Does Motivation Impact OCD Symptom Severity? An Exploration of Longitudinal Effects

Understanding the role of patient motivation in OCD treatment is of clinical importance given the requisite autonomous role of patients in Exposure and Response Prevention. The present study investigated state- and trait-like relations between three variables: two previously established motivational constructs, readiness to change (RTC) and committed action (CA), derived from the University of Rhode Island Change Assessment, and OCD symptom severity as measured by the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR). Utilizing a random-intercept cross-lagged panel model (RI-CLPM) design, we assessed autoregressive, within-time correlations, and cross-lagged effects of RTC, CA, and Y-BOCS-SR scores at admission, month 1 of treatment, and discharge from an intensive/residential treatment program for OCD. Results revealed significant autoregressive (i.e., state-like) effects for CA and Y-BOCS-SR, negative within-time correlations between state CA and Y-BOCS-SR across all time points, a positive within-time correlation between state CA and RTC at admission, and a cross-lagged effect between state Y-BOCS-SR at month 1 of treatment and state RTC at discharge. Results also demonstrated that the stability of the RTC variable was attributable to trait-like factors in the present sample. This study is novel in its use of RI-CLPM in an OCD sample and represents an important addition to the literature on the longitudinal impacts of dynamic constructs of motivation. Our findings may provide future researchers with strategies to supplement ERP with CA-driven motivational interviewing.     

The role of grammatical class on word recognition

The double dissociation between noun and verb processing, well documented in the neuropsychological literature, has not been supported in imaging studies. Recent imaging studies, in fact, suggest that once confounding with semantics is eliminated, grammatical class effects only emerge as a consequence of building frames. Here we assess this hypothesis behaviorally in two visual word recognition experiments. In Experiment 1, participants made lexical decisions on verb targets. We manipulated the grammatical class of the prime words (either nouns or verbs and always introduced in a minimal phrasal context, i.e., “the + N” or “to + V”), and their semantic similarity to a target (related vs. unrelated). We found reliable effects of grammatical class, and no interaction with semantic similarity. Experiment 2 further explored this grammatical class effect, using verb targets preceded by semantically unrelated verb vs. noun primes. In one condition, prime words were presented as bare words; in the other, they were presented in the minimal phrasal context used in Experiment 1. Grammatical class effects only arose in the latter but not in the former condition thus providing evidence that word recognition does not recruit grammatical class information unless it is provided to the system.     

Is the exogenous orienting of spatial attention truly automatic? Evidence from unimodal and multisensory studies

The last decade has seen great progress in the study of the nature of crossmodal links in exogenous and endogenous spatial attention (see [Spence, C., McDonald, J., & Driver, J. (2004). Exogenous spatial cuing studies of human crossmodal attention and multisensory integration. In C. Spence, & J. Driver (Eds.), Crossmodal space and crossmodal attention (pp. 277-320). Oxford, UK: Oxford University Press.], for a recent review). A growing body of research now highlights the existence of robust crossmodal links between auditory, visual, and tactile spatial attention. However, until recently, studies of exogenous and endogenous attention have proceeded relatively independently. In daily life, however, these two forms of attentional orienting continuously compete for the control of our attentional resources, and ultimately, our awareness. It is therefore critical to try and understand how exogenous and endogenous attention interact in both the unimodal context of the laboratory and the multisensory contexts that are more representative of everyday life. To date, progress in understanding the interaction between these two forms of orienting has primarily come from unimodal studies of visual attention. We therefore start by summarizing what has been learned from this large body of empirical research, before going on to review more recent studies that have started to investigate the interaction between endogenous and exogenous orienting in a multisensory setting. We also discuss the evidence suggesting that exogenous spatial orienting is not truly automatic, at least when assessed in a crossmodal context. Several possible models describing the interaction between endogenous and exogenous orienting are outlined and then evaluated in terms of the extant data.     

Different Associations of Health Related Quality of Life with Pain,Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder

The primary aim of this study was to measure psychological distress, pain severity, health related quality of life (QOL) and pain coping strategies in patients with irritable bowel syndrome (IBS) and ulcerative colitis (UC). A second aim was to determine the influence of somatic and psychological variables on health related QOL. Eighty-eight IBS and 66 UC patients completed the Irritable Bowel Syndrome Quality of Life Questionnaire (IBSQOL), Pain Severity Scale of West Haven Yale Multidimensional Pain Inventory (WHYMPY), Symptom Checklist-90-R (SCL-90-R) and Coping Strategies Questionnaire (CSQ). T-tests and GLM Analysis of Covariance were used for statistical analysis. IBS patients had significantly higher levels of psychological distress, pain severity and maladaptive pain coping strategies (catastrophization), and lower QOL than UC patients. Variance of QOL in IBS was explained for the most part by catastrophization (15%), then by psychological distress (8%), and for the less part by pain severity (5%). In UC, pain severity explained 21%, psychological distress 8%, and catastrophization 3% of the variance of QOL. These results suggest there are differences between IBS and UC patients in the role of physical and psychological factors in QOL and emphasize the importance of cognitive processes in IBS.     

Capturing spatial attention with multisensory cues

We assessed the influence of multisensory interactions on the exogenous orienting of spatial attention by comparing the ability of auditory, tactile, and audiotactile exogenous cues to capture visuospatial attention under conditions of no perceptual load versus high perceptual load. In Experiment 1, participants discriminated the elevation of visual targets preceded by either unimodal or bimodal cues under conditions of either a high perceptual load (involving the monitoring of a rapidly presented central stream of visual letters for occasionally presented target digits) or no perceptual load (when the central stream was replaced by a fixation point). All of the cues captured spatial attention in the no-load condition, whereas only the bimodal cues captured visuospatial attention in the highload condition. In Experiment 2, we ruled out the possibility that the presentation of any changing stimulus at fixation (i.e., a passively monitored stream of letters) would eliminate exogenous orienting, which instead appears to be a consequence of high perceptual load conditions (Experiment 1). These results demonstrate that multisensory cues capture spatial attention more effectively than unimodal cues under conditions of concurrent perceptual load.     

Memory in dreams1

In this paper the author discusses a specific type of dreams encountered in her clinical experience, which in her view provide an opportunity of reconstructing the traumatic emotional events of the patient’s past. In 1900, Freud described a category of dreams – which he called ‘biographical dreams’– that reflect historical infantile experience without the typical defensive function. Many authors agree that some traumatic dreams perform a function of recovery and working through. Bion contributed to the amplification of dream theory by linking it to the theory of thought and emphasizing the element of communication in dreams as well as their defensive aspect. The central hypothesis of this paper is that the predominant aspect of such dreams is the communication of an experience which the dreamer has in the dream but does not understand. It is often possible to reconstruct, and to help the patient to comprehend and make sense of, the emotional truth of the patient’s internal world, which stems from past emotional experience with primary objects. The author includes some clinical examples and references to various psychoanalytic and neuroscientific conceptions of trauma and memory. She discusses a particular clinical approach to such dreams and how the analyst should listen to them.     

Emotion words, regardless of polarity, have a processing advantage over neutral words

Despite increasing interest in the interface between emotion and cognition, the role of emotion in cognitive tasks is unclear. According to one hypothesis, negative valence is more relevant for survival and is associated with a general slowdown of the processing of stimuli, due to a defense mechanism that freezes activity in the face of threat. According to a different hypothesis which does not posit a privileged role for the aversive system, valence, regardless of polarity, facilitates processing due to the relevance of both negative and positive stimuli for survival and for the attainment of goals. Here, we present evidence that emotional valence has an overall facilitatory role in the processing of verbal stimuli, providing support for the latter hypothesis. We found no asymmetry between negative and positive words and suggest that previous findings of such an asymmetry can be attributed to failure to control for a number of critical lexical variables and to a sampling bias.     

Health-Related Quality of Life Among Substance Abusers in Residential Drug Abuse Treatment

Health-related quality of life (HRQOL) in substance abusers remains an area of inquiry in need of investigation. The few studies on the topic have found substance abuser HRQOL less than that of the general population. The present research compared 303 substance abusers in long-term residential therapeutic community treatment in New York with a general non-institutionalized adult sample from New York (N = 27,465) whose data were collected between 2002 and 2006 during the yearly administrations of the Behavioral Risk Factor Surveillance System (BRFSS), a state-based system of health surveys gathering data from upwards of 350,000 adults per year across all 50 states. One sample t-tests found that the in-treatment substance abusers reported significantly more physically and mentally unhealthy days over the past 30 days, as well as significantly more inactive days over the past 30 days due to illness.     

Multisensory cues capture spatial attention regardless of perceptual load

We compared the ability of auditory, visual, and audiovisual (bimodal) exogenous cues to capture visuo-spatial attention under conditions of no load versus high perceptual load. Participants had to discriminate the elevation (up vs. down) of visual targets preceded by either unimodal or bimodal cues under conditions of high perceptual load (in which they had to monitor a rapidly presented central stream of visual letters for occasionally presented target digits) or no perceptual load (in which the central stream was replaced by a fixation point). The results of 3 experiments showed that all 3 cues captured visuo-spatial attention in the no-load condition. By contrast, only the bimodal cues captured visuo-spatial attention in the high-load condition, indicating for the first time that multisensory integration can play a key role in disengaging spatial attention from a concurrent perceptually demanding stimulus.