Efficacy of a Manualized and Workbook-Driven Individual Treatment for Social Anxiety Disorder

Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska-Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed.     

Space in Hand and Mind: Gesture and Spatial Frames of Reference in Bilingual Mexico

Speakers of many languages prefer allocentric frames of reference (FoRs) when talking about small-scale space, using words like “east” or “downhill.” Ethnographic work has suggested that this preference is also reflected in how such speakers gesture. Here, we investigate this possibility with a field experiment in Juchitán, Mexico. In Juchitán, a preferentially allocentric language (Isthmus Zapotec) coexists with a preferentially egocentric one (Spanish). Using a novel task, we elicited spontaneous co-speech gestures about small-scale motion events (e.g., toppling blocks) in Zapotec-dominant speakers and in balanced Zapotec-Spanish bilinguals. Consistent with prior claims, speakers’ spontaneous gestures reliably reflected either an egocentric or allocentric FoR. The use of the egocentric FoR was predicted—not by speakers’ dominant language or the language they used in the task—but by mastery of words for “right” and “left,” as well as by properties of the event they were describing. Additionally, use of the egocentric FoR in gesture predicted its use in a separate nonlinguistic memory task, suggesting a cohesive cognitive style. Our results show that the use of spatial FoRs in gesture is pervasive, systematic, and shaped by several factors. Spatial gestures, like other forms of spatial conceptualization, are thus best understood within broader ecologies of communication and cognition.     

The Confusion of Fear and Surprise: A Developmental Study of the Perceptual-Attentional Limitation Hypothesis Using Eye Movements

The goal of the present study was to test the Perceptual-Attentional Limitation Hypothesis in children and adults by manipulating the distinctiveness between expressions and recording eye movements. Children 3–5 and 9–11 years old as well as adults were presented pairs of expressions and required to identify a target emotion. Children 3–5 years old were less accurate than those 9–11 years old and adults. All children viewed pictures longer than adults but did not spend more time attending to the relevant cues. For all participants, accuracy for the recognition of fear was lower than for surprise when the distinctive cue was in the brow only. They also took longer and spent more time in both the mouth and brow zones than when a cue was in the mouth or both areas. Adults and children 9–11 years old made more comparisons between the expressions when fear comprised a single distinctive cue in the brow than when the distinctive cue was in the mouth only or when both cues were present. Children 3–5 years old made more comparisons for brow only than both. The results of the present study extend on the Perceptual-Attentional Limitation Hypothesis showing an importance of both decoder and stimuli, and an interaction between decoder and stimuli characteristics.     

Children's emotions and coping with interpersonal stress as correlates of social competence

Identifying correlates of children's emotional reactions and coping can provide information about developmental processes and identify useful strategies for improving children's adaptation to stress. We investigated associations of social competence with children's responses to standardised, controllable interpersonal stressors. The stressors included bullying, arguing with a parent, and not being picked for a team sport. We expected greater competence to be associated with certain coping responses, and expected that coping would be better explained by also considering emotional reactions. Children (N = 230, Grades 3 to 7) reacted to three videotaped stressors, and children and parents completed questionnaires. Children rated as more competent used active and challenge coping strategies, such as problem solving and support seeking, more than other children, and they also responded with more sadness. Children's competence was associated with fear, but only in bivariate correlations, and was not associated with angry responses. In a structural equation model, emotions were associated with more coping responses, and the emotional reaction of sadness accounted for the link between children's social competence and adaptive (i.e., challenge) coping. Findings suggest that competent children use more adaptive coping, and this is accounted for by their greater feelings of sadness when dealing with controllable interpersonal stressors.     

Depression, low self-esteem and mindfulness

Negative biases in processing information about the self have long been recognised as a central feature in the development and maintenance of clinical depression. In practice, however, it may not be easy to distinguish between patients whose negative thinking about the self is primarily an aspect of current mood state, and those for whom it represents a reflection of more enduring issues (low self-esteem). The paper speculates that, in both cases, metacognitive awareness (acceptance of the idea that thoughts, assumptions and beliefs are mental events and processes rather than reflections of objective truth) may be an important precursor to active engagement in therapy on the part of the patient, and considers what aspects of cognitive therapy might be used to promote it in clinical practice.