效度概化：预测效度元分析的30年成果述评

效度概化是通过元分析技术对普遍化的预测效度的估计。元分析是研究效度概化问题的技术,是对具有“预测因子-效标”特征的相关数据进行定量综合的方法。效度概化促进了预测因子与效标之间关系的理论研究和应用研究,是应用心理学领域近30年（1977~2007）来最重要的进展之一。30年来的效度概化研究表明,认知能力测验、知识和技能测验、人格测验、结构化面试和评价中心技术等的预测效度具有鲁棒性、对应性和联合增值性     

大脑前额叶信息处理的电生理研究

前额叶(Prefrontal lobule)是哺乳类动物大脑额叶前端的皮层区,位于运动前区的前方,包括额叶眼区在内的新皮层区,它属于大脑皮层联合区。人类的前额叶最发达,超过了整个皮层的1/4。灵长类动物的前额叶也相当发达,例如,猕猴的前额区占据了大脑嘴侧部到弓状沟之间的区域以及整个眶底面。在灵长类动物前额叶皮层以显著的第Ⅳ层颗粒层为特征,因此,灵长类前额叶皮层也称为“额叶颗粒皮层”。大量研究证明,前额叶与感觉的产生和肌肉运动的发生没有直接关系,而在脑的高级功能中起着重要作用。     

强迫症的脑功能障碍

近期,对强迫症(OCD)的现象学解释强调了病人在特定情境下错误识别和情绪与动机功能的异常加工。来自神经解剖、神经生理以及近期神经心理和功能成像等的相关研究证据显示：OCD病人眶额皮层（OFC）、前扣带回皮层（ACC）的过度激活可能会导致错误识别功能和对行为结果预期的情绪与动机评价增高;背外侧前额皮层(DLPC)的活动减弱损害了对信息加工的认知整合能力。以上这些皮层信号在控制行为活动程序的尾状核进行整合。OCD病人的强迫性观念和行为可能由这些结构相关的神经网络中一个或多个环节的功能障碍所致     

元认知中自信心对联合决策的预测作用

元认知通常指个体对自身认知活动的主观判断, 自信心作为其指标之一, 对个体认识和调节自己的行为有重要作用。研究表明自信心指标在联合研究过程中常见的任务类型涉及基础和高级心理加工过程, 此外, 自信心对联合决策的预测逐渐向基于计算模型的探索性参数变化。最后, 自信心的神经生理研究发现了前额叶皮层及其相关脑区和后顶叶皮层的重要性。今后应注重探索可能的预测参数和模型, 优化自信心对联合决策的预测作用。     

早期听觉剥夺后的大脑可塑性：来自先天性听力障碍群体的证据

皮层功能的正常发展依赖于充分的外部感觉信息的输入。先天性听力障碍群体由于经历早期听觉剥夺, 皮层功能往往出现异常。具体表现为初级听皮层功能退化, 初级、次级听皮层的功能连接变弱, 次级听皮层出现跨通道功能重组; 在后天听力重建后听皮层功能重组仍然存在, 言语加工需要更多高级认知资源的补偿。已有研究在探讨听力重建后皮层的长期可塑性机制、复杂声学环境下言语加工机制、汉语言加工独特性等方面尚不深入, 值得进一步研究。     

经颅直流电刺激在抑郁症治疗中的应用

已有的神经影像学研究成果揭示, 抑郁症发作的重要原因之一是大脑前额叶皮层结构和功能受损。经颅直流电刺激(tDCS)作为一种无创脑刺激, 选取前额叶皮层作为刺激区域, 通过调节皮层兴奋性来治疗抑郁症, 能够有效缓解抑郁症状和改善受损的认知功能, 疗效明显且持久稳定。针对tDCS在抑郁症治疗研究中的问题, 未来可从有效性、个体差异以及预防干预等六个方面进一步研究, 以期tDCS作为一种具有潜力的治疗手段, 在临床上有更为广泛地应用。     

音乐愉悦体验的神经机制

愉悦情绪体验是音乐活动中最普遍的心理现象。通过系统回顾相关的神经科学研究, 认为音乐愉悦体验与大脑奖赏系统的活动有关, 并涉及伏隔核与听觉皮层等其他脑区的交互。在这个过程中, 多巴胺的传递与音乐愉悦体验存在因果联系。基于预期视角, 奖赏预测误差理论和音乐信息理论模型可以解释音乐愉悦体验的产生机制。未来研究应进一步检验伏隔核及各皮层在音乐愉悦体验中的功能, 并整合不同的预期理论。     

数字加工的脑功能成像研究进展及其皮层定位

数字加工是人类最重要的认知功能之一。当前的脑功能成像研究有助于对数字加工与皮层之间的联系进行更精确的定位。基于对上世纪80年代来有关数字加工脑功能成像研究的主要成果的回顾,尤其是一些重要区域,如双侧顶叶与前额叶等在数字加工中的地位与作用,以及不同脑区之间的关系进行了探讨,并对一个广泛运用的数字加工神经机制模型进行了简要评述。在此基础上,对数字加工的皮层定位问题进行了简要的总结。     

大学生家庭功能、心理弹性与自我分化的关系

研究了378名大学生心理弹性在家庭功能与自我分化关系中的中介作用。结果:(1)家庭功能亲密度、适应性与心理弹性、自我分化均呈正相关;(2)心理弹性的情绪控制、家庭支持和人际协助三个因子对自我分化有一定程度的预测作用;(3)层级回归发现,在同时考虑心理弹性各因子的影响时,对自我分化具有显著预测作用的家庭功能亲密度β值下降且显著性水平降低。结论:心理弹性的情绪控制、家庭支持和人际协助三个因子在家庭功能亲密度与自我分化的关系中具有部分中介作用。     

错误记忆年老化的认知与神经机制

老年人错误记忆的增加与内侧颞叶、前额叶皮层的功能下降以及二者之间功能性联结减少有关。这些功能下降导致编码阶段信息联结不足或过度联结、编码及提取阶段依赖语义要点信息、提取监控障碍及记忆判断过度依赖熟悉性。未来研究应当关注不同类型错误记忆年老化的形成机制、内侧颞叶及前额叶皮层的特定分区对错误记忆年老化的影响、信息编码及提取对错误记忆年老化的独立作用,以及测试环境与文化对错误记忆年老化的影响等问题。     

The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder

Distress tolerance (DT) and intolerance of uncertainty (IU) have been identified as transdiagnostic processes that predict symptom severity across a range of distinct anxiety disorders. However, the joint effect of these two variables on therapeutic outcome has not yet been examined. It is possible that DT and IU may both impact on treatment response to cognitive-behavioural therapy (CBT) in clients with anxiety, as clients with weak DT and strong IU may be less likely to engage in exposure and cognitive restructuring tasks across treatment due to their associated distress. The purpose of this study was to examine the interaction of DT and IU as predictors of post-treatment symptom severity and treatment response to group CBT in participants with primary DSM-IV-TR diagnosed social anxiety disorder (SAD). Participants (N = 95) with SAD completed 12 weeks of manualized group CBT. Results of multilevel longitudinal analysis demonstrated an interaction effect, such that lower DT and higher IU predicted higher SAD symptom severity across the course of therapy. The findings are discussed in terms of clinical implications for the disorder-specific and transdiagnostic treatment of anxiety disorders.     

The role of maladaptive beliefs in cognitive-behavioral therapy: Evidence from social anxiety disorder

Beliefs that are negatively biased, inaccurate, and rigid are thought to play a key role in the mood and anxiety disorders. Our goal in this study was to examine whether a change in maladaptive beliefs mediated the outcome of individual cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD). In a sample of 47 individuals with SAD receiving CBT, we measured maladaptive interpersonal beliefs as well as emotional and behavioral components of social anxiety, both at baseline and after treatment completion. We found that (a) maladaptive interpersonal beliefs were associated with social anxiety at baseline and treatment completion; (b) maladaptive interpersonal beliefs were significantly reduced from baseline to treatment completion; and (c) treatment-related reductions in maladaptive interpersonal beliefs fully accounted for reductions in social anxiety after CBT. These results extend the literature by providing support for cognitive models of mental disorders, broadly, and SAD, specifically.     

睡眠对恐惧学习的影响及其认知神经机制

睡眠问题可能会诱发恐惧相关情绪障碍(焦虑、创伤性应激障碍、恐怖症等),研究睡眠影响恐惧学习的认知神经机制,有助于增强对恐惧相关情绪障碍的预测、诊断和治疗。以往研究表明睡眠剥夺影响恐惧习得和消退主要是通过抑制vmPFC活动,阻碍其与杏仁核的功能连接,从而导致恐惧习得增强或是消退学习受损。进一步研究发现睡眠不同阶段对恐惧学习相关脑区有独特的影响:剥夺(缺乏)快速眼动睡眠会抑制vmPFC活动、增强杏仁核、海马激活,导致恐惧习得增强,消退学习受损,此外边缘皮层的功能连接减少破坏了记忆巩固(恐惧记忆和消退记忆);而慢波睡眠主要与海马变化有关,慢波睡眠期间进行目标记忆重激活可促进恐惧消退学习。未来研究需要增加睡眠影响恐惧泛化的神经机制研究、及昼夜节律中断对恐惧消退的影响,以及关注动物睡眠研究向人类睡眠研究转化中存在的问题。     

Cognitive Behavioral Therapy for Social Anxiety Disorder: Predictors of Treatment Outcome in a Quasi-Naturalistic Setting

We examined the outcomes of individual cognitive behavioral therapy (CBT) for social anxiety disorder (SAD) in a sample of 93 adults seeking treatment in a university outpatient clinic specializing in CBT for SAD. Treatment followed the structure of a manual, but number of sessions varied according to client needs. After approximately 20 weeks of therapy, patients’ social anxiety had decreased and their quality of life had increased. Patients with more severe SAD or comorbid major depressive disorder (MDD) at pretreatment demonstrated higher levels of social anxiety averaged across pre- and posttreatment. However, clinician-rated severity of SAD, comorbid MDD, or comorbid generalized anxiety disorder did not predict treatment outcome. Higher pretreatment scores on measures of safety behaviors and cognitive distortions were associated with higher social anxiety averaged across pre- and posttreatment and predicted greater decreases from pre- to posttreatment on multiple social anxiety outcome measures. We found no predictors of change in quality of life. Those with high levels of safety behaviors and distorted cognitions may benefit more from CBT, perhaps due to its emphasis on targeting avoidance through exposure and changing distorted thinking patterns through cognitive restructuring methods. Our study lends support to the body of research suggesting that manualized CBT interventions can be applied flexibly in clinical settings with promising outcomes for patients over a relatively short course of therapy.     

Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder

Traditional cognitive-behavioral therapy (CBT) for anxiety disorders has been designed to target reductions in negative affect (NA) associated with defense-related processes. However, a subset of anxiety disorders, including social anxiety disorder (SAD), are also characterized by low positive affect (PA) resulting from separate deficits in appetitive-related processes. In contrast to CBT, “third-wave” approaches, such as acceptance and commitment therapy (ACT), align more consistently with motivational processes and, as a result, PA. However, the differential effect of CBT and ACT on PA and NA has yet to be investigated. Using secondary data from a randomized controlled trial, the present study sought to compare CBT’s (n = 45) and ACT’s (n = 35) effect on PA and NA in SAD. Findings were compared to a wait-list (WL) control condition (n = 31), as well as normative data from a general adult sample. Baseline PA and NA were also examined as moderators and predictors of theory-relevant treatment outcomes. NA decreased significantly in both CBT and ACT from pre to posttreatment. Although ACT outperformed WL in reducing NA, this effect was not observed for CBT. PA increased significantly in both CBT and ACT from pre to posttreatment, with neither ACT nor CBT outperforming WL in increasing PA. Neither PA nor NA were found to moderate theoretically relevant treatment outcomes. Findings suggest that ACT and CBT share common treatment mechanisms, making them more similar than distinct. Further efforts should be focused on optimizing CBT’s and ACT’s influence on threat and reward learning, and elucidating common processes of change.     

Homework Compliance and Quality in Cognitive Behavioral Therapies for Anxiety Disorders and Obsessive-Compulsive Disorder

Homework assignments are an integral part of cognitive behavioral therapy, providing patients with opportunities to practice skills between sessions. Generally, greater homework compliance is associated with better treatment outcomes. However, fewer studies have examined the effect of homework quality on treatment outcomes. This study examined homework compliance and quality as predictors of outcome and attrition across five CBT protocols. A sample of 179 individuals with principal diagnoses of generalized anxiety disorder, panic disorder, social anxiety disorder, or obsessive-compulsive disorder were randomized to receive a transdiagnostic CBT protocol (the Unified Protocol) or a single-diagnosis CBT protocol corresponding to their principal diagnosis. The Unified Protocol had a lower homework burden than the majority of the single-diagnosis protocols, which varied in degree of assigned homework. Despite this, there were no differences in average homework compliance or quality across principal diagnosis, treatment condition, or their interaction. Homework quality was significantly related to all symptom outcomes (self-reported and clinician-rated anxiety and depressive symptoms, clinician-rated clinical severity). Homework compliance was significantly related to clinician-rated anxiety symptom outcomes. Additionally, greater homework quality and compliance were both significantly associated with increased odds of completing treatment, suggesting homework variables can be useful and easily obtainable predictors of treatment retention.     

Integrating neurobiology and psychopathology into evidence-based treatment of social anxiety disorder

Social anxiety disorder (SAD) is a common, chronic psychiatric disorder characterized by a persistent fear of social or performance situations in which embarrassment can occur. This disorder typically appears during the mid-adolescent years and is unremitting throughout life if not properly treated. SAD presents as two subtypes: the more common and debilitating generalized form, and the nongeneralized form, which consists predominantly of performance anxiety. The majority of patients with SAD have comorbid mental disorders, including mood, anxiety, and substance abuse. No single development theory has been proposed to account for the origins of SAD, although current understanding of the etiology of SAD posits an interaction between psychological and biological factors. Risk factors include environmental and parenting influences and dysfunctional cognitive and conditioning events in early childhood. The neurobiology of SAD appears to involve neurochemical dysfunction, as evidenced by studies of neuroreceptor imaging, neuroendocrine function, and profiles of response to specific medications. Clinical trials have demonstrated that benzodiazepines and antidepressants are effective in the treatment of SAD. The selective serotonin reuptake inhibitors are emerging as the first-line treatment for SAD, based on their proven safety, tolerability, and efficacy. Goals for ongoing future research include development of approaches to achieve remission, to convert nonresponders and partial responders to full responders, and to prevent relapse and maintain long-term efficacy. This monograph explores the epidemiology, clinical presentation, and differential diagnosis of SAD, with a focus on neural circuitry of social relationships and neurochemical dysfunction. The prevalence, rates of recognition and treatment, patterns of comorbidity, quality-of-life issues, and natural history of SAD are discussed as well as pharmacologic and psychosocial treatment strategies for SAD.     

Expectation and temperament moderate amygdala and dorsal anterior cingulate cortex responses to fear faces

A chronic tendency to avoid novelty is often the result of a temperamental bias called inhibited temperament, and is associated with increased risk for anxiety disorders. Neuroimaging studies have demonstrated that an inhibited temperament is associated with increased amygdalar blood-oxygenation-level-dependent (BOLD) response to unfamiliar faces that were not expected; however, the effects of variations in expectancy remain unknown. Using functional magnetic resonance imaging (fMRI), we studied BOLD response to infrequently encountered fear faces that were either expected or not expected in 42 adults with an inhibited or an uninhibited temperament. Individuals with an inhibited temperament had greater amygdala, but less dorsal anterior cingulate cortex (dACC), BOLD response when the stimuli were expected. In contrast, those with an uninhibited temperament had a smaller amygdala but larger dorsal anterior cingulate cortex BOLD response when expecting to see fear faces. These findings demonstrate temperament differences in expectancy effects and provide preliminary evidence for the dACC as a neural substrate mediating differences in inhibited temperament. Enhanced amygdala sensitivity coupled with weak inhibitory control from the dACC may form a neural circuit mediating behaviors characteristic of inhibited temperament and risk for anxiety disorders.     

Neural correlates of automatic mood regulation in girls at high risk for depression

Daughters of depressed mothers are at significantly elevated risk for developing a depressive disorder themselves. We have little understanding, however, of the specific factors that contribute to this risk. The ability to regulate negative affect effectively is critical to emotional and physical health and may play an important role in influencing risk for depression. We examined whether never-disordered daughters whose mothers have experienced recurrent episodes of depression during their daughters' lifetime differ from never-disordered daughters of never-disordered mothers in their patterns of neural activation during a negative mood induction and during automatic mood regulation. Sad mood was induced in daughters through the use of film clips; daughters then recalled positive autobiographical memories, a procedure shown previously to repair negative affect. During the mood induction, high-risk girls exhibited greater activation than did low-risk daughters in brain areas that have frequently been implicated in the experience of negative affect, including the amygdala and ventrolateral prefrontal cortex. In contrast, during automatic mood regulation, low-risk daughters exhibited greater activation than did their high-risk counterparts in brain areas that have frequently been associated with top-down regulation of emotion, including the dorsolateral prefrontal cortex and dorsal anterior cingulate cortex. These findings indicate that girls at high and low risk for depression differ in their patterns of neural activation both while experiencing, and while repairing negative affect, and suggest that anomalies in neural functioning precede the onset of a depressive episode.     

Reward-related brain function as a predictor of treatment response in adolescents with major depressive disorder

The present study provides preliminary evidence that pretreatment reward-related brain function in the striatum and medial prefrontal cortex (PFC) could have relevance for predicting both final level and rate of change of clinical characteristics in adolescents with major depressive disorder. Adolescents with depression underwent a functional MRI scan during a monetary reward task, participated in an 8-week open trial of cognitive behavioral therapy (CBT) or CBT plus selective serotonin reuptake inhibitor, and completed reports of anxiety and depressive symptoms before, during, and after treatment. Clinicians rated adolescents’ improvement and severity at the same time points. Growth models were used to examine change in clinical characteristics and its association with brain function. Severity, anxiety symptoms, and depressive symptoms decreased over treatment. Final levels of severity and anxiety symptoms were associated with pretreatment striatal reactivity, and rate of anxiety symptom reduction was associated with greater striatal reactivity and lower medial PFC reactivity.