A quality assurance programme for psychotherapy — The finnish experience

In many respects the status of psychotherapy in public health-care systems is similar to that of alternative medicine. The roots of training are outside universities. Legitimation and public funding have been non-existent or insufficient as compared with other fields of health care. Also a great deal of mysticism is attached to both. It is therefore relevant to study the role of psychotherapy from the frame of reference given by research into alternative health care.

Formal health care is characterised by (1) legalised status, (2) access to public funding and (3) integration in the formal medical curriculum. On the other hand there are several treatment philosophies which remain as outsiders from the point of view of formal health care. Informal health care approaches are characterised by (1) lack of legalised status, (2) no access to public funding and (3) no integration in the medical curriculum. Alternative medicine is a term usually attached to forms of informal health care like acupuncture, Spa-culture etc.

Psychotherapy in the public health sector lies somewhere between formal and informal health care. While it has no legalised status, anyone may call himself ‘psychotherapist’. Its definition remains obscure and its public accountability poor.

In this paper I have tried to show how one country — Finland — has tried to grapple with this problem as it attempted to set up psychotherapy services whose quality could be properly monitored — ‘Quality Assurance’ — allowing for public accountability. Now that psychotherapy is well established as a valuable treatment in the field of mental health it is possible to consider future expansion as a cost-effective way to improve the general mental health of the country.     

The indirect effect of attention bias on memory via interpretation bias: Evidence for the combined cognitive bias hypothesis in subclinical depression

Little research has investigated functional relations among attention, interpretation, and memory biases in depressed samples. The present study tested the indirect effect of attention bias on memory through interpretation bias as an intervening variable in a mixed sample of non-depressed and subclinically depressed individuals. Subclinically depressed and non-depressed individuals completed a spatial cueing task (to measure attention bias), followed by a scrambled sentences test (to measure interpretation bias), and an incidental free recall task (to measure memory bias). Bias-corrected bootstrapping yielded evidence for the hypothesised indirect effect model, in that an emotional bias in attention is related to a congruent bias in interpretative choices which are in turn reflected in memory. These findings extend previous research and provide further support for the combined cognitive bias hypothesis in depression. Theoretical and clinical implications of our findings are discussed.     

Elevated disgust sensitivity in blood phobia

In order to demonstrate elevated disgust sensitivity and facilitated disgust learning in patients suffering from blood injection injury phobia, 23 phobics and 20 controls underwent an evaluative conditioning experiment. They were presented with picture pairs consisting of affectively neutral pictures (CS), which were followed by either disgust-inducing, fear-inducing, pleasant, or neutral scenes (US). During the presentation we recorded the electromyogram (EMG) of the musculus levator labii as a specific disgust indicator. Affective ratings for the pictures were determined before and after conditioning. Also, CS-US contingency verbalisation (CV) was assessed. Phobics reported a greater overall disgust sensitivity, experienced stronger feelings of disgust, and showed greater EMG responses while viewing disgust-eliciting scenes than control subjects. Evaluative conditioning occurred equally in both groups and depended on CV.     

The time course of resource allocation in spider-fearful participants during fear reactions

The dynamics of resource allocation to pictures of spiders and other animals in spider-fearful participants was investigated. The task of the participants was to respond rapidly and accurately to various probe stimuli superimposed on pictures of different animals. These were arguably fear relevant (spiders, snakes, and wolves) and fear irrelevant (beetles, turtles, and rabbits). The probes were shown with different stimulus onset asynchronies (SOAs) from picture onset to address the dynamics of resource allocation. A larger allocation of resources to spider pictures than to pictures of all other animals, with no difference between the latter regarding resource allocation was found. For the task that demanded more resources the fear-related physiological responses decreased, suggesting that controlled processing modulates fear responses.     

The effects of physical exercise on psychophysiological reactions under stress

Abstract

The effects of moderate physical exercise during a 20-minute anticipation period of a public speech were investigated. Mood before the anticipation period was manipulated as an additional stress factor. As a third experimental factor the subjects were given the opportunity for task preparation or not. Besides cardiovascular variables and self-reports of bodily symptoms, mood reports served as dependent variables and as indicators of general well-being. Eighty female students took part in the study. Moderate exercise was associated with strongly increased activation and reports of related bodily symptoms. The reported mood changes as a function of exercise included a decrease in anxiety and an increase in self-reliance. This mood repair effect of exercise was especially apparent when the subjects entered the anticipation period in a negative emotional state. The exercised subjects spoke with greater calmness. The task preparation during anticipation led to slightly increased activation and to reports of bodily symptoms as well as increased anxiety and less self-reliance. The prepared subjects made fewer pauses in their speeches.     

The role of cognitive appraisal in media-induced presence and emotions

In the present study, we applied Valins’ (1966) bogus bodily feedback paradigm to investigate the roles of cognitive appraisal (tele)presence, and emotion in the context of media usage. Participants (N=30) viewed short sequences of a TV show, whereby false heart rate feedback was provided. In line with Valins’ paradigm, the manipulation we used in this study included two levels: high vs. low false heart rate feedback. We assessed presence, enjoyment, and the real heart rate. Participants reported stronger experiences of presence and enjoyed the clips more when they wrongly believed that they had been aroused. Since bogus feedback increases the sensation of presence, the results indicate that presence—like emotions—can be influenced by cognitive appraisals. It is likely that the false heart rate feedback was attributed to the stimulus, which in turn enhanced the sensation of presence.     

It Only Looks the Same From a Distance: How U.S., Finnish,and Irish Schools Support Struggling Readers

This study examined how U.S., Finnish, and Irish educators identified and supported struggling readers. Using Johnston's (2011) framework for evaluating reading interventions and activity theory (Engeström, 1999), we interviewed educators in four U.S., three Irish, and three Finnish schools. In the United States, the adoption of three beliefs—reductionist reading philosophy, difficulties as cognitive and remediated through instruction, and reading problems as unexpected phenomena—reinforced a skills-driven approach. Irish and Finnish educators adopted a more holistic view of reading, and teachers used formative assessment to support struggling students over extended periods while working collaboratively with other staff. Discussion focuses on how these beliefs influenced divisions of labor, roles and responsibilities, and the urgency with which difficulties were addressed.     

Intending or Pretending? Automatic Evaluations of Goal Cues Discriminate True and False Intentions

This research presents a novel approach to discriminating between true and deceptive statements about intended future behavior. Arguing that true intentions are goal‐directed, we predict that people who genuinely intend to pursue a reported goal will implicitly evaluate goal‐relevant cues positively, whereas people who do not intend to pursue the goal will not. Participants in an experiment were instructed to tell the truth about a planned future behavior (true intention) or to falsely report that same behavior to mask their actual mock‐criminal intention (false intention). As predicted, an evaluative priming task showed that participants with true intention exhibited implicit positive evaluations of cues relevant to the reported goal, whereas participants with false intention did not. Subsequent analyses showed that implicit positivity significantly discriminated between true and false intentions. The findings are discussed in terms of theoretical contributions and implications for the development of future detection tools. Copyright © 2012 John Wiley & Sons, Ltd.     

Expect the Unexpected? Variations in Question Type Elicit Cues to Deception in Joint Interviewer Contexts

We examined the effect of (i) a second interviewer's demeanour and (ii) asking expected and unexpected questions on cues to deception. We predicted that liars compared with truth tellers would provide more detail to expected questions and less detail to unexpected questions, particularly when the second interviewer is supportive. Liars prepare answers for expected questions, and a supportive interviewer will encourage them to provide more detail. By definition, liars have not prepared answers for unexpected questions, and their answers to such questions will be less detailed. Participants (N = 168) appeared before two interviewers: The first asked all the questions, and the second remained silent. The second interviewer exhibited either a supportive or a neutral demeanour. As predicted, liars provided more detail to expected questions and less detail to unexpected questions, particularly when the second interviewer was supportive. In conclusion, a supportive second interviewer elicits cues to deceit. Copyright © 2013 John Wiley & Sons, Ltd.     

The Cognitive Processes Underlying Risky Choice

In this article, we tested two concepts of decision making: expected utility theory and heuristic choice. In Experiment 1, we applied think‐aloud protocols to investigate violations of expected utility theory. In Experiments 2 to 4, we introduced a new process‐tracing method—called predict‐aloud protocols—that has advantages over previously suggested research methods. Results show the following: (i) people examine information between rather than within gambles; (ii) the priority heuristic emerges as the most frequently used strategy when problems are difficult; and (iii) people check for similarity when problems are easy. Copyright © 2012 John Wiley & Sons, Ltd.