Virtual Reality Exposure in the Treatment of Panic Disorder With Agoraphobia: A Case Study

In this work we present a case example of the use of virtual reality exposure for the treatment of panic disorder with agoraphobia. The assessment protocol and procedure (including a baseline period) and the cognitive-behavioral treatment program are described. The clinical measures were categorized into target behaviors, panic and agoraphobia measures, global functioning, and general psychopathology measures. The patient’s expectations and satisfaction with regard to the virtual treatment were also assessed. The results showed an important reduction in all clinical measures after treatment with virtual exposure and the patient reached the therapeutic goals established during the pretreatment assessment. The patient also reported a good acceptance of virtual exposure. The goals achieved in the virtual environment generalized to real agoraphobic situations and to other real situations not treated. Three-, 6-, and 12-month follow-up assessments were conducted and long-term therapeutic gains were maintained.     

Heart rate and blood pressure responses to a competitive role‐playing game

The effects of the outcome of competitive encounters on physiological parameters have been studied, especially testosterone levels, but hardly on other systems that, however, present a high sensitivity to stress. This study assessed the effect of a competitive game on heart rate (HR) and blood pressure (BP) in a sample of university students. In addition, the influence of anxiety and attributions of the outcome was also explored. Only winners significantly showed a rise in HR during the competition followed by a decrease along the posttask phase in addition to more internal attributions. On the contrary, the average HR for losers during the competition was lower compared with their baseline values. No differences depending on the outcome were found in BP. The cardiovascular response as well as the subjective interpretation of the outcome suggest a more active strategy employed by winners vs. a more passive strategy of losers. Future studies should specifically investigate the importance of coping strategies for psychophysiological adaptation to contests and for the outcome reached. This would permit an advance in the understanding of the role of individual differences in the processes of stress and in associated diseases. Aggr. Behav. 27:351–359, 2001. © 2001 Wiley‐Liss, Inc.     

The proper sequence for correcting correlation coefficients for range restriction and unreliability

Corrections of correlations for range restriction (i.e., selection) and unreliability are common in psychometric work. The current rule of thumb for determining the order in which to apply these corrections looks to the nature of the reliability estimate (i.e., restricted or unrestricted). While intuitive, this rule of thumb is untenable when the correction includes the variable upon which selection is made, as is generally the case. Using classical test theory, we show that it is the nature of the range restriction, not the nature of the available reliability coefficient, that determines the sequence for applying corrections for range restriction and unreliability.We would like to thank Malcolm James Ree for his encouragement and helpful comments as well as those of the editors, associate editor, and reviewers.     

Racial phenotypicality bias in educational expectations for both male and female teenagers from different socioeconomic backgrounds

In three experiments (N = 56, 99, and 225), we showed that racial phenotypicality bias characterizes educational expectations for Chilean mestizo students: participants displayed more positive educational expectations for light complexioned than for dark complexioned high school students. In Study 1, with male high school target students, the relation between racial phenotypic appearance and educational expectations was mediated by differences in perceived competence. Study 2 suggests that the gender of the target student did not influence the occurrence of racial phenotypicality bias. Study 3 showed that racial phenotypicality bias occurs in both university students and high school teachers' judgements. Although socioeconomic background of the target student partially explained the effects of racial phenotypic appearance (especially in teachers), the latter exerted an additional and independent influence on educational expectations. These results underline the fact that effects of racial phenotypicality bias should not be overlooked in the educational domain. As mediational analyses suggested, these effects only partly occur because of stereotypical associations between racial phenotypic appearance and socioeconomic background, but also because of stereotypical associations between racial phenotypic appearance and attributed competence.     

Psycho-ophthalmology: Contributions of Health psychology to the assessment and treatment of glaucoma

Background: Asymptomatic in its early stages, glaucoma is the second leading cause of blindness worldwide. While psychosocial factors are taken into consideration for a host of diseases such as cancer, heart disease and autoimmune conditions, to date, psychological issues have been ignored in the clinical management of glaucoma.

Objective: This work reviews the most relevant contributions from a health psychology perspective for the assessment and treatment of glaucoma, which is emerging in the field of psycho-ophthalmology.

Method: To provide scientific evidence regarding contributions of psychology to the comprehension of glaucoma, a bibliographic review of three databases (Psicodoc, PsycInfo and Medline) was conducted, spanning the period between 1940 and 2016.

Results: This review yielded a total of 66 studies published in the period analysed and identified three areas where health psychology has made substantive contributions to glaucoma screening, monitoring and treatment: the emotional impact on patients suffering from glaucoma, the adherence to treatment and the effects of stress on intraocular pressure.

Conclusions: A health psychology approach for research and therapy of glaucoma must focus on the management of the negative affect associated with the diagnosis, the optimisation of treatment adherence and the stress management of the intraocular pressure measurements.     

Analysis of distractor difficulty in multiple-choice items

Two psychometric models are presented for evaluating the difficulty of the distractors in multiple-choice items. They are based on the criterion of rising distractor selection ratios, which facilitates interpretation of the subject and item parameters. Statistical inferential tools are developed in a Bayesian framework: modal a posteriori estimation by application of an EM algorithm and model evaluation by monitoring posterior predictive replications of the data matrix. An educational example with real data is included to exemplify the application of the models and compare them with the nominal categories model.This research was supported by the DGI grant BSO2002-01485.I would like to thank Eric Maris and Vicente Ponsoda for their advice, Juan Botella for providing the data for the empirical application, and three anonymous reviewers for their comments that were essential for improving the quality of the paper.     

Retrieval does not induce reconsolidation of inhibitory avoidance memory

It has been suggested that retrieval during a nonreinforced test induces reconsolidation instead of extinction of the mnemonic trace. Reconsolidation would preserve the original memory from the labilization induced by its nonreinforced recall through a hitherto uncharacterized mechanism requiring protein synthesis. Given the importance that such a process would have in terms of maintaining, as part of the animal behavioral repertoire, a learned response that has been devalued by experience, we analyzed its existence for the memory associated with a one-trial, step-down inhibitory avoidance task (IA), a memory whose consolidation and extinction require protein synthesis in the CA1 region of the dorsal hippocampus (CA1) and involve the participation of the basolateral amygdala (BLA) and entorhinal cortex (ENT). Rats were trained in IA, and 24 h later they were submitted either to a pure reactivation session (retrieval without stepping down), which was unable by itself to initiate extinction of the avoidance response, or to a second training session. Fifteen minutes before or 3 h after either the reactivation or the retraining sessions, animals were infused with the protein synthesis inhibitor anisomycin (ANI) into CA1, BLA, or ENT. Contrary to the prediction of the reconsolidation hypothesis, none of these treatments affected subsequent memory retention. Because reconsolidation is regarded to be a direct consequence of retrieval, one would expect that, when given before a retention test or a pure reactivation session, enhancers of memory expression should permanently improve retention and, therefore, facilitate retrieval both in that and in subsequent sessions. Using two well-known retrieval enhancers, noradrenaline and adrenocorticotropin(1-24), we could not find any evidence suggestive of reconsolidation. Hence, our results indicate that there is no retrieval-induced, protein synthesis-dependent process that would cause reconsolidation of IA memory.     

Skinner and the rise of behavior modification and behavior therapy

Skinner is, without a doubt, one of the most predominant figures in the development of Behavior Modification and Behavior Therapy. Skinners' work is essential to the development of Behavior Modification and Behavior Therapy. Beginning with the social need for efficient psychotherapy, and after having generated a solid theoretical body of behavioral laws, Skinner indicated and also developed the appropriate path towards efficient interventions for unadaptive behavior. He developed a new theory regarding abnormal behavior (psychopathology), as well as a procedural model for evaluation (diagnosis) and intervention: "The functional analysis of behavior". His applications for this kind of work are pioneering and at the same time, he is the agglutinant figure of what we today call "Behavior Modification and/or Therapy". It is remarkable that a scientist could change the theories and practices of a discipline as radically as Skinner and his work did. His work, however, still has its limitations. The best way to acknowledge and pay tribute to Skinners' work is to overcome these limitations.     

Assessment of deviant arousal in adult male sex offenders with developmental disabilities

Ten individuals, residing in a treatment facility specializing in the rehabilitation of sex offenders with developmental disabilities, participated in an arousal assessment involving the use of the penile plethysmograph. The arousal assessments involved measuring change in penile circumference to various categories of stimuli both appropriate (adult men and women) and inappropriate (e.g., 8- to 9-year-old boys and girls). This approach extends the existing assessment literature by the use of repeated measurement and single-subject experimental design. Data from these assessments were analyzed to determine if clear and informative outcomes were obtained. Overall, three general patterns of results emerged. Some participants showed differentiated deviant arousal or higher levels of arousal to specific inappropriate stimuli (deviant is a term used in the existing sex-offender literature to describe this type of arousal). Other participants showed undifferentiated deviant arousal, in which case they showed nonspecific arousal to inappropriate stimuli. The remaining participants showed no arousal to inappropriate stimuli but did show arousal to appropriate stimuli. Implications for assessment, treatment, and future directions are discussed.