Cognitive-Behavioral Versus Supportive Psychotherapy for Intermittent Explosive Disorder: A Randomized Controlled Trial

Few clinical trials have evaluated the efficacy of psychotherapy for Intermittent Explosive Disorder (IED). The present study tested the efficacy of a cognitive behavioral intervention (versus supportive psychotherapy) among adults with IED. In this randomized clinical trial, 44 participants with IED (22 men and 22 women) aged 20–55 years completed twelve 50-minute individual sessions of either a multi-component cognitive behavioral intervention for IED (n = 19) or a time equated supportive psychotherapy (n = 25). At baseline, posttreatment, and 3-month follow-up, all participants received the Overt Aggression Scale–Modified, which was conducted by an interviewer who was blind to the participant’s study condition. During these visits, participants also completed self-report measures of relational aggression (Self-Report of Relational Aggression and Social Behavior), anger (State-Trait Anger Expression Inventory-2), cognitive biases (e.g., Social Information Processing Questionnaire Attribution and Emotional Response Questionnaire), and associated symptoms (e.g., Beck Depression Inventory). Primary study outcomes were aggressive behavior and anger. Though participants in both treatments tended to improve over time, the cognitive behavioral intervention was superior to supportive psychotherapy in decreasing aggressive behavior and relational aggression. These findings support the efficacy of a multicomponent cognitive behavioral intervention in treating aggression in IED.     

Definitions of bullying: Age and sex differences in a Turkish sample

The aim of the present study was to investigate the meaning profile of the Turkish term ‘zorbal?k’, which is considered the most similar to the English word ‘bullying’, and of five other terms in Turkish that describe bullying‐like behaviours. We used the cartoon methodology of a previous study, but with an expanded task of 40 stick‐figure cartoons. These cartoons were shown to 124 students (70 girls and 54 boys), in fourth grade (M = 9.3 years) and eighth grade (M = 13.3 years). Our findings indicated four major clusters: neutral or non‐aggressive, physically aggressive, verbally aggressive, and social exclusion, with the physically‐aggressive cluster splitting into two clusters, physical bullying and other physical aggression, in the older students.     

Oxytocin increases willingness to socially share one's emotions

Oxytocin (OT) is a neuropeptide that is attracting growing attention from researchers interested in human emotional and social behavior. There is indeed increasing evidence that OT has a calming effect and that it facilitates pair‐bonding and social interactions. Some of OT's effects are thought to be direct, but it has been suggested that OT also may have indirect effects, mediated by changes in behavior. One potentially relevant behavioral change is an increased propensity for “emotional sharing” as this behavior, like OT, is known to have both calming and bonding effects. In this study, 60 healthy young adult men were randomly assigned to receive either intranasal placebo (PL; n = 30) or oxytocin (OT; n = 30). Participants were then instructed to retrieve a painful memory. Subsequently, OT and placebo participants’ willingness to disclose to another person event‐related facts (factual sharing) vs. event‐related emotions (emotional sharing) was evaluated. Whereas the two groups were equally willing to disclose event‐related facts, oxytocin was found to specifically increase the willingness to share event‐related emotions. This study provides the first evidence that OT increases people's willingness to share their emotions. Importantly, OT did not make people more talkative (word counts were comparable across the two groups) but instead increased the willingness to share the specific component that is responsible for the calming and bonding effects of social sharing: emotions. Findings suggest that OT may shape the form of social sharing so as to maximize its benefits. This might help explain the calming and bonding effects of OT.     

Psychiatric nurses' attitudes towards inpatient aggression: preliminary report of the development of attitude towards aggression scale (ATAS)

Professional skills to adequately manage patient aggression are a prerequisite for nurses working in psychiatric hospitals. These ‘technical’ skills, however, are necessary but not sufficient for effective nurse intervention. The attitude of nurses' towards client aggression also contributes to their response to a patient's behaviour. In order to study the domains (types) of attitudes towards aggression, a sample was taken of nurses working in the fields of general psychiatry (n=288), psychiatry for children and adolescents (n=242) and psychogeriatrics (n=88). A cross‐sectional survey design was adopted for the study. The Attitudes Towards Aggression Scale (ATAS) consisting of 32 items is presented, representing three types of attitudes towards aggression: aggression as a ‘harming’ reaction, a ‘normal’ reaction and a ‘functional’ reaction. The strongest predictors of the type of attitude respondents had towards the aggressive behaviour of their clients were (1) field, (2) setting they worked in, (3) gender and (4) type of shifts they predominantly had. Although the measure of domains of nurses' attitudes towards aggression needs further psychometric testing, it can be a useful tool in clinical practice for the assessment of staff attitudes towards aggression. This can support the decision‐making about the management of aggressive behaviour on a ward. Aggr. Behav. 00:1–10, 2005. © 2005 Wiley‐Liss, Inc.     

Affective flexibility and generalized anxiety disorder: valence-specific shifting difficulties

ABSTRACT

Background: Growing evidence suggests that generalized anxiety disorder (GAD) is associated with poor affective flexibility, defined as the ability to switch between emotional aspects and non-emotional aspects of a situation. However, it is unclear whether affective inflexibility is valence-specific in GAD.

Methods: Participants with GAD (n?=?21) and non-clinical control participants (n?=?28) were tested on an Affective Switching Task during which participants were asked to categorize pictures either by the valence or by the number of humans present in the pictures.

Results: Individuals with GAD, but not healthy controls, exhibited greater difficulty shifting from emotional aspects of negative material compared to emotional aspects of positive material and shifting to the emotional aspects of positive material compared to emotional aspects of negative material.

Conclusions: These findings suggest that GAD is associated with valence-specific affective flexibility biases. The relevance of the findings and directions for future research are discussed.     

Emotion regulation and psychopathological symptoms of Chinese school‐age children: A person‐centred and multi‐informant approach

Emotion regulation (ER) is a critical component of children's development. Many previous studies have utilised a single‐assessment method to reflect child ER, which might result in losing important information regarding the unique contribution of each informant. With a person‐centred approach and multi‐informant reports (mother, teacher and child), the current study examined 196 children's (age M = 9.21, SD = 1.10, range = 7–11 years; 51% girls) ER patterns and their associations with psychopathological symptoms in a Chinese sample. A model‐based clustering procedure resulted in 3 ER groups: the poor family ER group (n = 36), poor school ER group (n = 120), and overall good ER group (n = 40). Significant differences were found among ER clusters on teacher‐reported child psychopathological symptoms compared on the levels of withdrawn depression, somatic complain, thought problems and attention problems. No significant differences were found on the mother‐reported psychopathological symptoms. Compared with children in the poor school or poor family ER clusters, children in the overall good ER group demonstrated fewer psychopathological symptoms at school. Our results confirmed the advantage of adopting multi‐informant assessments to fully capture children's emotional profiles and linked these profiles with children's emotional and behavioural functioning at school.     

Women are more sensitive than men to prior trial events on the Stop‐signal task

Sexual dimorphism in the brain and cognition is a topic of widespread interest. Many studies of sex differences have focused on visuospatial and verbal abilities, but few studies have investigated sex differences in executive functions. We examined two key components of executive function – response inhibition and response monitoring – in healthy men (n = 285) and women (n = 346) performing the Stop‐signal task. In this task, participants are required to make a key press to a stimulus, unless a tone is presented at some delay following the initial stimulus presentation; on these infrequent trials, participants are instructed to inhibit their planned response. Response inhibition was assessed with an estimate of the latency needed to inhibit a response (stop‐signal reaction time), and response monitoring was measured by calculating the degree to which participants adjusted their reaction times based on the immediately preceding trial (e.g., speeding following correct trials and slowing following errors). There were no sex differences in overall accuracy or response inhibition, but women showed greater sensitivity to trial history. Women sped up more than men following correct ‘Go’ trials, and slowed down more than men following errors. These small but statistically significant effects (Cohen's d = 0.25–0.3) suggest more flexible adjustments in speed–accuracy trade‐offs in women and greater cognitive flexibility associated with the responsive control of action.     

Effectiveness Evaluation of Search and Target Acquisition Training Prototype Using Performance Metrics With Eye-Tracking Data

Despite the increased use of sensor technologies, including unmanned vehicles, the vast majority of improvised explosive device (IED) detections are made by human vision. Thus, TRAC-Monterey developed a simulation-based training prototype called the perceptual learning trainer (PLT). Fourteen novice and 5 expert IED detectors participated in human-in-the-loop experiments in which all participants were trained using the PLT tool while their eye-movement and IED detection performance were tracked in real-time. A series of 100 IED images with various degrees of difficulty was used for the training session. Pre- and posttraining assessments were conducted. Both speed and accuracy improved after just 1 session of the PLT training: RT decreased by 3.7 s for novices (p < .001) and 3.4 s for experts (p = .031), and detection probability increased by 5.9% for novices (p = .001). The PLT tool improved IED detection performance more in novice IED detectors than in experts. Novices and experts showed different visual scan patterns.     

Extraversion and neuroticism: Investigation of resting electrodermal activity

In 1967 Eysenck published his biological account of extraversion and neuroticism. In the same year Claridge identified several problems with this theory. More recently Robinson has detailed a promising modification to Eysenck's theory which addresses many of the issues raised by Claridge. Drawing on Robinson's theory it was hypothesised that differences in resting electrodermal activity (EDA) would contrast extraverted‐neurotics (low arousal) and introverted‐neurotics (high arousal). The Eysenck Personality Questionnaire (EPQ) was used to identify four extreme groups of female participants: extraverted‐stable (n = 16), extraverted‐neurotic (n = 15), introverted‐stable (n = 8) and introverted‐neurotic (n = 16). EDA measures of skin conductance level (SCL) and non‐specific skin conductance response (NS‐SCR) were collected during two rest periods. Planned contrasts between the extraverted‐neurotic and introverted‐neurotic groups provided support for Robinson's theory on SCL but not NS‐SCR. It was argued that the results for NS‐SCR frequency could be accommodated by Robinson's theory if NS‐SCR was conceptualised as a measure of cortical reactivity to unspecified stimuli rather than as a measure of tonic arousal.     

Autobiographical memories and views of the future: In relation to dysphoria

The present study investigated dysphoric individuals' self‐referential processing of autobiographical memories and future personal events, in relation to specificity and response latency. Dysphoric individuals (n  =  17) and nondysphoric controls (n  =  17) were selected from a larger sample based on self‐reported depression. Participants completed an autobiographical memory task (AMT) and a future event task (FET), using pleasant and unpleasant (anxiety‐relevant, depression‐relevant) emotional word cues. In response to each emotional cue, participants were required to access and write down a specific personal memory and future event, respectively. Consistent with the hypotheses, dysphoric individuals were less specific in describing pleasant and unpleasant experiences (particularly pleasant), irrespective of time condition. As expected, dysphoric individuals' specificity for distinct depression‐relevant and anxiety‐relevant experiences did not differ significantly. As predicted, all participants were less specific in describing future personal events than in recalling personal memories. As predicted, dysphoric individuals took longer to think of pleasant memories and pleasant future experiences than controls but, as expected, groups did not differ significantly on mean reaction times for past and future unpleasant experiences. Overall, the data showed a degree of consistency in participants' past and future‐oriented processing of self‐referential material. Although considerable research has investigated autobiographical memories in relation to emotional disturbance, the present findings suggest that constructing future emotional experiences is also an important aspect of mental health.     

Associations of Trait Emotional Intelligence with Social Support,Work Engagement,and Creativity in Japanese Eldercare Nurses

Work‐related resources can be positive antecedents of employee work engagement (WE) and creativity. Although trait emotional intelligence (EI) and social support may be crucial resources in nursing, their relationships with WE and creativity remain unclear. Hence, with special focus on the role of trait EI, we examined this relationship by applying the job demands‐resources (JD‐R) model. The participants were 489 eldercare nurses in Japan (female: n = 401; male: n = 88; age = 39.5 ± 11.0 years). The results showed positive associations between EI and the other studied variables. Furthermore, moderated mediation analyses revealed that higher trait EI enhanced the positive association among the triad of social support, WE, and creativity. The findings provide additional evidence that, in nurses, trait EI may be a noteworthy personal resource for creativity in the relationship between social support and WE.     

Better the Devil You Know? High-Risk Individuals’ Anticipated Psychological Responses to Genetic Testing for Melanoma Susceptibility

Purpose: The psychological consequences of genetic testing for mutations among individuals at increased risk of developing melanoma remain unexamined. The present study aimed to explore anticipated emotional, behavioral, cognitive, and familial responses to hypothetical genetic testing for melanoma susceptibility. Methods: Forty semi-structured interviews were undertaken with affected (n=20) and unaffected (n=20) individuals at either high or average risk of developing melanoma due to family history. Results: In-depth thematic analysis revealed that, in response to being identified as a mutation carrier, most participants with a family history anticipated calmly accepting their increased risk; either increasing precaution adoption or maintaining already vigilant behavioral practices; perceiving such information as important and valuable; and communicating genetic test results to family members, despite the acknowledgement of potential difficulties. In response to being identified as a non-carrier, the majority of participants expected to feel relieved; to maintain current precautionary health practices; to still perceive themselves at some risk of developing melanoma; and to be wary of the potential negative behavioral consequences of disclosing such information to family members. Women appeared more likely than men to acknowledge the potential for depression and worry following genetic testing. In contrast, more males than females expected to carry a gene mutation, and viewed their current preventive practices as optimum. Conclusion: Genetic testing for melanoma risk is likely to elicit a complex array of emotional, behavioral, cognitive, and familial responses for both testees and their family members, and these responses are likely to bear subtle differences for males and females.     

Alexithymia and relaxation: Considerations in optimising the emotional effectiveness of journaling about stressful experiences

The emotional benefits of pairing a brief relaxation with journaling about a stressful event were considered through an experimental design, with alexithymia included as a potential moderator. Participants (n=217) were randomly assigned to a full treatment group (n=54), relaxation-only group (n=57), journaling-only group (n=51), or control group (n=55). The results indicated an interaction, with high-alexithymic participants in the full treatment group reporting increased levels of emotional distress several days after writing. The hypothesis that preceding journaling with a relaxation would be beneficial for non-alexithymic participants was not supported. These findings contribute to the ongoing examination of how best to optimise the effectiveness of journaling. They also lend support to the importance of including alexithymia as a moderator variable in future journaling research.     

Mass communication,social influence,and consumer behavior: two field experiments

The present article connects advertising by means of mass communication with social influence processes. Predictions derived from a theoretical model on the impact of mass communication on consumers who were not directly exposed to the message (distant consumers) were tested with two field experiments (Experiment 1: n = 77 participants, n = 261 peers; Experiment 2: n = 97 participants, n = 289 peers). Both studies addressed consumer behavior in the media sector. The results suggest that mass communication changes the behavior of distant consumers, that recipients' opinion leadership enhances the indirect impact of mass communication, and that recipients' consumer behavior mediates the influence of mass communicated messages on distant consumers. The role of word‐of‐mouth is also examined.     

Determinants and Predictive Value of Clinician Assessment of Short‐Term Suicide Risk

We examine the interrelations among clinicians' judgment of patients' suicide risk, clinicians' emotional responses, and standard risk factors in the short‐term prediction of suicidal thoughts and behaviors. Psychiatric outpatients (n = 153) with a lifetime history of suicide ideation/attempt and their treating clinicians (n = 67) were evaluated at intake. Clinicians completed a standard suicide risk instrument (modified SAD PERSONS scale), a 10‐point Likert scale assessment of judgment of patient suicide risk (Clinician Prediction Scale), and a measure of their emotional responses to the patient (Therapist Response Questionnaire‐Suicide Form). The Columbia Suicide Severity Rating Scale and the Beck Scale for Suicide Ideation were administered at a one‐month follow‐up assessment (n = 114, 74.5%). Clinician judgment of risk significantly predicted suicidal thoughts and behaviors at follow‐up. Both the standard suicide risk instrument and clinician emotional responses contributed independently to the clinician assessment of risk, which, in turn, mediated their relationships with suicidal thoughts and behaviors. Our findings validate the importance of clinical judgment in assessing suicide risk. Clinical judgment appears to be informed both by concrete risk factors and clinicians' emotional responses to suicidal patients, highlighting emotional awareness as a promising area for research and training.     

Psychological Empowerment Among Urban Youth: Measurement Model and Associations with Youth Outcomes

Empowerment‐based strategies have become widely used method to address health inequities and promote social change. Few researchers, however, have tested theoretical models of empowerment, including multidimensional, higher‐order models. We test empirically a multidimensional, higher‐order model of psychological empowerment (PE), guided by Zimmerman's conceptual framework including three components of PE: intrapersonal, interactional, and behavioral. We also investigate if PE is associated with positive and negative outcomes among youth. The sample included 367 middle school youth aged 11–16 (M = 12.71; SD = 0.91); 60% female, 32% (n = 117) white youth, 46% (n = 170) African‐American youth, and 22% (n = 80) identifying as mixed race, Asian‐American, Latino, Native American, or other ethnic/racial group; schools reported 61–75% free/reduced lunch students. Our results indicated that each of the latent factors for the three PE components demonstrate a good fit with the data. Our results also indicated that these components loaded on to a higher‐order PE factor (X² = 32.68; df: 22; p = .07; RMSEA: 0.04; 95% CI: .00, .06; CFI: 0.99). We found that the second‐order PE factor was negatively associated with aggressive behavior and positively associated with prosocial engagement. Our results suggest that empowerment‐focused programs would benefit from incorporating components addressing how youth think about themselves in relation to their social contexts (intrapersonal), understanding social and material resources needed to achieve specific goals (interactional), and actions taken to influence outcomes (behavioral). Our results also suggest that integrating the three components and promoting PE may help increase likelihood of positive behaviors (e.g., prosocial involvement); we did not find an association between PE and aggressive behavior. Implications and future directions for empowerment research are discussed.     

Responses to Conflict and Cooperation in Adolescents with Anxiety and Mood Disorders

This study examined patterns of behavioral and emotional responses to conflict and cooperation in adolescents with anxiety/mood disorders and healthy peers. We compared performance on and emotional responses to the Prisoner’s Dilemma (PD) game, an economic exchange task involving conflict and cooperation, between adolescents with anxiety/depressive disorders (A/D) (N=21) and healthy comparisons (n = 29). Participants were deceived to believe their co-player (a pre-programmed computer algorithm) was another study participant. A/D adolescents differed significantly from comparisons in patterns of play and emotional response to the game. Specifically, A/D participants responded more cooperatively to cooperative overtures from their co-players; A/D girls also reported more anger toward co-players than did comparison girls. Our findings indicate that A/D adolescents, particularly females, respond distinctively to stressful social interchanges. These findings offer a first step toward elucidating the mechanisms underlying social impairment in youth with internalizing disorders. This research was supported by the Intramural Research Program of the NIH, NIMH.     

The costs of suppressing stressful memories

We investigated the costs of suppressing emotional and nonemotional memories, as evidenced in response times on a concurrent sentence verification task with three levels of syntactic complexity. Participants suppressing memories of personal negative experiences (n=26) had slower response times compared to the control group (n=23) and to participants suppressing nonemotional memories (n=25) particularly on the most complex sentences. Participants suppressing nonpersonal negative experiences (n=26) did not differ from either of the other two suppression groups. Suppression failures did not differ between conditions, but failures during the sentence task were related to the intrusiveness of the memory being suppressed. The findings indicate that different kinds of memories have different suppression costs and that even successful thought suppression can impair performance on concurrent tasks, supporting Wegner's ironic processing model in which suppression attempts must compete with other ongoing tasks for scarce mental resources.     

How long do the short‐term violent video game effects last?

How long do the effects of the initial short‐term increase in aggression and physiological arousal last after violent video game play? Study 1 (N=91) had participants complete pre‐ and postvideo game measures of aggressive thoughts, aggressive feelings, and heart rate. Then, participants completed Time 3 measures after 4 min or 9 min of delay. Study 2 employed a similar procedure, but had participants (N=91) complete the hot sauce paradigm to assess aggressive behavior after a 0, 5, or 10 min delay. First, results indicated that aggressive feelings, aggressive thoughts, aggressive behavior, and heart rate initially increased after violent video game play. Second, results of the delay condition revealed that the increase in aggressive feelings and aggressive thoughts lasted less than 4 min, whereas heart rate and aggressive behavior lasted 4–9 min. Aggr. Behav. 35:225–236, 2009. © 2009 Wiley‐Liss, Inc.