A psychophysiological model of emotion space

Despite a wide variety of emotions that can be subjectively experienced, the emotion space has consistently revealed a low dimensionality. The search for corresponding somato-visceral response patterns has been only moderately successful. The authors suggest a solution based on an assumed parallelism between emotion coding and color coding. According to the color detection model proposed by Sokolov and co-workers, neurons responsible for color detection are triggered by a combination of excitations in a limited number of input cells. Similarly, a limited number of input channels may feed complex emotion detectors being located on a hypersphere in a four-dimensional emotion space, the three angles of which correspond to emotional tone, intensity, and saturation, in parallel to hue, lightness, and saturation in color perception. The existence of such a four-dimensional emotion space in the subjective domain is shown by using schematic facial expressions as stimuli. A neurophysiological model is provided in which reticular, hypothalamic, and limbic structures constitute input channels of an emotion detecting system, thus acting as the first layer of emotion predetectors. Hypothalamic neurons with differential sensitivity for various transmitters may elicit a subsequent selective activation in a second layer of predetectors at the thalamic level. The latter are suggested to trigger emotion detectors located in cortical areas, the action of which should be revealed by measures of central nervous system activity. Preliminary results from evoked potential studies show that switching between schematic faces that express different emotions may be used as an objective measure for establishing a psychophysiological emotion space.     

A psychophysiological model of emotion space.

Despite a wide variety of emotions that can be subjectively experienced, the emotion space has consistently revealed a low dimensionality. The search for corresponding somato-visceral response patterns has been only moderately successful. The authors suggest a solution based on an assumed parallelism between emotion coding and color coding. According to the color detection model proposed by Sokolov and co-workers, neurons responsible for color detection are triggered by a combination of excitations in a limited number of input cells. Similarly, a limited number of input channels may feed complex emotion detectors being located on a hypersphere in a four-dimensional emotion space, the three angles of which correspond to emotional tone, intensity, and saturation, in parallel to hue, lightness, and saturation in color perception. The existence of such a four-dimensional emotion space in the subjective domain is shown by using schematic facial expressions as stimuli. A neurophysiological model is provided in which reticular, hypothalamic, and limbic structures constitute input channels of an emotion detecting system, thus acting as the first layer of emotion predetectors. Hypothalamic neurons with differential sensitivity for various transmitters may elicit a subsequent selective activation in a second layer of predetectors at the thalamic level. The latter are suggested to trigger emotion detectors located in cortical areas, the action of which should be revealed by measures of central nervous system activity. Preliminary results from evoked potential studies show that switching between schematic faces that express different emotions may be used as an objective measure for establishing a psychophysiological emotion space.     

Automatic and controlled processing in chronic tic disorders

The study compared controlled and automatic processing in 17 people diagnosed with chronic tic disorder (CTD), 20 with habit disorder (HT), and 30 screened controls. Using a countermanding paradigm, time to initiate a response (GO-time) was compared with time taken to inhibit a response (STOP-time) under automated and controlled response conditions. The signals were 2 sets of traffic-light-like computer displays with ready, go, and stop lights. The automated response was a repetitive series of taps and the controlled response was a morse code pattern of taps. There were no group differences in GO time under any conditions. The control group but not the HD or CTD groups showed a significant practice effect over time. The CTD group was significantly slower to STOP the automated than the controlled response. The results suggest that the CTD group had specifically, greater difficulty inhibiting automated than controlled actions.     

Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety

Many individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.     

Parents' perceptions of pharmacological and cognitive-behavioral treatments for childhood anxiety disorders

Cognitive-behavioral therapy (CBT) and pharmacotherapy are the most well-established treatments for childhood anxiety disorders. This study examined how parents (N=71) seeking treatment for their child's anxiety disorder perceive the acceptability, believability, and effectiveness of these treatments. While both treatments were perceived favorably, CBT was rated as more acceptable, believable, and effective in the short- and long-term. Children's treatment history influenced parents' perceptions of pharmacotherapy, with parents of children with no treatment history perceiving medication treatment as less acceptable and believable than parents of children with a history of medication alone or in combination with behavior therapy. No effect of treatment history was found for perceptions of CBT. Significant positive correlations emerged between parents' perceived acceptance and believability for pharmacotherapy and child age and level of dysfunction due to their child's anxiety, respectively. The level of the child's anxiety was not significantly correlated with parents' perceptions of either CBT or pharmacotherapy. Our results suggest that parents of anxious children prefer CBT to medication for the treatment of their child's anxiety disorder. Directions for future research are discussed.     

A randomized pilot trial comparing videoconference versus face-to-face delivery of behavior therapy for childhood tic disorders

Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to be effective for reducing tics in children with chronic tic disorder. Unfortunately, there remain significant barriers to dissemination. The aim of the current study was to examine the effectiveness of CBIT delivered over videoconference. Twenty children were randomly assigned to receive CBIT over videoconference or via traditional face-to-face delivery. Results show that both treatment delivery modalities resulted in significant tic reduction with no between group differences. Furthermore, acceptability and therapist-client alliance ratings were strong for both groups. Together, these results suggest that videoconference is a viable option for disseminating CBIT.     

Adjustment to disability: A cognitive-behavioral model for analysis and clinical management

Profound psychological reactions are frequently seen following the onset of severe disability. Stage models of adjustment, although limiting when used dogmatically, can serve as a helpful guideline for intervention when integrated within a framework that also addresses the sequence of associated irrational beliefs. This article proposes a three phase model for analyzing and facilitating the adjustment process which follows disability. Adjustment is analyzed along cognitive, emotional, and environmental dimensions.The first stage immediately follows the onset of incapacitating disability and is termed the Pre-encounter phase. From a rational emotive perspective, the individual in this phase has not yet acknowledged that an activating, or disabling event has occurred. Acknowledgment is limited to brief contact which is then followed by excessive arousal and extreme distortions in evaluative capabilities. Shock and denial are characteristic of this phase. During this stage, strategies for clinical management are specified with a stronger emphasis on targeting the environment and belief system of the rehabilitation team than the beliefs of the patient.The second stage is referred to as the Post encounter phase during which the disabling condition has been acknowledged as a valid activating event. Periods of anxiety, depression, and expressed anger are common at this time. The final stage is coined the Rational re-encounter phase and is highlighted by repeated re-encounters with various forms of the disabling activating event and anticipated activating events. During this phase the patient is more able to benefit from a traditional psychotherapeutic approach which has been tailored to the specific pattern of irrational beliefs often exhibited in response to life with a disability.     

The suicidal mode: a cognitive-behavioral model of suicidality

This article discusses the theoretical foundation and potential clinical application of the suicidal mode, a cognitive behavioral theory of suicidality. The model presented represents a specific elaboration of Beck's modal theory of psychopathology. In addition to discussing the fundamental requirements of a theory of suicidality, the theoretical assumptions of the suicidal mode are identified, its component parts defined, its inherent strengths emphasized, and its application in clinical settings detailed. Definition of a modal theory of suicidality represents the growing influence of cognitive-behavioral theory in efforts at psychotherapeutic integration in clinical suicidology.     

A cognitive-behavioral perspective on intelligence

The present editorial has two purposes. The first purpose is to indicate a parallel trend in two seemingly disparate areas of research which upon closer examination have interesting possible ties. These research areas are information processing and cognitive-behavior modification (CBM). The second purpose is to highlight the role that affect plays in intellectual functioning, noting some of the implications which then follow for the assessment of intelligence.     

Comparing fixed‐amount and progressive‐amount DRO Schedules for tic suppression in youth with chronic tic disorders

Chronic tic disorders (CTDs) involve motor and/or vocal tics that often cause substantial distress and impairment. Differential reinforcement of other behavior (DRO) schedules of reinforcement produce robust, but incomplete, reductions in tic frequency in youth with CTDs; however, a more robust reduction may be needed to affect durable clinical change. Standard, fixed‐amount DRO schedules have not commonly yielded such reductions, so we evaluated a novel, progressive‐amount DRO schedule, based on its ability to facilitate sustained abstinence from functionally similar behaviors. Five youth with CTDs were exposed to periods of baseline, fixed‐amount DRO (DRO‐F), and progressive‐amount DRO (DRO‐P). Both DRO schedules produced decreases in tic rate and increases in intertic interval duration, but no systematic differences were seen between the two schedules on any dimension of tic occurrence. The DRO‐F schedule was generally preferred to the DRO‐P schedule. Possible procedural improvements and other future directions are discussed.     

Bulimia: A case study with mediating cognitions and notes on a cognitive-behavioral analysis of eating disorders

A case study of a young woman who was following a complex bulimic chain is described. Her emotional-behavioral sequence involved (1) feeling upset, (2) feeling more upset and taking a high dose of laxatives, (3) hinging, (4) taking additional laxatives, (5) feeling depressed, guilty, and angry, and then (6) starving herself for days on end. This paper lists the selfdefeating cognitions mediating the above sequence of emotions and behaviors and reports on a successful disputation of them through a Rational-Emotive Therapy approach. She resumed a normal eating pattern; her menstrual cycle returned in 2 months after having been absent for 13 months; and at followup, 15 months after termination of therapy, disclosed normal weight with no regression to any bulimic behavior. The case study concludes with preliminary notes on a cognitive-behavioral analysis of eating disorders. A model for eating disorders is proposed based upon the study and treatment of other selfindulgent disorders.Paul J. Woods, Ph.D., Co-Editor of thisJournal, is a Fellow of the Institute for Rational-Emotive Therapy in New York City, a Professor Emeritus of Psychology at Hollins College, and a Licensed Psychologist in independent practice in Roanoke, Virginia.Russell M. Grieger, Ph.D., Co-Editor of thisJournal, is a Fellow of the Institute for Rational-Emotive Therapy in New York City, and a Licensed Clinical Psychologist in independent practice in Charlottesville, Virginia.     

The effect of inpatient cognitive-behavioral therapy for eating disorders on temperament and character

Personality traits seem to have an important role in the development, clinical expression, course, and treatment response in eating disorders (EDs). We investigated the effects of an inpatient cognitive-behavioral treatment (CBT) on the measures of temperament and character (Temperament and Character Inventory (TCI)) in 149 consecutive patients with EDs. Baseline assessment included anthropometry, the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), and the TCI. Treatment was based on the transdiagnostic cognitive behavior theory and treatment of ED, adapted for an inpatient setting. Treatment effects were tested by paired ANOVA, adjusted for covariates. No effects were found on Novelty Seeking, Reward Dependence, and Cooperativeness. Harm Avoidance (F=18.17, p<0.001), Persistence (F=7.71, p=0.006), Self-Directedness (F=27.55, p<0.001), and Self Transcendence (F=16.38, p<0.001) significantly changed after treatment. Changes in TCI scores were wholly dependent on the changes in BDI and EDE, and independent of ED diagnosis and behavior and of BMI changes. We conclude that in ED, a few scales of both temperament and character are significantly modified by CBT, in relation to changes in psychopathology and depression, independently of nutrition. These results are relevant for future studies based on TCI.     

Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders

The aim was to evaluate the efficacy of a manualized cognitive-behavioural program based on habit reversal for the management of chronic tic disorder (CTD) and habit disorder (HD). Forty-seven CTD and 43 HD received a 4-month treatment program. Thirty-eight (22 CTD, 16 HD) were placed on a waitlist control group, which subsequently received treatment. The treatment approach combined awareness training, relaxation (including modification of a tension-producing style of action), and habit-reversal training, with more general cognitive restructuring of anticipations linked to ticcing. Sixty-five percent of completers reported between 75 and 100% control over the tic. At 2-year follow-up, 52% rated 75-100% control. There were also significant changes post-treatment in measures of self-esteem, anxiety, depression and style of planning action. Successful tic/habit modification was associated in CTD and HD groups with successful change in style of planning action. There were no consistent differences in any outcome measures between CTD and HD groups.     

Towards a cognitive-behavioral model of PTSD in children and adolescents

Posttraumatic stress disorder in children and adolescents has been studied only for the past 15–20 years and is the subject of a burgeoning corpus of research. Much research has focused on examining whether children and adolescents have the same responses to trauma as those experienced by adults. Many of the research tools used to investigate children's responses are taken from measures designed for use with adults, and these measures have proven to be useful. However, it has not been established that children's responses to traumatic events are related to the same underlying processes as are adults' responses. The possible application of 2 recent cognitive models of PTSD in adults to understanding PTSD in children and adolescents is discussed in this paper, within the context of what is already known about children's reaction to trauma and existing theoretical accounts of childhood PTSD. Particular attention is paid toward the nature of children's memories of traumatic events and how these memories relate to the reexperiencing symptoms of PTSD, and cognitive processes that may play a role in the maintenance of PTSD. It is proposed that the adoption of a more specific cognitive–behavioral framework in the study of this disorder may be beneficial and lead to better treatment outcomes.     

Type A behaviour and psychophysiological arousal

The "coronary prone" or Type A behaviour pattern, characterized by e.g., hard-driving competitiveness, impatience and aggressiveness, is associated with elevated systolic blood pressure and catecholamine secretion during challenge. In experiments at our laboratory, elevated psychophysiological arousal was found in Type A subjects during understimulation, but not during active performance on a self-paced reaction time task. Results suggest that differences in cardiovascular and behavioural reactivity between Type A and B persons tend to be related to the pace of the environment to which they are exposed. Studies of antecedents of Type A behaviour in children show that "Type A children" respond to challenge with a greater increase in sympathetic arousal than "non-Type As". This suggests the possibility that genetic dispositions and/or conditioned sympathetic reactivity play an important role in the development of the Type A behaviour pattern.     

A psychophysiological therapy for dental fear

A partly automated method for treating dental fear and avoidance is outlined. The method combines a desensitization procedure with EMG biofeedback and cognitive reattribution. After therapy, 21 out of 24 patients suffering from severe dental fear were able to complete dental rehabilitation. The therapy process is discussed in terms of reconditioning, cognitive reorientation and coping training.