Emotion-Focused Cognitive-Behavioral Therapy for Youth with Anxiety Disorders: A Randomized Trial

Difficulties with emotion regulation are a core feature of anxiety disorders (ADs) in children and adults. Interventions with a specific focus on emotion regulation are gaining empirical support. Yet, no studies to date have compared the relative efficacy of such interventions to existing evidence-based treatments. Such comparisons are necessary to determine whether emotion-focused treatments might be more effective for youth exhibiting broad emotion-regulation difficulties at pretreatment. This study examined an emotion-focused cognitive-behavioral therapy (ECBT) protocol in comparison to traditional cognitive-behavioral therapy (CBT) in a sample of children with a primary anxiety disorder diagnosis. Moderation analyses examined whether children with higher levels of emotion dysregulation at pretreatment would show greater levels of improvement in ECBT than CBT. Ninety-two youth ages 7 to 12 years (58% male) with a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia were included. Participants were randomly assigned to ECBT or CBT. Results showed that youth in both conditions demonstrated similar improvements in emotion regulation and that pretreatment levels of emotion dysregulation did not moderate treatment outcomes. Additional analyses showed that ECBT and CBT were similarly effective on diagnostic, severity, and improvement measures. Future work is needed to further explore the ways that emotion regulation is related to treatment outcome for anxious youth.     

Mental imagery, reasoning, and blindness

Although reasoning seems to be inextricably linked to seeing in the “mind's eye”, the evidence is equivocal. In three experiments, sighted, blindfolded sighted, and congenitally totally blind persons solved deductive inferences based on three sorts of relation: (a) visuo-spatial relations that are easy to envisage either visually or spatially, (b) visual relations that are easy to envisage visually but hard to envisage spatially, and (c) control relations that are hard to envisage both visually and spatially. In absolute terms, congenitally totally blind persons performed less accurately and more slowly than the sighted on all such tasks. In relative terms, however, the visual relations in comparison with control relations impeded the reasoning of sighted and blindfolded participants, whereas congenitally totally blind participants performed the same with the different sorts of relation. We conclude that mental images containing visual details that are irrelevant to an inference can even impede the process of reasoning. Persons who are blind from birth—and who thus do not tend to construct visual mental images—are immune to this visual-impedance effect.     

Epidemiology of nonfatal deliberate self-harm in the United States as described in three medical databases

The absence of validated U.S. rates of nonfatal suicidal behavior places risk management and injury prevention programs at danger of being poorly informed and inadequately conceptualized. In this study we compare estimated rates of intentional self-harm from two ongoing surveys (National Electronic Injury Surveillance System-All Injury Program-NEISS-AIP; National Hospital Ambulatory Medical Care Survey-NHAMCS) to data from the Toxic Exposure Surveillance System. Results suggest that, for every 2002-2003 suicide, there were 12 (NEISSAIP) or 15 (NHAMCS) self-harm-related emergency department visits, and for every intentional self-poisoning death there were 33 intentional overdoses reported to poison control centers, of which two ultimately went untreated.     

Age-related differences in ambulatory blood pressure during daily stress: evidence for greater blood pressure reactivity with age

Prior research on age and emotions has found that older adults may show better physiological regulation to stressful stimuli than do younger adults. However, the stress reactivity literature has shown that age is associated with higher cardiovascular reactivity to laboratory stress (J. R. Jennings et al., 1997). The authors investigated these conflicting findings further by examining daily ambulatory blood pressure in 428 middle-aged to older adults. Consistent with the age and reactivity literature, relatively old individuals showed significantly greater increases in ambulatory diastolic blood pressure compared with younger individuals when dealing with daily stressors. However, results also revealed that relatively old individuals reported less of an increase in negative affect during daily stress compared with their younger counterparts. The results of this study are consistent with the age-related increase in cardiovascular risk but highlight the complex links between stress and different facets of the aging process.     

Choice of conflict-handling strategy: a matter of context

In this study, a follow-up to Callanan and Perri (2006), the authors investigated whether individuals are inclined to choose a conflict-handling approach based on their primary orientation as given by a standardized instrument, or whether they choose a style different from their primary orientation. The authors also assessed whether individuals are inclined to choose the appropriate or "optimal" strategy as based on contextual factors embodied in the conflict situation. Participants in the study were 184 graduate and undergraduate students from two universities located in the United States. Results show that when individuals are presented with conflict scenarios based on real-life events, they can and do choose conflict-handling strategies that are different from their presumed dominant strategy. Further, results show that individuals are generally able to read contextual factors and social cues to select the most "situationally appropriate" conflict-handling response. This study presents implications for future research and discusses issues related to the management of interpersonal and intragroup conflict.     

Connectivity among semantic associates: an fMRI study of semantic priming

Semantic priming refers to a reduction in the reaction time to identify or make a judgment about a stimulus that has been immediately preceded by a semantically related word or picture and is thought to result from a partial overlap in the semantic associates of the two words. A semantic priming lexical decision task using spoken words was presented in event-related fMRI and behavioral paradigms. Word pairs varied in terms of semantic relatedness and the connectivity between associates. Thirteen right-handed subjects underwent fMRI imaging and 10 additional subjects were tested in a behavioral version of the semantic priming task. It was hypothesized priming would be greatest, reaction time fastest, and cortical activation reduced the most for related word pairs of high connectivity, followed by related word pairs of low connectivity, and then by unrelated word pairs. Behavioral and fMRI results confirmed these predictions. fMRI activity located primarily in bilateral posterior superior and middle temporal regions showed modulation by connectivity and relatedness. The results suggest that these regions are involved in semantic processing.