Mechanisms of change in cognitive behaviour therapy for panic disorder: The role of panic self-efficacy and catastrophic misinterpretations

The efficacy of cognitive behavioural therapy (CBT) for panic disorder with or without agoraphobia (PD) is well-established; however, little is known about the underlying change processes of clinical improvement during therapy. According to cognitive theories, CBT for PD primarily works by changing catastrophic misinterpretations of bodily symptoms and panic attacks. However, panic self-efficacy, i.e. the perceived ability to cope with panic attacks, has also been suggested as an important change mechanism in CBT for PD. The aim of the study was to investigate if change in catastrophic misinterpretations and panic self-efficacy mediated change in the level of anxiety during the course of thirteen sessions of group CBT for PD. Forty-five participants completed weekly self-report measures of the possible cognitive mediators and the level of anxiety throughout therapy. The results indicated that within-person change in panic self-efficacy in one session, but not in catastrophic misinterpretations, predicted within-person level of anxiety symptoms the following week. However, in a reversed analysis, prior change in level of anxiety symptoms also predicted change in panic self-efficacy the following session. These results support panic self-efficacy as a mediator of change in CBT for PD, although a reciprocal causal relationship between panic self-efficacy and level of anxiety seems to be implied.     

Epistemic dependence in interdisciplinary groups

In interdisciplinary research scientists have to share and integrate knowledge between people and across disciplinary boundaries. An important issue for philosophy of science is to understand how scientists who work in these kinds of environments exchange knowledge and develop new concepts and theories across diverging fields. There is a substantial literature within social epistemology that discusses the social aspects of scientific knowledge, but so far few attempts have been made to apply these resources to the analysis of interdisciplinary science. Further, much of the existing work either ignores the issue of differences in background knowledge, or it focuses explicitly on conflicting background knowledge. In this paper we provide an analysis of the interplay between epistemic dependence between individual experts with different areas of expertise. We analyze the cooperative activity they engage in when participating in interdisciplinary research in a group, and we compare our findings with those of other studies in interdisciplinary research.     

Assessments in Psychotherapy with Suicidal Patients: The Precedence of Alliance Work

Journal of Contemporary Psychotherapy - In this article the aim was to explore how therapists handle suicide risk assessment in connection with patient’s experience of alliance in...     

Wittgenstein on the grounds of religious faith: A Kantian proposal

This paper argues that there is an important continuity between Wittgenstein's early remarks on religion and his later treatment of the theme as it appears in his lectures in the 1930s and in his personal diary notes at that time. This continuity pertains to 3 features. First, the early and later Wittgenstein share a critical stance on methodological naturalism, that is, the view that the method of philosophy is relevantly similar to that of the natural sciences. Importantly, religion figures as one of Wittgenstein's examples of the limits of the factual language of natural sciences. Second, both the early and the later Wittgenstein connect religion to the problem of seeing one's life as meaningful while denying the possibility of establishing any objectively understood meaning of life. Third, both evoke the idea of different types of judgments, the conditions of which are independent of each other. Although religious faith is not grounded in factual knowledge and cannot be justified by appeal to empirical evidence or conceptual argumentation, it is not groundless either. Rather, in accordance with Kant who claims that faith may have a nontheoretical justification, Wittgenstein shows that religious faith may result from a personal experience of one's life as a meaningful whole.     

Communication Between Spouses as a Resilience Factor in Families in Which a Parent Has Depression: A Condensed Report

This study focused on communication as a family resilience factor in families in which an adult suffers from a depressive disorder. Six partners of depressive adults were interviewed. Results revealed two groups of couples. The “talkative couples” have many conversations during the depression and a facilitating factor was having insight into the depression. The other group, the “taciturn couples,” indicated large difficulties in having conversations, resulting in silence being the dominant contact between the partners. The majority of the participants stated that the absence of conversation would have meant the end of their relationship.     

The Relationship Between Sluggish Cognitive Tempo,Subtypes of Attention-Deficit/Hyperactivity Disorder,and Anxiety Disorders

The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7–13 years were assigned to four groups, i.e., referred children with comorbid AnxDs and ADHD (n = 25), ADHD (n = 39), AnxDs (n = 41), and nonreferred controls (n = 36). Furthermore we explored the association between SCT and several neurocognitive measures (reaction time, verbal memory, and spatial memory). Diagnoses were established using Kiddie-SADS P/L. SCT was assessed using a 17-item mother-reported questionnaire. SCT correlated significantly with inattentiveness, regardless of the subtype of ADHD. Furthermore, we found significant differences in the levels of SCT among the four groups, with the highest SCT scores observed in the comorbid group. SCT correlated with variability in spatial memory; in contrast, there was no correlation between SCT and reaction time.     

Brooding and Reflection as Subtypes of Rumination: Evidence from Confirmatory Factor Analysis in Nonclinical Samples using the Dutch Ruminative Response Scale

Previous research has shown that depressive rumination is an important vulnerability factor for experiencing depressive symptoms. The most widely used measure to assess depressive rumination is the Ruminative Response Scale (RRS). According to Treynor et al. (Cognitive Therapy and Research 27:247–259, 2003), the RRS contains two subscales, reflecting two different rumination subcomponents: brooding and reflection. The present study examined the psychometric properties of the RRS in two samples (N = 432 and N = 407). Based on a confirmatory factor analysis (CFA), results confirmed that a two-dimensional model with brooding and reflection factors provided an adequate fit to the data. Reliability, convergent and discriminant validity of the rumination subcomponents were appropriate. Furthermore, brooding but not reflection predicted depressive symptoms prospectively, even when accounting for concurrent depressive feelings. The results provide the first confirmatory factor-analytical support for the widely assumed two-factor model of the RRS and add to the accumulating body of evidence supporting the multidimensional nature of depressive rumination.     

The influence of war on moral judgments about harm

How does war influence moral judgments about harm? While the general rule is “thou shalt not kill,” war appears to provide an exception to the moral prohibition on intentional harm. In three studies (n = 263, n = 557, n = 793), we quantify the difference in moral judgments across peace and war contexts, and explore two possible explanations for the difference. The findings demonstrate that third-party observers judge a trade-off of one life for five as more morally acceptable in war than in peace, especially if the one person is from an outgroup of the person making the trade-off. In addition, the robust difference in moral judgments across “switch” and “footbridge” trolley problems is attenuated in war compared to in peace. The present studies have implications for moral psychology researchers who use war-based scenarios to study broader cognitive or affective processes. If the war context changes judgments of moral scenarios by triggering group-based reasoning or altering the perceived structure of the moral event, using such scenarios to make decontextualized claims about moral judgment may not be warranted.     

Maternal soothing and infant stress responses: soothing, crying and adrenocortical activity during inoculation

The relation between maternal soothing and infant stress response during inoculation was examined in a sample of 37 mothers and their 3-month-old infants. The mothers' soothing and the infants' cry vocalizations and the mothers' and the infants' salivary cortisol level pre- and post-injection were analysed. There was a positive relation between infants' cry vocalization post-injection and maternal soothing pre- and post-injection. The sample was divided in two sub-groups depending on whether the mothers evidenced most soothing of the infants in the period before (Preparatory group; n=20) or after (Contingent group; n=17) the syringe injection. In the Preparatory group, the duration of infant cry vocalizations was related to amount of maternal soothing before and after the injection, while cry vocalizations in the Contingent group was related to amount of maternal soothing after the injection. The Contingent infants responded to the injection with a significant increase in cortisol, while there was no increase in the Preparatory infants. The Preparatory infants evidenced significantly longer duration of looking at the target stimuli in a visual marking task, suggesting greater difficulties in disengaging attention. These findings indicate that 3-month-olds' stress responses and their mothers' situational behaviour are mutually regulated.