Effects of imaginal exposure to feared disasters in obsessive-compulsive checkers

The combined effects of imaginal exposure to feared catastrophes and in vivo exposure to external stimuli were compared with the effects of in vivo exposure alone in 15 obsessive-compulsives with checking rituals. The first group received 90 min of uninterrupted exposure in imagination, which concentrated mainly on disastrous consequences, followed by 30 min of exposure in vivo to stimuli-situations which triggered rituals. The second group was given 2 hr of exposure in vivo only. Both groups were prevented from performing rituals. Treatment consisted of 10 daily sessions within a 2 week period.Assessments were conducted before and after treatment and at follow-up ranging from 3 months to 2.5 yr with a mean of 11 months. At post-treatment both groups improved considerably and did not differ. But at follow-up those who received imaginal and in vivo exposure maintained their gains, whereas the group who were treated by exposure in vivo alone evidenced partial relapse on four of the six dependent measures. The results tend to indicate that a closer match between a patient's internal fear model and the content of exposure enhances long term treatment efficacy.     

Holding true and holding as true

Our thanks go to Jonathan Malino. We also wish to express our gratitude to the reviewers of Synthese for their exacting and valuable comments.     

Terrorism research and the diffusion of ideas

The diffusion of ideas about contemporary terrorism is analyzed using a sociology of science methodology. One of the most common means of creating understandings of a phenomenon is the development and diffusion of ideas that influence the positions adopted by a wide range of actors, including government bureaucrats and decision makers, legislative and corporate bodies, and the public. How did terrorism researchers interact with these actors to construct, maintain, and modify the development and perception of contemporary terrorism? How were the ideas diffused and what impact did they have on policymakers? Did the invisible college of terrorism researchers function as an epistemic community? These questions are analyzed using an integrated research strategy that employs a number of techniques and data sources such as bibliometrics, content analysis, and citation analysis of selected terrorism research publications, biographies, and conferences, and on-line tracing of researchers’ affiliations, participations, and collaborations.     

Habituation of subjective anxiety during flooding in imagery

Patterns of habituation of subjective anxiety during flooding in fantasy are delineated for eleven obsessive-compulsive and six agoraphobic patients. The majority showed a curvilinear pattern of subjective anxiety response, while three patients showed a linear decelerating pattern. Habituation was found both within and across sessions. The results are compared with habituation patterns in physiological responses during flooding in fantasy and in vivo.     

Interpretation bias in social anxiety as detected by event-related brain potentials

Little is known about psychophysiological correlates of interpretation bias in social anxiety. To address this issue, the authors measured event-related brain potentials (ERPs) in high and low socially anxious individuals during a task wherein ambiguous scenarios were resolved with either a positive or negative ending. Specifically, the authors examined modulations of the P600, an ERP that peaks approximately 600 ms following stimulus onset and indexes violations of expectancy. Low-anxious individuals were characterized by an increased P600 to negative in comparison with positive sentence endings, suggesting a positive interpretation bias. In contrast, the high-anxious group evidenced equivalent P600 magnitude for negative and positive sentence endings, suggesting a lack of positive interpretation bias. Similar, but less reliable results emerged in earlier time windows, that is, 200-500 ms poststimulus. Reaction time, occurring around 900 ms poststimulus, failed to show a reliable interpretation bias. Results suggest that ERPs can detect interpretation biases in social anxiety before the emission of behavioral responses.     

“We have answered their prayer”: American Jewish old age homes as guardians of religious tradition

ABSTRACT

The old age home was the major American Jewish communal response to aged poverty during the late nineteenth and early twentieth centuries. The first homes offered a self-conscious projection of their sponsors as socially progressive and compassionate in a new landscape. For a religious community increasingly distanced from formal hierarchies of traditional religious practice, the highly visible performance of good deeds under explicitly Jewish auspices became central to its communal identity. Acting on a combination of compassion and the perceived moral imperative of providing a Jewish environment, the founders and supporters of these homes recast Judaism and Jewish identity through an idealized image of aged piety.     

Directed forgetting following mood induction in chronic posttraumatic stress disorder patients

Current research of posttrauma sequelae suggests that intrusive rather than avoidant-dissociative models more accurately represent the encoding processes of trauma cues. However, posttraumatic stress disorder (PTSD) is often conceptualized as a phasic phenomenon, altering between arousal and avoidance states. The failure to support a relationship between avoidant encoding style and PTSD may reflect this alteration. To explore this hypothesis, participants with PTSD and controls (no PTSD) completed an item-cued directed-forgetting task, following either a dissociative or a serenity (control) mood induction. Results suggested that, following the serenity induction, a standard directed-forgetting effect was observed. However, following the dissociation induction, this effect was not observed. The role of dissociation in impairing encoding via lack of selective rehearsal or source discrimination is discussed.     

Long-term efficacy of exposure and ritual prevention therapy and serotonergic medications for obsessive-compulsive disorder

What is the long-term outcome of patients with obsessive-compulsive disorder (OCD) who are treated with exposure and response (ritual) prevention (EX/RP) alone, serotonergic medications alone, or their combination? How is the long-term outcome of these patients affected by the discontinuation? Follow-up assessments were conducted with 62 patients treated for OCD an average of 17 months posttreatment (range: 6-43 months). Patients received one of three treatments: serotonergic medications (fluvoxamine or clomipramine), intensive behavior therapy involving EX/RP, or intensive EX/RP with concurrent antidepressant medication. At follow-up, no differences in OCD symptom severity were found among the three treatment groups. However, when current medication use was taken into consideration, differences among the three treatment groups emerged. Among patients who were medication-free at the time of follow-up assessment (n=37), those in the EX/RP-alone and EX/RP-with-medication groups had lower symptom severity ratings than those in the medication-only group on 4 out of 6 measures. There were no differences in OCD severity ratings among patients taking medications at follow-up (n=25). Although these findings are interpreted with caution due to the uncontrolled nature of the study, results suggested that long-term outcome may be superior following EX/RP than following serotonergic medications, after discontinuation. For patients who remain on medications, the treatment produced benefits equivalent to EX/RP.     

Victim-centric diversion? The electronic monitoring of domestic violence cases

This article discusses the electronic monitoring of domestic violence cases as a form of diversion. The data derive from a two and a half year study of two "bilateral" electronic monitoring programs geared towards domestic violence offenders, mostly defendants, and their former or current intimate partners. Analysis consists of an examination of how the programs under study manifest the aims and tensions of diversion, and highlights how a victim-centered approach to diversion can amplify the tensions of diversion.