Cognitive therapy for post-traumatic stress disorder: development and evaluation

The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT (N = 14) and a 3-month waitlist condition (WL, N = 14). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70-2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome.     

Recipient Design in Communicative Pointing

A long‐standing debate in the study of human communication centers on the degree to which communicators tune their communicative signals (e.g., speech, gestures) for specific addressees, as opposed to taking a neutral or egocentric perspective. This tuning, called recipient design, is known to occur under special conditions (e.g., when errors in communication need to be corrected), but several researchers have argued that it is not an intrinsic feature of human communication, because that would be computationally too demanding. In this study, we contribute to this debate by studying a simple communicative behavior, communicative pointing, under conditions of successful (error‐free) communication. Using an information‐theoretic measure, called legibility, we present evidence of recipient design in communicative pointing. The legibility effect is present early in the movement, suggesting that it is an intrinsic part of the communicative plan. Moreover, it is reliable only from the viewpoint of the addressee, suggesting that the motor plan is tuned to the addressee. These findings suggest that recipient design is an intrinsic feature of human communication.     

How people familiarize themselves with complex ecological concepts—anchoring of social representations of invasive non‐native species

New terms and frameworks are constantly being incorporated into scientific and public discourses on the management of natural resources and the environment. The idea of invasive non‐native plant and animal species, i.e. of species that enter a new range and spread prolifically, is currently becoming part of the public discourse in Scotland. This constitutes a valuable opportunity to study how people engage with new scientific concepts. We analysed focus group and personal interview data to examine how participants (including the general public, conservation volunteers and scientists) familiarized themselves with the ecological concept of invasive non‐native species. Our analysis draws on the idea of anchoring in the formation of social representations, complemented by concepts from cognitive linguistics and conceptual blending, and defines anchoring as a process of information transfer from source to target domains. Our findings suggest that social representations of invasive non‐native species were constituted to a large degree by perceptions of species' detrimental impacts and the human role in and responsibility for the introduction process. By contrast, the non‐nativeness of a species was not relevant for participants from the general public and conservation volunteers. Three types of anchoring could be distinguished in our participants' discussions that differed with regard to the relations between source and target domain. Whereas participants from the general public and conservation volunteers used all three types of anchoring, scientists did not. The identification of different anchoring types also helped to explain incongruencies in the scientific discourse on invasive non‐native species, and has implications for public information campaigns. Copyright © 2010 John Wiley & Sons, Ltd.     

Approach and Avoidance Tendencies in Spider Fearful Children: The Approach-Avoidance Task

Fear in children is associated with the tendency to avoid situations related to the fear. In this study, the Approach-Avoidance Task (AAT) was evaluated as a test of automatic behavioral avoidance tendencies in children. A sample of 195 children aged between 9 and 12 years completed an AAT, a Behavioral Assessment Task (BAT), and two spider fear questionnaires. The results indicate that all children showed an automatic avoidance tendency in response to spider pictures, but not pictures of butterflies or neutral pictures. Girls who reported more fear of spiders on the self-reports and behaved more anxiously during the BAT also showed a greater avoidance tendency in the AAT. These relationships were absent in boys.     

Relationship between patient characteristics and treatment allocation for patients with personality disorders

Within a large multi-center study in patients with personality disorders, we investigated the relationship between patient characteristics and treatment allocation. Personality pathology, symptom distress, treatment history, motivational factors, and sociodemographics were measured at intake in 923 patients, who subsequently enrolled in short-term or long-term outpatient, day hospital, or inpatient psychotherapy for personality pathology. Logistic regressions were used to examine the predictors of allocation decisions. We found a moderate relationship (R(2) = 0.36) between patient characteristics and treatment setting, and a weak relationship (R(2) = 0.18) between patient characteristics and treatment duration. The most prominent predictors for setting were: symptom distress, cluster C personality pathology, level of identity integration, treatment history, motivation, and parental responsibility. For duration the most prominent predictor was age. We conclude from this study that, in addition to pathology and motivation factors, sociodemographics and treatment history are related to treatment allocation in clinical practice.     

Reviewers for Special Issue

Objective: An enhanced stress and coping model was used to explain depression among HIV‐positive women in healthcare and community settings where highly active anti‐retroviral treatment (HAART) was commonplace. Method: HIV‐infected women in four cities (N=978) were assessed, cross‐sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self‐reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self‐efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self‐efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self‐efficacy, bolstering social supports, and decreasing stress in the lives of HIV‐positive women may help to reduce the negative effects of HIV disease on mood.