Acceptability,Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York

Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States.     

Equivalence class formation as a function of preliminary training with pictorial stimuli

The present experiment investigated the effects of preliminary training with pictorial stimuli on the subsequent formation of three 5‐member equivalence classes (A?B?C?D?E) in 84 university students assigned to seven groups of 12. In the Abstract (ABS) group, all stimuli were abstract shapes. In the Picture (PIC) group, the C stimuli were pictures, and the remaining stimuli were the same abstract shapes as in the ABS group. For the remaining five groups, all stimuli were the same abstract shapes as in the ABS group. However, across groups, preliminary training involved either the establishment of conditional relations with simultaneous (SMTS) or delayed (DMTS) matching‐to‐sample with 0 s, 3 s, 6 s, or 9 s between the abstract C stimuli and the meaningful pictures. For the ABS and the PIC groups, 16.7% and 83.3% of participants formed classes, respectively. Preliminary training with SMTS and DMTS with 0 s, 3 s, and 6 s produced a linear increase in the likelihood of equivalence class formation, 41.7%, 50%, and 75%, respectively. Increasing the duration of delay further from 6 s to 9 s produced a substantial decline, 50%. This experiment extends knowledge about how including meaningful pictures enhances equivalence class formation.     

Analytic change: Assessing ways of being in a psychoanalytic follow‐up interview

The article argues that the concepts of relational scenario, structuralized affect and actualized affect are proposed candidates for observation of changes in relational ways of being as it is expressed in transference. A psychoanalytic follow‐up interview of a former analytic patient is presented in order to illustrate how change in relational ways of being may be registered and studied. By triangulating the patient's verbal report of change with nonverbal information and transference–countertransference dynamics, one may grasp qualitative changes in relational ways of being. The case presented illustrates a former patient's on‐going process of working towards representing aggression in a more direct manner and how this process is made observable with the aid of the proposed concepts in the interview situation. The proposed concepts of relational scenario, structuralized and actualized affect discussed are compared to the concept of transference used in studies of core conflictual relationship theme (CCRT).     

Frequency judgements: the problem of defining a perceptual event

In four experiments the conditions under which frequency judgments reflect the relative frequency of complex perceptual events were explored. Subjects viewed a series of 4 x 4 grids each containing seven items, which were letters and numbers in one of four typefaces. Later judgments of the relative frequency with which particular letters appeared in particular typefaces were unaffected by a warning about an upcoming frequency judgment task, but were affected by both the time available for processing the stimuli and the nature of the cover task subjects engaged in while viewing the grids. Frequency judgments were poor when exposure durations were less than 2 s and when the cover task directed subjects' attention merely to the locations of the items within the grids. Frequency judgments improved when the cover task directed subjects' attention to the identity of the stimuli, especially to the conjunction of letter and typeface. The results suggest that frequency estimation of complex stimuli may be possible only for stimuli that have been processed as phenomenal objects.