Laboratory analogue investigation of defusion and reappraisal strategies in the context of symbolically generalized avoidance

The present study examined and compared the effects of 2 analogues of cognitive treatments—cognitive defusion and cognitive reappraisal—on symbolically generalized avoidance established using a basic behavioral laboratory paradigm. This back‐translation design contributes to the development and validation of principle‐based definitions of the applied constructs of defusion and reappraisal. Eighty‐eight participants first underwent basic laboratory procedures designed to establish symbolically generalized avoidance in response to an arbitrary stimulus (a nonsense word). Participants were then randomized to defusion, reappraisal, or control conditions. The response variables were (a) equivalence responding—indicative of the trained relational network and analogous to the cognitive content responsible for symbolic generalization—and (b) avoidance—the behavioral impact of symbolic generalization. A between‐groups analysis revealed that defusion and reappraisal significantly increased the odds of nonavoidance responding. Discrete‐time survival mediation analyses provided preliminary support for the classification of defusion as a functional context intervention and reappraisal as a relational context intervention.     

Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance

The present research describes the development and psychometric evaluation of a second version of the Acceptance and Action Questionnaire (AAQ-II), which assesses the construct referred to as, variously, acceptance, experiential avoidance, and psychological inflexibility. Results from 2,816 participants across six samples indicate the satisfactory structure, reliability, and validity of this measure. For example, the mean alpha coefficient is .84 (.78–.88), and the 3- and 12-month test–retest reliability is .81 and .79, respectively. Results indicate that AAQ-II scores concurrently, longitudinally, and incrementally predict a range of outcomes, from mental health to work absence rates, that are consistent with its underlying theory. The AAQ-II also demonstrates appropriate discriminant validity. The AAQ-II appears to measure the same concept as the AAQ-I (r = .97) but with better psychometric consistency.     

Transfer of conditioned fear and avoidance: Concurrent measurement of arousal and operant responding

A reversal design was employed for the analysis of transfer of fear and avoidance through equivalence classes. Two 5-member equivalence classes (A1-B1-C1-D1-E1 and A2-B2-C2-D2-E2) were established. Then B1 and C1 were paired with shock (CS+) and served as S^Ds in avoidance training (B2 and C2 were trained as CS-/S^∆s for avoidance). Further avoidance training followed with D1 and E1 (as S^Ds) and D2 and E2 (as S^∆s), with the first presentation of each of these stimuli serving as the first transfer test. Afterwards, aversive conditioning contingencies were reversed: B2 and D2 were paired with shock and trained as S^Ds for avoidance, B1 and D1 were presented without shock (CS-/S^∆s). Transfer was tested again with C1, E1, C2 and E2. This reversal was implemented to allow for the within-subject replication of transfer effects upon changes in the function of only a subset of each class's elements. Avoidance (key presses) and conditioned fear (skin conductance and heart rate) were simultaneously measured. Results show a clear transfer effect for avoidance, with between- and within-subject replications. For physiological measures, transfer effects in the first test could only be imputed on the basis of group-based inferential statistical analysis. Evidence for between-subject replication was weaker, with only a limited proportion of participants meeting the individual criterion for transfer.     

Relapse of anxiety-related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

Excessive fear and avoidance in relatively safe situations can lead to a narrowing of one's behavioral repertoire and less engagement with valued aspects of living. Ultimately, these processes can reach clinical levels, as seen in anxiety, trauma, and obsessive–compulsive disorders. Research on the basic behavioral processes underlying successful treatment with exposure therapy is growing, yet little is known about the mechanisms contributing to clinical relapse. Until recently, these mechanisms have largely been conceptualized in terms of Pavlovian return of fear, with relatively little research into operant processes. In the current paper, we briefly review translational research in anxiety disorders and the connections between fear and avoidance, focusing on recent work in the acquisition, extinction, and relapse of avoidance behavior and the generalization of this learning through arbitrary symbolic relations. We then introduce one possible treatment approach to mitigating clinical relapse, acceptance and commitment therapy (ACT), and provide a conceptual analysis for why ACT may be especially well-situated to address this issue. Finally, we end with potential directions for future research on treatment and relapse of anxiety disorders.     

Opposing effects of income inequality on health: The role of perceived competitiveness and avoidance/approach motivation

Income inequality is commonly posited to elevate concerns about social status that undermine psychological health, but the empirical evidence is inconsistent. Here we propose that these inconsistencies conceal opposing processes: Income inequality prompts perceived competitiveness, which can both negatively predict psychological health via avoidance motivation and positively predict psychological health via approach motivation. First, we conducted a two-year longitudinal study (1,700+ participants from 500+ county identifiers) and provided support for our opposing processes model. Second, we conducted three pre-preregistered studies using an experimental-causal-chain design. We sequentially showed that induced income inequality increased perceived competitiveness (Study 2a; 444 participants), induced perceived competitiveness increased avoidance and approach motivation (Study 2b; 1,018 participants), and induced avoidance/approach motivation decreased/increased psychological health (Study 2c; 562 participants). These findings suggest that scholars should shift from studying the main effects of income inequality on psychological health to studying the psychological processes involved in the inequality-health relation.     

Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial

Objective

The current study examined the efficacy of an early intervention based on acceptance and commitment therapy (ACT) for depressive symptomatology. The ACT intervention is aimed at increasing the acceptance of negative thoughts and emotions and living a mindful and value-based life.

Method

Adults with mild to moderate depressive symptomatology were randomly assigned to the ACT intervention (n = 49) or to a waiting list (n = 44). The mean age of the participants was 49 years. The majority of the participants was female and of Dutch origin. All the participants completed measures before and after the intervention, as well as three months later at follow-up to assess depression (CES-D), anxiety (HADS-A), fatigue (CIS), alcohol use and acceptance (AAQ-II).

Results

The ACT intervention led to statistically significant reduction in depressive symptomatology (Cohen’s d = .60). These reductions were maintained at the three-month follow-up. Also significant reductions in anxiety and fatigue were observed. Moreover, mediational analysis showed that the improvement of acceptance during the intervention mediated the effects of the intervention on depressive symptomatology at follow-up.

Conclusion

These findings suggest that an early intervention based on ACT, aimed at increasing acceptance, is effective in reducing depressive symptomatology.     

Effect of exposure to lithium-paired or amphetamine-paired saccharin solution on open arm avoidance in an elevated plus maze

Recent evidence suggests that drug-induced conditioned taste avoidance may be mediated by conditioned fear (e.g., Parker, 2003). The experiments reported here evaluated the effect of exposure to a drug-paired flavor on open arm exploration in an elevated plus maze (EPM), a measure of fear. When rats were tested on a familiar (trial 2) EPM, but not on a novel (trial 1) EPM, prior exposure to a lithium-paired saccharin solution enhanced open arm activity relative to saline-paired saccharin. On the other hand, when rats were exposed to lithium-paired saccharin during plus maze exposure, they displayed suppressed open arm activity relative to unpaired controls when tested in a familiar maze. The pattern of results was specific to the conditional affective properties of the taste, because exposure to unconditional sickness produced by administration of lithium, and unconditionally unpalatable quinine solution did not produce this pattern. These results were interpreted in terms of the opponent process model of motivation; that is, exposure to a lithium-paired flavor elicits conditioned fear which is immediately followed by conditioned relief when the exposure is terminated. On the other hand, exposure to an amphetamine-paired flavor either before or during EPM testing enhanced open arm exploration. Since the strength of taste avoidance did not differ among amphetamine and lithium conditioned rats, these results provide further evidence that the nature of a saccharin-lithium association differs from that of a saccharin-amphetamine association.     

Effects of "Dirty" Information on Disgust Responding to an Unknown Animal in Children: The Moderating Role of Maternal Disgust Proneness

Although research has shown that disgust facilitates avoidance of small animals among adults, much less is known about disgust appraisals of small animals in children as well as the predictors of such appraisals. To address this gap, children (ages 5–13) were exposed to dirt-related and cleanliness-related information about unknown animals. The extent to which these types of information influenced children's feelings of fear, disgust, positivity, and avoidance behavior in relation to the animals was examined. The present study then examined the extent to which child and maternal disgust proneness predicted feelings of disgust to the ‘dirty’ animal. The findings show that providing dirt-related information resulted in a significant increase in disgust, but not fear, responding to the animal. Dirt-related information also resulted in a significant decrease in positive feelings toward the animal. Conversely, providing cleanliness-related information resulted in a significant decrease in disgust, but not fear, responding to the animal. In addition, providing cleanliness-related information resulted in a significant increase in positive feelings toward the animal. Children also engage in more avoidance of the animal described as dirty compared to the animal described as clean. In addition, subsequent analysis revealed an interaction between child and maternal disgust propensity in predicting learned disgust to the dirty animal such that the highest levels of feelings of disgust to the dirty animal were observed among children with high disgust proneness who also have mothers with high disgust proneness. The implications of these findings for conceptualizing the role of disgust in animal phobias among youth will be discussed.     

Effects of voice and similarity on procedural fairness and trust: A dual process model of public acceptance based on representatives’ participation

In citizen participation, a few representatives of the total citizen population participate in discussions with authorities regarding public decisions and policies. The present study examines a dual process model in which the representatives’ voice and similarity of values facilitate public acceptance through procedural fairness and trust in representatives, respectively. The results of an experiment employing a scenario method, which included participants from Japan (n = 211) and the Netherlands (n = 200), indicate that the representatives’ voice increased procedural fairness and public acceptance when the similarity of representatives was high. The effects of representatives’ voice on public acceptance via procedural fairness was supported in both nations, while other effects of representatives’ similarity on acceptance via trust were indicated only in Japan. These results suggest that the indirect voice of citizens, as conveyed by representatives, plays an important role in increasing perceptions of procedural fairness and public acceptance among citizens.     

Towards Working Life: Effects of an intervention on mental health and transition to post-basic education

The Towards Working Life group method was designed to promote the transition to the upper secondary level or vocational studies and to support mental health among young people finishing their basic education. This study examined the effects of the intervention during upper secondary and vocational studies in a randomized field experimental study among a total of 1034 students. At the one-year follow-up, the program had increased both education related social ties and the number of adults in these ties. The group intervention had interaction effects with baseline risk of depression and learning difficulties on symptoms of depression and school burnout. Among those initially at risk of depression, the intervention decreased symptoms of depression. For students who were at risk of depression and had learning difficulties, the intervention decreased school burnout.     

Anxiety sensitivity and its impact on pain experiences and conditions: A state of the art

This paper serves as an introduction to the special issue of Cognitive Behaviour Therapy devoted to the topic of anxiety sensitivity (AS) and its impact on pain experiences and conditions. We provide a historical overview of relevant cognitive behavioural models of chronic pain, summarize recent models incorporating the AS construct, and introduce the papers in the special issue. These papers are organized into two sets – basic laboratory‐based investigations and relatively more applied studies. We attempt to highlight some of the most important findings from each of these investigations and studies, in turn. Then, we consider several important conclusions derived from the set of special issue papers and the implications of these for the practice of cognitive‐behavioural interventions with pain populations. Finally, we make several suggestions for directions for future investigations in this burgeoning area of cognitive behavioural research and practice.