Journal of Behavior Therapy and Experimental Psychiatry最新文献

Background and objectives

A proposed strategy for attenuating the return of fear is conducting exposure therapy in multiple contexts (e.g., different locations), which is believed to enhance the generalizability of safety learning. Although conducting exposure in multiple contexts can be differentiated from conducting exposure with multiple stimuli, the two strategies are often conflated. Furthermore, researchers have not yet determined whether one of these strategies, or a combination thereof, is most effective in attenuating fear renewal.

Methods

Accordingly, the present treatment-analogue study examined the unique and combined effects of multiple-context and multiple-stimulus imagery-based exposure manipulations on threat expectancy, behavioral approach/anxiety, and attentional bias for threat over Zoom. Community adults (N = 134) who met diagnostic criteria for snake phobia were randomized to exposure to a single snake in multiple environmental contexts (MC), exposure to multiple snakes in a single environmental context (MS), or exposure to multiple snakes in multiple environmental contexts (MS/MC).

Results

Results revealed significant reductions in threat expectancy and behavioral anxiety, but not attentional bias for threat in all three groups. However, behavioral approach declined over the course of exposure in the MS/MC condition but remained stable in the MC and MS conditions. There were no significant group differences in behavioral approach/anxiety or attentional bias at a one-week follow-up. However, participants in the MC condition reported lower threat expectancy at a one-week follow-up than the other groups and this group difference was partially mediated by lower mean distress during exposure.

Conclusions

Implications of these findings for the inhibitory retrieval theory are discussed.

Background and objectives

Methods

Results

Limitations

Conclusions

Background

Methods

Results

Limitations

Conclusions

Background

Depression is usually characterized by impairments in reward function, and shows altered motivation to reward in reinforcement learning. This study further explored whether task difficulty affects reinforcement learning in college students with and without depression symptom.

Methods

The depression symptom group (20) and the no depression symptom group (26) completed a probabilistic reward learning task with low, medium, and high difficulty levels, in which task the response bias to reward and the discriminability of reward were analyzed. Additionally, electrophysiological responses to reward and loss feedback were recorded and analyzed while they performed a simple gambling task.

Results

The depression symptom group showed more response bias to reward than the no depression symptom group when the task was easy and then exhibited more quickly decrease in response bias to reward as task difficulty increased. The no depression symptom group showed a decrease in response bias only in the high-difficulty condition. Further regression analyses showed that, the Feedback-related negativity (FRN) and theta oscillation could predict response bias change in the low-difficulty condition, the FRN and oscillations of theta and delta could predict response bias change in the medium and high-difficulty conditions.

Limitations

The electrophysiological responses to loss and reward were not recorded in the same task as the reinforcement learning behaviors.

Conclusions

College students with depression symptom are more sensitive to task difficulty during reinforcement learning. The FRN, and oscillations of theta and delta could predict reward leaning behavior.

Background and objectives

Despite documented alterations in future thinking in posttraumatic stress disorder (PTSD), our understanding of how individuals with PTSD make future-oriented decisions is limited. We tested the hypothesis that increased discounting in association with PTSD reflects failure to spontaneously envision future rewarding situations.

Methods

Thirty-seven trauma exposed war-zone veterans completed a standard temporal discounting task as well as a temporal discounting task accompanied by episodic future thinking cues.

Results

Severity of PTSD symptoms was associated with preference for sooner, smaller rewards in the standard task. Consistent with our hypothesis, when participants engaged in future thinking, greater PTSD symptom severity was no longer associated with steeper discounting. Moreover, difficulty anticipating future events, as measured contemporaneously in a separate task (Verfaellie et al., 2024), mediated the relationship between PTSD symptom severity and degree of discounting in the standard task. Among PTSD symptom clusters, the severity of avoidance and negative alterations in cognition and mood was related to steeper discounting. Measures of depression and alcohol use were not associated with discounting.

Limitations

The sample included mostly male, predominantly White veterans who experienced primarily combat-related trauma.

Conclusions

PTSD-associated alterations in temporal discounting reflect failure to spontaneously imagine future positive events. Two common correlates of PTSD, depression and alcohol use, could not account for the observed associations between PTSD and future-oriented decisions.

Background and objectives

Consumption of sugar-sweetened beverages (SSBs) is a global public health issue. Consequently, there is strong interest in advancing understanding of the cognitive mechanisms that underpin excessive SSB consumption. This work proposes that selective interrogation of taste-based characteristics (e.g., flavour), rather than health-based characteristics (e.g., sugar content), of beverages is associated with greater SSB choice and consumption.

Methods

To evaluate this novel hypothesis, undergraduate students (n = 210) were recruited to complete self-report measures of SSB consumption, motivation and success in reducing SSB consumption and unhealthy eating more broadly, as well as a novel selective interrogation assessment task. This task provided participants with the opportunity to selectively interrogate taste-based and health-based characteristics of various mystery beverages.

Results

Results supported the hypothesis that greater selective interrogation of taste-based characteristics, rather than health-based characteristics, of beverages is associated with greater SSB choice and consumption. Additionally, results revealed that greater selective interrogation of taste-based characteristics was associated with decreased motivation to reduce SSB consumption and decreased motivation and success to reduce unhealthy consumption more broadly.

Limitations

The current study did not evaluate whether selective interrogation of taste-based characteristics of beverages predicted actual SSB consumption.

Conclusion

These findings provide novel evidence for the potential role of selective interrogation of taste-based characteristics of beverages in SSB choice and consumption. An important implication of these findings is that in order for interventions focusing on front-of-package nutrition labels to be effective in reducing unhealthy consumption, it is necessary that individuals are selectively interrogating this ‘health-based’ information.

Background and objectives

Transdiagnostic approaches have been promoted as a means of maximising preventative effects across multiple problems with depression and anxiety suitable targets as they appear to have highly interconnected systems in pathology development and maintenance. This study investigated long-term effects of two universal school-based programs, Emotion Regulation (ER) and Behavioral Activation (BA), that sought to prevent depression and anxiety by targeting worry (a transdiagnostic feature) to promote resilience.

Methods

This follow-up study captured data from 162 of 316 initial students (aged 8–13; 52.2% female), from six Australian schools. The original study design cluster randomised students by school into BA, ER, or a usual class control. Intervention conditions consisted of 8 × 50-min weekly sessions. This study measured the effects of these interventions after 24 months on resilience, worry, depression, and anxiety. Resilience was also examined as a potential mediator.

Results

At 24-month follow-up, there was no significant effect of either intervention on depression, anxiety, worry, or resilience levels. Significantly fewer participants in ER and BA met clinical thresholds for separation anxiety disorder (SAD) and obsessive-compulsive disorder (OCD) in the 24-month follow-up compared with baseline. No mediation effects were found.

Limitations

Although self-report measures are common in universal, school-based research, this represents a study limitation.

Conclusions

Both interventions may provide limited long-term protective effects on SAD and OCD symptoms, which appear to have a shelf-life shorter than 24 months. To maintain program effects, refresher sessions at shorter intervals may be a consideration for future research.

Background

Social anxious individuals show attention bias towards emotional stimuli, this phenomenon is considered to be an important cause of anxiety generation and maintenance. Cognitive-behavioral therapy (CBT) is a standard psychotherapy for social anxiety disorder. CBT decreases attention biases by correcting the maladaptive beliefs of socially anxious individuals, but it is not clear whether CBT alters neurophysiological features of socially anxious individuals at early automatic and/or late cognitive strategy stage of attentional processing.

Method

To address this knowledge gap, we collected pre-treatment event-related potential data of 22 socially anxious individuals while they performed a dot-probe task. These participants then received eight weeks of CBT, and post-treatment ERP data were collected after completion of CBT treatment. We also included 29 healthy controls and compared them with individuals with social anxiety to determine the neural mechanisms underlying the effectiveness of CBT.

Results

Participants’ social anxiety level was significantly alleviated with CBT. ERP results revealed that (1) compared to pre-treatment phase, P1 amplitudes induced by probes significantly decreased at post-treatment phase, whereas P3 amplitudes increased at post-treatment phase; the P1 amplitudes induced by probes following happy-neutral face pairs in socially anxious individuals after treatment was significantly different with that in healthy controls; (2) amplitude of components elicited by face pairs did not change significantly between pre-treatment and post-treatment phases; (3) changes of Liebowitz Social Anxiety Scale were positively correlated with changes of P1 amplitude, and negatively correlated with changes of N1 amplitude.

Limitations

Our sample was university students and lacked randomization, which limits the generalizability of the results.

Conclusion

The present results demonstrated that CBT may adjust cognitive strategies in the later stage of attentional processing, indicating by changed ERPs appeared in probe-presenting stage for social anxiety.

Background and objectives

Ecological momentary assessment is a popular method for monitoring symptoms in real-time. Especially for fleeting experiences, such as intrusions, real-time assessments may be more accurate than retrospective estimates. However, there are concerns regarding reactivity effects associated with real-time assessments and, conversely, the reliance on bias-prone retrospective assessments in clinical science and practice. In this study we used a between-groups design to examine whether real-time intrusion assessments influence retrospective reports (aim 1). Then, we investigated whether real-time and retrospective assessments systematically differed within individuals (aim 2).

Methods

Over two weeks, 150 non-clinical individuals provided weekly retrospective intrusion assessments, while the majority (n = 102) additionally reported their intrusions in real-time, via smartphones. We examined both naturally occurring intrusions, which individuals experience in their everyday lives, and intrusions related to a standardized stressor (i.e., Trier Social Stress Test), taking place halfway.

Results

Using Bayesian statistics, we found that assessing intrusions in real-time did not convincingly affect retrospective reports, and there was no strong evidence that real-time and retrospective intrusion assessments differed. However, the evidence of absence was inconclusive for some measures. Real-time and retrospectively reported intrusion frequencies and distress were strongly associated with one another.

Limitations

Future research is advised to replicate these findings with larger samples, for other types of stressors, in clinical populations, and over extended assessment periods.

Conclusions

The general agreement between real-time and retrospective assessments of intrusions is encouraging, tentatively suggesting that researchers and clinicians can flexibly select the assessment method that best suits their objectives.

Background and objectives

The conditioned-intrusion paradigm was designed to provide insight into the relationship between fear conditioning and intrusive memory formation, which is relevant to understanding posttraumatic stress disorder symptoms and treatment. However, boundary conditions of this new paradigm have not been explored and it is currently not known whether findings from this work are valid in a clinical context.

Methods

In the current study, we explored the relationship between stress reactivity to trauma film clips, usual exposure to violent media, renewal of fear conditioning using skin conductance as well as subjective ratings, and the effect of shock versus film clip during conditioning on the frequency of intrusive memories. An adapted fear conditioning paradigm using trauma clips as unconditional stimuli was used, and participants subsequently reported intrusive memories of the trauma clips.

Results

Skin conductance responses to conditioned stimuli paired with shocks and film clips were significantly higher than conditioned stimuli paired with film clips alone. Subjective stress reactivity, previous exposure to violent media, and film valence rating were associated with the frequency of intrusive memories. No aspects of fear conditioning were associated with intrusive memories, and factor analysis suggested the fear conditioning and stress related to film clip viewing were mostly separate constructs. Similarly, content and triggers of intrusive memories were usually film-clip related rather than conditional stimulus related.

Limitations

We did not observe strong conditioning effects of the unconditional stimuli to conditional stimuli, which were shapes rather than high frequency stimuli such as faces.

Conclusions

These findings provide potential boundary conditions for this paradigm and suggest multiple ways in which the validity of the paradigm can be tested in the future.