Effectiveness of an empirically supported treatment for social phobia in the field

This study examined the effectiveness of individual exposure combined with cognitive restructuring for social phobia in a clinical setting as well as the influence of sample restriction criteria on the effect size. Participants were 217 unselected patients with a primary diagnosis of social phobia who were treated by 57 therapists in four outpatient clinics of the Christoph-Dornier-Foundation of Clinical Psychology in Germany. Results 6 weeks after the end of therapy showed highly significant reductions in social phobic fears and avoidance as well as in general anxiety and symptoms of depression. However, patients who dropped out during therapy reported a significantly higher degree of depression. Results did not differ between the four outpatient clinics and are comparable with the average effect-sizes reported by meta-analytic studies of controlled efficacy research, using selected patients. Also, restricting the sample according to the selection criteria often applied in research settings did not result in higher effect sizes for the applied outcome measures. We conclude that individual cognitive behavioural therapy for social phobia can be transported from research settings to the field of mental health.     

The perceived onset time of self- and other-generated actions

Awareness of actions is partly based on the intentions accompanying them. Thus, the awareness of self- and other-generated actions should differ to the extent that access to own and other's intentions differs. Recent studies have found a brain circuit (the mirror-neuron system) that represents self- and other-generated actions in an integrated fashion. This system does not respond to actions made by nonagents, such as machines. We measured the estimated onset time of actions that subjects either executed themselves or observed being executed by someone else or by a machine. In three experiments, the estimates of the machine actions always differed from those of self- and other-generated actions, whereas the latter two were indistinguishable. Our results are consistent with the view that intentions are attributed to others but not to machines. They also raise the interesting possibility that people attribute intentions to themselves in the same way as they do to others.     

Inactivation of the ventral tegmental area abolished the general excitatory influence of Pavlovian cues on instrumental performance

Pavlovian stimuli can markedly elevate instrumental responding, an effect known as Pavlovian-instrumental transfer (PIT). As the role of the ventral tegmental area (VTA) in PIT is yet unknown, we examined the effects of transient VTA inactivation by direct microinjections of a mixture of the GABA(A) and GABA(B) receptor agonists, muscimol and baclofen. Results reveal that PIT, i.e., the increase in instrumental responding during presentation of a Pavlovian stimulus, was abolished by intra-VTA microinjections of muscimol/baclofen. These data provide the first evidence that the VTA mediates Pavlovian influences on instrumental behavior.     

Dopamine D1 receptors in the anterior cingulate cortex regulate effort-based decision making

The anterior cingulate cortex (ACC) has been implicated in encoding whether or not an action is worth performing in view of the expected benefit and the cost of performing the action. Dopamine input to the ACC may be critical for this form of effort-based decision making; however, the role of distinct ACC dopamine receptors is yet unknown. Therefore, we examined in rats the effects of an intra-ACC D1 and D2 receptor blockade on effort-based decision making tested in a T-maze cost-benefit task. In this task, subjects could either choose to climb a barrier to obtain a high reward in one arm or a low reward in the other arm without a barrier. Unlike vehicle-treated rats, rats with intra-ACC infusion of the D1 receptor antagonist SCH23390 exhibited a reduced preference for the high-cost- high-reward response option when having the choice to obtain a low reward with little effort. In contrast, in rats with intra-ACC infusion of the D2 receptor antagonist eticlopride, the preference for the high-cost-high-reward response option was not altered relative to vehicle-treated rats. These data provide the first evidence that D1 receptors in the ACC regulate effort-based decision making.     

Does sound stimulation have additive effects on cognitive-behavioral treatment of chronic tinnitus?

Psychological and physiological habituation are major goals in the treatment of patients suffering from chronic tinnitus. This study evaluates whether sound stimulation provided by use of low level white noise generators (NG) enhances the effects of cognitive-behavioral treatment (CBT). 124 outpatients with tinnitus of >6 months received manualized group treatment and were randomly assigned to the NG/no NG conditions. Those with moderate tinnitus-related distress obtained four sessions focusing on education, while severely distressed subjects were treated according to a full 10-session CBT program. Outcome was assessed at post-treatment and at 6- and 18-month follow-up. No additive effects due to the NGs could be demonstrated. All groups improved significantly on measures of tinnitus-related distress, dysfunctional cognitions, general psychopathology, depression, hypochondriasis and psychosocial functioning. Beneficial effects of the NGs were only observed for patients with concurrent tinnitus and hyperacusis. As systematic physical stimulation of the auditory system does not further improve the effects of CBT, the importance and strength of psychological interventions are emphasized. The clinical relevance of recently developed "retraining" approaches accentuating physical stimulation should be reconsidered.     

The strategic regulation of children's memory performance and suggestibility

We report two empirical studies that investigated previously reported benefits of a high accuracy motivation, and thus a high threshold, for children's and adults' event recall and for their ability to resist false suggestions. In the studies, 6-, 7-, and 8-year-olds, as well as adults, were shown a brief video about an event and were later asked unbiased and misleading questions about it. In Study 1, participants were either (a) given the typical accuracy instructions (including the option to answer with "I don't know"), (b) reminded of the accuracy instructions during the interview, or (c) immediately given feedback and a token for every correct answer. The results showed that the reminders were ineffective in stimulating strategic control behavior in children, independent of age. In Study 2, the confounding effects of feedback and incentives were disentangled by contrasting (a) free report, (b) feedback only, (c) incentives only, and (d) feedback plus incentives. Analyses on recall performance and suggestibility revealed that both feedback and incentives are necessary to increase children's accurate memory reports.     

The development of organizational strategies in children: evidence from a microgenetic longitudinal study

The authors examined memory on a sort-recall task in children 8 to 12 years of age. Children were first classified as either strategic or nonstrategic on a sort-recall pretest and then participated in an 11-week microgenetic study involving nine sessions. Strategy use was assessed on each trial. Consistent with past longitudinal research, changes from nonstrategic to strategic behavior occurred suddenly rather than gradually. Once children began using organizational strategies, their recall performance improved immediately. Deliberate strategy use was clearly reflected by sorting behavior during encoding but not in clustering during recall. Conclusions about whether there are children with utilization deficiencies are thus affected by how the concept is defined and whether sorting or clustering is taken as the indicator of spontaneous strategy use.