Cognitive behavior therapy for fear of flying: sustainability of treatment gains after September 11

This study examines the long-term efficacy of cognitive-behavioral therapy (CBT) for fear of flying (FOF) after a catastrophic fear-relevant event, the September 11, 2001, terrorist attacks. Participants (N = 115) were randomly assigned to and completed treatment for FOF using 8 sessions of either virtual reality exposure therapy (VRE) or standard exposure therapy (SE) prior to September 11, 2001. Individuals were reassessed in June, 2002, an average of 2.3 years after treatment, with a response rate of 48% (n = 55). Analyses were run on the original data and, using multiple imputation procedures, on imputed data for the full sample. Individuals maintained or improved upon gains made in treatment as measured by standardized FOF questionnaires and by number of flights taken. There were no differences between VRE and SE. Thus, results suggest that individuals previously treated for FOF with cognitive-behavioral therapy can maintain treatment gains in the face of a catastrophic fear-relevant event, even years after treatment is completed.     

Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying

This controlled clinical trial tested virtual reality exposure (VRE) therapy for the fear of flying (FOF), a relatively new and innovative way to do exposure therapy, and compared it to standard (in vivo) exposure therapy (SE) and a wait list (WL) control with a 6- and 12-month follow-up. Eighty-three participants with FOF were randomly assigned to VRE, SE, or WL. Seventy-five participants, 25 per group, completed the study. Twenty-three WL participants completed randomly assigned treatment following the waiting period. Treatment consisted of 4 sessions of anxiety management training followed either by exposure to a virtual airplane (VRE) or an actual airplane at the airport (SE) conducted over 6 weeks. Results indicate that VRE was superior to WL on all measures, including willingness to fly on the posttreatment flight (76% for VRE and SE; 20% for WL). VRE and SE were essentially equivalent on standardized questionnaires, willingness to fly, anxiety ratings during the flight, self-ratings of improvement, and patient satisfaction with treatment. Follow-up assessments at 6 and 12 months indicated that treatment gains were maintained, with more than 70% of respondents from both groups reporting continued flying at follow-up. Based on these findings, the use of VRE in the treatment of FOF was supported in this controlled study, suggesting that experiences in the virtual world can change experiences in the real world.     

A TEST OF THE FORMAL AND MODERN THEORIES OF MATCHING

Pigeons' choosing between fixed-interval and random-interval schedules of reinforcement was investigated in three experiments using a discrete-trial procedure. In all three experiments, the random-interval schedule was generated by sampling a probability distribution at an interval (and in multiples of the interval) equal to that of the fixed-interval schedule. Thus the programmed delays to reinforcement on the random alternative were never shorter and were often longer than the fixed interval. Despite this feature, the fixed schedule was not strongly preferred. Increases in the probability used to generate the random interval resulted in decreased preferences for the fixed schedule. In addition, the number of consecutive choices on the preferred alternative varied directly with preference, whereas the consecutive number of choices on the nonpreferred alternative was fairly constant. The probability of choosing the random alternative was unaffected by the immediately prior interval encountered on that schedule, even when it was very long relative to the average value. The results loosely support conceptions of a "preference for variability" from foraging theory and the "utility of behavioral variability" from human decision-making literatures.     

Defining Location in the Mental Health System: A Case Study of a Consumer-Run Agency

In this ethnographic study of a mental health service agency staffed by “consumers,” or fellow “recipients” of services for serious mental illness, the concept of community narrative provides the framework for examining how such an agency preserves its consumer identity while providing services dictated by the established service system. Locating the agency's narrative in its “origins tale,” analysis revealed five principles comprising the agency's identity: a normalizing view of mental illness, a commitment to helping, a dual-valued understanding of the mental health system, and beliefs in recovery and in the significance of employment as a criterion for recovery. Predicted consequences of narrative functioning emerged in social climate and staff expressions of cohesion and commitment. The local meaning of these narrative themes reveals the agency's view of the consumer element in its work and its solution to the dilemma of being both inside and outside of the mental health system.     

Environmental topography and postural control demands shape aging-associated decrements in spatial navigation performance

This study tests the hypothesis that aging-induced cognitive permeation of sensorimotor functions contributes to adult age differences in spatial navigation performance. Virtual maze-like museums were projected in front of a treadmill. Sixteen 20-30-year-old men and sixteen 60-70-year-old men performed a way-finding task in city-block or variable topographies while walking with or without support. Walking support attenuated age-related decrements in navigational learning. Navigation load increased trunk-angle variability for older adults only. Age differences in spatial knowledge persisted despite perfect place-finding performance. City-block topography was easier than variable topography for younger adults only, indicating age-related differences in reliance on spatial relational learning. Attempts at supporting older adults' navigation performance should consider sensorimotor/cognitive interactions and qualitative differences in navigational activity.     

Temperament, personality, and developmental psychopathology as childhood antecedents of personality disorders

To contribute to the case for a dimensional conceptualization of psychopathology in general and maladaptive personality or personality disorders in particular, the present paper reviews the evidence for a dimensional representation of childhood temperament and personality. The review of temperament and variable-centered as well as person-centered approaches to childhood personality leads us to propose five broadband dimensions that capture individual differences in children and adolescents: extraversion, emotional stability, agreeableness, conscientiousness, and openness/intellect. Our analysis of the CBCL (Achenbach, 1991) and the DIPSI (currently under development at Ghent University), two dimensional models for childhood psychopathology, suggests two common broadband factors, internalizing and externalizing. The relations between the dimensional representation of childhood temperament/personality and psychopathology are documented with data from general population and clinical samples of children and adolescents. The article concludes with a proposal on how the higher-order dimensions emerging from studies of adaptive and maladaptive individual differences in childhood could be integrated in a common dimensional model.     

Predictors of Young Adolescents’ Math Grades and Course Enrollment Intentions: Gender Similarities and Differences

Gender differences and similarities in the relations of key constructs in Eccles and colleagues (Wigfield & Eccles, 2000) model of achievement were examined as predictors of math grades and enrollment intentions for Grade 9 boys (n = 263) and girls (n = 277). A number of gender similarities were found, particularly in the prediction of math grades. There were, however, two gender-specific paths: for girls, a direct path from competence beliefs to enrollment intentions, and for boys, a direct path from prior math grades to enrollment intentions. In addition, for boys, the path from utility value to enrollment intentions was stronger than it was for girls. These differential predictive patterns were found even though girls and boys reported similar levels of math utility and girls had lower math competence beliefs. For girls, competence beliefs were a significant predictor of both intentions and current math grades, which indicates the central role of competence beliefs.     

Discounting and conditionalization

When people are asked to judge the strengths of two potential causes of an effect, they often demonstrate discounting--devaluing the strength of a target cause when it is judged in the presence of a strong (relative to a weak) alternative cause. Devaluing the target cause sometimes results from conditionalization--holding alternative causes constant while evaluating the target cause. Yet discounting not attributable to conditionalization also occurs. We sought to dissociate conditionalization and discounting (beyond that accounted for by conditionalization) by having subjects perform either a spatial or a verbal working memory task while learning a causal relation. Conditionalization was disrupted by the verbal task but not the spatial task; however, discounting was disrupted by the spatial task but not the verbal task. Conditionalization and discounting are therefore cognitively dissociable processes in human causal inference.