Behaviour Research and Therapy最新文献

Despite various efforts in the field, no consistent predictors of treatment outcome in anxiety disorders have been identified. Based on the Dynamic System Theory, this study proposes a novel, dynamic predictor of treatment outcome in those with public speaking anxiety. It was assessed whether speed of return to one's interpretation bias equilibrium after an experimentally-induced perturbation (i.e., interpretation training targeting negative interpretation bias as a critical maintaining factor for anxiety) predicts subsequent outcome to online exposure treatment. Women with subclinical public speaking anxiety (N = 100, M age = 23.13, SD = 3.89) were randomly allocated to a positive interpretation training (n = 50) or a neutral interpretation training (n = 50). Dynamic changes in negative interpretations were measured using Experience Sampling Method. Later, participants followed an online one-session exposure therapy for public speaking anxiety. Positive interpretation training resulted in a stronger reduction in negative interpretations compared to the neutral interpretation training. Fear of public speaking decreased from before to after the exposure therapy. Consistent with our central hypothesis, results showed that slower return to one's interpretation bias equilibrium after the positive interpretation training was associated with a greater decline in fear of public speaking after exposure treatment. These results show the potential of a dynamic approach in predicting treatment outcome in public speaking anxiety. This study contributes to the field of clinical psychology, as finding more reliable predictors of treatment outcome before the start of therapy could contribute to the efficiency of care delivery.

Observational threat learning is a complex social learning process through which typical and atypical fears develop. While studies have demonstrated the effectiveness of observational learning for the acquisition and extinction of threat, the intricacies of this learning process and how it varies across development have been less explored. To this end, we examined the extent to which children, adolescents, and adults generalized threat responses following observational threat learning. We also tested the capacity for reversal acquisition of these threat associations, again through observation. Participants (n = 159) from three age groups underwent four consecutive learning phases: observational threat acquisition, direct generalization, observational reversal threat acquisition, and a direct reversal test. Threat responses were measured using psychophysiological and subjective indices. Results indicated that following successful observational threat learning, children, adults, and adolescents experienced threat generalization. Developmental differences emerged for reversal threat acquisition, with adolescents demonstrating poorer learning than children and adults. The study expands current knowledge on how observational threat learning is used in changing circumstances and how it unfolds across development.

Emotion regulation is a topic of growing interest in the field of post-traumatic stress disorder (PTSD). Despite the field's concentrated efforts in this area, the research has not matched advancements in the general emotion regulation literature, which have proposed more holistic models to understanding to how individuals identify and respond to emotions. In looking at emotion regulation in PTSD, this paper reviews the current state of the literature using the Extended Process Model proposed by Gross (2015). Considering emotion perception, beliefs, emotion regulation strategies (in terms of choice, flexibility of use, and repertoire of strategies available), and tactics, it discusses how these constructs help us understand the pathogenesis of PTSD and identifies areas in need of further research, including assessing the role of culture and improving measurement of emotion regulation constructs. Clinical implications of the emotion regulation literature for PTSD treatment are discussed.

Although exposure-based therapy is widely recognized as effective for treating various anxiety disorders, a significant proportion of patients fail to benefit or experience a return of fear following successful treatment. One promising strategy involves occasional presentation of fear-evoking stimuli during extinction (occasional reinforced extinction, ORE). This study investigates a novel approach to translate ORE into clinical practice by incorporating occasional vivid imagery of individuals' worst-case fear scenarios during in-vivo exposure. Forty-seven spider-fearful individuals were randomly assigned to receive either a one-session in-vivo standard exposure treatment (Exp-Only) or an one-session in-vivo exposure treatment supplemented with occasional mental imagery of their worst-case spider scenario (Exp + ORE). Fear of spider questionnaires and a generalization behavioral approach test were administered prior to and one week after treatment. Both groups showed improvement from baseline to post-assessment, but the Exp + ORE group demonstrated significantly greater reductions in self-reported fear and avoidance of spiders compared to standard exposure training. During the generalization behavioral approach test, subjective distress and approach behavior toward the spider significantly improved from baseline to post-assessment in all participants, with no discernible group differences. Findings moreover indicate that occasional imagery during exposure lead to greater expectancy violation compared to standard exposure, providing insights into potential underlying mechanisms of the ORE approach. Incorporating mental imagery into the occasional reinforced extinction approach could hold promise for enhancing the efficacy of exposure-based treatments for anxiety disorders in clinical settings.

This study was aimed to evaluate whether the efficacy of invoking anti-depressive self-statements to cope with depressed mood can be enhanced for depressed individuals by systematically guiding them to amplify the expression of conviction in their voice. Accordingly, we recruited N = 144 participants (48 clinically depressed individuals, 48 sub-clinically depressed individuals, and 48 non-depressed individuals). Participants were randomly assigned to an experimental or control condition. Across study conditions, participants completed a mood induction procedure, then read aloud scripted anti-depressive self-statements designed to reduce depressed mood. Participants in the experimental condition received instructions to heighten the prosodic expression of conviction in their voice; participants in the control condition received no prosodic expression instructions. Results showed that depressed participants achieved a more pronounced decrease of depressed mood in the experimental condition than in the control condition. Further, the results indicated no effects in sub-clinically depressed and non-depressed individuals. Finally, heightened conviction expressed by participants in the experimental condition was associated with lower depressed mood and diminished depressive symptom severity. Overall, our findings suggest that fostering the prosodic expression of conviction in depressed persons' voices, while they vocalize anti-depressive self-statements, represents a promising method for augmenting the efficacy of cognitive interventions for depression.

Fear overgeneralization is widely considered to be a core feature of pathological anxiety, and the excessive spread of fear can be a great burden on patients. Although perceptual processing is a basic process of human cognition, the impact of visual perception recognition on fear generalization has not yet been fully explored. In this study, 69 subjects were recruited to explore the effects of the hierarchical features of stimuli on fear generalization and examine the roles of trait anxiety (TA) and intolerance of uncertainty (IU) in this process. The results reveal that compared with the local features, the subjects showed stronger fear responses to global features of the stimuli, and the weakest fear response was to the reversed features. Furthermore, the results preliminarily suggest that in generalization dominated by global features, TA intensifies the fear response; while in generalization dominated by local features, along with TA, IU makes a unique contribution to increasing the magnitude of fear generalization. These results confirm new potential pathways for fear generalization, specifically the configurational hierarchical features of stimuli. This is explained through object recognition and cognitive bias, implying that cognitive processes and personality traits have interacting effects on fear generalization.

Depression is related to difficulty revising established negative self-beliefs in response to novel positive experiences. This propensity is in some way paradoxical because negative beliefs usually have many obvious negative consequences for the individual (e.g., feeling upset). Using a qualitative approach, the present study sought to explore what makes such negative self-beliefs valuable from the patients' perspectives. In 14 patients with major depression, we conducted semi-structured interviews that explored the perceived benefits of retaining an individually specified negative core belief as well as the perceived costs of changing it. In a deductive-inductive approach based on a recent theoretical model of the value of beliefs, we found eight themes that may explain why people with depression uphold negative beliefs (intercoder agreement: κ = .81): expectation management, certainty and control, avoiding cognitive dissonance, adaptivity in the past, protection of higher values, attachment and belonging, saving resources, short-term counterevidence. The two most frequently mentioned themes were that retaining negative beliefs helps patients sustain certainty and keep expectations low to prevent future disappointments. While previous research has advanced the understanding of how (i.e., through which mechanisms) people with depression maintain negative self-beliefs, the present study provides novel insights into why they do so.

Diagnostic overshadowing occurs when healthcare professionals misattribute an individual's presenting symptoms to other features of an individual's clinical presentation. Mental health providers may incorrectly diagnose and treat trauma-exposed individuals due to trauma-related diagnostic overshadowing bias. No research has investigated provider factors associated with this bias. Mental health provider background and training characteristics were examined as predictors of trauma-related diagnostic overshadowing in a sample of mental health providers (N = 210). Hierarchical regression modeling was used to evaluate predictors related to trauma-related diagnostic overshadowing in diagnostic and treatment decision-making. Providers with diagnostic responsibilities in their professional role were significantly less likely to demonstrate bias in some diagnostic and treatment decisions. Older mental health providers and providers with more clients experiencing traumatic stress demonstrated greater bias in some diagnostic responses. Providers with doctoral degrees, compared to all other degree types, demonstrated less bias through some diagnostic and treatment responses. Bias in diagnostic decisions strongly predicted bias in treatment decision-making. Findings suggest that factors related to clinical experience may be important in predicting trauma-related diagnostic overshadowing. Future work should extend this research to understand which factors affect trauma-related diagnostic overshadowing in real-world settings.

This study investigated between-person associations among PTSD symptoms, fear of emotion, and perceived couple communication difficulties in a dyadic context among 64 trauma-exposed, mixed gender community couples (N = 128 individuals) using the Actor-Partner Interdependence Mediation Model. Individuals with higher PTSD symptoms endorsed greater fear of their emotions (β_Men = .72; β_Women = .49), and those with greater fear of their emotions reported lower levels of constructive couple communication (β_Men = -.19; β_Women = -.21) and higher levels of self-demand/partner-withdraw communication (β_Men = .20; β_Women = .25) and partner-demand/self-withdraw communication (β_Men = .26; β_Women = .33) with their partners. Additionally, women whose partners had higher PTSD symptoms endorsed greater fear of their emotions (β = .30). The most robust indirect PTSD-communication links were between (a) individuals' PTSD symptoms and their perceptions of partner-demand/self-withdraw communication when accounting for associations with fear of their emotions and (b) men's PTSD symptoms and women's perceived partner-demand/self-withdraw communication accounting for associations with women's fear of their emotions. Men with higher PTSD symptoms also reported greater self-demand/partner-withdraw communication (β = .28), independent of their fear of emotion. Couple-based treatments for PTSD that promote emotional tolerance and are sensitive to gender differences in how PTSD symptoms relate to each partner's perception of the man-demand/woman-withdraw communication pattern may improve trauma survivors' relationship functioning and increase the potential for relationships to serve as a conduit for recovery from PTSD.

Objectives: This study aimed to investigate the characteristics of attentional capture by reward signals in individuals with depression during classical conditioning.

Methods: A variant of the additional singleton paradigm was adopted with a high- or low-reward signal as the prominent distracting stimulus. In Experiment 1, 46 participants with depressive symptoms and 46 healthy controls were asked to conduct a keypress response to the visual target. In Experiment 2, 58 participants with depressive symptoms and 58 healthy controls were asked to conduct a fixation response to the visual target.

Results: In the keypress response task, the presence of high-reward signals slowed down the responses of participants in the control group, whereas the response times of individuals with depression were not significantly affected. In the fixation response task, when the high-reward signal was presented, individuals with depression were more likely to choose the target location as the first saccade destination, compared with healthy controls. In addition, individuals with depression exhibited fewer oculomotor capture by high-reward signals than healthy controls, a trait which was closely linked to the enhanced saccadic inhibition.

Conclusion: The results of our study indicated that individuals with depression exhibited an abnormality in attentional capture by reward-related conditioned stimuli during classical conditioning.