Journal of Behavior Therapy and Experimental Psychiatry最新文献

Background and objectives

Affective forecasting (AF) is the prediction of future emotional states. Negatively biased affective forecasts (i.e., overestimating negative affect) have been associated with trait anxiety, social anxiety, and depression symptoms, but few studies have tested these relationships while covarying commonly co-occurring symptoms.

Methods

In this study, participants (N = 114) completed a computer game in dyads. Participants were randomized into one of two conditions: a condition in which they were led to believe they were at-fault for losing their dyad money (n = 24 dyads) or a condition in which they were told no one was at fault (n = 34 dyads). Prior to the computer game, participants forecasted their affect for each potential game outcome.

Results

More severe social anxiety, trait-level anxiety, and depressive symptoms were all associated with more negative AF bias in the at-fault relative to the no-fault condition, and this effect persisted when controlling for other symptoms. Cognitive and social anxiety sensitivity was also associated with more negative AF bias.

Limitations

The generalizability of our findings is innately limited by our non-clinical, undergraduate sample. Future work should replicate and extend our research in more diverse populations and clinical samples.

Conclusions

Overall, our results support that AF biases are observed across a range of psychopathology symptoms and associated with transdiagnostic cognitive risk factors. Future work should continue investigating the etiological role of AF bias in psychopathology.

Background and objectives

Looming cognitive style (LCS) and intolerance of uncertainty (IUC) are both cognitive risk factors that play an important role in development of anxiety disorders. Even though both are known to be triggered by ambiguous situations, there is inadequate research on how they predict anxiety and repetitive negative thinking (RNT) patterns in response to ambiguity. The current study aimed to examine the interactive association of IUC and LCS with state anxiety and intensity of RNT following exposure to a stressor that involves ambiguity.

Methods

Data were collected from 292 (153 women) individuals aged between 18 and 63 (M = 20.82, SD = 5.20) who were administered self-report measures of LCS, IUC, and anxiety followed by a vignette describing an ambiguous situation. State RNT and anxiety were assessed following exposure to the vignette.

Results

The results indicated that IUC moderated the association of physical looming with state RNT. Individuals who have elevated levels of both physical looming and IUC reported experiencing more higher frequency of RNT when compared with other individuals.

Limitations

Although the manipulation check has shown that the scenario is effective it was not pilot tested. Also, since the manipulation was conducted online, the manipulation may not have been presented in a standardized way to all the participants.

Conclusions

Overall, the study shows that the two risk factors enhance each other's effect and lead to more intense levels of repetitive, uncontrollable, and distressing thoughts following exposure to ambiguity.

Background and objectives

Panic disorder is defined by recurring and unexpected panic attacks, accompanied by anticipatory anxiety about future attacks and their consequences. This generally involves avoiding situations and behaviors that can produce panic attacks (American Psychiatric Association [APA], 2013). Among anxiety disorders, panic disorder is associated with some of the greatest burdens in terms of personal suffering, occupational disability, and societal cost. The objective of this article is to systematically identify and review the empirical literature on emotional management processes and strategies associated with panic disorder, with the aim of evaluating their role in the development and maintenance of panic disorder, in order to better understand the pathogenesis of the disorder and guide clinicians to improve their current treatments.

Methods

Four databases were searched for studies which were based on self-reported questionnaires or a methodology based on an experimental procedure.

Results

Of the 1719 articles identified, 61 referred to different aspects of emotional management. People living with PD are characterized by low emotional intelligence levels, excessive use of suppression, impaired cognitive reappraisal, high levels of alexithymia and maladaptive coping strategies.

Limitations

Most of the reviewed studies used measures of emotional management in cross-sectional models and were based on self-assessment reports.

Conclusions

Improving emotional intelligence levels is key to increasing emotion regulation flexibility for people living with PD. Automatic cognitive reappraisal impairment in these people indicates low importance of cognitive restructuring in psychotherapeutic treatment.

Background and objectives

Positive affect treatments, which hold great promise to connect with those who are otherwise resistant to depression treatments, attempt to upregulate positive emotions. These treatments have potential advantages over standard therapies because they target cross-diagnostic core symptoms (e.g., anhedonia) that may respond better to interventions aimed at increased positivity. However, the extent to which these treatments are a perceived fit by individuals for whom they were developed (i.e., individuals who are afraid of, avoid, or experience less positivity) is unclear.

Methods

We conducted two independent studies utilizing a cross-sectional, experimental design to examine perceived treatment fit. Participants (Study 1: N = 416; Study 2: N = 321) read counterbalanced treatment descriptions of (1) positive affect treatment and (2) psychodynamic psychotherapy and answered questions regarding perceived treatment fit, effectiveness, and preference of the two treatments.

Results

Our findings suggest that individuals fearful of happiness perceived a prospective depression treatment specifically targeting positivity as a poorer fit, demonstrating an opposite pattern to the overall samples’ treatment preference in both studies. Thus, as predicted by Reward Devaluation Theory, those fearing positivity exhibited avoidance behaviors for treatments that are to an extent designed, and might otherwise be most effective, for them.

Limitations

The current study utilized a college student sample.

Conclusion

These empirical findings may ultimately inform psychoeducation of why positive affect treatments, which are in direct contrast with clients’ preferences, may be the very treatments they need the most.

Background and objectives

A disruption in the co-ordination of bottom-up and top-down processing is thought to underlie anomalous perceptual experiences in psychosis. Visual illusions represent a valuable methodology in exploring this disruption. Here, we examined visual illusions in a group of young people having psychotic-like experiences. We also examined the relationship between illusion susceptibility and appraisal of psychotic-like experiences as well as depression, anxiety and stress levels.

Method

25 young people reporting psychotic-like experiences and 53 healthy participants performed an adjustment task that measured susceptibility to a battery of 13 visual illusions. Levels of depression, anxiety and stress were quantified in both groups. The clinical group also completed measures examining frequency, appraisals and emotional responses to psychotic-like experiences.

Results

A general increase of illusion susceptibility was found in the clinical group compared to the control group. However, when depression, anxiety and stress levels were controlled for, this difference disappeared. Stress turned out to be the best predictor of illusion susceptibility in the clinical group, whereas anomalous experiences, depression and anxiety were unrelated to overall illusion strength.

Limitations

This study is limited to young participants reporting significant mental health difficulties and psychotic-like experiences. Findings should be replicated in an Ultra High Risk (prodromal) group.

Conclusions

Increased levels of stress explained the enhanced vulnerability to illusions in the clinical group. This increased susceptibility suggests a perceptual style that relies too heavily on prior expectations at the expense of the true sensory evidence, potentially leading to an altered perceptual experience of the world.

Background and objectives

Overgeneral autobiographical memory (OGM) has been shown to occur in depressed and previously depressed populations regardless of the emotional valence of cues. However, recent research has pointed out that the retrieval process underlying OGM, generative retrieval (i.e., retrieval requiring effort or additional information) or direct retrieval (i.e., memory that comes to consciousness without effort or additional information), may differ depending on the emotional valence of cues. We examined the hypotheses that a remitted MDD (major depressive disorder), group compared with a control group, would show (a) more direct retrieval of categoric memories for negative cues, (b) more generative retrieval of categoric memories for positive cues, and (c) less direct retrieval of specific memories for positive cues.

Methods

A remitted clinical MDD group (n = 21) and control group (n = 21) completed the Autobiographical Memory Test with minimal instruction, and were required to subjectively judge generative retrieval and direct retrieval.

Results

As expected, results showed that the remitted MDD group reported more frequent direct retrieval of categoric memory for negative cues and more generative retrieval of categoric memory for positive cues than the control group.

Limitations

Our paradigm for distinguishing between generative and direct retrieval relied on subjective judgements.

Conclusions

This extends the findings from student sample in previous studies to a help-seeking population. Increased availability of negative categoric memories and the attenuation of positive specific recall represent vulnerabilities for MDD. We discuss how these findings provide further rationale for memory therapeutics for MDD and refinement of those techniques.

Background and objectives

Cognitive bias modification of interpretation (CBM-I) has been widely used and yielded mixed results. This experiment explored the unique role of mental imagery in positive CBM-I.

Methods

60 participants (M = 23.13, SD = 1.04) were randomly assigned to a imagery-based positive CBM-I group (imagery group) and a conventional verbal-based positive CBM-I group (control group). The imagery group received additional practice in generating mental imagery and were instructed to fully focus on the imagery during the formal training. The dependent variables included interpretation bias (probe latencies and similarity ratings for recognition task), memory bias, and intrusive memory.

Results

(1) For the positive probe scenario, the reaction time of the two groups was shorter in the posterior five blocks than the anterior five blocks. However, the difference in latency between pre- and post- training for the imagery group was larger than that of the control group; (2) For the recognition task, the positive target statement score was significantly higher, while the negative one was significantly lower for the imagery group than that of the control group (3) The imagery group (vs. control); showed more beneficial effects on memory bias.

Limitations

The limitations consisted of the difference in time of the manipulation between the two groups, the richness of the imagery operationalization, generalizability, and the lack of pre-manipulation of interpretation bias assessments.

Conclusions

The imagery-based CBM-I led to more positive interpretation biases, less negative interpretations, and more positive memory biases, indicating that mental imagery can boost the effect of the positive CBM-I.

Background and objectives

Performance on implicit measures of suicidality has been associated with suicidal and nonsuicidal self-injury. Despite the high prevalence of self-harm in patients with borderline personality disorder (BPD), no previous study has assessed implicit measures in this patient group.

Methods

Forty patients with BPD and 25 healthy controls completed three implicit association tests (IATs) (Death words – Me/Others words, Self-Harm pictures – Me/Others, and Self-Harm pictures – Good/Bad words) and a subliminal priming task (effect of the primes “dying”/“growing” on the categorization speed of positive/negative adjectives) as well as measures of psychopathology (suicidal ideation, previous nonsuicidal self-injury, borderline symptomatology, depression, and hopelessness).

Results

Patients with BPD had higher scores on all three IATs than healthy controls. The subliminal priming procedure did not reveal group differences. Correlations between implicit measures and psychopathology among patients with BPD were mostly weak and nonsignificant with a few exceptions: Positive correlations were observed between IAT Self-Harm – Good/Bad and lifetime frequency of nonsuicidal self-injury, between IAT Self-Harm – Me/Others and depression, and between IAT Death – Me/Others and depression. Correlations between implicit measures were weak to moderate.

Limitations

The study was cross-sectional only, and the study had reduced power as the sample size was limited.

Conclusions

As expected, patients with BPD had higher scores than healthy controls on the IATs, which indicates higher implicit self-identification with self-harm and death as well as stronger implicit positive attitudes towards self-harm. The mostly weak correlations between implicit and explicit measures speak against the discriminative value of IATs in patients with BPD.

Intolerance of uncertainty (IU) has gained widespread interest as a construct of broad interest from both transdiagnostic and trans-situational perspectives. We have approached this article inspired by the curiosity, clinical observation, consideration of different theoretical perspectives, speculation, optimism and indeed fun that can be seen in S. J. Rachman's work. We address some of what we know about IU before considering one way of conceptualizing IU from the standpoint of a felt sense or embodied experience.

In the first part, we start with Woody and Rachman's (1994) observations of people with GAD. Second, we consider some key findings from the literature. Third, we consider two important perspectives on uncertainty, namely, Brosschot et al.’s (2016, 2018) influential Generalized Unsafety Theory of Stress and uncertainty as an emotion.

In the second part, backing our clinical hunch about the importance of the felt sense of uncertainty, we consider IU from the perspective of interoception and the somatic error theory of anxiety (Khalsa & Feinstein, 2018). We propose the somatic error theory of intolerance of uncertainty, which places the experience of uncertainty at the heart of our understanding of intolerance of uncertainty. This is followed by predictions, unresolved questions, and potential clinical implications.

Finally, we revisit Woody and Rachman's (1994) suggestions for treatment as internalizing “a sense of safety in a range of circumstances (p. 750)” and update this from the perspective of the felt sense of uncertainty. We finish by suggesting that uncertainty can be tolerated, perhaps accepted, and even embraced.