The relation between anxiety disorder and experiential avoidance in inpatient adolescents

The current study aimed to examine the relation between experiential avoidance and anxiety disorders, as well as the usefulness of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) in detecting anxiety disorder in a sample of adolescent inpatients. First, the relation between experiential avoidance and anxiety among inpatient adolescents was investigated from categorical and dimensional points of view, making use of self-report and parent report, as well as clinical interview, while controlling for depression and externalizing problems. Second, we sought to establish the clinical utility value of the AFQ-Y by determining the sensitivity, specificity, and clinical cutoff score of this measure in predicting anxiety disorder. To this end, a sample of inpatient adolescents (N = 111) with a mean age of 16.14 (SD = 1.39) years completed the AFQ-Y, alongside interview- and questionnaire-based measures of psychopathology. Results showed a significant relation between anxiety disorder and experiential avoidance, independent of depression. Receiver operating characteristics analysis revealed that the AFQ-Y has moderate accuracy (area under the curve = .815, SE = .047, p < .001) in discriminating adolescents with a diagnosis of any anxiety disorder (cutoff score 26.5; sensitivity = .74, specificity = .76). Given the comorbidity of anxiety and depression in this sample, this cutoff is not indicative of pure anxiety disorder but may be helpful in predicting those with emotional disorders in general.     

A Test of the Effect of Reverse Speech on Priming

J. R. Vokey and J. D. Read (1985) indicated that listeners cannot consciously recognize backward messages but that some information can be obtained from reversed speech. If reverse speech has a powerful influence on language processing, as D. J. Oates (1991) has claimed, then one should be able to measure a reliable priming effect from reversed messages. Sixty undergraduate students listened to short messages presented either backward or forward. Immediately after listening to each message, they responded in a lexical decision task to a visually presented word that had either been present or had not been present in the preceding message. No priming effect was found for backward messages, although there was significant priming for forward messages. The results are not consistent with an effect of reverse speech on word processing.     

Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: A pilot study

IntroductionChronic pain is difficult to treat and often precedes or exacerbates sleep disturbances such as insomnia. Insomnia, in turn, can amplify the pain experience. Both conditions are associated with inflammatory processes, which may be involved in the bi-directional relationship between pain and sleep. Cognitive behavioral therapy (CBT) for pain and CBT for insomnia are evidence based interventions for, respectively, chronic pain and insomnia. The study objectives were to determine the feasibility of combining CBT for pain and for insomnia and to assess the effects of the combined intervention and the stand alone interventions on pain, sleep, and mood outcomes compared to a control condition.MethodsTwenty-one adults with co-occurring chronic pain and chronic insomnia were randomized to either CBT for pain, CBT for insomnia, combined CBT for pain and insomnia, or a wait-list control condition.ResultsThe combined CBT intervention was feasible to deliver and produced significant improvements in sleep, disability from pain, depression and fatigue compared to the control condition. Overall, the combined intervention appeared to have a strong advantage over CBT for pain on most outcomes, modest advantage over both CBT for insomnia in reducing insomnia severity in chronic pain patients.DiscussionCBT for pain and CBT for insomnia may be combined with good results for patients with co-occurring chronic pain and insomnia.     

Counterspaces: A Unit of Analysis for Understanding the Role of Settings in Marginalized Individuals’ Adaptive Responses to Oppression

Research and theory on the intervening variables that enable individuals who experience marginalization and oppression to achieve well-being have historically relied on an individual level of analysis. Yet, there is a growing body of literature that highlights the roles that contexts play in facilitating processes that result in wellness among marginalized individuals. This paper proposes a conceptual framework that highlights a specific type of setting, referred to as "counterspaces," which promotes the psychological well-being of individuals who experience oppression. Counterspaces are theorized to enhance well-being by challenging deficit-oriented societal narratives concerning marginalized individuals' identities. The conceptual frame proposed here suggests that "challenging" can occur through at least three processes: (1) narrative identity work, (2) acts of resistance, and (3) direct relational transactions. This paper articulates each of these challenging processes. Additionally, the utility of using the Counterspaces framework for thinking critically about and investigating how settings-and the transactional processes that unfold within them-are associated with the promotion of psychological wellness for various marginalized populations is discussed.     

Remembering the silver lining: reappraisal and positive bias in memory for emotion

Reappraisal and distraction, unlike suppression, are known to decrease the intensity of negative emotion in the short term. Little is known about long-term characteristics associated with emotion regulation strategies, however. In a longitudinal study, we examined the relation between the strategies people reported using to regulate emotions during a stressful situation and their later memory for their emotions. Students in Italy rated the intensity of positive and negative emotions they were experiencing as they prepared for their high school exit exam. They also rated the extent to which they were regulating emotion using reappraisal, distraction, and suppression. Six weeks later, students recalled their pre-exam emotions. The more students reported engaging in reappraisal before the exam, the more they overestimated positive emotion and underestimated negative emotion when recalling their experience. The association between reported reappraisal and memory bias was partially mediated by positive changes over time in students' appraisals of the exam preparation experience. Reports of engaging in distraction and suppression were not associated with memory bias. Because remembered emotion guides future choices, these findings suggest that reappraisal is a highly adaptive strategy for coping with stressful situations, not only in the short run, but also in the long run.     

Logistics of hurricane evacuation in Hurricanes Katrina and Rita

This study examines household hurricane evacuation logistics—the activities and associated resources needed to reach a safe location and remain there until it is safe to return—during Hurricanes Katrina and Rita. Evacuation logistics variables include evacuation route information sources, evacuation departure dates, vehicles taken, evacuation routes and destinations, travel distances and times, shelter accommodations, and costs of transportation, food, and lodging. This study confirmed previous findings that evacuees take multiple cars, rely on personal experience and traffic conditions to choose their evacuation routes, and are most likely to choose the homes of friends/relatives as their shelter accommodations. However, this study also produced new data on evacuation distances, durations, and costs—as well as associations with demographic and situational variables that are associated with household evacuation logistics. In addition, this study provides additional data indicating that common assumptions about evacuation route choice are incorrect. More research is needed to understand evacuees’ choices of ultimate destinations and evacuation routes.     

Can We Identify Emotion Over‐regulation in Infancy? Associations with Avoidant Attachment,Dyadic Emotional Interaction and Temperament

Emotion over‐regulation in infancy has seldom been the focus of empirical research. This study analysed the specificities of over‐regulation when compared with under‐regulation (maladaptive) and adaptive regulation by testing its association with attachment, dyadic emotional interaction, and temperament. The sample consisted of 52 low‐risk mother–infant dyads. During a home visit, dyadic emotional interaction was assessed in the daily routines and free play of 10‐month‐old infants. The infant's emotion regulation was assessed using the Shape Sorter Task, and a temperament questionnaire was completed by the mother. Attachment was assessed at 12 or 16 months using the Strange Situation. As hypothesized, (i) emotion over‐regulation (versus adaptive regulation) was predicted by a lower quality of dyadic emotional interaction and marginally by avoidant attachment; (ii) over‐regulation (versus under‐regulation) was predicted by avoidant attachment; and (iii) the predictive role of avoidant attachment was substantiated after controlling for another measure of mother–infant interaction. Contrary to expectations, temperament did not distinguish between emotion regulation styles. The link between over‐regulation and lower quality of mother–infant emotional interaction and avoidant attachment was demonstrated. There is empirical support to the claim that it is possible to identify emotion over‐regulation in infancy and that it is a maladaptive style of emotion regulation. Copyright © 2012 John Wiley & Sons, Ltd.     

Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration

Pain is one of the most common health problems and has a severe impact on quality of life. Yet, a suitable and efficient treatment is still not available for all patient populations suffering from pain. Interestingly, recent research shows that low threshold mechanosensory C-tactile (CT) fibres have a modulatory influence on pain. CT-fibres are activated by slow gentle stroking of the hairy skin, providing a pleasant sensation. Consequently, slow gentle stroking is known as affective touch. Currently, a clear overview of the way affective touch modulates pain, at a neural level, is missing. This review aims to present such an overview. To explain the interaction between affective touch and pain, first the neural basis of the affective touch system and the neural processing of pain will be described. To clarify these systems, a schematic illustration will be provided in every section. Hereafter, a novel model of interactions between affective touch and pain systems will be introduced. Finally, since affective touch might be suitable as a new treatment for chronic pain, possible clinical implications will be discussed.     

Transactional Paths Between Children and Parents in Pediatric Asthma: Associations Between Family Relationships and Adaptation

The particular challenges posed by pediatric asthma may have a negative impact on the adaptation of children and their parents. From a transactional approach it is important to examine how reciprocal links between children and parents contribute to explain their adaptation and under which conditions these associations occur. This cross-sectional study aimed at examining the direct and indirect links between children’s and parents’ perceptions of family relationships and adaptation, separately (within-subjects) and across participants (cross-lagged effects), and the role of asthma severity in moderating these associations. The sample comprised 257 children with asthma, aged between 8 and 18 years-old, and one of their parents. Both family members completed self-reported questionnaires on family relationships (cohesion and expressiveness) and adaptation indicators (quality of life and psychological functioning). Physicians assessed asthma severity. Structural Equation Modeling was used to test within-subjects and cross-lagged paths between children’s and parents’ family relationships and adaptation. The model explained 47 % of children’s and 30 % of parents’ adaptation: family relationships were positively associated with adaptation, directly for children and parents, and indirectly across family members. Asthma severity moderated the association between family relationships and health-related quality of life for children: stronger associations were observed in the presence of persistent asthma. These results highlight the need of including psychological interventions in pediatric healthcare focused on family relationships as potential targets for improving children’s and parents’ quality of life and psychological functioning, and identified the children with persistent asthma as a group that would most benefit from family-based interventions.