Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Effects of containment and closure policies on controlling the COVID‐19 pandemic in East Asia

Growing efforts have been made to pool coronavirus data and control measures from countries and regions to compare the effectiveness of government policies. We examine whether these strategies can explain East Asia’s effective control of the COVID‐19 pandemic based on time‐series data with cross‐correlations between the Stringency Index and number of confirmed cases during the early period of outbreaks. We suggest that multidisciplinary empirical research in healthcare and social sciences, personality, and social psychology is needed for a clear understanding of how cultural values, social norms, and individual predispositions interact with policy to affect life‐saving behavioural changes in different societies.     

Affect and emotions in placebo and nocebo effects: What do we know so far?

Once considered nuisance variance in clinical trials, placebo effects and nocebo effects are now widely recognized as important and mutable psychobiological contributors to mental and physical health. Psychological theory explaining these effects emphasizes associative learning and conscious expectations. It has long been suggested, however, that affective states such as moods, emotions, and distress could play a significant role. In this paper, we draw together and review the empirical data linking affective states to placebo and nocebo effects. To organize this disparate literature, three questions are addressed: (1) Does pre‐existing state and trait affect modulate placebo and nocebo effects? (2) Does administering placebo and nocebo treatments change affective states, and if so, does the resulting affect causally influence placebo and nocebo effects? Finally, (3) Can placebo treatments be successfully employed as a regulation strategy to modulate different affective states? In reviewing the evidence in relation to these three questions, it is clear that affect does play a key role in placebo and nocebo effects in many circumstances, and further, there may be a reciprocal dynamic at play between a treatment event, affect, and placebo/nocebo effects. The paper concludes by discussing implications for theory and intervention and recommends future research priorities.     

Preference and resistance to change in concurrent variable-interval schedules

Pigeons were trained on a multiple schedule in which separate concurrent schedules were presented in the two components of the schedule. During one component, concurrent variable-interval 40-sec variable-interval 80-sec schedules operated. In the second component, concurrent variable-interval 40-sec variable-interval 20-sec schedules operated. After stable baseline performance was obtained in both components, extinction probe choice tests were presented to assess preference between the variable-interval 40-sec schedules from the two components. The variable-interval 40-sec schedule paired with the variable-interval 80-sec schedule was preferred over the variable-interval 40-sec schedule paired with the variable-interval 20-sec schedule. The subjects were also exposed to several resistance-to-change manipulations: (1) prefeeding prior to the experimental session, (2) a free-food schedule added to timeout periods separating components, and (3) extinction. The results indicated that preference and resistance to change do not necessarily covary.     

Inhibition and superconditioning

Superconditioning is said to occur when learning an association between a conditioned stimulus (CS) and unconditioned stimulus (US) is facilitated by pairing the CS with the US in the presence of a previously established conditioned inhibitor. Previous demonstrations of superconditioning have been criticized because their control conditions have allowed alternative interpretations. Using a within–subjects autoshaping procedure, the present study unambiguously demonstrated superconditioning. The results support the view that superconditioning is the symmetric opposite of blocking.     

Anxiety-related bias in the classification of emotionally ambiguous facial expressions

High- and low-trait socially anxious individuals classified the emotional expressions of photographic quality continua of interpolated ("morphed") facial images that were derived from combining 6 basic prototype emotional expressions to various degrees, with the 2 adjacent emotions arranged in an emotion hexagon. When fear was 1 of the 2 component emotions, the high-trait group displayed enhanced sensitivity for fear. In a 2nd experiment where a mood manipulation was incorporated, again, the high-trait group exhibited enhanced sensitivity for fear. The low-trait group was sensitive for happiness in the control condition. The mood-manipulated group had increased sensitivity for anger expressions, and trait anxiety did not moderate these effects. Interpretations of the results related to the classification of fearful expressions are discussed.     

Adults with dyslexia demonstrate space-based and object-based covert attention deficits: shifting attention to the periphery and shifting attention between objects in the left visual field

Performance on a covert visual attention task is compared between a group of adults with developmental dyslexia (specifically phonological difficulties) and a group of age and IQ matched controls. The group with dyslexia were generally slower to detect validly-cued targets. Costs of shifting attention toward the periphery when the target was invalidly cued were significantly higher for the group with dyslexia, while costs associated with shifts toward the fovea tended to be lower. Higher costs were also shown by the group with dyslexia for up-down shifts of attention in the periphery. A visual field processing difference was found, in that the group with dyslexia showed higher costs associated with shifting attention between objects in they LVF. These findings indicate that these adults with dyslexia have difficulty in both the space-based and the object-based components of covert visual attention, and more specifically to stimuli located in the periphery.