Cognitive Behavioral Treatment of PTSD with Comorbid Panic Attacks

Many individuals that experience traumatic events such as sexual and physical assault develop posttraumatic stress disorder (PTSD). More recently, research has indicated that a significant proportion of PTSD sufferers may also have comorbid panic attacks. Although there are several effective treatments that focus on alleviating PTSD symptoms, until now there were no treatments that focused on also treating comorbid panic attacks. Multiple channel exposure therapy (M-CET) is the first treatment developed to specifically treat comorbid PTSD and panic attacks. It is also unique in that it has been used to treat women who have multiple trauma histories as well as a wide range of different types of traumatic event exposure in a group format. This treatment is described in a session by session format and special considerations in implementing the treatment are discussed.     

Dangerous Enough: Moderating Racial Bias with Contextual Threat Cues

Research shows that participants shoot armed Blacks more frequently and quickly than armed Whites, but make don't-shoot responses more frequently and quickly for unarmed Whites than unarmed Blacks. We argue that this bias reflects the perception of threat — specifically, threat associated with Black males. Other danger cues (not just race) may create a similar predisposition to shoot, and if these cues promote shooting when the target is White, they should attenuate racial bias. We embedded targets in threatening and safe backgrounds. Racial bias was evident in safe contexts but disappeared when context signaled danger, and this reduction was largely due to an increased tendency to shoot White targets.     

Stability of Cognitive Bias for Threat Cues in Phobia

The present study examined whether the cognitive bias for threat is a stable phenomenon in spider phobics and not in nonphobic controls. The rationale of this study was that the use of emotional bias for individual assessment in clinical practice requires stability of this phenomenon. In order to assess the stability of the emotional bias, the spider Stroop task was administered twice to spider phobics and controls, with a time lag of 3 weeks. In two experiments, spider phobics (n_{exp. 1} = 20; n_{exp. 2} = 33) and controls (n_{exp. 1} = 24; n_{exp. 2} = 25) were selected on basis of a structured interview. In the second experiment, subjects anticipated exposure to a real-life spider. Emotional bias was inferred from color-naming latencies on spider words versus control words. In line with our prediction, the bias for threat was stable in spider phobic individuals but not in controls. This stability could not be attributed to a general cognitive characteristic because a standard Stroop task did not differentiate between the spider phobics and the controls. The results support the view that cognitive processing of threat in anxiety is stable. It is proposed to use both the emotional bias and its stability as measures of the constraints on the flexibility of the cognitive fear-network.     

A Study of Panic Attacks in University Students of Iran

This study examined the parameters of panic, fear, and avoidance among university students in Iran. Data were collected from 347 students using Farsi translations of the Panic Attack Questionnaire, Beck Depression Inventory, Taylor Manifest Anxiety Scale, State-Trait Anxiety Inventory, and Anxiety Sensitivity Index. Thirty-eight percent of participants reported panic attacks in the past year and 21.4% reported panic attacks in the past 4 weeks when prompted by a broad definition of panic. Men and those with unexpected panic reported greater panic severity whereas women with panic attacks reported greater situational fear and avoidance. Panickers who satisfied DSM-III-R panic disorder (PD) criteria reported greater lifestyle restriction and general psychopathology. The findings provide tentative support for cross-cultural similarity in panic phenomenology and the validity of DSM-III-R PD criteria among university students in Iran. The results are discussed by reference to nonclinical panic research and general themes of Iranian culture.     

The Use of Paradoxical Intention in the Treatment of Panic Attacks

Paradoxical intention can be used in the treatment of panic attacks. In this article the author provides a brief case example and discussion of the nature and implementation of the technique.     

Cognitive Bias for Pictorial and Linguistic Threat Cues in Children

The present study was designed to test the conditions under which threat-related cognitive bias can be observed in anxious children. Measures of cognitive bias for threatening words and pictures were obtained from spider fearful children (N = 55) and non-fearful children (N = 58) aged 8–11 in the first experiment, and from spider fearful children (N = 44), and two control groups (N = 41; N = 36) aged 8 in the second experiment. Cognitive bias was assessed by the emotional Stroop task. In line with our previous findings, all children aged 8 showed a bias for spider words, but not for spider pictures. However, a relation between spider fear and bias was observed when age was taken into account: bias for spider words decreased with age in the non-fearful children whereas this bias maintained in the fearful group. This differential age effect too replicated earlier findings (Kindt, Bierman, & Brosschot, 1997). It is suggested that a bias for threat words is a normal characteristic in children aged 8. During development, normal children learn to inhibit this processing bias, whilst fearful children fail to learn this ability.     

The Impact of Spatial Cues on Preschoolers' Selective Attention

The effects of spatial arrangement on preschool children's ability to selectively attend were investigated. Three- and 4-year old children were shown a multicolored dollhouse room intended to serve as a special place containing miniature chairs and models of animals. One category of objects was designated as relevant and 1 as irrelevant. Relevant items were placed in each of the apparatus's corners or in the middle of its walls. Children in the corners condition correctly relocated more relevant items than children in the wall or control conditions. The findings suggest that for both age groups, the ability to recall relevant items may be independent of their ability to demonstrate a selective attention strategy.     

Intolerance of Uncertainty as a Contributor to Fear and Avoidance Symptoms of Panic Attacks

Panic disorder symptoms are persistent for 50–80% of cases even after treatment, resulting in experiences of disability and dissatisfaction in life. Previous research has focused on anxiety sensitivity (AS) and its dimensions as contributing to symptoms of panic disorder; however, recent research has suggested that intolerance of uncertainty (IU)—the tendency for a person to consider the possibility of a negative event occurring as threatening, irrespective of the actual probability of its occurrence—may also play a critical role. The current study was designed to assess the specific relationships between dimensions of IU (i.e. prospective IU and inhibitory IU) and the fear and avoidance symptoms associated with panic disorder. Participants included 122 community members (81% women) with a history of at least one panic attack who participated in a larger study on fear. Participants completed measures of AS, IU, and panic disorder symptoms. Correlation and regression analyses supported a significant and substantial relationship between AS, inhibitory IU, and panic disorder symptoms. Inhibitory IU accounted for relatively more variance in avoidance symptoms related to panic disorder than did the fears of physical sensations dimension of AS. As such, further investigation of the role of IU in panic disorder symptoms appears warranted. Comprehensive results, implications, and directions for future research are discussed.     

Smoking and Non-Clinical Panic Attacks: An Initial Empirical Test of Panic-Relevant Cognitive Processes

The present study evaluated panic-relevant cognitive processes in a sample of persons ( n = 70) who met criteria for either: (a) a positive panic attack history and regular smoking (smoking at least 10 cigarettes per day for S 12 months); (2) a positive panic attack history but no history of smoking; or (3) regular smoking history alone (smoking at least 10 cigarettes per day for S 12 months). As hypothesized, participants in group (a) demonstrated significantly greater bodily vigilance and anxiety sensitivity Mental Incapacitation Concerns compared with persons in either groups (b) or (c). Effects involving other dimensions of anxiety sensitivity, suffocation fear and trait anxiety did not discriminate between panickers as a function of smoking status. The observed effects could not be attributed to self-reported physical health status or history of medical problems. The implication of the present findings for understanding the potential role of smoking in panic pathology is discussed.     

Effects of Unimodal and Multimodal Cues About Threat Locations on Target Acquisition and Workload

Two studies were conducted to examine the effects of unimodal and multimodal cueing techniques for indicating the location of threats on target acquisition, the recall of information from concurrent communications, and perceived workload. One visual, two auditory (i.e., nonspatial speech and spatial tones [3-D]), and one tactile cue were assessed in Experiment 1. Experiment 2 examined the effects of combinations of the cues assessed in the first investigation: visual + nonspatial speech, visual + spatial tones, visual + tactile, and nonspatial speech + tactile. A unimodal, “visual only” condition was included as a baseline to determine the extent to which a supplementary cue might influence changes in performance and workload. The results of the studies indicated that time to first shot and the percentage of hits can be improved and workload reduced by providing cues about target location. The multimodal cues did not yield significant improvements in performance or workload beyond that achieved by the unimodal visual cue.     

繁衍线索对风险信息加工的影响

进化理论认为风险行为与求偶有关。研究通过比较求偶信息(异性照片或描述异性的词语)、养育后代(孕妇照片)及奖赏信息(金牌照片等)试图进一步探讨繁衍线索对两性知觉和判断风险信息的影响。研究1中, 被试描述理想约会对象后求偶动机得到激发, 相对于描述晴朗天气的控制组, 求偶动机让两性更慢地从高风险信息(如滑雪、冲浪等)转移注意力, 且两性对风险信息的注意转移与社群性向无关。研究2显示, 相对于养育后代和奖赏信息, 求偶信息更为迅速地促使男性对高风险信息做出判断, 但求偶信息让女性比男性更慢地对高风险信息做出判断。研究结果进一步证实了自然选择理论及性选择理论对两性加工风险信息的认知机制具有预测作用。     

Configural Processing in Memory Retrieval: Multiple Cues and Ensemble Representations

When retrieving information from memory, a number of contextual cues may interact to determine which ideas will be easily accessible. Even the simplest case in which joint cue action obtains (two cues) is very revealing of the principles of memory access and representation of compounds. Mechanisms by which dual cues interact to constrain retrieval from episodic memory are considered. A holistic mechanism of cue integration is contrasted with two nonholistic mechanisms: a multiplicative or intersection mechanism and an independent-contributions mechanism. Holistic- and intersection-cuing mechanisms are consistent with different variants of compound cue models of priming. The independent cuing mechanism is consistent with spreading activation models of priming. Data from four experiments which examined dual-cued recognition of items from (newly learned) triples demonstrated strongly configural, holistic, action of dual cues. The two cues and test item must form an encoded compound to yield cuing advantages. Two independent cues to the test item are ineffective if the two cues and test were not learned together as a triple; one valid and one invalid cue are also ineffective. This is so despite the availability of pairwise information for each cue–test relation, and despite the fact that these cues are effective when operating alone. A compound cue model which predicts precisely this surprising pattern of priming is developed. The compound cue model also predicts previously obtained configural priming of associative judgments, as well as the bias priming generally observed in item recognition and similar paradigms.     

Attentional Processing of Threat in Bipolar Disorder: Going Beyond Mood-Congruency

Emotional processing in bipolar disorder (BD) entails a complex attentional pattern not merely restricted to happy or sad biases, but also directed towards threatening information. This study examined threat-related bias on attentional orienting when participants were not instructed about the presentation of emotional stimuli (i.e., implicit instructions). An emotional dot-probe task in which an emotional face (i.e., threat, sad, happy) is simultaneously displayed with a neutral face was applied to BD individuals in their different episodes: mania (n?=?26), depression (n?=?24), and euthymia (n?=?28) as well as to a group of healthy controls (n?=?28). Symptomatic BD patients (i.e., in a manic or depressive episode) showed an attentional orienting bias toward threatening faces but not for happy or sad faces, while euthymic BD patients did not exhibit any attentional bias for emotional stimuli. A bias toward happy faces was found in the control group. Threat-related bias was not related to the severity of affective and anxiety symptoms in BD. When attention is not explicitly directed to emotional information, threat-related bias may characterize attentional orienting during mania and depression, but may be attenuated during euthymia.

     

Visual Information Processing Speed in Hypnotized and Nonhypnotized Subjects

Using a backward-masking paradigm with a bias-free and ceiling-free psychophysical task, we tested hypnotized and control subjects for speed of visual information processing. Approximately half of each group received visual imagery suggestions in an attempt to influence attention. Imagery produced no significant differential effect. Although an absence of a hypnotizability-performance relationship was in keeping with findings of a previous study, those subjects in the present study who performed under hypnosis were, as a group, significantly superior to the other subjects in speed of information processing.     

Endorsements as Voting Cues: Heuristic and Systematic Processing in Initiative Elections1

This project explores how organizational endorsements influence voter attitudes during initiative elections. Building on the heuristic‐systematic model (Chaiken, 1980; Chen & Chaiken, 1999), we propose that voters use organizational endorsements as heuristic cues to help them develop their attitudes toward initiatives. It is hypothesized that the influence of endorsements on initiative voting depends on the applicability, availability, and diagnosticity of the endorsement voting cue and on the degree to which the voter is motivated to fully evaluate the arguments behind the initiative. An experiment was conducted in which motivation (processing goal instructions), cue applicability (match between endorsing organization and initiative), and initiative (four different hypothetical ballot issues) were manipulated. Results showed support for our first two hypotheses, but not for the third.     

文盲文字加工的行为和脑机制

文盲作为一个特殊的被试群体,对其的研究一直备受关注。文盲研究最初集中在文盲的口语加工和语音意识等方面。其后比较关注文盲字词的语音和语义加工。随着脑成像技术的发展,对文盲的文字加工脑认知机制进行了研究,探讨脑功能组织是如何受到早期学习的调制,左侧梭状回在字词识别中的作用及其文盲脑功能偏侧化问题。以后此类研究应关注文盲字词识别学习过程中的脑功能变化和文化认知对认知老化的影响等科学问题。     

Distraction Effects of Smoking Cues in Antismoking Messages: Examining Resource Allocation to Message Processing as a Function of Smoking Cues and Argument Strength

Findings from previous studies on smoking cues and argument strength in antismoking messages have shown that the presence of smoking cues undermines the persuasiveness of antismoking public service announcements (PSAs) with weak arguments. This study conceptualized smoking cues (i.e., scenes showing smoking-related objects and behaviors) as stimuli motivationally relevant to the former smoker population and examined how smoking cues influence former smokers' processing of antismoking PSAs. Specifically, by defining smoking cues and the strength of antismoking arguments in terms of resource allocation, this study examined former smokers' recognition accuracy, memory strength, and memory judgment of visual (i.e., scenes excluding smoking cues) and audio information from antismoking PSAs. In line with previous findings, the results of the study showed that the presence of smoking cues undermined former smokers' encoding of antismoking arguments, which includes the visual and audio information that compose the main content of antismoking messages.     

陌生面孔的印象加工:基于面孔特征的视角

个体往往会基于面孔特征对他人进行特质推断和社会评价,这种推进和评价会影响个体的行为决策。结合印象形成的双加工理论和面孔加工的双通路模型,本文提出陌生面孔的印象加工主要包括两类方式:一是基于社会分类线索及相似特征的加工,激活个体的刻板印象;二是基于熟悉面孔的相似性特征线索,通过过度泛化激活与熟悉他人相一致的印象。本文进一步阐述了两类面孔线索印象加工的过程和影响陌生面孔印象加工的相关因素。在此基础上,本文提出现有的研究对两类加工方式的交互作用及其加工阶段尚未作深入探讨,同时指出知觉者本人的人格特质和面孔信息对印象加工的影响也需要在未来研究中进一步探索。     

Multiple Cues in Social Perception: The Time Course of Processing Race and Facial Expression

The purpose of the present study was to examine the time course of race and expression processing to determine how these cues influence early perceptual as well as explicit categorization judgments. Despite their importance in social perception, little research has examined how social category information and emotional expression are processed over time. Moreover, although models of face processing suggest that the two cues should be processed independently, this has rarely been directly examined. Event-related brain potentials were recorded as participants made race and emotion categorization judgments of Black and White men posing either happy, angry, or neutral expressions. Our findings support that processing of race and emotion cues occur independently and in parallel, relatively early in processing.     

Developmental Timescale of Rapid Adaptation to Conflicting Cues in Real‐Time Sentence Processing

Children and adults use established global knowledge to generate real‐time linguistic predictions, but less is known about how listeners generate predictions in circumstances that semantically conflict with long‐standing event knowledge. We explore these issues in adults and 5‐ to 10‐year‐old children using an eye‐tracked sentence comprehension task that tests real‐time activation of unexpected events that had been previously encountered in brief stories. Adults generated predictions for these previously unexpected events based on these discourse cues alone, whereas children overall did not override their established global knowledge to generate expectations for semantically conflicting material; however, they do show an increased ability to integrate discourse cues to generate appropriate predictions for sentential endings. These results indicate that the ability to rapidly integrate and deploy semantically conflicting knowledge has a long developmental trajectory, with adult‐like patterns not emerging until later in childhood.