Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context

Background and Objectives: Anxiety and insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students. Design: A randomized, controlled study. Methods: Students were randomly allocated to intervention (“Anxiety Relief”: n?=?43; “Insomnia Relief”: n?=?48; control: n?=?47). Interventions lasted six weeks. Outcome measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index. Results: Significant within-group reductions in anxiety (t(31)?=?2.00, p?=?.03) with moderate between-groups (compared to control) effect size (d?=?.64) and increases in sleep quality (t(31)?=?3.46, p?=?.002) with a moderate between-groups effect size (d?=?.55) were found for completers of the anxiety program from pre- to post-intervention. Significant within-group increases in sleep quality were found for completers of the insomnia program from pre- to post-intervention (t(35)?=?4.28, p?>?.001) with a moderate between-groups effect size (d?=?.51). Conclusions: Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed.     

Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders

ObjectiveTo compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders.MethodOne hundred five veterans (83% male, mean age = 46 years, 30% minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT.ResultsBoth groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps < .001, d = ?4.08 for adapted MBSR; d = ?3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p < .01, d = .49) whereas adapted MBSR reduced worry at a greater rate than CBT (p < .05, d = .64) and resulted in greater reduction of comorbid emotional disorders (p < .05, d = .49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement.ConclusionsCBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders.     

Role of dopamine,the frontal cortex and memory circuits in drug addiction: insight from imaging studies

Drug addiction is characterized by a set of recurring processes (intoxication, withdrawal, craving) that lead to the relapsing nature of the disorder. We have used positron emission tomography to investigate in humans the role of dopamine (DA) and the brain circuits it regulates in these processes. We have shown that increases in DA are associated with the subjective reports of drug reinforcement corroborating the relevance of drug-induced DA increases in the rewarding effects of drugs in humans. During withdrawal we have shown in drug abusers significant reductions in DA D2 receptors and in DA release. We postulate that this hypodopaminergic state would result in a decreased sensitivity to natural reinforcers perpetuating the use of the drug as a means to compensate for this deficit and contributing to the anhedonia and dysphoria seen during withdrawal. Because the D2 reductions are associated with decreased activity in the anterior cingulate gyrus and in the orbitofrontal cortex we postulate that this is one of the mechanisms by which DA disruption leads to compulsive drug administration and the lack of control over drug intake in the drug-addicted individual. This is supported by studies showing that during craving these frontal regions become hyperactive in proportion to the intensity of the craving. Craving is also associated with activation of memory circuits including the amygdala (implicated in conditioned learning), hippocampus (implicated in declarative learning), and dorsal striatum (implicated in habit learning) all of which receive DA innervation. We therefore postulate that dopamine contributes to addiction by disrupting the frontal cortical circuits that regulate motivation, drive, and self-control and by memory circuits that increase the motivational salience of the drug and drug-associated stimuli.     

Intuitive (in)coherence judgments are guided by processing fluency, mood and affect

Recently proposed accounts of intuitive judgments of semantic coherence assume that processing fluency results in a positive affective response leading to successful assessment of semantic coherence. The present paper investigates whether processing fluency may indicate semantic incoherence as well. In two studies, we employ a new paradigm in which participants have to detect an incoherent item among semantically coherent words. In Study 1, we show participants accurately indicating an incoherent item despite not being able to provide an accurate solution to coherent words. Further, this effect is modified by affective valence of solution words that are not retrieved from memory. Study 2 replicates those results and extend them by showing that mood moderates incoherence judgments independently of affective valence of solutions. The results support processing fluency account of intuitive semantic coherence judgments and show that it is not fluency per se but fluency variations that drive judgments.     

Improving Treatment Plan Implementation in Schools: A Meta-analysis of Single Subject Design Studies

Twenty-nine peer-reviewed journal articles that analyzed intervention implementation in schools using single-case experimental designs were meta-analyzed. These studies reported 171 separate data paths and provided 3,991 data points. The meta-analysis was accomplished by fitting data extracted from graphs in mixed linear growth models. This analytic approach was adopted to provide a model whose assumptions were met and could model both level and trend. The extent to which interventions were implemented as planned in baseline was low with a downward trend. Performance feedback, performance feedback augmented with additional procedures, and self-monitoring with environmental supports were found to be highly effective for improving intervention implementation. Follow-up meetings without review of implementation data were ineffective. Maintenance data were positive across studies. Implications of the results for future research and practice are discussed.     

How We Feel is a Matter of Time: Relationships Between Time Perspectives and Mood

Both personality and emotional experiences may be influenced by people’s time perspectives. The Zimbardo time perspective inventory measures five trait dimensions related to past, present and future perspectives. Two studies were conducted to investigate how these time perspective dimensions related to mood. The first study (n = 260) confirmed that ZTPI scales predicted moods including energetic arousal, tense arousal and Hedonic Tone, revealing that past negative and Present Hedonistic time perspectives are the most robust predictors of current emotional states. Moreover, future time perspective proved to predict energetic arousal, but the effect was suppressed by present hedonism. The second study (n = 65) measured mood twice in a 4-week period, and focused on relationships between the ZTPI and recalled and anticipated mood. Analyses conducted using DBTP, an index of temporal harmony based on the ZTPI scores, proved that balanced time perspective was related to more positive mood states in both studies. Findings confirmed that time perspective appears to influence both recall and anticipation of mood. For example, past negative time perspective is associated with anticipation of negative moods, and Past Positive perspective relates to both recall and anticipation of energy. Time perspective may structure the individual’s affective experience.     

Mechanisms of mindfulness: emotion regulation following a focused breathing induction

The current study investigated whether a 15 min recorded focused breathing induction in a normal, primarily undergraduate population would decrease the intensity and negativity of emotional responses to affectively valenced picture slides and increase willingness to remain in contact with aversive picture slides. The effects of the focused breathing induction were compared with the effects of 15 min recorded inductions of unfocused attention and worrying. The focused breathing group maintained consistent, moderately positive responses to the neutral slides before and after the induction, whereas the unfocused attention and worry groups responded significantly more negatively to the neutral slides after the induction than before it. The focusing breathing group also reported lower negative affect and overall emotional volatility in response to the post-induction slides than the worry group, and greater willingness to view highly negative slides than the unfocused attention group. The lower-reported negative and overall affect in response to the final slide blocks, and greater willingness to view optional negative slides by the focused breathing group may be viewed as more adaptive responding to negative stimuli. The results are discussed as being consistent with emotional regulatory properties of mindfulness.     

Freely generated filters in free Boolean algebras

In this paper we will prove that ifF is a filter of a free Boolean algebra such that the minimal cardinality of the set of generators ofF is an uncountable regular cardinal or a singular cardinal with uncountable cofinality thenF is freely generated.Presented byPiotr Wojtylak