Cognitive-behavioral therapy for panic disorder: a review of treatment elements,strategies, and outcomes

This article provides an overview of cognitive-behavioral therapy (CBT) for panic disorder. CBT is currently considered a first-line treatment for panic disorder. It offers benefit after short-term intervention, typically consisting of 12-15 sessions conducted in either an individual or a group format. The treatment focuses on the elimination of the patterns that underlie and perpetuate the disorder. Through CBT, patients learn about the nature of the disorder and acquire a set of strategies that counter the fears of panic attacks themselves, and break the recurring cycle of anticipatory anxiety, panic, and agoraphobic avoidance. The collaborative format of treatment, and a focus on elimination of core fears may be factors in enhancing longer-term outcome. In this article, we review the efficacy of CBT as a first-line treatment, a strategy for medication nonresponders, a replacement strategy for patients who wish to discontinue pharmacotherapy, and a potential preventive strategy for at-risk individuals. We also discuss some of the complex issues involved with combination-treatment strategies.     

Figural aftereffects in the perception of faces

We examined figural aftereffects in images of human faces, for which changes in configuration are highly discriminable. Observers either matched or rated faces before or after viewing distorted images of faces. Prior adaptation strongly biases face perception by causing the original face to appear distorted in a direction opposite to the adapting distortion. Aftereffects transferred across different faces and were similar for upright or inverted faces, but were weaker when the adapting and test faces had different orientations (e.g., adapt inverted and test upright). Thus the aftereffects depend on which images are distorted, and not simply on the type of distortion introduced. We further show that the aftereffects are asymmetric, for adapting to the original face has little effect on the perception of a distorted face. This asymmetry suggests that adaptation may play an important normalizing role in face perception. Our results suggest that in normal viewing, figural aftereffects may strongly influence form perception and could provide a novel method for probing properties of human face perception.     

Group cognitive-behavior therapy for patients failing to respond to pharmacotherapy for panic disorder: a clinical case series.

The last decade has brought exciting advances to the treatment of panic disorder and agoraphobia, and a variety of cognitive-behavioral and pharmacologic treatment strategies offer clear benefit to patients. Nonetheless, treatment nonresponse continues to be a chronic problem, and additional strategies are needed to aid patients who do not respond fully to initial interventions. In the present study, we use 'services' research to document the clinical response of pharmacotherapy nonresponders to a standard program of brief, group cognitive-behavioral therapy. Patients responded well, regardless of whether they had received a full, adequate trial of pharmacotherapy. In addition to its application as an initial treatment for panic disorder, routine application of cognitive-behavioral therapy in pharmacologic treatment algorithms is encouraged, with attention to referral of pharmacotherapy nonresponders to cognitive-behavioral therapy.     

Social psychology at the crossroads: Its encounter with cognitive and ecological psychology and the interactive perspective

This article discusses the implications for social psychology of recent developments in the neighbouring fields of cognitive and ecological psychology. The authors stress the importance of studying the cognitive processes directly instead of inferring them as hypothetical constructs from aggregate responses. This paradigmatic shift implies a change in the conduct of research from the traditional nomothetic perspective to a neo-idiographic one. A method of representational contextualization is offred to generate the affective and cognitive deep structure from surface, first order data. This structure identified as the internal environment, reflects simultaneously the construction of reality by a situated individual and the recoding rules operating in such a construction.     

The effect of organismic disadvantage on allocation behavior in children

Equity theory (Adams, 1965) suggests that when persons are asked to divide a given amount of reward between two other persons, one relatively more disadvantaged than the other at performing a task, they will make allocations that are disproportionate to the two persons' performance levels, giving the disadvantaged person a disproportionately larger share and the advantaged person a disproportionately smaller share of the reward. The theory attributes this effect to the allocator's perception that the disadvantaged individual expended a disproportionately greater amount of effort. A group of third- and fourth-graders and a group of seventh-graders were asked to divide rewards between pairs of children that were described to vary in age (“younger” vs. older) or ability (“unskilled” vs. skilled) or that were the “same” in age and ability and that were described to vary (5 vs. 15, or 0 vs. 20 baskets) or to be equal (10 vs. 10 baskets) in performance on a basketball-shooting task. Unlike the group of third- and fourth-graders, the seventh-graders generally made significantly larger allocations to the disadvantaged individuals (“younger” and “unskilled”) than to the “same” individuals, making the largest allocations under the most discrepant performance condition (0 vs. 20). Overall, the results suggested that the equity principle becomes more salient in children as age increases.     

An empirical study of the reports of APA's peer review panel in the congressional review of the U.S.S. IOWA incident

The U.S. House of Representatives Armed Services Committee (HASC) review of the US. Navy's investigation of the U.S.S. IOWA incident provides a case study of the problems with reconstructive psychological evaluations. The US. Navy attributed the explosion on board the U.S.S. IOWA to the intentional suicidal acts of Gunner's Mate Clayton Hartwig, a conclusion supported primarily by an Equivocal Death Analysis (EDA) conducted by the FBI. Systematic analysis of the reports of the expert panelists who consulted to the NASC reveals that 11 of the 14 panelists were critical of the conclusions reached by the Navy/FBI. There was considerable variability among the judgments of the panelists, who reached consensus only for broad categories. Because the reliability and validity of postmortem psychological reconstructions such as EDA and psychological autopsy have not been established, clinicians are urged to exercise caution in the use of such procedures and to be sensitive to ethical obligations to consumers when using such techniques.     

Neurobehavioral Evaluation System (NES) and school performance

The aims of this study were to explore the validity of a set of computerized tests, and to explore the validity of reaction time variability as an index of sustained attention. In Phase 1, 105 children 7–10 years old were presented with five tests from the Neurobehavioral Evaluation System (NES). The children were able to complete four of the tests: the Continuous Performance, Simple Reaction Time, Symbol-Digit Substitution, and Digit Span tests. In Phase 2, a follow-up of 88 children, performance on these tests was significantly associated with teachers' ratings of attention and with standardized academic achievement measures. Moreover, variability on the Simple Reaction Time and performance on the Digit Span and Symbol-Digit tests significantly predicted reading achievement. Similarly, performance on the Digit Span and Symbol-Digit tests significantly predicted mathematics achievement. In addition, variability on the Simple Reaction Time and Digit Span test performance were significant predictors of reading achievement above and beyond the prediction provided by teachers' ratings.     

Analysis of four measures of positional bias within a multiple stimulus without replacement preference assessment

Positional bias is a pattern of responding to a specific location that can be influenced by response effort and/or prior learning history. Prior research on positional bias within stimulus preference assessments have focused primarily on its use in paired stimulus assessments due to the complex nature of the multiple stimulus without replacement (MSWO) preference assessment. The present study is a secondary data analysis that utilized four different methods to measure side and center bias in a MSWO preference assessment for 19 young children with autism spectrum disorder. Participants displayed varying degrees of biased responding but collectively engaged in minimal biased responding. This study includes an analysis of the four methodologies, discussion of general patterns of responding, and general recommendations for the application of these methodologies in future research.