001). Conclusions The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms.
Authors:Stephan Stevens; Ruth Cooper; Trisha Bantin; Christiane Hermann; Alexander L. Gerlach Abstract: Publication date: Available online 18 April 2017 Source:Behaviour Research and Therapy Author(s): Stephan Stevens, Ruth Cooper, Trisha Bantin, Christiane Hermann, Alexander L. Gerlach Social anxiety disorder (SAD) and alcohol use disorders (AUD) co-occur frequently and there is preliminary evidence that alcohol might reduce social anxiety. It is, however, unclear which mechanisms contribute to the anxiety reducing effect, particularly regarding key aspects of social anxiety such as deficits in social performance. We compared self-rated and physiological measures of anxiety as well as self- and observer-rated social performance in a sample of 62 individuals with SAD and 60 nonanxious control participants during a speech task after receiving either alcohol, an alcohol-free placebo drink or orange juice. SAD patients reported more anxiety during the speech task than did control participants. Furthermore, SAD patients underestimated their performance in comparison to observer ratings. Alcohol reduced self-report anxiety only in SAD patients, while observers rated all participants as less competent when intoxicated. Although individuals with SAD experience a reduction in anxiety when drinking alcohol, simultaneous decreases in social performance might contribute to negative reactions from others and consequently increase the risk of further alcohol use to cope with these negative reactions.
Authors:Gitta H. Lubke; Justin Luningham Abstract: Publication date: Available online 17 April 2017 Source:Behaviour Research and Therapy Author(s): Gitta H. Lubke, Justin Luningham Latent variable mixture models (LVMMs) are models for multivariate observed data from a potentially heterogeneous population. The responses on the observed variables are thought to be driven by one or more latent continuous factors (e.g. severity of a disorder) and/or latent categorical variables (e.g., subtypes of a disorder). Decomposing the observed covariances in the data into the effects of categorical group membership and the effects of continuous trait differences is not trivial, and requires the consideration of a number of different aspects of LVMMs. The first part of this paper provides the theoretical background of LVMMs and emphasizes their exploratory character, outlines the general framework together with assumptions and necessary constraints, highlights the difference between models with and without covariates, and discusses the interrelation between the number of classes and the complexity of the within-class model as well as the relevance of measurement invariance. The second part provides a growth mixture modeling example with simulated data and covers several practical issues when fitting LVMMs.
Authors:Weike Xia; Simon Dymond; Keith Lloyd; Bram Vervliet Abstract: Publication date: Available online 12 April 2017 Source:Behaviour Research and Therapy Author(s): Weike Xia, Simon Dymond, Keith Lloyd, Bram Vervliet In anxiety, maladaptive avoidance behavior provides for near-perfect controllability of potential threat. There has been little laboratory-based treatment research conducted on controllability as a contributing factor in the transition from adaptive to maladaptive avoidance. Here, we investigated for the first time whether partial reinforcement rate, or the reliability of avoidance at controlling or preventing contact with an aversive event, influences subsequent extinction of avoidance in humans. Five groups of participants were exposed to different partial reinforcement rates where avoidance cancelled upcoming shock on 100%, 75%, 50%, 25% or 0% of trials. During extinction, all shocks were withheld. Avoidance behavior, online shock expectancy ratings and skin conductance responses (SCRs) were measured throughout. We found that avoidance was a function of relative controllability: higher reinforcement rate groups engaged in significantly more extinction-resistant avoidance than lower reinforcement groups, and shock expectancy was inversely related with reinforcement rate during avoidance acquisition. Partial reinforcement effects were not evident in SCRs. Overall, the current study highlights the clinical relevance of laboratory-based treatment research on partial reinforcement or controllability effects on extinction of avoidance.
Authors:Antje Horsch; Yvan Vial; Céline Favrod; Mathilde Morisod Harari; Simon E. Blackwell; Peter Watson; Lalitha Iyadurai; Michael B. Bonsall; Emily A. Holmes Abstract: Publication date: Available online 6 April 2017 Source:Behaviour Research and Therapy Author(s): Antje Horsch, Yvan Vial, Céline Favrod, Mathilde Morisod Harari, Simon E. Blackwell, Peter Watson, Lalitha Iyadurai, Michael B. Bonsall, Emily A. Holmes Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomised controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game ‘Tetris’ via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182] over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: −0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention “rather” to “extremely” acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child. Clinical trial registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT02502513.
Authors:Dieter Struyf; Jonas Zaman; Dirk Hermans; Bram Vervliet Abstract: Publication date: Available online 5 April 2017 Source:Behaviour Research and Therapy Author(s): Dieter Struyf, Jonas Zaman, Dirk Hermans, Bram Vervliet The current experiment investigated whether overgeneralization of fear could be due to an inability to perceptually discriminate the initial fear-evoking stimulus from similar stimuli, as fear learning-induced perceptual impairments have been reported but their influence on generalization gradients remain to be elucidated. Three hundred and sixty-eight healthy volunteers participated in a differential fear conditioning paradigm with circles of different sizes as conditioned stimuli (CS), of which one was paired to an aversive IAPS picture. During generalization, each subject was presented with one of 10 different sized circles including the CSs, and were asked to categorize the stimulus as either a CS or as novel after fear responses were recorded. Linear mixed models were used to investigate differences in fear generalization gradients depending on the participant's perception of the test stimulus. We found that the incorrect perception of a novel stimulus as the initial fear-evoking stimulus strongly boosted fear responses. The current findings demonstrate that a significant number of novel stimuli used to assess generalization are incorrectly identified as the initial fear-evoking stimulus, providing a perceptual account for the observed overgeneralization in panic and anxiety disorders. Accordingly, enhancing perceptual processing may be a promising treatment for targeting excessive fear generalization.
Authors:Susanne Schweizer; Zobair Samimi; Jafar Hasani; Alireza Moradi; Fatemeh Mirdoraghi; Mohammad Khaleghi Abstract: Publication date: Available online 2 April 2017 Source:Behaviour Research and Therapy Author(s): Susanne Schweizer, Zobair Samimi, Jafar Hasani, Alireza Moradi, Fatemeh Mirdoraghi, Mohammad Khaleghi The adverse impact of posttraumatic stress disorder (PTSD) on the developing mind in adolescence can extend well into adulthood. The developmental malleability of cognitive control capacity in this age group, however, may hold particular promise for cognitive training interventions. The present study investigated the effects of affective working memory (aWMT) compared to placebo-training on cognitive and affective functioning in adolescents with PTSD. 30 treatment-seeking adolescents trained for 20 days on either an affective dual n-back task (aWMT; n = 15) or a feature match task (placebo; n = 15). The aWMT group showed greater pre-to post-training increases in cognitive control as measured by the GoNogo task as well as improvements in symptoms of PTSD and increased use of adaptive emotion regulation strategies. These preliminary findings are promising given the potential for free and easy dissemination of the aWMT in schools and online.
Authors:Lance M. Rappaport; Christina Sheerin; Jeanne E. Savage; John M. Hettema; Roxann Roberson-Nay Abstract: Publication date: Available online 30 March 2017 Source:Behaviour Research and Therapy Author(s): Lance M. Rappaport, Christina Sheerin, Jeanne E. Savage, John M. Hettema, Roxann Roberson-Nay Although breathing CO2-enriched air reliably increases anxiety, there is debate concerning the nature and specificity of CO2 hypersensitivity to panic risk and panic disorder versus anxiety disorders and related traits broadly, particularly among adolescents and emerging adults. The present study sought to clarify the association of CO2 hypersensitivity with internalizing conditions and symptoms among adolescents and young adults. Participants (N = 628) self-reported anxiety levels every 2 min while breathing air enriched to 7.5% CO2 for 8 min. Growth mixture models were used to examine the structure of anxiety trajectories during the task and the association of each trajectory with dimensional and diagnostic assessments of internalizing disorders. Three distinct trajectories emerged: overall low (low), overall high (high), and acutely increased anxiety (acute). Compared to the low class, the acute class reported elevated neuroticism, anxiety sensitivity, stress whereas the high class reported elevated anxiety symptoms, depression symptoms, neuroticism, anxiety sensitivity, and increased likelihood of an anxiety disorder diagnosis. Moreover, the acute and high classes reported experiencing a panic-like event at a higher rate than the low class while participants in the high class terminated the task prematurely at a higher rate. The present study clarifies the nature of response to CO2 challenge. Three distinct response profiles emerged, which clarifies the manifestation of CO2 hypersensitivity in anxiety disorders with strong, though not unique, associations with panic-relevant traits.
Authors:Vincent Dethier; Pierre Philippot Abstract: Publication date: Available online 28 March 2017 Source:Behaviour Research and Therapy Author(s): Vincent Dethier, Pierre Philippot This study examines the impact of partial distractor valence and schematicity (i.e., their relation to fear representation) on exposure efficacy. One hundred forty-one spider phobics were exposed to spider pictures and asked, in a between-subjects experimental design, to form mental images of words that were fear related (to spiders) and negative (schematic negative), fear unrelated and negative (non-schematic negative) or fear unrelated and positive (non-schematic positive). Multilevel measures of anxiety were performed at pre-exposure, post-exposure and 6 days’ follow-up. Results show that both of the negative condition groups displayed similar results on all outcome variables and systematically differed from the positive condition group. While the latter group displayed a stronger decline in distress during exposure itself, the other groups showed greater exposure benefits: a stronger decline in emotional and avoidance responses and skin conductance responses from pre- to post-exposure and more approach behaviours when confronted with a real spider. The critical feature of distraction thus seems not to be the fact of being distracted from the phobic stimulus, but rather the fact of performing emotional avoidance by distracting oneself from negative affect. The results highlight that the acceptance of aversive emotional states is a critical active process in successful exposure.
Authors:Andres G. Viana; Cara A. Palmer; Michael J. Zvolensky; Candice A. Alfano; Laura J. Dixon; Elizabeth Raines Abstract: Publication date: Available online 28 March 2017 Source:Behaviour Research and Therapy Author(s): Andres G. Viana, Cara A. Palmer, Michael J. Zvolensky, Candice A. Alfano, Laura J. Dixon, Elizabeth Raines Although behavioral inhibition (BI) is clearly identified as a temperamental risk factor for childhood anxiety psychopathology, much less is known about whether the strength of this association may vary as a function of parasympathetic nervous system regulation in children with anxiety disorders. To build upon extant research in this area, the present study examined whether respiratory sinus arrhythmia (RSA) can explicate the conditions in which BI is linked to increased symptom severity among anxiety-disordered children (N = 44; M = 9.61 years, SD = 1.63; 52% female and African American, respectively). We examined RSA responding both during a basal period and during a stressor (“challenge” RSA): interacting with a “mystery guest” who was wearing a mask. As hypothesized, the interaction between BI and both basal and challenge RSA was significantly related to anxiety disorder symptom severity, even after controlling for depressive symptoms. The form of the interaction indicated that highest levels of anxiety disorder symptoms were found among children with high levels of BI and low basal and challenge RSA, respectively. These data provide novel empirical evidence of a clinically-relevant interplay between RSA and BI in relation to anxiety disorder symptom severity among clinical youth. Future work is needed to expand on the specific mechanisms that may be responsible e for the interplay between temperamental and psychobiological risks for childhood anxiety.
Authors:Thomas Armstrong; Bunmi O. Olatunji Abstract: Publication date: Available online 23 March 2017 Source:Behaviour Research and Therapy Author(s): Thomas Armstrong, Bunmi O. Olatunji Pavlovian fear conditioning provides a model for anxiety-related disorders, including obsessive-compulsive disorder (OCD). However, disgust is the predominant emotional response to contamination, which is a common theme in OCD. The present study sought to identify disgust conditioning abnormalities that may underlie excessive contamination concerns relevant to OCD. Individuals high and low in contamination concern (HCC, n = 32; LCC, n = 30) completed an associative learning task in which one neutral face (conditioned stimulus; CS+) was followed by a disgusting image (unconditioned stimulus; US) and another neutral face (CS–) was unreinforced. Following this acquisition procedure, there was an extinction procedure in which both CSs were presented unreinforced. The groups did not show significant differences in discriminant responding to the CSs following acquisition. However, following extinction, the HCC group reported less reduction in their expectancy of the US following the CS+, and also reported greater disgust to the CS+, compared to the LCC group. Increased disgust to the CS + following both acquisition and extinction was correlated with increased symptoms of contamination-based OCD and increased disgust sensitivity. Additionally, disgust sensitivity mediated group differences in disgust responding to the CS + at acquisition and extinction. Also, failure to adjust US expectancy in response to extinction partially mediated group differences in disgust to the CS + following extinction. Together, these findings suggest that excessive contamination concerns observed in OCD may be related to difficulty inhibiting acquired disgust, possibly due to elevated disgust sensitivity that characterizes the disorder.
Authors:Ee Pin Chang; Ullrich K.H. Ecker; Andrew C. Page Abstract: Publication date: Available online 21 March 2017 Source:Behaviour Research and Therapy Author(s): Ee Pin Chang, Ullrich K.H. Ecker, Andrew C. Page We present evidence that dysphoric rumination involves a working memory (WM) updating deficit. Sixty-one undergraduates—pre-screened with rumination and depression scales—completed a novel task providing a specific measure of WM updating. This task involved the substitution of emotionally-valenced words, and provided an online measure of the time taken to remove outdated items from WM. Results showed that dysphoric ruminators spent less time removing outdated words from WM when the new to-be-remembered word was negative. This effect was (1) associated with impaired subsequent recall of negative words, arguably caused by interference from the insufficiently removed outdated words; and (2) correlated with participants’ rumination scores. This is the first study to use the novel removal task to investigate the nature of WM-updating impairments in rumination. The findings are consistent with a negative attentional bias in rumination, and provide preliminary evidence that rumination is associated with a valence-generic removal deficit during WM updating. Reducing the attentional bias could thus be an intervention target in the treatment of dysphoric rumination.
Authors:Julie Ji; Ben Grafton; Colin MacLeod Abstract: Publication date: Available online 21 March 2017 Source:Behaviour Research and Therapy Author(s): Julie Ji, Ben Grafton, Colin MacLeod While there is consensus that depression is associated with a memory bias characterized by reduced retrieval of positive information that is restricted to information that had been self-referentially processed, there is less agreement concerning whether depression is characterized by an attention bias involving reduced attention to positive information. However, unlike memory research, previous attention research has not systematically examined the potential role of referential processing focus. The present study tested the hypothesis that evidence of depression-linked attentional avoidance of positive information would be more readily obtained following the self-referential processing of such information. We assessed attentional responding to positive information (and also to negative information) using a dot-probe procedure, after this information had been processed either in a self-referential or other-referential manner. The findings lend support to the hypothesis under scrutiny. Participants scoring high in depression score exhibited reduced attention to positive information compared to those scoring low in depression score, but only when this information had been processed in a self-referential manner. These findings may shed light on the mechanisms that underpin attentional selectivity in depression, while potentially also helping to account for inconsistencies in previous literature.
Authors:Arne Leer; Iris M. Engelhard; Bert Lenaert; Dieter Struyf; Bram Vervliet; Dirk Hermans Abstract: Publication date: Available online 9 March 2017 Source:Behaviour Research and Therapy Author(s): Arne Leer, Iris M. Engelhard, Bert Lenaert, Dieter Struyf, Bram Vervliet, Dirk Hermans Eye Movement Desensitization and Reprocessing (EMDR) therapy for posttraumatic stress disorder involves making eye movements (EMs) during recall of a traumatic image. Experimental studies have shown that the dual task decreases self-reported memory vividness and emotionality. However valuable, these data are prone to demand effects and little can be inferred about the mechanism(s) underlying the observed effects. The current research aimed to fill this lacuna by providing two objective tests of memory performance. Experiment I involved a stimulus discrimination task. Findings were that EM during stimulus recall not only reduces self-reported memory vividness, but also slows down reaction time in a task that requires participants to discriminate the stimulus from perceptually similar stimuli. Experiment II involved a fear conditioning paradigm. It was shown that EM during recall of a threatening stimulus intensifies fearful responding to a perceptually similar yet non-threat-related stimulus, as evidenced by increases in danger expectancies and skin conductance responses. The latter result was not corroborated by startle EMG data. Together, the findings suggest that the EM manipulation renders stimulus attributes less accessible for future recall.
Authors:Noortje Vriends; Yasemin Meral; Javier A. Bargas-Avila; Christina Stadler; Susan M. Bögels Abstract: Publication date: Available online 3 March 2017 Source:Behaviour Research and Therapy Author(s): Noortje Vriends, Yasemin Meral, Javier A. Bargas-Avila, Christina Stadler, Susan M. Bögels We investigated the role of self-focused attention (SFA) in social anxiety (disorder) in an ecologically valid way. In Experiment 1 high (n = 26) versus low (n = 25) socially anxious single women between 18 and 30 years had a video (“Skype”) conversation with an attractive male confederate, while seeing themselves and the confederate on-screen. The conversation was divided in four phases: (I) warm-up, (II) positive (confederate was friendly to the participant), (III) critical (confederate was critical to the participant), and (IV) active (participant was instructed to ask questions to the confederate). Participant's SFA was measured by eye-tracked gaze duration at their own image relative to the confederates' video image and other places at the computer screen. Results show that high socially anxious participants were more self-focused in the critical phase, but less self-focused in the active phase than low socially anxious participants. In Experiment 2 women diagnosed with SAD (n = 32) and controls (n = 30) between 18 and 30 years conducted the same experiment. Compared to controls participants with SAD showed increased SFA across all four phases of the conversation, and SFA predicted increased self-rated anxiety during the conversation. In conclusion, in subclinical social anxiety SFA is high only when the interaction partner is critical, whereas instructions to ask questions to the confederate reduces subclinical socially anxious’ SFA, while clinical SAD is characterized by heightened self-focused attention throughout the interaction. Results support theories that social anxiety disorder is maintained by SFA, and imply that interventions that lower SFA may help prevent and treat social anxiety disorder, but that self-focused attention can also be adaptive in certain types of interaction, such as when receiving compliments.
Authors:Armita Golkar; Cathelijn Tjaden; Merel Kindt Abstract: Publication date: Available online 22 February 2017 Source:Behaviour Research and Therapy Author(s): Armita Golkar, Cathelijn Tjaden, Merel Kindt Background Previous studies have suggested that fear memories can be updated when recalled, a process referred to as reconsolidation. Given the beneficial effects of model-based safety learning (i.e. vicarious extinction) in preventing the recovery of short-term fear memory, we examined whether consolidated long-term fear memories could be updated with safety learning accomplished through vicarious extinction learning initiated within the reconsolidation time-window. We assessed this in a final sample of 19 participants that underwent a three-day within-subject fear-conditioning design, using fear-potentiated startle as our primary index of fear learning. Methods On day 1, two fear-relevant stimuli (reinforced CSs) were paired with shock (US) and a third stimulus served as a control (CS). On day 2, one of the two previously reinforced stimuli (the reminded CS) was presented once in order to reactivate the fear memory 10 min before vicarious extinction training was initiated for all CSs. The recovery of the fear memory was tested 24 h later. Results and conclusion Vicarious extinction training conducted within the reconsolidation time window specifically prevented the recovery of the reactivated fear memory (p = 0.03), while leaving fear-potentiated startle responses to the non-reactivated cue intact (p = 0.62). These findings are relevant to both basic and clinical research, suggesting that a safe, non-invasive model-based exposure technique has the potential to enhance the efficiency and durability of anxiolytic therapies.
Authors:E.L. De Voogd; R.W. Wiers; E. Salemink Abstract: Publication date: Available online 22 February 2017 Source:Behaviour Research and Therapy Author(s): E.L. De Voogd, R.W. Wiers, E. Salemink Anxiety and depression, which are highly prevalent in adolescence, are both characterized by a negative attentional bias. As Attentional Bias Modification (ABM) can reduce such a bias, and might also affect emotional reactivity, it could be a promising early intervention. However, a growing number of studies also report comparable improvements in both active and placebo groups. The current study investigated the effects of eight online sessions of visual search (VS) ABM compared to both a VS placebo-training and a no-training control group in adolescents with heightened symptoms of anxiety and/or depression (n = 108). Attention bias, interpretation bias, and stress-reactivity were assessed pre- and post-training. Primary outcomes of anxiety and depressive symptoms, and secondary measures of emotional resilience were assessed pre- and post-training and at three and six months follow-up. Results revealed that VS training reduced attentional bias compared to both control groups, with stronger effects for participants who completed more training sessions. Irrespective of training condition, an overall reduction in symptoms of anxiety and depression and an increase in emotional resilience were observed up to six months later. The training was evaluated relatively negatively. Results suggest that online ABM as employed in the current study has no added value as an early intervention in adolescents with heightened symptoms.
Authors:Kristof Vansteelandt; Marlies Houben; Laurence Claes; Ann Berens; Ellen Sleuwaegen; Pascal Sienaert; Peter Kuppens Abstract: Publication date: Available online 21 February 2017 Source:Behaviour Research and Therapy Author(s): Kristof Vansteelandt, Marlies Houben, Laurence Claes, Ann Berens, Ellen Sleuwaegen, Pascal Sienaert, Peter Kuppens Nonsuicidal Self-Injury (NSSI) is prominent in individuals with Borderline Personality Disorder (BPD), and there is abundant evidence that affect regulation plays an important role in NSSI in the majority of patients. Affective variability is a core feature of BPD, and thus, we hypothesize that NSSI has an affect stabilization function in BPD. Affect stabilization is a process through which individuals attempt to make their affect more stable by reducing affective variability. We tested this hypothesis in 32 participants with BPD who reported on their NSSI and affect –using a displeasure-pleasure (valence) and activation-deactivation (activation) dimension– in an experience sampling study with 10 random signals scheduled per day for 8 days. Results indicated that individuals who engaged in NSSI show more Within Subject (WS) variance in valence and activation than individuals who did not engage in NSSI. However, within the NSSI patients, individuals who engaged more frequently in NSSI during the study showed less WS variance in valence and activation than patients who engaged less frequently in NSSI. This suggests that NSSI may be reinforced by its affect stabilization function. In the discussion, we explore alternative explanations for the relation between NSSI and affective variability, and consider the clinical implications.
Authors:Darius Gadeikis; Nikita Bos; Susanne Schweizer; Fionnuala Murphy; Barnaby Dunn Abstract: Publication date: Available online 21 February 2017 Source:Behaviour Research and Therapy Author(s): Darius Gadeikis, Nikita Bos, Susanne Schweizer, Fionnuala Murphy, Barnaby Dunn It is important to identify effective emotion regulation strategies to increase positive emotion experience in the general population and in clinical conditions characterized by anhedonia. There are indications that engaging in experiential processing (direct awareness of sensory and bodily experience) bolsters positive emotion experience but this has not been extensively tested during memory recall. To further test this notion, 99 community participants recalled two positive autobiographical memories. Prior to the second recall, participants either underwent an experiential, analytical, or distraction induction (n = 33 per condition). Subjective happiness and sadness ratings and heart rate variability (HRV) response were measured during each recall. Greater spontaneous use of experiential processing during the first memory was associated with greater happiness experience, but was unrelated to HRV and sadness experience. Inducing experiential processing increased happiness experience relative to both the analytical and distraction conditions (but had no impact on sadness experience). There was a significant difference in HRV between conditions. The experiential condition led to a trend-significant increase, and the other conditions a non-significant decrease, in HRV from the first to the second memory. These results suggest that engaging in experiential processing is an effective way to up-regulate positive emotion experience during positive memory recall.
Authors:Louise Beattie; Markus Bindemann; Simon D. Kyle; Stephany M. Biello Abstract: Publication date: Available online 10 February 2017 Source:Behaviour Research and Therapy Author(s): Louise Beattie, Markus Bindemann, Simon D. Kyle, Stephany M. Biello Attention biases to sleep-related stimuli are held to play a key role in the development and maintenance of insomnia, but such biases have only been shown with controlled visual displays. This study investigated whether observers with insomnia symptoms allocate attention to sleep-related items in natural scenes, by recording eye movements during free-viewing of bedrooms. Participants with insomnia symptoms and normal sleepers were matched in their visual exploration of these scenes, and there was no evidence that the attention of those with insomnia symptoms was captured more quickly by sleep-related stimuli than that of normal sleepers. However, the insomnia group fixated bed regions on more trials and, once fixated on a bed, also remained there for longer. These findings indicate that sleep stimuli are particularly effective in retaining visual attention in complex natural scenes.
Authors:Laurie Loop; Bénédicte Mouton; Marie Stievenart; Isabelle Roskam Abstract: Publication date: Available online 31 January 2017 Source:Behaviour Research and Therapy Author(s): Laurie Loop, Bénédicte Mouton, Marie Stievenart, Isabelle Roskam This research compared the efficacy of two parenting interventions that vary according to the number and the nature of variables in reducing preschoolers' externalizing behavior (EB). The goal was to identify which parenting intervention format (one-variable versus two-variable) caused higher behavioral adjustment in children. The first was a one-variable intervention manipulating parental self-efficacy beliefs. The second was a two-variable intervention manipulating both parents' self-efficacy beliefs and emotion coaching practices. The two interventions shared exactly the same design, consisting of eight parent group sessions. Effect on children's EB and observed behaviors were evaluated through a multi-method assessment at three points (pre-test, post-test and follow-up). The results highlighted that compared to the waitlist condition, the two intervention formats tended to cause a significant reduction in children's EB reported by their parent. However, the one-variable intervention was found to lead to a greater decrease in children's EB at follow-up. The opposite was reported for children's observed behavior, which was improved to a greater extent in the two-variable intervention at post-test and follow-up. The results illustrated that interventions' format cannot be considered as purely interchangeable since their impact on children's behavior modification is different. The results are discussed for their research and clinical implications.
Authors:Sergiu P. Vălenaș; Aurora Szentágotai-Tătar; Ben Grafton; Lies Notebaert; Andrei C. Miu; Colin MacLeod Abstract: Publication date: Available online 25 January 2017 Source:Behaviour Research and Therapy Author(s): Sergiu P. Vălenaș, Aurora Szentágotai-Tătar, Ben Grafton, Lies Notebaert, Andrei C. Miu, Colin MacLeod Rumination is a maladaptive form of repetitive thinking that enhances stress responses, and heightened disposition to engage in rumination may contribute to the onset and persistence of stress-related symptoms. However, the cognitive mechanisms through which ruminative disposition influences stress reactivity are not yet fully understood. This study investigated the hypothesis that the impact of ruminative disposition on stress reactivity is carried by an attentional bias reflecting impaired attentional disengagement from negative information. We examined the capacity of a measure of ruminative disposition to predict both attentional biases to negative exam-related information, and state anxiety, in students approaching a mid-term exam. As expected, ruminative disposition predicted state anxiety, over and above the level predicted by trait anxiety. Ruminative disposition also predicted biased attentional disengagement from, but not biased attentional engagement with, negative information. Importantly, biased attentional disengagement from negative information mediated the relation between ruminative disposition and state anxiety. These findings confirm that dispositional rumination is associated with difficulty disengaging attention from negative information, and suggest that this attentional bias may be one of the mechanisms through which ruminative disposition influences stress reactivity.
Authors:Andrew T. Gloster; Jens Klotsche; Joseph Ciarrochi; Georg Eifert; Rainer Sonntag; Hans-Ulrich Wittchen; Jürgen Hoyer Abstract: Publication date: Available online 24 January 2017 Source:Behaviour Research and Therapy Author(s): Andrew T. Gloster, Jens Klotsche, Joseph Ciarrochi, Georg Eifert, Rainer Sonntag, Hans-Ulrich Wittchen, Jürgen Hoyer Background Psychological flexibility theory (PFT) suggests three key processes of change: increases in value-directed behaviors, reduction in struggle with symptoms, and reduction in suffering. We hypothesized that Acceptance and Commitment Therapy (ACT) would change these processes and that increases in valued action and decreases in struggle would precede change in suffering. Method Data were derived from a randomized clinical trial testing ACT (vs. waitlist) for treatment-resistant patients with primary panic disorder with/without agoraphobia (n = 41). Valued behavior, struggle, and suffering were assessed at each of eight sessions. Results Valued actions, struggle, and suffering all changed over the course of therapy. Overall changes in struggle and suffering were interdependent whereas changes in valued behavior were largely independent. Levels of valued behaviors influenced subsequent suffering, but the other two variables did not influence subsequent levels of valued action. Discussion This finding supports a central tenet of PFT that increased (re-)engagement in valued behaviors precedes reductions in suffering. Possible implications for a better understanding of response and non-response to psychotherapy are discussed.
Authors:Leigh-Anne Burr; Mahmood Javiad; Grace Jell; Aliza Werner Seidler; Barnaby D. Dunn Abstract: Publication date: Available online 24 January 2017 Source:Behaviour Research and Therapy Author(s): Leigh-Anne Burr, Mahmood Javiad, Grace Jell, Aliza Werner Seidler, Barnaby D. Dunn The way individuals appraise positive emotions may modulate affective experience during positive activity scheduling. Individuals may either engage in dampening appraisals (e.g., think “this is too good to last”) or amplifying appraisals (e.g., think “I deserve this”). A cross-over randomized design was used to examine the consequences of these appraisal styles. Participants (N = 43) rated positive affect (PA) and negative affect (NA) during four daily walks in pleasant locations, whilst following dampening, emotion-focus amplifying (focusing on how good one feels), self-focus amplifying (focusing on positive self qualities), or control instructions. There was no difference between the two amplifying and control conditions, which all increased PA and reduced NA during the walks. However, the dampening condition significantly differed from all other conditions, reducing PA and increasing NA during the walk. Individual differences in anhedonia symptoms did not significantly moderate the pattern of findings. This evidence supports the view that dampening appraisals may be one mechanism driving anhedonia and may account for why positive activity scheduling can sometimes backfire when utilized in the clinic.
Authors:H.R. Trompetter; S.M.A. Lamers; G.J. Westerhof; M. Fledderus; E.T. Bohlmeijer Abstract: Publication date: Available online 19 January 2017 Source:Behaviour Research and Therapy Author(s): H.R. Trompetter, S.M.A. Lamers, G.J. Westerhof, M. Fledderus, E.T. Bohlmeijer The dual-factor model of mental health suggests that enhancing positive mental health and alleviating psychopathology do not automatically go hand-in-hand. This study investigates the relationship between the effectiveness on depression/anxiety symptoms and positive mental health of Acceptance and Commitment Therapy (ACT). It draws on RCT data (n = 250) of a self-help ACT. Patients’ depression/anxiety symptoms and positive mental health were completed at baseline, at post-intervention after nine weeks, and at follow-up after five months. Percentage of unique variance of depression/anxiety symptoms explained by positive mental health (and vice versa), and the degree of classificatory agreement between improvements in positive mental health and depression/anxiety, were examined using regression analysis and Reliable Change Index (RCI). Positive mental health, i.e. baseline and change, explained 15% and 12% of the variance in follow-up depression and anxiety symptoms, beyond the 7% and 9% that was explained by baseline levels of depression and anxiety. Depression and anxiety symptoms, i.e., baseline and change, explained 10% and 9% of the variance in follow-up positive mental health, on top of the 35% that was explained by baseline levels of positive mental health. Cross-classification of the Reliable Changes showed that 64% of the participants that improved during the ACT-intervention, improved on either depression symptoms or positive mental health, and 72% of the participants improved on either anxiety symptoms or positive mental health. The findings support the dual-factor model and suggest that it is important to systematically implement measures of both psychopathology and positive mental health in mental health care and therapy evaluations.
Authors:Trine Eilenberg; Ditte Hoffmann; Jens S. Jensen; Lisbeth Frostholm Abstract: Publication date: Available online 19 January 2017 Source:Behaviour Research and Therapy Author(s): Trine Eilenberg, Ditte Hoffmann, Jens S. Jensen, Lisbeth Frostholm Objective The present study is based on a previously reported successful randomized controlled trial (RCT) on Acceptance and Commitment Group therapy (ACT-G) for severe health anxiety (HA) and investigates intervening variables of ACT for HA. The process primarily targeted by ACT is psychological flexibility (PF). No randomized study has yet examined the possible intervening variables of ACT for HA. Methods 126 patients diagnosed with severe HA were enrolled in the RCT of which 107 were included in the analyses. The outcome measure was illness worry (Whiteley Index) and included process variables were PF and facets of mindfulness. Results Statistically significant indirect effects (IE) of ACT-G on the outcome of illness worry 6 months after treatment were found for PF (IE = 5.5, BCa 99% CI -12.3;-1.2) and one mindfulness subscale, namely ‘non-react’ (IE = 6.5 BCa 99% CI -15.3: 1.0). Conclusion In line with the ACT model of change, PF may have a small to moderate IE on decrease in illness worry. Of the mindfulness scales, only ‘non-react’ showed a significant IE. Although tentative, due to no active comparison control condition, these results support that PF is a intervening variable in ACT treatment aimed at reducing illness worry in patients with severe HA.
Authors:Shian-Ling Keng; Elysia Li Yan Tan; Tory A. Eisenlohr-Moul; Moria J. Smoski Abstract: Publication date: Available online 18 January 2017 Source:Behaviour Research and Therapy Author(s): Shian-Ling Keng, Elysia Li Yan Tan, Tory A. Eisenlohr-Moul, Moria J. Smoski The present study investigated the relative effects of mindfulness, reappraisal and suppression in reducing sadness, and the extent to which implementation of these strategies affects cognitive resources in a laboratory context. A total of 171 Singaporean undergraduate participants were randomly assigned to receive brief training in mindfulness, reappraisal, or suppression prior to undergoing a sad mood induction. Individual adherence to Asian cultural values was assessed as a potential moderator of strategy effectiveness. Participants rated their mood and completed a Color-Word Stroop task before and after mood regulation instructions. Analyses using multi-level modelling showed that the suppression condition caused less robust declines in sadness over time compared to mindfulness. There was also a nonsignificant trend in which mindfulness was associated with greater sadness recovery compared to reappraisal. Suppression resulted in lower average sadness compared to mindfulness among those high on Asian cultural values, but not those low on Asian cultural values. Both mindfulness and reappraisal buffered against increases in Stroop interference from pre-to post-regulation compared to suppression. The findings highlight the advantage of mindfulness as a strategy effective not only in the regulation of sad mood, but also in the preservation of cognitive resources in the context of mood regulation.
Authors:Thomas H. Ollendick; Lars-Göran Öst; Sarah M. Ryan; Nicole N. Capriola; Lena Reuterskiöld Abstract: Publication date: Available online 18 January 2017 Source:Behaviour Research and Therapy Author(s): Thomas H. Ollendick, Lars-Göran Öst, Sarah M. Ryan, Nicole N. Capriola, Lena Reuterskiöld Catastrophic beliefs and lowered coping expectancies are often present in individuals with specific phobias (SPs). The current study examined these beliefs and expectancies in 251 youth who received One Session Treatment for one of the three most common types of SP in youth (animals, natural environment, and situational). We compared the children's subjective beliefs to objective ratings of the likelihood of occurrence and the dangerousness of the feared events. Results revealed pre-treatment differences in the youths' beliefs across phobia types and age. Specifically, children with animal phobias rated their beliefs as more likely to occur than did children with environmental and situational phobias. In addition, older children rated their beliefs as more dangerous than younger children. However, regardless of phobia type or child age, the beliefs improved following treatment. Changes in catastrophic beliefs and coping expectancies were related to changes in clinical severity following treatment but not 6-months following treatment. Moreover, at pre-treatment, children viewed their beliefs as significantly more catastrophic and likely to occur than did independent coders of these beliefs; however, these differences were no longer evident following treatment. Clinical implications are discussed, highlighting how changes in beliefs and expectancies might be associated with treatment outcomes.
Authors:J. Cobb Scott; Gerlinde Harb; Janeese A. Brownlow; Jennifer Greene; Ruben C. Gur; Richard J. Ross Abstract: Publication date: Available online 13 January 2017 Source:Behaviour Research and Therapy Author(s): J. Cobb Scott, Gerlinde Harb, Janeese A. Brownlow, Jennifer Greene, Ruben C. Gur, Richard J. Ross Posttraumatic stress disorder (PTSD) is associated with cognitive deficits in attention, executive control, and memory, although few studies have investigated the relevance of cognitive difficulties for treatment outcomes. We examined whether cognitive functioning and history of traumatic brain injury (TBI) were associated with response to cognitive-behavioral therapy (CBT) for PTSD-related sleep problems. In a randomized controlled trial of Imagery Rehearsal (IR) added to components of CBT for Insomnia (IR + cCBT-I) compared to cCBT-I alone for PTSD-related recurrent nightmares, 94 U.S. veterans completed a battery of cognitive tests. TBI was assessed via structured clinical interview. Mixed-effects models examined main effects of cognitive functioning and interactions with time on primary sleep and nightmare outcomes. Significant verbal immediate memory by time interactions were found for nightmare distress, nightmare frequency, and sleep quality, even after controlling for overall cognitive performance and depression. TBI exhibited main effects on outcomes but no interactions with time. Findings indicated that individuals with lower verbal memory performance were less likely to respond to treatment across two sleep interventions. Veterans with TBI displayed greater symptoms but no altered trajectories of treatment response. Together with prior literature, findings suggest that verbal memory functioning may be important to consider in PTSD treatment implementation.
Authors:Dubravka Gavric; David A. Moscovitch; Karen Rowa; Randi E. McCabe Abstract: Publication date: Available online 4 January 2017 Source:Behaviour Research and Therapy Author(s): Dubravka Gavric, David A. Moscovitch, Karen Rowa, Randi E. McCabe Background Post-event processing (PEP) is defined as repetitive negative thinking following anxiety provoking social events. PEP is thought to maintain anxiety symptoms in Social Anxiety Disorder (SAD) but little is known about the specific factors that contribute to the maintenance of PEP. Aims The current study investigated how perceptions of performance and positive metacognitive beliefs might contribute to the persistence of PEP. Method Participants with SAD (n = 24) as well as anxious (n = 24) and healthy (n = 25) control participants completed a standardized social performance task in the lab. Their engagement in PEP and perceptions of performance were assessed in the week that followed. Results Immediately following the social task, individuals with SAD rated their performance more negatively and endorsed a greater number of positive metacognitive beliefs about PEP than did participants in both control groups. Importantly, both metacognitive beliefs and initial negative self-ratings of performance mediated the relationship between group status and PEP in the days following the event. Conclusions These results are consistent with cognitive and metacognitive models of SAD and enhance our understanding of the cognitive processes which may function to initiate and maintain negative thinking patterns in SAD.
Authors:Andrea N. Niles; Kate B. Wolitzky-Taylor; Joanna J. Arch; Michelle G. Craske Abstract: Publication date: Available online 4 January 2017 Source:Behaviour Research and Therapy Author(s): Andrea N. Niles, Kate B. Wolitzky-Taylor, Joanna J. Arch, Michelle G. Craske Background No prior studies have examined moderators of dropout between distinct treatments for anxiety disorders. This study applied a novel statistical approach for examining moderators of dropout from traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Method We combined data from two randomized controlled trials (N = 208) comparing CBT and ACT for patients with DSM-IV anxiety disorders. Adapting Kraemer's method for constructing and evaluating composite moderators (2013), 26 variables were examined for individual effect sizes. Forward-stepwise regression combined with k-fold cross validation was used to identify a model to predict treatment dropout. Results Four baseline variables comprised the final composite moderator: self-reported degree of control over internal anxiety, current psychiatric medication use, religiosity, and endurance in a voluntary hyperventilation stressor. This composite moderator predicted differential dropout from ACT vs. CBT with a medium effect size (r = 0.28), and had a significantly larger effect size than any individual moderator. Conclusions Findings reveal that specific patient profiles predict differential dropout from ACT vs. CBT for anxiety disorders. In the first investigation of a composite moderator with a dichotomous outcome, findings also support the superiority of composite over individual moderators.