Translating CBM-I Into Real-World Settings: Augmenting a CBT-Based Psychiatric Hospital Program

Cognitive bias modification for interpretation (CBM-I) is an appealing augmentation to cognitive-behavioral therapy (CBT) because it targets cognitive bias efficiently via computerized training. Few studies have tested the combination of CBM-I and CBT, and none have translated lab-based CBM-I protocols to an acute psychiatric setting. The present study describes the development and implementation of CBM-I as an augmentation to a CBT-based partial hospital. We developed a transdiagnostic CBM-I based on the word–sentence association paradigm (WSAP), which reinforces individuals for endorsing benign interpretations and rejecting negative interpretations of ambiguous sentences. Over two iterations of development, we randomly assigned patients (N = 127; M age = 34.21; 58% female, 40% male, 2% nonbinary) to either CBM-I or a control group (Phase 1: neutral WSAP task; Phase 2: treatment as usual). CBM-I comprised daily sessions (10 minutes) completed during program hours, and number of sessions varied naturalistically according to patient length of stay. Primary outcomes included feasibility, acceptability, and target engagement (interpretation bias). CBM-I was feasible and acceptable to acute psychiatric patients, and successfully shifted interpretation for novel stimuli. Patient feedback suggested that participants viewed CBM-I as bolstering their primary CBT-based care. Exploratory analyses examining clinical benefit revealed a small between-group effect on anxiety severity (d = 0.378), but no group differences on depression outcomes (d = 0.008). Findings indicate that CBM-I is a feasible and acceptable augmentation to CBT-based partial hospital care. Future studies are warranted to determine who is most likely to benefit from this low-intensity approach.     

Sleep disruption explains age-related prospective memory deficits: implications for cognitive aging and intervention

The high prevalence of sleep disruption among older adults may have implications for cognitive aging, particularly for higher-order aspects of cognition. One domain where sleep disruption may contribute to age-related deficits is prospective memory—the ability to remember to perform deferred actions at the appropriate time in the future. Community-dwelling older adults (55–93 years, N = 133) undertook assessment of sleep using actigraphy and participated in a laboratory-based prospective memory task. After controlling for education, sleep disruption (longer awakenings) was associated with poorer prospective memory. Additionally, longer awakenings mediated the relationship between older age and poorer prospective memory. Other metrics of sleep disruption, including sleep efficiency and wake after sleep onset, were not related to prospective memory, suggesting that examining the features of individual wake episodes rather than total wake time may help clarify relationships between sleep and cognition. The mediating role of awakening length was partially a function of greater depression and poorer executive function (shifting) but not retrospective memory. This study is among the first to examine the association between objectively measured sleep and prospective memory in older adults. Furthermore, this study is novel in suggesting sleep disruption might contribute to age-related prospective memory deficits; perhaps, with implications for cognitive aging more broadly. Our results suggest that there may be opportunities to prevent prospective memory decline by treating sleep problems.     

Motives matter: The emotional consequences of recalled self- and other- focused prosocial acts

Past research has demonstrated that engaging in and reflecting upon past instances of prosocial behavior promote happiness. Yet, people provide help for a myriad of reasons. Do the motives for giving impact its emotional consequences? In three experiments (N?>?680), we compared the emotional outcomes of recalling a past instance of prosocial behavior motivated by self-focused and other-focused concerns. Using both between and within subjects designs, we find that recalling an instance of other-focused helping leads to higher positive affect than recalling an instance of self-focused helping. This finding was mediated by feelings of morality. The present work suggests that not all acts of kindness offer equivalent well-being benefits and that selfish motives may undermine the emotional rewards that typically follow other-focused prosocial behavior.     

Patterns of Response and Remission Following a One-Session Treatment for Blood-Injection-Injury Phobia in Youth

Blood-Injection-Injury (BII) Phobia is a severe and impairing disorder that has been understudied in youth. The present study aimed to define patterns of response and remission following a modified One-Session Treatment (OST) including an e-therapy maintenance program for children and adolescents with BII Phobia. Moreover, characteristics of different responder groups were examined in order to determine correlates of a poorer response. Youth (n?=?20; 8–18 years) were categorized into four responder groups (e.g., immediate remitter, delayed remitter, partial responder, and nonresponder) based upon defined criteria for remission. Immediate remitters to treatment were more likely to have a primary diagnosis of injection phobia, rather than a combined blood and injection phobia. Nonresponders reported significantly greater disgust sensitivity at pretreatment and were more likely to have a comorbid diagnosis of Social Phobia. In regards to within session change, youth who achieved the exposure goal of having a blood test during treatment had a significantly stronger treatment response. These preliminary findings may assist clinicians in the planning and delivering of intensive Cognitive Behavioral Treatment (CBT) approaches for BII Phobia in youth.     

ERP components activated by the "GO!" and "WITHHOLD!" conflict in the random Sustained Attention to Response Task

The present study investigates the event related potential (ERP) components associated with the random version of the Sustained Attention to Response Task (SART). The random SART is a Go/No-Go task in which the No-Go target appears unpredictably and rarely. In the present experiment, the EEG was recorded from 58 electrodes with mastoids as reference. As expected, the N2 and P3 were larger in the No-Go trials compared to the Go trials, with the P3 more frontal for the No-Go trials compared to the Go trials. The functional role of the N2 and P3 in the No-Go trials is discussed comparing our results to the fixed SART results obtained by Dockree et al. [Dockree P. M., Kelly S. P., Robertson I. H., Reilly R. B., & Foxe J. J. (2005). Neurophysiological markers of alert responding during goal-directed behaviour: A high-density electrical mapping study. NeuroImage, 27, 587-601]. In addition, the lateralized readiness potential (LRP) was computed. The absence of an LRP in the No-Go trials suggests that a central inhibitory mechanism intervenes to prevent the preparation and execution of a dominant motor response.     

An asymmetric effect of relational integration on recognition memory

Two experiments assessed whether conceptual relations (e.g., contains: COOKIE JAR) facilitate the retrieval of concepts (e.g., COOKIE and JAR) from long-term memory. The CARIN model of nominal combination asserts that conceptual relations are represented with and selected from the modifier noun (COOKIE). Thus, the model predicts that relational integration will facilitate memory for modifiers but not for head nouns (JAR). In Experiment 1, concepts were studied in pairs and were then tested individually. Recognition accuracy was higher for modifiers than for head nouns. In Experiment 2, the studied concepts (e.g., COOKIE JAR) were tested in the context of a new pair that instantiated either the same relation (e.g., COOKIE plate) or a different relation (e.g., COOKIE crumb). Recognition was again better for modifiers than for head nouns, but only when the same conceptual relation was instantiated at both study and test. Thus, results indicate that conceptual relations (a) facilitate recognition memory, and (b) are associated more strongly with the modifier than with the head noun.     

Mock juror's perceptions of a child witness passing or failing a truth and lies discussion or promising to tell the truth

This study examined the effect of a child passing or failing the UK truth and lies discussion (TLD) compared with the Canadian promise to tell the truth on mock jurors' decisions regarding witness credibility and truthfulness and defendant guilt. Ninety-two participants read a vignette that described a child witnessing his father physically attacking his mother. The vignette was manipulated for witness age (age 4 years and age 8 years) and TLD performance/promise. Supporting the hypotheses, participants rated the witness's credibility and truthfulness significantly higher after a witness passed a TLD and after promising to tell the truth. The age of the child witness did not significantly affect jurors' decision making. The results are discussed in relation to arguments regarding the abolition of the UK's TLD in favour of introducing a promise to tell the truth.     

“I think you understand me.” Studying the associations between actual,assumed, and perceived understanding within couples

The current study examined the associations between actual, assumed, and perceived understanding and partners’ levels of dyadic adjustment. One hundred fifty-two couples provided questionnaire data (assumed and perceived understanding), participated in a videotaped conflict interaction, and in a video-review task to assess actual understanding (empathic accuracy). The data were analyzed by means of the Actor-Partner Interdependence Model. The results suggest that (a) some aspects of how well someone assumes that (s)he has understood the partner during a preceding conflict interaction were positively associated with his/her own objective level of understanding (actor effect), (b) that someone's perception of how understood (s)he feels was not associated with the partner's objective level of understanding (partner effect), and (c) perceived understanding, but not actual understanding, was positively associated with dyadic adjustment.