Cognitive-Behavioral Treatment of Panic Disorder: Confronting Situational Precipitants

Panic Disorder is a common, debilitating psychological problem which is often effectively treated through cognitive behavioral approaches. Cognitive-behavioral treatment incorporates education, relaxation training, cognitive therapy, behavioral exposure, and relapse prevention treatment strategies. A case illustration demonstrates how cognitive-behavioral treatment facilitated a client's ability to identify and confront situational precipitants to panic in a gradual and systematic manner. A therapeutic and collaborative relationship provided the foundation for treatment, while education helped the client to understand the vicious cycle between somatic symptoms, catastrophic thoughts, and anxiety. Passive relaxation training incorporated deep breathing, muscle relaxation, and positive imagery generated from the client's own experience. Cognitive restructuring involved identifying automatic thoughts related to panic, challenging dysfunctional beliefs associated with the client's depression and low self-esteem, and generating alternative ways of thinking. Behavioral exposure (e.g., imaginal exposure, behavioral rehearsal, in vivo techniques) helped the client gain a greater sense of mastery over panic attacks triggered by his fear of hypodermic needles. Over the course of treatment, the frequency and intensity of the client's panic attacks decreased. Furthermore, the client's sense of mastery over panic had beneficial effects on his mood and self-esteem. Treatment gains were maintained at one-year follow-up.     

Storage of verbal associations is sufficient to activate the left medial temporal lobe

Neuroimaging studies have shown that memory encoding activates the medial temporal lobe (MTL). Many believe that these activations are related to novelty but it remains unproven which is critical - novelty detection or the rich associative encoding it triggers. We examined MTL activation during verbal associative encoding using functional magnetic resonance imaging. First, associative encoding activated left posterior MTL more than single word encoding even though novelty detection was matched, indicating not only that associative encoding activates the MTL particularly strongly, but also that activation does not require novelty detection. Moreover, it remains to be convincingly shown that novelty detection alone does produce such activation. Second, repetitive associative encoding produced less MTL activation than initial associative encoding, indicating that priming of associative information reduces MTL activation. Third, re-encoding familiar associations in a well-established way had a minimal effect on both memory and MTL activation, indicating that MTL activation reflects storage of associations, not merely their initial representation.     

The relationship between personal philosophy and effectiveness in counsellors

This study investigates the relationship between the effectiveness of counsellors and their personal philosophy, beliefs and attitudes. There is a review of the relevant literature concerning the qualities and attributes of effective counsellors, with a detailed examination of studies of counsellor philosophy. Two groups (n = 14 and n = 19) of counsellors on training courses were studied. Each participant wrote an account of a ‘Helping Relationship Incident’ which was rated on the 12 dimensions of counsellor ‘perceptual organization’ developed by Combs & Soper (1963). Course tutors gave ratings of the counselling effectiveness of their students. Rank order correlations between judgements of counsellor effectiveness and ratings of perceptual organization/philosophy were made. In both groups statistically significant results were found, adding weight to the hypothesis that a ‘person-centred’ perceptual organization or belief system is an important factor in counsellor effectiveness. The implications for counsellor selection and training are discussed, and suggestions are made for further research on this topic.     

Authorial intentions and metaphor comprehension

Three experiments investigated the role of authorial intentions in metaphor comprehension. In these studies, subjects read metaphoric (e.g., A family album is like a museum), literal (e.g., An art gallery is like a museum), and anomalous (e.g., A tortoise shell is like an art gallery) comparisons and rated their degreeof meaningfulness (Experiment 1), made speeded decisions as to whether each phrase was meaningful or not (Experiment 2), or wrote out interpretations of each comparison statement (Experiment 3). The subjects were tolt that the comparisons were written either by famous 20th century poets or by a computer program that randomly generated the statements from a list of words. Our general hypothesis was that knowing that intentional agents (the poets) authored the different comparisons should facilitate subjects' comprehension of the metaphors. Experiment 1 showed that subjects rated both metaphoric and literal comparisons as being more meaningful in the poet condition than when these statements were supposedly written by computer. Experiment 2 demonstrated that subjects were faster in making their meaningfulness judgments for metaphors in the poet condition than in the computer context, but that subjects were also slower in rejecting anomalous comparisons when these were supposedly written by the poets. Experiment 3 indicated that subjects produced more meanings or interpretations for comparisons presumably written by poets than by computer. These results highlight the improtance of implied, authorial intentions in understanding metaphorical statements. We discuss the implications of this work for psycholinguistic theories of figurative language comprehension, as well as for theories of literary interpretation.     

Cognitive variables related to suicidal contemplation in adolescents with implications for long-range prevention

In a series of studies with college and high school students (Total N=808) consistent and strong relationships were found between suicidal contemplation and the irrational beliefs considered by Rational-Emotive Theory & Therapy (RET) to underlie emotional distress. Suicidal contemplation was measured first by an item from the Beck Depression Inventory and subsequently by the Suicide Probability Scale. Irrational beliefs were measured by the Jones Irrational Beliefs Test and, in the third study, by the new Attitudes & Belief Scale-II as well. Groups formed on the basis of increasing indices of suicidal contemplation were found to be consistently, increasingly more irrational on both measures. Also groups created according to low, medium, and high levels of irrational beliefs (the B in RET) were found to be markedly different on C variables such as anxiety, depression, hopelessness, anger, psychosomoatic symptoms and suicidal contemplation. The findings were interpreted as strongly inferring a causational relationship from attitudes and beliefs to emotional distress and the contemplation of suicide. The implications of the findings for RET theory and for therapeutic and preventive strategies related to emotional distress and suicidal contemplation are clear. Other approaches to the explanation of suicide are cited and reference is made to a previous critical summary of them (Woods & Muller, 1988).Paul J. Woods, Ph.D., Co-Editor of this Journal, is a Fellow of the Institute for Rational-Emotive Therapy in New York City, a Professor of Psychology at Hollins College, and a Licensed Psychologist in independent practice in Roanoke, Virginia.Ellen S. Silverman, R. N., C. & M.A. collaborated in Study III for a Master's thesis at Hollins College. She is currently in a Ph.D. program in psychology at Virginia Polytechnic Institute & State University.Julia M. Gentilini, B. A. collaborated on Study I for an Honors' thesis in psychology at Hollins College.Deborah K. Cunningham, M. A. collaborated on Study II for a Master's thesis at Hollins College. She is currently in a Ph.D. program in psychology at the University of Memphis.Russell M. Grieger, Ph.D., Co-Editor of this Journal, is a Licensed Clinical Psychologist in independent practice in Charlottesville, Virginia, and a Fellow of the Institute for Rational-Emotive Therapy in New York City.     

Behavioral routines in decision making: the effects of novelty in task presentation and time pressure on routine maintenance and deviation

This article examines the role of behavioral routines in decision making. In order to induce routines, participants were confronted with recurrent route decisions in a computer-controlled trucking game, which allows for manipulation of routine acquisition and strength. During the final round of the game, time pressure and novelty in task presentation were varied as between-factors. It was hypothesized that time pressure would increase the likelihood of routine maintenance and novelty would increase the likelihood of deviation. Besides individual choices, response latencies and self-reports were additionally assessed to measure the amount of deliberation during decision making. Results show that time pressure strongly increased the probability of routine maintenance, even though the situation indicated the inadequacy of the routine. In contrast, novelty in task presentation provoked routine deviation and increased deliberation, as evident from response latencies and self-reports. Copyright © 1998 John Wiley & Sons, Ltd.     

Understanding allies’ participation in social change: A multiple perspectives approach

The introduction to the EJSP special issue brings together recent literature on allyship. We present and discuss different definitions of allyship and highlight a multiple perspectives approach to understanding the predictors and consequences of allyship. This approach suggests that engagement in allyship can be driven by egalitarian and non-egalitarian motivations and that the behaviours identified as allyship can have different meanings, causes and consequences depending on whether researchers take into account the allies’ perspective or the disadvantaged groups’ perspective. We use this approach as an organizing principle to identify themes that emerge in the papers included in this special issue. We start with four papers that consider the perspective of the advantaged group, followed by two papers that consider the perspective of the disadvantaged group. Finally, we introduce two theoretical papers that examine the relations between disadvantaged groups and allies, and we set out directions for future research.     

Children can optimally integrate multisensory information after a short action‐like mini game training

Combining information across different sensory modalities is of critical importance for the animal's survival and a core feature of human's everyday life. In adulthood, sensory information is often integrated in a statistically optimal fashion, so that the combined estimates of two or more senses are more reliable than the best single one. Several studies have shown that young children use one sense to calibrate the others, which results in unisensory dominance and undermines their optimal multisensory integration abilities. In this study we trained children aged 4–5 years with action‐like mini games, to determine whether it could improve their multisensory as well as their visuo‐spatial skills. Multisensory integration abilities were assessed using a visuo‐haptic size discrimination task, while visuo‐spatial attention skills were investigated using a multiple object tracking task (MOT). We found that 2‐weeks training were sufficient to observe both optimal multisensory integration and visuo‐spatial enhancements selectively in the group trained with action‐like mini games. This plastic change persisted up to 3 months, as assessed in a follow‐up. Our novel findings reveal that abilities that are commonly known to emerge in late childhood can be promoted in younger children through action‐like mini games and have long‐lasting effects. Our data have clinical implications, in that they suggest that specific trainings could potentially help children with multisensory integration deficits.     

The effect of shopping channel (online vs. offline) on message framing of naturalness

Naturalness is a significant driver of food-related choices. However, there is scarce knowledge of how textual cues could be utilised to enhance the effectiveness of naturalness claims. Drawn from construal level theory, we attempted to examine how different methods of framing naturalness affect consumers in online vs. offline shopping contexts. Study 1 employed a 2 (abstract vs. concrete) × 2 (online vs. offline) experiment with 127 respondents and demonstrated that concrete framing heightens positive attitudes via increased perceived concreteness of the message, especially in offline shopping situations. Study 2 employed a 4 (abstract vs. control vs. concrete without mentioning natural vs. concrete mentioning natural) × 2 (online vs. offline) experiment with 173 respondents and replicated findings from Study 1. Furthermore, Study 2 ruled out alternative explanations of message authenticity, transparency and credibility and indicated that the effect of message framings is truly driven by the congruency between consumers' construal level and message framings. Interestingly, no significant effect of abstractly framed naturalness claims was observed in online shopping situations, contradicting existing studies. This suggests that other psychological mechanisms may interplay and hinder the effectiveness of abstract framing in our study. Taken together, the current research demonstrate that consumers' mental representation varies across shopping platforms and how it affects their evaluation of different methods of message framing.