Effectiveness of Seeking Safety for Co‐Occurring Posttraumatic Stress Disorder and Substance Use

The authors evaluated the Seeking Safety program's effectiveness for treating posttraumatic stress disorder (PTSD) and substance use symptoms across 12 between‐groups studies (N = 1,997 participants). Separate meta‐analytic procedures for studies implementing wait list/no treatment (n = 1,042) or alternative treatments (n = 1,801) yielded medium effect sizes for Seeking Safety for decreasing symptoms of PTSD and modest effects for decreasing symptoms of substance use. Limitations of the findings and implications for counselors are discussed.     

Effects of mineralocorticoid receptor blockade on empathy in patients with major depressive disorder

Background

The mineralocorticoid receptor (MR) is highly expressed in the hippocampus and prefrontal cortex and is involved in social cognition. We recently found that pharmacological stimulation of the MR enhances emotional empathy but does not affect cognitive empathy. In the current study, we examined whether blockade of the MR impairs empathy in patients with major depressive disorder (MDD) and healthy individuals.

Methods

In a placebo-controlled study, we randomized 28 patients with MDD without psychotropic medication and 43 healthy individuals to either placebo or 300 mg spironolactone, a MR antagonist. Subsequently, all participants underwent two tests of social cognition, the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC), measuring cognitive and emotional facets of empathy.

Results

In the MET, we found no significant main effect of treatment or main effect of group for cognitive empathy but a highly significant treatment by group interaction (p < 0.01). Patients had higher cognitive empathy scores compared to controls in the placebo condition but not after spironolactone. Furthermore, in the spironolactone condition reduced cognitive empathy was seen in MDD patients but not in controls. Emotional empathy was not affected by MR blockade. In the MASC, no effect of spironolactone could be revealed.

Conclusion

Depressed patients appear to exhibit greater cognitive empathy compared to healthy individuals. Blockade of MR reduced cognitive empathy in MDD patients to the level of healthy individuals. Future studies should further clarify the impact of MR functioning on different domains of social cognition in psychiatric patients.

     

Shame: mechanisms of activation and consequences for social perception, self-image, and general negative emotion

In two experiments we explored Tomkins's (1963) concept of shame, comparing conscious versus unconscious shame activation. In line with Tomkins' theory, an impeded positive feedback sequence, consciously or unconsciously perceived, elicited more shame than continuously negative feedback. This was, however, true only for participants with an initially low degree of internalized shame. Participants with a high degree of internalized shame unexpectedly displayed shame following the positive feedback intended to elicit positive emotion. Whether this has implications for Tomkins's theory or rather for methodological issues is discussed. Exploring consequences of shame for social perception and self-image, we found reversed results depending on level of consciousness. Effects were consistently greater for women, although at marginal significance levels. Results partly support Tomkins's notion of shame, but imply that his theory might need modification in terms of the role played by consciousness and, possibly, by individual differences such as sex and shame proneness.     

Emotional Stroop task: effect of word arousal and subject anxiety on emotional interference

Inconsistent findings regarding the emotional Stroop effect in healthy subjects may be explained by confounding effects of stimulus valence and arousal, as well as individual differences in anxiety. We examined reaction time data in a healthy sample using the emotional Stroop task while carefully matching arousal level of positive and negative words. Independent of valence, emotional relative to neutral words elicited emotional interference, indicating that arousal determines emotional interference. Independent of valence, emotional words were better re-called and recognized than neutral words. Individual differences in state anxiety were associated with emotional interference, that is, emotional interference was enhanced in subjects with high state anxiety. There was no influence of trait anxiety. These findings indicate that word arousal produces emotional interference independent of valence. State anxiety exacerbates interference of emotional words by further biasing attention towards emotionally salient stimuli. Thomas Dresler and Katja Mériau have contributed equally.     

The Neurobiological Underpinnings of Coping With Pain

ABSTRACT— The biopsychosocial model treats pain as resulting from a complex interaction of biological, psychological, and social factors. Individual differences in approaches to coping with pain-related symptoms are important determinants of pain-related outcomes, and are often classified under the "psychological" category within the biopsychosocial model. However, engagement in various cognitive, affective, and behavioral pain-coping strategies appears to exert biological effects, which we review here. Pain-coping activities such as catastrophizing, distracting oneself from pain sensations, or reappraisal of pain may exert effects on activity in a variety of pain-processing and pain-modulatory circuits within the brain, as well affect the functioning of neuromuscular, immune, and neuroendocrine systems. The interface between pain-related neurobiology and the use of specific pain-coping techniques represents an important avenue for future pain research.     

A tool for thought! When comparative thinking reduces stereotyping effects

Stereotypes have pervasive, robust, and often unwanted effects on how people see and behave towards others. Undoing these effects has proven to be a daunting task. Two studies demonstrate that procedurally priming participants to engage in comparative thinking with a generalized focus on differences reduces behavioral and judgmental stereotyping effects. In Study 1, participants who were procedurally primed to focus on differences sat closer to a skinhead - a member of a negatively stereotyped group. In Study 2, participants primed on differences ascribed less gender stereotypic characteristics to a male and female target person. This suggests that comparative thinking with a focus on differences may be a simple cognitive tool to reduce the behavioral and judgmental effects of stereotyping.     

Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents

This meta‐analysis evaluated the effectiveness of dialectical behavior therapy for adolescents in reducing symptoms of depression, anxiety, self‐injury, and suicide risk. Twelve between‐group studies (N = 834) were chosen that met the inclusion criteria. Results revealed small‐to‐medium Hedges's g effect sizes for all 4 symptoms compared with control and alternative treatment groups. However, the small number of effect sizes available for each analysis limited the generalizability of the findings. Implications and suggestions for future research are discussed.     

Understanding others,reciprocity, and self-consciousness

The article explores the basic conceptual relationship between social cognition, intersubjectivity and self-consciousness. A much-debated recent approach to social cognition, the so-called interaction theory, is the view that the ability to perceive, understand and interpret the behavior of others relies on interaction in the sense of mutual coordination of the embodied agents involved. It will be shown that this notion of reciprocity is too weak in order to fully account for social understanding. It will be argued that the idea of reciprocity should at least in some cases be conceived of as a stance persons adopt towards each other, which in turn presupposes that they acknowledge each other as self-conscious agents. This view is inspired by an argument originally introduced by Johann Gottlieb Fichte.     

Processes underlying congruent and incongruent facial reactions to emotional facial expressions

The present electromyographic study is a first step toward shedding light on the involvement of affective processes in congruent and incongruent facial reactions to facial expressions. Further, empathy was investigated as a potential mediator underlying the modulation of facial reactions to emotional faces in a competitive, a cooperative, and a neutral setting. Results revealed less congruent reactions to happy expressions and even incongruent reactions to sad and angry expressions in the competition condition, whereas virtually no differences between the neutral and the cooperation condition occurred. Effects on congruent reactions were found to be mediated by cognitive empathy, indicating that the state of empathy plays an important role in the situational modulation of congruent reactions. Further, incongruent reactions to sad and angry faces in a competition setting were mediated by the emotional reaction of joy, supporting the assumption that incongruent facial reactions are mainly based on affective processes. Additionally, strategic processes (specifically, the goal to create and maintain a smooth, harmonious interaction) were found to influence facial reactions while being in a cooperative mindset. Now, further studies are needed to test for the generalizability of these effects.