Cognitive Behavior Therapy for Women With Generalized Anxiety Disorder in the Perinatal Period: Impact on Problematic Behaviors

Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder among women in the perinatal period (pregnancy to one year postpartum). Recent studies have examined the relationship between problematic behaviors and GAD symptoms. Studies in nonperinatal samples indicate that adults with GAD engage in avoidance and safety behaviors and these behaviors are associated with greater symptom severity. Little research has examined the use of problematic behaviors among pregnant or postpartum women. However, preliminary research suggests that these behaviors may have a negative impact on both anxious women and their children. Our aim was to examine the extent to which women with GAD in pregnancy or the postpartum engage in problematic behaviors and whether cognitive behavioral therapy is effective in reducing these behaviors. Fifty-eight women with GAD in pregnancy or postpartum were recruited from a larger clinical trial (Clinicaltrials.gov ID NCT02850523) evaluating the effectiveness of group-based cognitive behavioral therapy (CBGT) for perinatal anxiety disorders. The results indicated that women with perinatal GAD reported high levels of avoidance and safety behaviors and greater engagement in these behaviors was associated with higher levels of worry and related symptoms. CBGT was effective in reducing GAD symptoms and problematic behaviors and a bidirectional relationship was found between changes in worry and problematic behaviors during treatment. Limitations and future directions are discussed.     

Dealing with feeling: a meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation

The present meta-analysis investigated the effectiveness of strategies derived from the process model of emotion regulation in modifying emotional outcomes as indexed by experiential, behavioral, and physiological measures. A systematic search of the literature identified 306 experimental comparisons of different emotion regulation (ER) strategies. ER instructions were coded according to a new taxonomy, and meta-analysis was used to evaluate the effectiveness of each strategy across studies. The findings revealed differences in effectiveness between ER processes: Attentional deployment had no effect on emotional outcomes (d(+) = 0.00), response modulation had a small effect (d(+) = 0.16), and cognitive change had a small-to-medium effect (d(+) = 0.36). There were also important within-process differences. We identified 7 types of attentional deployment, 4 types of cognitive change, and 4 types of response modulation, and these distinctions had a substantial influence on effectiveness. Whereas distraction was an effective way to regulate emotions (d(+) = 0.27), concentration was not (d(+) = -0.26). Similarly, suppressing the expression of emotion proved effective (d(+) = 0.32), but suppressing the experience of emotion or suppressing thoughts of the emotion-eliciting event did not (d(+) = -0.04 and -0.12, respectively). Finally, reappraising the emotional response proved less effective (d(+) = 0.23) than reappraising the emotional stimulus (d(+) = 0.36) or using perspective taking (d(+) = 0.45). The review also identified several moderators of strategy effectiveness including factors related to the (a) to-be-regulated emotion, (b) frequency of use and intended purpose of the ER strategy, (c) study design, and (d) study characteristics.     

Behavioral training and predisposed coping strategies interact to influence resilience in male Long-Evans rats: implications for depression

Effective coping strategies and adaptive behavioral training build resilience against stress-induced pathology. Both predisposed and acquired coping strategies were investigated in rats to determine their impact on stress responsiveness and emotional resilience. Male Long-Evans rats were assigned to one of the three coping groups: passive, active, or variable copers. Rats were then randomly assigned to either an effort-based reward (EBR) contingent training group or a non-contingent training group. Following EBR training, rats were tested in appetitive and stressful challenge tasks. Physiological responses included changes in fecal corticosterone and dehydroepiandrosterone (DHEA) metabolites as well as neuropeptide Y (NPY)-immunoreactivity in the hippocampus and amygdala. Regardless of a rat's predisposed coping strategy, EBR rats persisted longer than non-contingent rats in the appetitive problem-solving task. Furthermore, training and coping styles interacted to yield the seemingly most adaptive DHEA/corticosterone ratios in the EBR-trained variable copers. Regardless of training group, variable copers exhibited increased NPY-immunoreactivity in the CA1 region.     

‘It's not supposed to be this way’: Psychological aspects of a premature menopause

Background: Premature menopause (menopause diagnosed at 40 years or under) is a challenging condition with no prevention or cure. Causes can be the result of surgical intervention or spontaneous and largely unknown. It affects 1–6% of women aged 14–40. Aim: This study investigated women's experience of diagnosis, perception of cause, treatment received, main concerns, perceived long‐term consequences and impact on psychological wellbeing. Method: A cross‐sectional single group design questionnaire study that included both quantitative and qualitative measures was used. It was distributed to women on the database of two specialist London clinics and an internet‐based patient support group. A thematic analysis was undertaken. Findings: The response rate was 62%. Women's experiences varied but showed common themes regardless of timing of diagnosis and services accessed. Improved understanding by health professionals could help this group accept and adjust to the condition more effectively as could psychological support. Fertility was a primary concern regardless of parity and there were several secondary impacts both physiological and psychological. Discussion: A clear need for the offer of emotional support was indicated for all, but particularly for teenage girls and single women who tended not to access support from their own social network. Conclusion: Young women with this diagnosis could benefit from the offer of counselling, though uptake may be influenced by individual factors and vary according to age and circumstances. A good understanding of the physical aspects of this condition is important in the counselling of this group.     

Social deviance activates the brain’s error-monitoring system

Social psychologists have long noted the tendency for human behavior to conform to social group norms. This study examined whether feedback indicating that participants had deviated from group norms would elicit a neural signal previously shown to be elicited by errors and monetary losses. While electroencephalograms were recorded, participants (N = 30) rated the attractiveness of 120 faces and received feedback giving the purported average rating made by a group of peers. The feedback was manipulated so that group ratings either were the same as a participant’s rating or deviated by 1, 2, or 3 points. Feedback indicating deviance from the group norm elicited a feedback-related negativity, a brainwave signal known to be elicited by objective performance errors and losses. The results imply that the brain treats deviance from social norms as an error.     

The implicit self and the specificity-matching principle: Implicit self-concept predicts domain-specific outcomes

According to the specificity-matching principle (Swann, Chang-Schneider, & McClarty, 2007), specific aspects of self-concept should predict domain specific outcomes, rather than broader outcomes. The purpose of the current study was to determine whether this principle, which has thus far been examined using explicit measures of the self, extends to the implicit self-concept. We tested this idea in the domain of math achievement. We observed that explicit math self-concept was correlated with specific outcomes (measures of math achievement), whereas explicit self-esteem was correlated with a broad outcome (satisfaction with life). Thus, we replicated the specificity-matching principle using explicit measures of self-esteem and self-concept. Moreover, we found that implicit self-concept was correlated with domain-specific outcomes, but not a global outcome, as the specificity-matching principle would predict. Furthermore, regression analyses indicated that implicit self-concept accounted for unique variance in the domain-specific outcomes, for which the other measures of the self could not account. Taken together, we conclude that the specificity-matching principle does indeed extend to the implicit self-concept.     

Psychometric properties of an experimental test for the assessment of basic arithmetic calculation efficiency / Propiedades psicométricas de una prueba experimental para la evaluación de la eficacia del cálculo aritmético básico

Abstract

In this article the ‘Arithmetic Calculation Efficiency Test’ (Test de Eficacia en el cálculo aritmético – TECA), a test for the assessment of arithmetic efficiency in terms of precision and speed in school-aged subjects, is introduced. The test aims to contribute to educational practices and the diagnosis of students who are at risk of Learning Difficulties in Calculations (LDC). Psychometric properties of the test items were analysed based on a sample of 331 subjects from grade 1 to 6 from Primary School. Analysis of content validity, item analysis, dimensionality and reliability have provided evidence of the validity of a one-dimensional structure consistent with the theoretical framework.     

Older,wiser, and happier? Comparing older adults’ and college students’ self-defining memories

The present study compared self-defining memories in adults 50 years of age and older to the self-defining memories of college students. Findings are largely congruent with previous memory and ageing research, but shed additional light on how personal memories are employed to achieve a sense of identity and continuity in older adults. Older adults’ self-defining memories, compared to those of younger adults, were more positive in emotional tone, more summarised and less detailed, and more likely to contain integrative meaning. The implications of these findings for assessing normative personal memory in older adults are discussed along with more general observations about narrative identity in older adulthood.     

Defining health and unhealthiness: Perceptions held by Native American Indians with persistent mental illness1

Discrepancies in definitions of health exist. These discrepancies, if not acknowledged, create major communication gaps between health-care professionals and their clients, which interferes with the provision of culturally responsive care. The purpose of this study was to understand how Native American Indians experiencing persistent mental illness (PMI) define/describe being healthy and being unhealthy. Grounded theory design was used in conducting data gathering (semistructured interviews) and analysis (constant comparative) because the study focuses on generating social/psychological phenomena or process. Forty-four audiotaped interviews were conducted and transcribed. Symbolic interactionism is this study's framework. During data analysis, health emerged as being in balance/equilibrium, having a sense of harmony, and not being out of control of spiritual, cognitive, emotional, and physical domains. Furthermore, as this study reflects, the modified Circle of Wellness model emerges as a better fit for Native American Indians with PMI than the traditional Medicine Wheel because it more effectively presents the social nature/needs and the centrality of spiritualism of this population. Clearly, deficits in healthy social environments and relationships affect the ability of a Native American Indian with PMI to maintain health. To provide culturally competent care, professionals and native healers need to work the integration of spirituality into treatment processes, and advocate the creation and maintenance of healthy environments for improved social opportunities.