An open trial of cognitive-behavioral therapy for compulsive hoarding

The aim of the present study was to provide preliminary data on the efficacy of a new cognitive-behavioral treatment (CBT) for compulsive hoarding. Fourteen adults with compulsive hoarding (10 treatment completers) were seen in two specialty CBT clinics. Participants were included if they met research criteria for compulsive hoarding according to a semistructured interview, were age 18 or above, considered hoarding their main psychiatric problem, and were not receiving mental health treatment. Patients received 26 individual sessions of CBT, including frequent home visits, over a 7-12 month period between December 2003-February 2005. Primary outcome measures were the Saving Inventory-Revised (SI-R), Clutter Image Rating (CIR), and Clinician's Global Impression (CGI). Significant decreases from pre- to post-treatment were noted on the SI-R and CIR, but not the CGI-severity rating. CGI-Improvement ratings indicated that at mid-treatment, 40% (n=4) of treatment completers were rated "much improved" or "very much improved;" at post-treatment, 50% (n=5) received this rating. Adherence to homework assignments was strongly related to symptom improvement. CBT with specialized components to address problems with motivation, organizing, acquiring and removing clutter appears to be a promising intervention for compulsive hoarding, a condition traditionally thought to be resistant to treatment.     

Lexical Mediation Between Sight and Sound in Speechreading

In two experiments, we investigated whether simultaneous speech reading can influence the detection of speech in envelope-matched noise. Subjects attempted to detect the presence of a disyllabic utterance in noise while watching a speaker articulate a matching or a non-matching utterance. Speech detection was not facilitated by an audio-visual match, which suggests that listeners relied on low-level auditory cues whose perception was immune to cross-modal top-down influences. However, when the stimuli were words (Experiment 1), there was a (predicted) relative shift in bias, suggesting that the masking noise itself was perceived as more speechlike when its envelope corresponded to the visual information. This bias shift was absent, however, with non-word materials (Experiment 2). These results, which resemble earlier findings obtained with orthographic visual input, indicate that the mapping from sight to sound is lexically mediated even when, as in the case of the articulatory-phonetic correspondence, the cross-modal relationship is non-arbitrary.     

Matching the graphical display of data to avoidance versus approach motivation increases outcome expectancies

This study is the first demonstration of the effect of motivational focus (approach vs. avoidance) on the interpretation of graphical view of personal data, specifically, weight loss progress. In two experiments, participants were randomly assigned to see the bogus weight loss data charted against either a goal or a baseline reference line. In the first experiment, we accessed participants' chronic motivational focus. In the second study, we primed motivation by exposing the participants to either a gain- or loss-focused health message. The results demonstrate that participants with either chronic or manipulated approach motivation predicted higher future weight loss in the goal reference line condition than in the baseline reference line condition. The opposite pattern was observed for participants with either chronic or manipulated avoidance motivation. The potential of matching graphical data display to personality characteristics to promote effective health management is discussed.     

Association between the Five Factor personality traits and perceived stress: is the effect mediated by general self-efficacy?

Abstract

Ill-health resulting from chronic stress is influenced by personality traits leading to different ways of appraising and coping with life's daily hassles. Using a large population sample the study aimed to investigate possible associations between perceived stress and the personality dimensions of neuroticism, extroversion, openness, agreeableness, and conscientiousness, and to explore the role of general self-efficacy (GSE). A population-based cross-sectional study was conducted at the Research Centre for Prevention and Health, Denmark, in 2006–2008. Men and women (N=3471) aged 18–69, were randomly sampled in the suburbs of Copenhagen. We used the NEO Five-Factor Inventory (NEO-FFI), Cohen's Perceived Stress Scale and the General Self-Efficacy Scale. Negative associations were found between perceived stress and extroversion, conscientiousness, agreeableness, and openness – the latter initially non-significant – whilst neuroticism had a positive association. The associations with agreeableness and openness became positive and significant, respectively, when GSE was included. All five personality-stress models were mediated by GSE, with extroversion and conscientiousness having the strongest mediating effect. The strongest stress-association was found for neuroticism. GSE was shown to change the impact and interpretation of the personality dimensions on perceived stress. These results indicate that GSE is an important factor to consider in the link between personality and perceived stress.     

Processing phonological and semantic ambiguity: evidence from semantic priming at different SOAs.

Disambiguation of heterophonic and homophonic homographs was investigated in Hebrew using semantic priming. Ambiguous primes were followed by unambiguous targets at 100 ms, 250 ms, and 750 ms stimulus onset asynchrony (SOA). Lexical decision for targets related to the dominant phonological alternatives of heterophonic homographs were facilitated at all SOAs. Targets related to subordinate alternatives were facilitated only at SOAs of 250 ms or longer. When the primes were homophonic homographs, semantic relationship facilitated lexical decision of targets at all SOAs regardless of the dominance of the meaning to which the targets were related. These data can be accounted for by assuming multiple lexical entries for heterophonic homographs, single lexical entries for homophonic homographs, and phonological mediation of accessing meanings. Language-specific factors probably account for the long-lasting activation of subordinate meanings.     

Should assisted dying be legalised?

When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework.     

Association between the Five Factor personality traits and perceived stress: is the effect mediated by general self-efficacy?

Ill-health resulting from chronic stress is influenced by personality traits leading to different ways of appraising and coping with life's daily hassles. Using a large population sample the study aimed to investigate possible associations between perceived stress and the personality dimensions of neuroticism, extroversion, openness, agreeableness, and conscientiousness, and to explore the role of general self-efficacy (GSE). A population-based cross-sectional study was conducted at the Research Centre for Prevention and Health, Denmark, in 2006-2008. Men and women (N=3471) aged 18-69, were randomly sampled in the suburbs of Copenhagen. We used the NEO Five-Factor Inventory (NEO-FFI), Cohen's Perceived Stress Scale and the General Self-Efficacy Scale. Negative associations were found between perceived stress and extroversion, conscientiousness, agreeableness, and openness - the latter initially non-significant - whilst neuroticism had a positive association. The associations with agreeableness and openness became positive and significant, respectively, when GSE was included. All five personality-stress models were mediated by GSE, with extroversion and conscientiousness having the strongest mediating effect. The strongest stress-association was found for neuroticism. GSE was shown to change the impact and interpretation of the personality dimensions on perceived stress. These results indicate that GSE is an important factor to consider in the link between personality and perceived stress.     

Words with and without internal structure: what determines the nature of orthographic and morphological processing?

Recent studies suggest that basic effects which are markers of visual word recognition in Indo-European languages cannot be obtained in Hebrew or in Arabic. Although Hebrew has an alphabetic writing system, just like English, French, or Spanish, a series of studies consistently suggested that simple form-orthographic priming, or letter-transposition priming are not found in Hebrew. In four experiments, we tested the hypothesis that this is due to the fact that Semitic words have an underlying structure that constrains the possible alignment of phonemes and their respective letters. The experiments contrasted typical Semitic words which are root-derived, with Hebrew words of non-Semitic origin, which are morphologically simple and resemble base-words in European languages. Using RSVP, TL priming, and form-priming manipulations, we show that Hebrew readers process Hebrew words which are morphologically simple similar to the way they process English words. These words indeed reveal the typical form-priming and TL priming effects reported in European languages. In contrast, words with internal structure are processed differently, and require a different code for lexical access. We discuss the implications of these findings for current models of visual word recognition.     

The Roman state and genetic pacification

Over the last 10,000 years, the human genome has changed at an accelerating rate. The change seems to reflect adaptations to new social environments, including the rise of the State and its monopoly on violence. State societies punish young men who act violently on their own initiative. In contrast, non-State societies usually reward such behavior with success, including reproductive success. Thus, given the moderate to high heritability of male aggressiveness, the State tends to remove violent predispositions from the gene pool while favoring tendencies toward peacefulness and submission. This perspective is applied here to the Roman state, specifically its long-term effort to pacify the general population. By imperial times, this effort had succeeded so well that the Romans saw themselves as being inherently less violent than the "barbarians" beyond their borders. By creating a pacified and submissive population, the empire also became conducive to the spread of Christianity-a religion of peace and submission. In sum, the Roman state imposed a behavioral change that would over time alter the mix of genotypes, thus facilitating a subsequent ideological change.     

When hoarding is a symptom of OCD: A case series and implications for DSM-V

Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.