Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation

We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen’s d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.     

Negative self-focused cognitions mediate the effect of trait social anxiety on state anxiety

The cognitive model of social anxiety predicts that negative self-focused cognitions increase anxiety when anticipating social threat. To test this prediction, 36 individuals were asked to anticipate and perform a public-speaking task. During anticipation, negative self-focused cognitions or relaxation were experimentally induced while self-reported anxiety, autonomic arousal (heart rate, heart rate variability, skin conductance level), and acoustic eye-blink startle response were assessed. As predicted, negative self-focused cognitions mediated the effects of trait social anxiety on self-reported anxiety and heart rate variability during negative anticipation. Furthermore, trait social anxiety predicted increased startle amplitudes. These findings support a central assumption of the cognitive model of social anxiety.     

Die Pharmakotherapie der Angststörungen

Angstst?rungen z?hlen zu den h?ufigsten psychischen St?rungen in der Allgemeinbev?lkerung. Die Lebenszeitpr?valenz liegt insgesamt bei 24,9 Prozent, und somit z?hlen sie zusammen mit den affektiven St?rungen zu den h?ufigsten Erkrankungen auf dem Gebiet der Psychiatrie und stellen auch in vielen anderen medizinischen Disziplinen, z. B. der inneren Medizin, einen klinisch bedeutsamen Faktor dar.     

Influence of expressed emotion and perceived criticism on cognitive-behavioral therapy for social phobia

This study examined significant others' expressed emotion (EE) and a closely related construct, perceived criticism, as predictors of cognitive-behavioral therapy outcome in a sample of 40 patients with social phobia (social anxiety disorder). Patients enrolled in group therapy for social phobia completed pre- and post-treatment questionnaire measures of perceived criticism and anxious and depressive symptoms. Designated significant others were assessed for the components of high EE (criticism, hostility and emotional overinvolvement) using the Camberwell Family Interview. It was hypothesized that these high-EE components and patients' perceived criticism would be associated with poorer treatment outcome, and results ran counter to these expectations. Controlling for initial social phobia severity, lower levels of perceived criticism predicted treatment dropout. There was also a nonsignificant trend for participants with a significant other rated as high in emotional overinvolvement to show less change on a composite symptom measure. Findings from this study suggest that close relationships impact the outcome of cognitive-behavioral interventions for social phobia.     

Enhancing exposure-based therapy from a translational research perspective

Combining an effective psychological treatment with conventional anxiolytic medication is typically not more effective than unimodal therapy for treating anxiety disorders. However, recent advances in the neuroscience of fear reduction have led to novel approaches for combining psychological therapy and pharmacological agents. Exposure-based treatments in humans partly rely on extinction to reduce the fear response in anxiety disorders. Animal studies have shown that D-cycloserine (DCS), a partial agonist at the glycine recognition site of the glutamatergic N-methyl-D-aspartate receptor facilitates extinction learning. Similarly, recent human trials have shown that DCS enhances fear reduction during exposure therapy of some anxiety disorders. This article discusses the biological and psychological mechanisms of extinction learning and the therapeutic value of DCS as an augmentation strategy for exposure therapy. Areas of future research will be identified.     

Temporal uncertainty degrades perceptual processing

When participants are required to react to a stimulus, reaction times (RTs) are usually reduced when temporal uncertainty about stimulus occurrence is minimized. Contrary to the common assumption attributing this RT benefit solely to the speeding of motor processes, recent evidence suggests that temporal uncertainty might rather influence premotoric processing levels. We employed a backward-masking procedure to further confine the locus of the temporal uncertainty effect. Participants performed a discrimination task and indicated whether a spatial gap within a square was on the right or the left side. In addition to the shorter RTs, visual discrimination accuracy was improved when temporal uncertainty was low. This result demonstrates that temporal uncertainty influences stimulus processing at a perceptual level.     

Clinical perspectives on the combination of D-cycloserine and cognitive-behavioral therapy for the treatment of anxiety disorders

In a particular success for translational research agendas, characterization of the neuronal circuits underlying fear extinction, and basic research in animal extinction paradigms, has led to intervention studies examining the use of D-cycloserine (DCS) to enhance therapeutic learning from exposure-based cognitive-behavioral therapy (CBT). In this article, we review these intervention studies, and discuss DCS augmentation of CBT relative to more traditional combination-treatment strategies in the treatment of anxiety disorders. We offer an accounting, based on evidence for internal context effects, of current limitations in the combination of antidepressant or benzodiazepine medications with CBT and discuss the advantages of isolated-dosing strategies with DCS relative to these limitations. This strategy is contrasted with the chronic-dosing applications of DCS for schizophrenia and Alzheimer's disease, and future directions for isolated-dosing strategies are discussed.     

How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal

It has been suggested that reappraisal strategies are more effective than suppression strategies for regulating emotions. Recently, proponents of the acceptance-based behavior therapy movement have further emphasized the importance of acceptance-based emotion regulation techniques. In order to directly compare these different emotion regulation strategies, 202 volunteers were asked to give an impromptu speech in front of a video camera. Participants were randomly assigned to one of three groups. The Reappraisal group was instructed to regulate their anxious arousal by reappraising the situation; the Suppression group was asked to suppress their anxious behaviors; and the Acceptance group was instructed to accept their anxiety. As expected, the Suppression group showed a greater increase in heart rate from baseline than the Reappraisal and Acceptance groups. Moreover, the Suppression group reported more anxiety than the Reappraisal group. However, the Acceptance and Suppression groups did not differ in their subjective anxiety response. These results suggest that both reappraising and accepting anxiety is more effective for moderating the physiological arousal than suppressing anxiety. However, reappraising is more effective for moderating the subjective feeling of anxiety than attempts to suppress or accept it.     

That’s Not Science! The Role of Moral Philosophy in the Science/Non-science Divide

The science/non-science distinction has become increasingly blurred. This paper investigates whether recent cases of fraud in science can shed light on the distinction. First, it investigates whether there is an absolute distinction between science and non-science with respect to fraud, and in particular with regards to manipulation and fabrication of data. Finding that it is very hard to make such a distinction leads to the second step: scrutinizing whether there is a normative distinction between science and non-science. This is done by investigating one of the recent internationally famous frauds in science, the Sudbø case. This case demonstrates that moral norms are not only needed to regulate science because of its special characteristics, such as its potential for harm, but moral norms give science its special characteristics. Hence, moral norms are crucial in differentiating science from non-science. Although this does not mean that ethics can save the life of science, it can play a significant role in its resuscitation.     

Computer-assisted implementation of the MMPI test

In a research programme lasting one year a computer-supported technique for the MMPI-Test has been developed in co-operation of the Clinical-Psychology and the Bio-Medical. Engineering Departments. The use of the microelectronically operated test apparatus has proved extremely economic.