A Single-Subject Evaluation of the Treatment of Morphing Fear

We present a single-subject prospective outcome study of a man with severe morphing fear and long history of OCD who was not helped by previous interventions, and who received an adapted form of cognitive behavior therapy (CBT) as part of this study. Treatment consisted of a cognitively focused approach tailored to address his fear of morphing and included developing a stronger sense of self-stability. We describe the details of the case, the treatment protocol, and the therapeutic outcomes as assessed over 36 weeks by questionnaires, rating scales, and semistructured interviews. The intervention was effective in eradicating the patient’s morphing fears and reducing other symptoms of OCD, anxiety, and depression. The presented case illustrates the need to appropriately conceptualize, assess, and address the specific nature of morphing fear symptoms in treatment.     

On the relation between theory of mind and executive functioning: A developmental cognitive neuroscience perspective

Theory of mind (ToM) and executive functioning (EF) show marked interrelatedness across childhood, and developmental psychologists have long been interested in understanding the nature of this association. The present review addresses this issue from a cognitive neuroscience perspective by exploring three hypotheses regarding their functional overlap: (1) ToM relies on EF (EF→ToM); (2) EF relies on ToM (ToM→EF); and (3) ToM and EF are mutually related, owing to shared neural structures or networks (ToM?EF). Drawing on evidence from normative brain development, neurodevelopmental and neurodegenerative diseases, patient lesion studies, and brain-imaging studies, we suggest that only a strict version of the ToM?EF proposal of complete neural overlap can be confidently ruled out on the basis of existing evidence. The balance of evidence suggests that separable neurobiological mechanisms likely underlie ToM and EF, with shared mechanisms for domain-general processing that support both abilities. We highlight how future studies may empirically substantiate the nature of the ToM–EF relationship using various biobehavioral approaches.     

Association splitting of the sexual orientation-OCD-relevant semantic network

There is little research on treating symptoms of sexual orientation-obsessive-compulsive disorder (SO-OCD). Semantic networks represent a new cognitive approach for understanding cognitive mechanisms of SO-OCD. Specifically, we tested whether the self-help cognitive technique of association splitting (AS) developed from this approach would be efficacious in reducing SO-OCD symptoms and thought suppression. One hundred and twenty heterosexual undergraduates (82 females, 38 males) were randomly assigned to either the AS or waitlist control group. At baseline and four weeks later, participants completed items assessing SO-OCD symptoms, measures of sexual obsessions and thought suppression, and an association task in which they generated associations to different cue words. Generated associations were coded based on SO-OCD relevance and emotional valence. Results indicated reductions in SO-OCD-relevant associations across levels of emotional valence and SO-OCD-irrelevant negative associations, and increases in SO-OCD-irrelevant positive and neutral associations, only in the AS group. Furthermore, there were reductions in SO-OCD symptoms, sexual obsessions, and thought suppression only in the AS group. Importantly, these findings were obtained with overall large effect sizes. AS appears to be an efficacious self-help technique in reducing SO-OCD symptoms, sexual obsessions, and thought suppression. Clinical implications, limitations, and suggestions for future research are discussed.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

“What Just Happened?”

The author discusses experiences in analysis during the formation of an object relationship, which can give rise to a phase of experiential “wholeness” when a particular piece of unconscious analytic work has been completed. The question of wholeness is also considered from an ontogenetic perspective. The difficulties in achieving a good object relationship are considered, including with those who have had little or no experience of a good internal object. Three stages in the formation of a good internal object relationship are proposed.     

Functional Communication Training and Demand Fading Using Concurrent Schedules of Reinforcement

Demand fading, a schedule thinning procedure for escape-maintained behaviors, typically includes an escape extinction component. The purpose of this study was to examine the effectiveness of demand fading with alternative reinforcement utilizing concurrent reinforcement schedules without extinction. During demand fading, aggression and requests emitted prior to meeting the task completion criterion were reinforced with short, low-quality breaks, but requests emitted following the task completion criterion were reinforced with long, high-quality breaks. Results suggest that concurrent schedules of reinforcement may be an effective alternative to extinction as a component of demand fading.     

High voice pitch mitigates the aversiveness of antisocial cues in men's speech

Speech contains both explicit social information in semantic content and implicit cues to social behaviour and mate quality in voice pitch. Voice pitch has been demonstrated to have pervasive effects on social perceptions, but few studies have examined these perceptions in the context of meaningful speech. Here, we examined whether male voice pitch interacted with socially relevant cues in speech to influence listeners’ perceptions of trustworthiness and attractiveness. We artificially manipulated men's voices to be higher and lower in pitch when speaking words that were either prosocial or antisocial in nature. In Study 1 , we found that listeners perceived lower-pitched voices as more trustworthy and attractive in the context of prosocial words than in the context of antisocial words. In Study 2 , we found evidence that suggests this effect was driven by stronger preferences for higher-pitched voices in the context of antisocial cues, as voice pitch preferences were not significantly different in the context of prosocial cues. These findings suggest that higher male voice pitch may ameliorate the negative effects of antisocial speech content and that listeners may be particularly avoidant of those who express multiple cues to antisociality across modalities.     

“Inside out”: Appraisals for achievement emotions from constructive,positive, and negative feedback on writing

Even with the recent surge of research on achievement emotions, few studies have investigated emotions in feedback situations and the appraisals associated with such emotions. The purpose of this study was to examine emotion appraisals of constructive criticism, negative, and positive feedback, to aid us in determining whether these appraisals differed by feedback type. In a task asking them to provide open-ended responses as they imagined receiving feedback on a writing task, undergraduates (N?=?270) gave reasons for why they might experience unpleasant emotions from positive feedback and pleasant emotions from negative feedback along with reasons for both pleasant and unpleasant emotions emanating from constructive feedback. Open coding of responses yielded categories for each emotion-feedback pairing that, across all emotions, were collapsed into five appraisal categories: feedback suggests ways to improve, a mismatch between feedback and task exists, feedback targets the self or one’s ability, feedback says something about the relationship between feedback giver and receiver, and the task is judged for its value. Distributions of appraisal categories distinguished constructive feedback from positive and negative feedback. Implications are drawn for control-value theory and for classroom feedback practices.