Reducing chronic anxiety by making the threatening event predictable: An experimental approach

Panic disorder is characterized by both specific, phased fear and generalized, chronic anxiety. Standard extinction procedures are efficient in reducing specific fear. However, methods based on human conditioning research - that are capable of reducing chronic anxiety have not yet been thoroughly investigated. This study evaluates a new way of reducing chronic anxiety by signaling aversive events (or by making them more predictable). Using an experimental approach with healthy participants, specific fear and chronic anxiety were operationalized in a within-subjects fear-potentiated startle paradigm by, respectively, conditioning to a cue by presenting predictable shocks and conditioning to a context induced by unpredictable shocks. The results clearly demonstrate that context conditioning is reduced when a discrete cue is added that predicts the onset of the aversive event. The data suggest that making unpredictable events, such as for example panic attacks, predictable, may reduce the generalized and sustained anxiety that often complicates exposure treatment.     

The detection of semantic illusions: Task-specific effects for similarity and position of distorted terms

The effect of task demands on the detection of semantic illusions was investigated. In Exp. 1, subjects were given a detection task with different instructions for accuracy. Less illusions occurred under instructions that stressed accuracy, indicating strategic control of detection rates. In Exp. 2, sentences with dissimilar distorted terms resulted in shorter latencies than sentences with similar distorted terms in a detection task, but in longer response times in a question-answering task. In Exp. 3, the similarity effect was found to vary with the position of the distorted term in combination with task demands. In a verification task, the similarity effect did not differ for the beginning or the end of sentences. In a question-answering task, a significant similarity effect was observed only for distorted terms at the beginning of sentences. We argue that the results indicate minimal depth of semantic processing with respect to different task requirements. Implications for different theoretical accounts of semantic illusions are discussed.     

The person as co-investigator in personality research

In this paper, arguments are presented for considering the subject as co-investigator in personality research. A review of current research methods suggests that personality psychology is well on its way to recognizing the individual as an expert on his or her own self and situation. This means that the subject should also be allowed to take a much more active role in psychological research. It is argued that the ideal methodology for accomplishing this integration of the individual into psychological research is to establish a dialogue between psychologist and subject, allowing each to contribute to the scientific process from his or her own perspective and on the basis of his or her own expertise. The present approach calls for greater emphasis on the organization and coherence of personality as a system, greater openness and sensitivity to the particular world of the individual, and an even more dynamic conception of individuality than is currently found in our field. An important implication of the open system approach advocated in this article, the reduced role of prediction in personality research, is discussed and, finally, a preliminary list of expected gains and losses is presented.     

Reduced autobiographical memory specificity and rumination in predicting the course of depression

Reduced autobiographical memory (AM) specificity is a known vulnerability factor for depression. AM specificity was investigated as a predictor of depression with the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986). When baseline depression scores were partialed, reduced AM specificity to negative cue words predicted higher levels of depression at 7-month follow-up. Once rumination was taken into account by means of the Rumination on Sadness Scale (M. Conway, P. A. R. Csank, S. L. Holm, & C. K. Blake, 2000), AM specificity no longer predicted depression, suggesting that the predictive value of AM specificity observed in previous studies might be--at least partly--explained as an effect of rumination. Further mediation analyses indeed revealed support for rumination as a mediator of the relation between reduced AM specificity and poor outcome of depression.     

Return of fear in a human differential conditioning paradigm caused by a stimulus change after extinction

In a human fear conditioning experiment, 32 participants were trained in a differential conditioning procedure with geometrical shapes as CS+ and CS- (four presentations each), and an electric shock as US. Measures of conditioned responding were skin conductance response (SCR) and retrospective US-expectancy ratings. For half of the participants (Generalization Group, GG), the subsequent extinction phase consisted of four nonreinforced presentations of generalization stimuli (GS+ and GS-). Participants from the Extinction control Group received an equal amount of nonreinforced presentations of the CSs. Finally, all participants were tested with the original CSs. The results from both measures clearly show an increase in the size of the discrimination upon the stimulus change after extinction in the GG. Because this pattern is not observed in the Extinction control Group, extinction performance appears to be somehow restricted to the perceptual characteristics of the extinction stimulus. Interestingly, the size of the conditioned SCR discrimination in the GG is not influenced by the stimulus change after acquisition. This observation points to a differential impact of stimulus change after acquisition vs. extinction treatment. The findings are discussed from the theoretical perspective of renewal and the clinical perspective of Return of Fear.     

Post-extinction conditional stimulus valence predicts reinstatement fear: Relevance for long-term outcomes of exposure therapy

Exposure therapy for anxiety disorders is translated from fear conditioning and extinction. While exposure therapy is effective in treating anxiety, fear sometimes returns after exposure. One pathway for return of fear is reinstatement: unsignaled unconditional stimuli following completion of extinction. The present study investigated the extent to which valence of the conditional stimulus (CS+) after extinction predicts return of CS+ fear after reinstatement. Participants (N = 84) engaged in a differential fear conditioning paradigm and were randomised to reinstatement or non-reinstatement. We hypothesised that more negative post-extinction CS+ valence would predict higher CS+ fear after reinstatement relative to non-reinstatement and relative to extinction retest. Results supported the hypotheses and suggest that strategies designed to decrease negative valence of the CS+ may reduce the return of fear via reinstatement following exposure therapy.     

Is overgeneral autobiographical memory an isolated memory phenomenon in major depression?

The present study explored the relation between overgeneral autobiographical memory (AM) and other aspects of memory functioning in depression. A total of 26 patients with major depressive disorder completed a set of memory tasks measuring AM specificity (AMT; Williams & Broadbent, 1986), working memory, semantic memory, verbal learning, delayed verbal recall, recognition memory, and source memory. Reduced specificity of AM was related to poor working memory (central executive functioning) and poor source memory. The former finding conforms to the idea that the voluntary retrieval of specific autobiographical memories (AMs) involves central executive processes (e.g., Conway & Pleydell-Pearce, 2000 Conway, M. A. and Pleydell-Pearce, C. W. 2000. The construction of autobiographical memories in the self-memory system. Psychological Review, 107: 261–288. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The latter finding replicates and extends recent findings suggesting that overgeneral AM is part of a broader memory deficit in retrieving the specific details of the context in which information was acquired (Ramponi, Barnard, & Nimmo-Smith, 2004 Raes , F. , Hermans , D. , Williams , J. M. G. , Demyttenaere , K. , Sabbe , B. , Pieters , G . & Eelen , P. ( 2004 ). Reduced specificity of autobiographical memory: A mediator between rumination and ineffective social problem solving in major depression? Journal of affective disorders , 87 , 331 – 335  [Google Scholar]). Furthermore, in line with Ramponi et al. (2004 Raes , F. , Hermans , D. , Williams , J. M. G. , Demyttenaere , K. , Sabbe , B. , Pieters , G . & Eelen , P. ( 2004 ). Reduced specificity of autobiographical memory: A mediator between rumination and ineffective social problem solving in major depression? Journal of affective disorders , 87 , 331 – 335  [Google Scholar]), rumination was found to be related to both overgeneral AM and poor source memory.     

Operant conditioning of autobiographical memory retrieval

Functional avoidance is considered as one of the key mechanisms underlying overgeneral autobiographical memory (OGM). According to this view OGM is regarded as a learned cognitive avoidance strategy, based on principles of operant conditioning; i.e., individuals learn to avoid the emotionally painful consequences associated with the retrieval of specific negative memories. The aim of the present study was to test one of the basic assumptions of the functional avoidance account, namely that autobiographical memory retrieval can be brought under operant control. Here 41 students were instructed to retrieve personal memories in response to 60 emotional cue words. Depending on the condition, they were punished with an aversive sound for the retrieval of specific or nonspecific memories in an operant conditioning procedure. Analyzes showed that the course of memory specificity significantly differed between conditions. After the procedure participants punished for nonspecific memories retrieved significantly more specific memories compared to participants punished for specific memories. However, whereas memory specificity significantly increased in participants punished for specific memories, it did not significantly decrease in participants punished for nonspecific memories. Thus, while our findings indicate that autobiographical memory retrieval can be brought under operant control, they do not support a functional avoidance view on OGM.     

Priming associations between bodily sensations and catastrophic misinterpretations: Specific for panic disorder?

Cognitive models assume that panic disorder is characterised by a tendency to misinterpret benign bodily symptoms (e.g. breathlessness) in a catastrophic fashion (e.g. suffocation). This is a central part of the cognitive model which presents a core focus for treatment. Several studies have supported this hypothesis. These studies have, however, almost always relied on self-report. In addition to susceptibility to biases (e.g. distortions of memory), a limitation of research based on verbal report is its inability to capture the spontaneous/automatic nature that is attributed to these catastrophic interpretations. The present paper reports on two experiments in which a priming procedure was used to test the hypothesis that panic disorder is characterised by spontaneous catastrophic interpretations and whether this effect is ‘specific’ to panic disorder. In line with predictions from the cognitive model, it was observed in the first experiment that the panic group demonstrated facilitated responses to trials consisting of a ‘symptom’ prime and a ‘catastrophic outcome’ target (e.g. breathlessness - suffocate). Similar effects were not observed for an anxious control group and a nonclinical control group, supporting the specificity of this effect. Interestingly, however, significant priming effects were observed for a group of mental health professionals (part of the healthy control group) who had no history of panic disorder. Subsequently, this unexpected observation was explicitly addressed in a second experiment, which confirmed the findings of Experiment 1. Together, these results suggest that associations between mental representations of benign bodily symptoms and catastrophic outcomes might develop as part of professional knowledge and experience, and should not necessarily be viewed as pathogenic. Theoretical and clinical implications are discussed.