Obsessive beliefs predict cognitive behavior therapy outcome for obsessive compulsive disorder

Cognitive accounts of obsessive compulsive disorder (OCD) assert that core beliefs are crucial to the development, maintenance, and treatment of the disorder. There are a number of obsessive beliefs that are considered fundamental to OCD, including personal responsibility, threat estimation, perfectionism, need for certainty, importance of thoughts, and thought control. The present study investigated if pretreatment severity of obsessive beliefs, as well as the change in obsessive beliefs following treatment, predicted intensive, residential cognitive behavioral therapy (CBT) treatment outcome. A series of hierarchical regression analyses were carried out to investigate the relations between obsessive beliefs and treatment outcome. Results indicated that inflated pretreatment responsibility/threat estimation beliefs were significantly related to less overall obsessive compulsive (OC) symptom reduction at discharge, explaining 2% of the overall variance. Changes in obsessive beliefs broadly, and importance/control of thoughts specifically, were positively related to overall OC symptom reduction at discharge, respectively explaining 18% and 3.6% variance. Results are modestly consistent with a number of theoretical models, which argue that inflated responsibility, threat estimation, and thought control are important to the maintenance and treatment of OCD.     

Binary ROCs in perception and recognition memory are curved

In recognition memory, a classic finding is that receiver operating characteristics (ROCs) are curvilinear. This has been taken to support the fundamental assumptions of signal detection theory (SDT) over discrete-state models such as the double high-threshold model (2HTM), which predicts linear ROCs. Recently, however, Br?der and Schütz (2009) challenged this argument by noting that most of the data on which support for SDT is based have involved confidence ratings. The authors argued that certain types of rating scale usage may result in curved ROCs even if the generating process is thresholded in nature. From this point of view, only ROCs constructed via experimental bias manipulations are useful for discriminating between the models. Br?der and Schütz conducted a meta-analysis and new experiments that compared SDT and the 2HTM using binary (yes-no) ROCs and found that many of these functions were linear, supporting 2HTM over SDT. We examine all the data reported by Br?der and Schütz, noting important limitations in their methodology, analyses, and conclusions. We report a new meta-analysis and 2 new experiments to examine the issue more closely while avoiding the limitations of Br?der and Schütz's study. These new data indicate that binary ROCs are curved in recognition, consistent with previous findings in perception and reasoning. Our results support classic arguments in favor of SDT and indicate that curvature in ratings ROCs is not task specific. We recommend the ratings procedure and suggest that analyses based on threshold models be treated with caution.     

Mistaking the recent past for the present: false seeing by older adults

Results of three experiments revealed that older, as compared to young, adults are more reliant on context when "seeing" a briefly flashed word that was preceded by a prime. In a congruent condition, the prime was the same word as flashed (e.g., DIRT dirt) whereas in an incongruent condition, the prime differed in a single letter from the word that was flashed (DART dirt). Following their attempt to identify the flashed word, participants were asked to report whether they had "seen" the flashed word or, instead, had responded on some other basis (knowing or guessing). Older adults showed dramatically higher false seeing by reporting the prime on incongruent trials and claiming to have seen it flashed. This was true even though a titration procedure was used to equate the performance of young and older adults on baseline trials which did not provide a biasing context. Results of Experiment 3 related age differences in false seeing to willingness to respond when given the option to withhold responses. Convergence of results with those showing higher false memory and false hearing are interpreted as evidence that older adults are less able to avoid misleading effects of context. That lessened ability may be associated with decline in frontal lobe functioning.     

Development and initial validation of the medical fear survey-short version

The present investigation employs item response theory (IRT) to develop an abbreviated medical fear survey (MFS). Application of IRT analyses in study 1 (n = 931) to the original 50-item MFS resulted in a 25-item shortened version. Examination of the location parameters also resulted in a reduction of the Likert-type scaling of the MFS by removing the last response category ("terror"). The five subscales of the original MFS were highly correlated with those of the MFS-short version. The short version also displayed comparable convergent and discriminant validity with the original MFS in relation to measures of fear, disgust, and anxiety. Confirmatory factor analysis in Study 2 revealed that the five-factor structure of the MFS-short form fit the data well in U.S. (n = 283) and Dutch (n = 258) samples. The short form also had comparable convergent and discriminant validity with the original MFS in relation to domains of disgust in both samples. Receiver operating characteristic (ROC) analysis in Study 3 demonstrated that the subscales of the short version were comparable with the original MFS in classifying participants high (n = 40) and low (n = 40) in blood/injection phobia. Last, structural equation modeling in Study 4 (n = 113) revealed that the MFS-short form demonstrated excellent convergent/discriminant validity with strong associations with injection fear and no association with spider fear. These findings suggest that the MFS-short form has considerable strengths, including decreased assessment time, while retaining sound psychometric properties.     

Trajectory of change in anxiety sensitivity in relation to anxiety,depression, and quality of life among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy

ABSTRACT

Persons living with HIV/AIDS (PLHIV) disproportionately suffer from anxiety and depressive symptoms and disorders. Although past work has examined the efficacy of cognitive-behavioral therapy (CBT) for depression, and to a lesser extent anxiety, among PLHIV, little is known regarding potential mechanisms underlying improvement in anxiety/depression among this group. Anxiety sensitivity is a well-established risk/maintenance factor for anxiety and depressive disorders and is hypothesized to play an important role in maintaining anxiety among PLHIV. Past work has identified anxiety sensitivity as a mechanism of action underlying changes in various anxiety domains yet it is unknown whether changes in anxiety sensitivity relate to changes in anxiety symptoms among PLHIV undergoing transdiagnostic CBT for anxiety. The current study sought to examine treatment-related changes in anxiety sensitivity and how the trajectory of change relates to anxiety and depressive symptoms as well as overall quality of life. Individuals (n = 35) with HIV/AIDS and elevated anxiety symptoms received CBT for anxiety. Results indicated that reductions in anxiety sensitivity were significantly related to changes in anxiety, depression, and quality of life. Together, these data suggest that changes in anxiety sensitivity are significantly related to changes in anxiety/depression and quality of life among PLHIV seeking treatment.     

Surfing the implicit wave

Implicit learning was investigated in two experiments involving a complex motor task. Participants were required to balance on a stabilometer and to move the platform on which they were standing to match a constantly changing target position. Experiment 1 examined whether a segment (middle third) that was repeated on each trial would be learned without participants becoming aware of the repetitions (i.e., implicitly). The purpose of Experiment 2 was to determine the relative effectiveness of explicit versus implicit learning. Here, two identical segments were presented on each trial (first and last thirds), with participants only being informed that one segment (either first or last) was repeated. The acquisition results from both experiments indicated large improvements in performance across 4 days of practice, with performance on the repeated segments being generally superior to that on the non-repeated segment. On the retention tests on Day 5, errors on the repeated segment(s) were smaller than those on the random segment(s). Furthermore, in Experiment 2, the errors on the repeated-known segment, although smaller than those on the random segment, were larger than those on the repeated-unknown segment. Interview results indicated that participants were not consciously aware that a segment was repeated unless they were informed. These results suggest that implicit learning can occur for relatively complex motor tasks and that withholding information concerning the regularities is more beneficial than providing this information.