Toward a Cognitive-Behavioral Classification System for Mental Disorders

As is true for its predecessors, the recently published DSM-5 uses arbitrary criteria and cutoffs to define categories of mental disorders that are of questionable validity and that provide no guidance for treatment. Recently, the NIMH introduced an alternative classification system, the Research Domain Criteria (RDoC). Both the DSM-5 and the RDoC initiative make the strong assumption that psychological problems are expressions of specific latent disease entities. In contrast, the complex causal network approach conceptualizes psychological problems as mutually interacting, often reciprocally reinforcing, elements of a complex causal network. The cognitive behavioral model offers a classification framework that is compatible with the complex causal network approach and provides a treatment-relevant alternative to the latent disease model that is the basis for the DSM-5 and the RDoC initiative.     

Relationship between social anxiety and perceived trustworthiness

Four different patterns of biased ratings of facial expressions of emotions have been found in socially anxious participants: higher negative ratings of (1) negative, (2) neutral, and (3) positive facial expressions than nonanxious controls. As a fourth pattern, some studies have found no group differences in ratings of facial expressions of emotion. However, these studies usually employed valence and arousal ratings that arguably may be less able to reflect processing of social information. We examined the relationship between social anxiety and face ratings for perceived trustworthiness given that trustworthiness is an inherently socially relevant construct. Improving on earlier analytical strategies, we evaluated the four previously found result patterns using a Bayesian approach. Ninety-eight undergraduates rated 198 face stimuli on perceived trustworthiness. Subsequently, participants completed social anxiety questionnaires to assess the severity of social fears. Bayesian modeling indicated that the probability that social anxiety did not influence judgments of trustworthiness had at least three times more empirical support in our sample than assuming any kind of negative interpretation bias in social anxiety. We concluded that the deviant interpretation of facial trustworthiness is not a relevant aspect in social anxiety.     

Neurobiological correlates of cognitions in fear and anxiety: A cognitive–neurobiological information-processing model

We review likely neurobiological substrates of cognitions related to fear and anxiety. Cognitive processes are linked to abnormal early activity reflecting hypervigilance in subcortical networks involving the amygdala, hippocampus, and insular cortex, and later recruitment of cortical regulatory resources, including activation of the anterior cingulate cortex and prefrontal cortex to implement avoidant response strategies. Based on this evidence, we present a cognitive–neurobiological information-processing model of fear and anxiety, linking distinct brain structures to specific stages of information processing of perceived threat.     

The Pursuit of Happiness and Its Relationship to the Meta‐experience of Emotions and Culture

In this commentary, I provide a brief background of the meta‐experience of emotions, the philosophical and psychological literature on happiness, and further discuss the influence of culture on happiness. The meta‐experience of emotions implies that there are primary and secondary emotions (i.e., emotions about emotions), similar to the concept of meta‐cognitions. Primary and secondary emotions are closely associated with one's cultural background and happiness. Most scholars throughout history believe that happiness per se cannot be taught. However, it is possible to teach practices that lead to the path towards happiness. Promising strategies include loving‐kindness and compassion meditation. These strategies are based on Buddhist teachings, which are deeply rooted in a collectivistic culture. This illustrates the close association among emotions, approaches towards happiness, and cultural background.     

The contributions of arousal and self-focused attention to avoidance in social anxiety

Abstract

Fear of blushing is a specific syndrome generally subsumed under the diagnostic category of social anxiety disorder (SAD). This study aims at gathering preliminary data about an intensive weekend intervention specifically designed for individuals with fear of blushing as the predominant complaint. Treatment consisted of a combination of attention training and behavioral therapy. Thirty-one blushing-fearful individuals meeting the criteria for SAD following the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) were treated in three groups. The study was conducted as an open trial. Full assessments were performed before treatment, six weeks after treatment, and at six-month follow-up. Only fear of blushing, the main outcome criterion, was assessed immediately before and after the treatment weekend. The intensive therapy program was well accepted. Fear of blushing and SAD were significantly reduced and reductions remained stable. At follow-up, nearly two-thirds of the participants achieved significant changes in fear of blushing. Despite the preliminary nature of this study, the condensed format of weekend therapy for treating fear of blushing calls for further investigation.     

Acceptance and Mindfulness Techniques as Applied to Refugee and Ethnic Minority Populations With PTSD: Examples From "Culturally Adapted CBT"

In this article we illustrate how we utilize acceptance and mindfulness techniques in our treatment (Culturally Adapted CBT, or CA-CBT) for traumatized refugees and ethnic minority populations. We present a Nodal Network Model (NNM) of Affect to explain the treatment's emphasis on body-centered mindfulness techniques and its focus on psychological flexibility. We explain the definition of mindfulness that guides our treatment, and we outline a typology of mindfulness states and show how many of the techniques in our treatment can be analyzed by these categories. We argue that acceptance and mindfulness are therapeutic for refugees and minority populations for several reasons. These include their increasing psychological flexibility, decreasing somatic distress, decreasing rumination, serving as emotion regulation techniques, decreasing the attentional bias to threat, and forming part of a new adaptive processing mode (which in CA-CBT centers on psychological flexibility). We describe the specific ways we teach acceptance and mindfulness with Latino and Southeast Asian refugee populations and present case examples of the treatment of a traumatized Latino and Cambodian patient.     

Slacking Off or Winding Down? An Experience Sampling Study on the Drivers and Consequences of Media Use for Recovery Versus Procrastination

Today's constant availability of media content provides users with various recreational resources. It may also challenge self‐control, however, once media exposure conflicts with other goals and obligations. How media users deal with these self‐regulatory chances and risks in their daily lives is largely unknown. Our study addressed the predictors and consequences of recreational and procrastinatory media use using experience sampling methodology (N = 215; 1,094 media use episodes). Results suggest that trait (self‐control, performance goal orientation) as well as state variables (exhaustion) are significant predictors of media use for recovery versus procrastination. Whereas recreational media use showed a positive effect on entertainment, which in turn enhanced subjective well‐being, negative self‐evaluation elicited by procrastinatory media use negatively affected well‐being.