A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations

BackgroundIrritable bowel syndrome (IBS) is a chronic and debilitating medical condition with few efficacious pharmacological or psychosocial treatment options available. Evidence suggests that visceral anxiety may be implicated in IBS onset and severity. Thus, cognitive-behavioral treatment (CBT) that targets visceral anxiety may alleviate IBS symptoms.MethodsThe current study examined the efficacy of a CBT protocol for the treatment of IBS which directly targeted visceral sensations. Participants (N = 110) were randomized to receive 10 sessions of either: (a) CBT with interoceptive exposure (IE) to visceral sensations; (b) stress management (SM); or (c) an attention control (AC), and were assessed at baseline, mid-treatment, post-treatment, and follow-up sessions.ResultsConsistent with hypotheses, the IE group outperformed AC on several indices of outcome, and outperformed SM in some domains. No differences were observed between SM and AC. The results suggest that IE may be a particularly efficacious treatment for IBS.ConclusionsImplications for research and clinical practice are discussed.     

Fruitful plans: adding targeted mental imagery to implementation intentions increases fruit consumption

Forming implementation intentions ('If I encounter situation X, then I will perform behaviour Y!') increases the probability of carrying out goals. This study tested the hypothesis that mental imagery targeting key elements of implementation intentions further increases goal achievement. The residents of a student residence were assigned the goal of consuming extra portions of fruit every day for 7 days and randomly assigned to one of four conditions: control (active rehearsal), implementation intentions, goal intention mental imagery or mental imagery targeted to the implementation intentions. Among low fruit consumers, but not high fruit consumers, fruit consumption at follow-up was higher in the targeted mental imagery group than in the other group, with the lowest fruit consumption in the control group. The findings suggest that it may be beneficial to use targeted mental imagery when forming implementation intentions.     

Female tokens in high-prestige work groups: Catalysts or inhibitors of group diversification?

There is a popular theory-based assumption that women, who are numerical minorities in high-prestige work groups, will advocate for other women as potential work group peers. However, these individuals may face special challenges in fulfilling this role. I examine how the prestige accorded to the work group and their numerical representation interact to impact women’s concerns about being considered valued members of their groups and hence, their propensity to support other women in the selection process. I conducted three studies which showed that women will abdicate the opportunity to support highly or moderately qualified female candidates as potential work group peers. Furthermore, the concern that a highly qualified female candidate will be seen as more of a valued group member (competitive threat) and that a moderately qualified female candidate will adversely affect their value by reinforcing negative stereotypes about their demographic category (collective threat) partially mediated the relationship between numerical representation and work group prestige and women’s preference for other women as work group peers.     

Perceptions of the cognitive compensation and interpersonal enjoyment functions of collaboration among middle-aged and older married couples

Perceptions of cognitive compensation and interpersonal enjoyment of collaboration were examined in three hundred middle-aged and older couples who completed measures of perceptions of collaboration, cognitive ability, marital satisfaction, an errand task and judged their spouse's affiliation. Older adults (especially men) endorsed cognitive compensation and interpersonal enjoyment and reported using collaboration more frequently than middle-aged adults. Greater need for cognitive compensation was related to lower cognitive ability only for older wives. Greater marital satisfaction was associated with greater interpersonal enjoyment. These two functions related to reports of more frequent use of collaboration and perceptions of spousal affiliation in a collaborative task.     

New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR’s potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use.     

Do intrusive memory characteristics predict depression at 6 months?

Two prospective studies have investigated whether the presence, intrusion, and avoidance of negative intrusive memories predict depression, and have reported conflicting findings. We aimed to replicate and extend these investigations by exploring the role of intrusion and avoidance of intrusive memories, as well as memory characteristics, in the prediction of depression prospectively. At Time 1 a mixed sample of community participants (N=85) were interviewed and completed self-report measures of depression, anxiety, and intrusive memory features. At Time 2 (6 months later, N=64) depression and anxiety symptoms were reassessed. Results were partly consistent with hypotheses for the sub-sample of participants who did not receive treatment between the baseline and follow-up assessments. Baseline levels of intrusion and some memory features (uncontrollability, distress, interference, numbness, detachment) predicted follow-up depression, controlling for baseline depression symptoms. Unexpectedly, avoidance of intrusive memories and other features (e.g., here and now quality) did not predict depression. Levels of intrusion and avoidance did not predict anxiety at follow-up. These results provide further evidence that intrusive memories are not simply an epiphenomenon of depression, but predict depression prospectively. Our results suggest that novel, depression-specific theories that emphasise the role of memory disturbances in the maintenance of depression are needed.     

Age-related differences in guessing on free and forced recall tests

This study examined possible age-related differences in recall, guessing, and metacognition on free recall tests and forced recall tests. Participants studied categorised and unrelated word lists and were asked to recall the items under one of the following test conditions: standard free recall, free recall with a penalty for guessing, free recall with no penalty for guessing, or forced recall. The results demonstrated interesting age differences regarding the impact of liberal test instructions (i.e., forced recall and no penalty) relative to more conservative test instructions (i.e., standard free recall and penalty) on memory performance. Specifically, once guessing was controlled, younger adults' recall of categorised lists varied in accordance with test instructions while older adults' recall of categorised lists did not differ between conservative and liberal test instructions, presumably because older adults approach standard free recall tests of categorised lists with a greater propensity towards guessing than young adults.     

Practicing what we know: Multicultural counseling competence among clinical psychology trainees and experienced multicultural psychologists

Multicultural (MC) competence is considered a necessary skill for clinical and counseling psychologists; however, there is little to no research on the assessment of demonstrated multicultural counseling competence (DMCCC) of clinical psychology graduate students. In this study, we developed a MC assessment instrument to assess DMCCC of clinical psychology graduate students compared with MC-experienced psychologists. In addition, we assessed for differences between the endorsement of MC-appropriate strategies and actual use of these strategies in clinical practice, both by MC-experienced psychologists and clinical psychology students. Results revealed significant differences between the DMCCC of clinical psychology graduate students and MC-experienced psychologists. Significant differences also emerged between endorsement of strategies as multiculturally appropriate and likelihood of actual use of these strategies. Findings suggest that future training and competence models should incorporate participants' ability to not only identify multiculturally appropriate strategies but also use these strategies in therapy.     

Effects of manifest ethnic identification on employment discrimination

Evidence from recent laboratory experiments suggests that ethnic identification can lead to negative evaluations of ethnic minorities (Kaiser & Pratt-Hyatt, 2009). The current research considers the generalizability of these findings to face-to-face interactions in contexts wherein impression management concerns are salient: the workplace hiring process. In a field experiment, Black, Hispanic, and Irish individuals applied for retail jobs with or without visible display of their ethnic identification. Analysis of indicators of formal (e.g., application offering, interview scheduling) and interpersonal discrimination (e.g., interaction length, nonverbal negativity) suggest store personnel interacting with other-race applicants exhibited greater positivity and longer interactions when applicants displayed ethnic identification than when they did not. The findings suggest that psychologists need to understand not only attitudes or intentions expressed in the lab, but also the behavioral consequences of manifest group identity as they unfold in natural environments.     

Breaking apart the typical mortality salience manipulation: Two questions,two outcomes

The typical mortality salience manipulation asks participants to reflect on two questions, one about the emotions associated with the thought of death and the other about what happens after one dies. In five experiments, we separated these two questions and gave participants either one or a control question. In Experiment 1, participants' responses to the afterlife question were coded as being informed more by cultural knowledge and values compared with responses to the emotion question. Experiments 2 and 3 demonstrated that participants responding to the afterlife question showed greater stereotype usage compared with those responding to the emotion or a control question. In Experiment 4, results illustrate that the afterlife and emotion question differ on various coding dimensions related to self‐focus, emotion, and culturally related death words, but not death‐related words. In addition, participants who responded to the afterlife question demonstrated greater cultural worldview defense by setting a higher bail for an alleged prostitute compared with those who answered the emotion or a control question. In Experiment 5, participants responding to the emotion question demonstrated a greater preference for personally endorsed values compared with those who responded to the emotion or a control question. These results suggest that the two questions used in the common mortality salience manipulation produce different results when separated. Copyright © 2012 John Wiley & Sons, Ltd.