Optimizing Exposure Therapy for Pathological Health Anxiety: Considerations From the Inhibitory Learning Approach

Exposure therapy has demonstrated its efficacy in the treatment of pathological health anxiety—however, psychotherapy research reveals that many patients do not show a clinically significant change. Therefore, improvements are necessary to optimize psychotherapy for pathological health anxiety. Most treatment rationales refer to habituation during exposure as the central mechanism of change. However, there is evidence that extinction learning is mediated by inhibitory learning processes. Targeting these processes may help to improve treatment outcomes in pathological health anxiety. The aim of this review was to adapt, from the inhibitory learning approach and empirical findings, the most promising strategies for the exposure-based treatment of pathological health anxiety. The exposure-optimizing strategies adapted are expectancy violation, combination, variability in contexts and stimuli, affect labeling, and removal of safety signals. A case example illustrates how to implement these methods for patients with pathological health anxiety.     

Uncovering a New Moral Dilemma of Economic Optimization in Biotechnological Processing

The trend of emerging biorefineries is to process the harvest as efficiently as possible and without any waste. From the most valuable phytomass, refined medicines, enzymes, dyes and other special reactants are created. Functional foods, food ingredients, oils, alcohol, solvents, plastics, fillers and a wide variety of other chemical products follow. After being treated with nutrient recovery techniques (for fertilizer production), biofuels or soil improvers are produced from the leftovers. Economic optimization algorithms have confirmed that such complex biorefineries can be financially viable only when a high degree of feedstock concentration is included. Because the plant material is extremely voluminous before processing, the farming intensity of special plants increases in the nearest vicinity of agglomerations where the biorefineries are built for logistical reasons. Interdisciplinary analyses revealed that these optimization measures lead to significantly increased pollen levels in neighbouring urban areas and subsequently an increased risk of allergies, respectively costs to the national health system. A new moral dilemma between the shareholder’s profit and public interest was uncovered and subjected to disputation.     

Development and validation of a brief self-report measure of trauma exposure: the Trauma History Screen

Although information about individuals' exposure to highly stressful events such as traumatic stressors is often very useful for clinicians and researchers, available measures are too long and complex for use in many settings. The Trauma History Screen (THS) was developed to provide a very brief and easy-to-complete self-report measure of exposure to high magnitude stressor (HMS) events and of events associated with significant and persisting posttraumatic distress (PPD). The measure assesses the frequency of HMS and PPD events, and it provides detailed information about PPD events. Test-retest reliability was studied in four samples, and temporal stability was good to excellent for items and trauma types and excellent for overall HMS and PPD scores. Comprehensibility of items was supported by expert ratings of how well items appeared to be understood by participants with relatively low reading levels. In five samples, construct validity was supported by findings of strong convergent validity with a longer measure of trauma exposure and by correlations of HMS and PPD scores with posttraumatic stress disorder (PTSD) symptoms. The psychometric properties of the THS appear to be comparable or better than longer and more complex measures of trauma exposure.     

The role of encoding strategies in the verbal memory performance in patients with schizophrenia

Background. Verbal learning and memory is often compromised in patients with schizophrenia who prefer encoding words in order of their presentation (serial clustering) rather than using semantic categories (semantic clustering). Method. One hundred and four in‐patients with schizophrenia were assessed twice with the California Verbal Learning Test. Results. Patients showed significantly less semantic than serial clustering at both assessment times. Usage of encoding strategies were not stable over time. An increase in semantic clustering improved recall and recognition performance. Conclusions. Patients with schizophrenia should be taught to use the more effective encoding strategy of semantic clustering in order to improve their memory performance.     

The importance of context information for the spatial specificity of gaze cueing

In three experiments, we investigated the spatial allocation of attention in response to central gaze cues. In particular, we examined whether the allocation of attentional resources is influenced by context information—that is, the presence or absence of reference objects (i.e., placeholders) in the periphery. On each trial, gaze cues were followed by a target stimulus to which participants had to respond by keypress or by performing a target-directed saccade. Targets were presented either in an empty visual field (Exps. 1 and 2) or in previewed location placeholders (Exp. 3) and appeared at one of either 18 (Exp. 1) or six (Exps. 2 and 3) possible positions. The spatial distribution of attention was determined by comparing response times as a function of the distance between the cued and target positions. Gaze cueing was not specific to the exact cued position, but instead generalized equally to all positions in the cued hemifield, when no context information was provided. However, gaze direction induced a facilitation effect specific to the exact gazed-at position when reference objects were presented. We concluded that the presence of possible objects in the periphery to which gaze cues could refer is a prerequisite for attention shifts being specific to the gazed-at position.     

Documentary Bioethics: Visual Narratives for Generations X and Y

Narrative bioethics is primarily understood to involve storytelling through the use of literature. This article suggests that other forms of media are necessary to convey stories of an ethical nature to an audience broader than one being trained as medical professionals. "Documentary bioethics" is a manner to present and interpret stories of an ethical nature using forms of popular electronic media in a reality-based documentary style to society at large, specifically Generations X and Y.     

Three Assistants on Boltzmann

The three demi-articles presented here would give a brief biographical account of Ludwig Boltzmann’s life plus some details about his Vienna laboratories first in the 1860’s in the Erdberg and second in Türkenstrasse from 1894. Josef Nabl’s account discusses J. J. Thomson’s Laboratory in Cambridge, which allows a provisional comparison between two different largely contemporary institutes. Nabl’s second letter also mentions Lord Kelvin’s late rejection of the kinetic gas theory of Maxwell and Boltzmann, rejection which on top of the negative attitude of Mach, Zermelo, and Poincaré probably did not benefit Boltzmann’s state of mind and may have contributed to the extreme character of Boltzmann’s anti-philosophical counterattack starting in 1903. This revised version was published online in June 2006 with corrections to the Cover Date.     

The Effects of Framing, Reflection, Probability, and Payoff on Risk Preference in Choice Tasks

A meta-analysis of Asian-disease-like studies is presented to identify the factors which determine risk preference. First the confoundings between probability levels, payoffs, and framing conditions are clarified in a task analysis. Then the role of framing, reflection, probability, type, and size of payoff is evaluated in a meta-analysis. It is shown that bidirectional framing effects exist for gains and for losses. Presenting outcomes as gains tends to induce risk aversion, while presenting outcomes as losses tends to induce risk seeking. Risk preference is also shown to depend on the size of the payoffs, on the probability levels, and on the type of good at stake (money/property vs human lives). In general, higher payoffs lead to increasing risk aversion. Higher probabilities lead to increasing risk aversion for gains and to increasing risk seeking for losses. These findings are confirmed by a subsequent empirical test. Shortcomings of existing formal theories, such as prospect theory, cumulative prospect theory, venture theory, and Markowitz's utility theory, are identified. It is shown that it is not probabilities or payoffs, but the framing condition, which explains most variance. These findings are interpreted as showing that no linear combination of formally relevant predictors is sufficient to capture the essence of the framing phenomenon.