The Bergen 4-day treatment for OCD: four years follow-up of concentrated ERP in a clinical mental health setting

There are few long-term follow-up studies on psychological treatment of anxiety disorders carried out in clinical mental health settings, so called effectiveness studies. The present paper presents a four year follow-up of patients with obsessive-compulsive disorder treated by the Bergen 4-day treatment (B4DT), a concentrated form of exposure and response prevention (ERP). A total of 77 obsessive–compulsive disorder (OCD) patients received treatment during four consecutive days and were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) pre, post, and at follow-ups after 3 and 6 months, and 4 years post-treatment. The Y-BOCS mean score changed from 25.9 at pre- to 10.0 post-treatment and 9.9 at long-term follow-up. The proportion fulfilling the strict international consensus criteria for remission was 73% at post-treatment and 69% at follow-up. When taking declining rate, attrition rate, remission, relapse, and further improvement during the follow-up period into account, 72% were recovered on a long-term basis. A comparison with previously published effectiveness studies of ERP indicated that the 4-day treatment yielded significantly higher proportions of remission at post-treatment and recovery at follow-up, as well as within-group effect size on the Y-BOCS. The implications of these results are discussed.     

A review of cognitive biases in youth depression: attention,interpretation and memory

Depression is one of the most common mental health problems in childhood and adolescence. Although data consistently show it is associated with self-reported negative cognitive styles, less is known about the mechanisms underlying this relationship. Cognitive biases in attention, interpretation and memory represent plausible mechanisms and are known to characterise adult depression. We provide the first structured review of studies investigating the nature and causal role of cognitive biases in youth depression. Key questions are (i) do cognitive biases characterise youth depression? (ii) are cognitive biases a vulnerability factor for youth depression? and (iii) do cognitive biases play a causal role in youth depression? We find consistent evidence for positive associations between attention and interpretation biases and youth depression. Stronger biases in youth with an elevated risk of depression support cognitive-vulnerability models. Preliminary evidence from cognitive bias modification paradigms supports a causal role of attention and interpretation biases in youth depression but these paradigms require testing in clinical samples before they can be considered treatment tools. Studies of memory biases in youth samples have produced mixed findings and none have investigated the causal role of memory bias. We identify numerous areas for future research in this emerging field.     

Promoting Positive Attitudes Toward People With Down Syndrome: The Benefit of School Inclusion Programs1

The effects of school inclusion programs on male and female nondisabled students' stereotypes and attitudes toward people with Down syndrome were studied. Nondisabled students (11–15 years of age) from schools with and without inclusion programs reported positive and negative attitudes toward people with Down syndrome. As hypothesized, girls and students attending schools with inclusion programs showed more favorable attitudes toward people with Down syndrome than did boys and students attending schools without inclusion programs, respectively. Interaction effects of school system and sex of participant suggest that boys' attitudes, in particular, benefit from inclusive schooling. The study provides evidence for the effectiveness of inclusion programs in ameliorating prejudice and intergroup anxiety; and in promoting positive attitudes, affect, and trust.     

Risky choice with heuristics: reply to Birnbaum (2008), Johnson, Schulte-Mecklenbeck, and Willemsen (2008), and Rieger and Wang (2008)

E. Brandst?tter, G. Gigerenzer, and R. Hertwig (2006) showed that the priority heuristic matches or outperforms modifications of expected utility theory in predicting choice in 4 diverse problem sets. M. H. Birnbaum (2008) argued that sets exist in which the opposite is true. The authors agree--but stress that all choice strategies have regions of good and bad performance. The accuracy of various strategies systematically depends on choice difficulty, which the authors consider a triggering variable underlying strategy selection. Agreeing with E. J. Johnson, M. Schulte-Mecklenbeck, and M. C. Willemsen (2008) that process (not "as-if") models need to be formulated, the authors show how quantitative predictions can be derived and test them. Finally, they demonstrate that many of Birnbaum's and M. O. Rieger and M. Wang's (2008) case studies championing their preferred models involved biased tests in which the priority heuristic predicted data, whereas the parameterized models were fitted to the same data. The authors propose an adaptive toolbox approach of risky choice, according to which people first seek a no-conflict solution before resorting to conflict-resolving strategies such as the priority heuristic.     

Position effects in encoding briefly exposed item matrices: evidence for a reading bias or merely a matter of the selection criterion?

Position effects are frequently reported in experiments that investigate the recognition of items from briefly exposed stimulus matrices. A reliable finding is the ability to report items from the first row of the matrix more accurately than from the second row. The present experiments explore whether this position effect depends upon the selection criterion used to indicate the subgroup of items that has to be reported in a given trial. In Experiment 1, German and Chinese participants were presented with language-specific items which had to be selected by column. In Experiment 2, Germans were presented with Latin letters and the selection criterion was letter color. A strong row effect was evident in both experiments although the selection criteria did not prompt a line-by-line grouping of the items. The row effect is seen as a manifestation of top-down processing that is derived from reading habits.     

Unerwünschte und schädliche Wirkungen von Psychotherapie

Unwanted effects or even damage due to psychotherapy are largely neglected issues within psychotherapy research as compared to other fields. On the other hand, it is reasonable to assume that unwanted effects of a treatment which intends to influence patients into a positive direction are very likely. The rate of negative effects of psychotherapy (the deterioration effect according to Bergin) is consistently estimated to be 10% of all cases and shows this same rate in a variety of studies. This review highlights side effects of psychotherapy both on the part of the patients and of the therapists. It reports unwanted effects related to different psychotherapeutic methods, i.e. psychoanalysis, cognitive behaviour therapy, client-centered psychotherapy and – beyond these basic orientations – group psychotherapy. The paper also reports on negative effects of psychotherapy on an untreated partner. Finally, some proposals are given on how negative effects of psychotherapy could be diminished. The authors especially highlight the possibilities of changing the therapist, the treatment technique, or the theoretical treatment approach as a way to reduce negative effects.     

Heuristic processing of distinctiveness information in minority and majority influence

The role of distinctiveness information in majority and minority influence was studied. Students read a message containing strong or weak arguments advocated by a minority or majority source. The communicator's minority (majority) status was said to be either distinctive to the target topic or nondistinctive across topics. Major dependent variables were attitude judgments and cognitive responses. Across conditions, messages were processed systematically, and a majority communicator tended to be more persuasive than a minority communicator. Most importantly, high distinctiveness led to greater influence than low distinctiveness, and this effect was independent of argument strength and minority versus majority status. Theoretical and applied implications of these findings are discussed. © 1998 John Wiley & Sons, Ltd.     

Motivational determinants of systematic processing: expectancy moderates effects of desired confidence on processing effort

Extending the motivational assumptions of the heuristic-systematic model (Chaiken, Liberman, & Eagly, 1989), the authors hypothesized that a discrepancy between desired and actual judgmental confidence raises processing effort only if the expectancy that processing will increase confidence is high. In Experiment 1, university students expected to review information for upcoming social judgments. Desired confidence was varied through low versus high task importance. To manipulate expectancy, low versus high perceived processing efficacy was induced via feedback. As predicted, high- (as compared to low-) importance participants expressed greater interest in receiving information and selected more information when perceived efficacy was high, and this effect was mediated via a heightened discrepancy between desired and actual confidence. These effects were not obtained under low perceived efficacy. In Experiment 2, students processed a persuasive message. Only high importance conditions were studied; processing efficacy and argument strength were manipulated. As predicted, high- (but not low-) efficacy participants processed the message systematically, as indicated by a different impact of argument strength and by mediational path analyses. It is argued that the precision of social judgment models would benefit from an explicit consideration of processing- and outcome-related expectancy variables. © 1998 John Wiley & Sons, Ltd.     

The interplay of modern myths about sexual aggression and moral foundations in the blaming of rape victims

Moral Foundations Theory proposes five intuition-based moral concerns: Care and Fairness (“individualizing foundations”) as well as Loyalty, Authority, and Sanctity (“binding foundations”). In studies carried out in Italy, Spain, and Germany, the authors examined how these concerns are associated with the acceptance of modern myths about sexual aggression (AMMSA), and how both jointly predict rape victim blaming. Overall, victim blaming was positively predicted by Authority and Sanctity, and negatively predicted by Care and Fairness. Although victim blaming was best predicted by AMMSA, moral concerns also contributed to its prediction, partly independently, partly mediated through AMMSA, and in the case of Sanctity in interaction with AMMSA. Discussion highlights how integrating moral foundations in the investigation of victim blaming and AMMSA across different cultural contexts may deepen our understanding of why, in each cultural context, victim blaming and related beliefs are resistant to change.