Exposure-based cognitive behavior therapy for atopic dermatitis: an open trial

Atopic dermatitis (AD) is a common and debilitating inflammatory dermatological disorder and is marked by itch and inflamed skin. Scratching, sleep loss, and avoidance of situations associated with more AD symptoms are central hypothesized mechanisms that perpetuate the disorder and cause reduced quality of life. We developed an exposure-based cognitive behavioral treatment (CBT) that entailed mindfulness practice as a means to increase tolerance for aversive experiences during exposure. The aim of the present study was to test the treatment’s acceptability and preliminary efficacy in adults with AD. We used an uncontrolled pretest-posttest design and recruited participants (N = 9) from a university hospital dermatological clinic. The treatment comprised 10 weekly sessions over 10 weeks and assessments of AD symptoms as well as psychiatric symptoms and quality of life were conducted at baseline, posttreatment and 6-month follow-up. The results showed significant and large baseline to posttreatment improvements on self-reported measures of AD symptoms (p = .020) and general anxiety (p = .005), but there was no significant improvement in depression or quality of life. Treatment satisfaction was high and a majority of participants (67%) completed the treatment. We conclude that exposure-based CBT for adult AD can be feasible, acceptable, and potentially efficacious.     

A Historical Perspective on the Distinction Between Basic and Applied Science

The traditional distinction between basic (“pure”) and applied science has been much criticized in recent decades. The criticism is based on a combination of historical and systematic epistemic argument. The present paper is mostly concerned with the historical aspect. I argue that the critics impose an understanding at odds with the way the distinction was understood by its supporters in debates on science education and science policy in the nineteenth and twentieth centuries. And I show how a distinction that refers to difference on several epistemic and social dimensions makes good sense of representative historical cases. If this argument is tenable it suggests more continuity in the epistemology and politics of science than has been claimed by a new paradigm of science studies and politics during recent decades.     

Long-term follow-up of internet-delivered exposure and mindfulness based treatment for irritable bowel syndrome

We conducted a follow-up of a previously reported study of internet-delivered cognitive behavior therapy (CBT) for IBS, based on exposure and mindfulness exercises (Ljótsson et al. (2010). Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome – a randomized controlled trial. Behaviour Research and Therapy, 48, 531–539). Seventy-five participants from the original sample of 85 (88%) reported follow-up data at 15–18 months (mean 16.4 months) after completing treatment. The follow-up sample included participants from both the original study’s treatment group and waiting list after it had been crossed over to treatment. Intention-to-treat analysis showed that treatment gains were maintained on all outcome measures, including IBS symptoms, quality of life, and anxiety related to gastrointestinal symptoms, with mainly large effect sizes (within-group Cohen’s d = 0.78–1.11). A total of fifty participants (59% of the total original sample; 52% of the original treatment group participants and 65% of the original waiting list participants) reported adequate relief of symptoms. Improvements at follow-up were more pronounced for the participants that had completed the full treatment and maintenance of improvement did not seem to be dependent on further treatment seeking. This study suggests that internet-delivered CBT based on exposure and mindfulness has long-term beneficial effects for IBS-patients.     

Phonemic imperception in aphasia

This study investigated characteristics of 14 aphasics with impaired phoneme discrimination identified from a population of 100 patients with left hemisphere lesions. All patients with impaired phoneme discrimination were significantly impaired in aural comprehension, but many showed intact sound recognition and some showed normal reading comprehension. Defects in phoneme discrimination were typically seen in the acute stage of aphasia resulting from stroke; and in most instances, defects in phoneme discrimination were no longer apparent 4 months postonset. All patients who recovered normal phoneme discrimination also made significant improvement in aural comprehension. The findings support the concept that some aural comprehension defects result from a specific disturbance in phoneme discrimination.     

Lacking power impairs executive functions

Four experiments explored whether lacking power impairs executive functioning, testing the hypothesis that the cognitive presses of powerlessness increase vulnerability to performance decrements during complex executive tasks. In the first three experiments, low power impaired performance on executive-function tasks: The powerless were less effective than the powerful at updating (Experiment 1), inhibiting (Experiment 2), and planning (Experiment 3). Existing research suggests that the powerless have difficulty distinguishing between what is goal relevant and what is goal irrelevant in the environment. A fourth experiment established that the executive-function impairment associated with low power is driven by goal neglect. The current research implies that the cognitive alterations arising from powerlessness may help foster stable social hierarchies and that empowering employees may reduce costly organizational errors.     

Therapeutisches Gruppenprogramm für Stalking-Opfer

Stalking victims show a high level of psychological disturbance and frequently need professional help. Thus, stalking must be considered as a serious issue in the field of psychosocial care. However, specific intervention programs to support stalking victims are not available. This paper reports on a pilot project that offers therapeutic help to stalking victims via a structured outpatient group therapy approach. The program aims at setting up appropriate behavior patterns concerning contact with the stalker, strengthening the victims’ self-efficacy and developing coping strategies for stalking-related stress situations. To investigate the effectiveness of the group program, an evaluation study has been conducted using self-report inventories, interview data and biological parameters. Preliminary results from 4 completed groups with 13 participants, indicating that the approach is highly effective, are reported. The potential of the group approach to improve psychosocial care provision for stalking victims is discussed. The need to integrate psychotherapeutic approaches into a multi-professional support system for stalking victims, comprising legal counsel, police measures and psychosocial interventions, is emphasized.     

Group acceptance and commitment therapy (ACT) for bipolar disorder and co-existing anxiety – an open pilot study

Previous studies have supported acceptance and commitment therapy (ACT) for reducing impairment related to various chronic conditions. ACT may possibly be beneficial for bipolar disorder (BD) with co-existing anxiety, which is associated with a poorer treatment outcome. Efforts are needed to identify suitable psychological interventions for BD and co-existing anxiety. In this open clinical trial, we included 26 patients with BD type 1 or 2 at an outpatient psychiatric unit specializing in affective disorders. The intervention consisted of a 12-session manualized group treatment that included psychoeducation, mindfulness, engaging in values-based behaviour, cognitive defusion, acceptance and relapse prevention modules. Participants completed four self-report questionnaires covering anxiety symptoms (Beck Anxiety Inventory - BAI), depressive symptoms (Beck Depression Inventory - BDI-II), quality of life (Quality of Life Inventory - QOLI) and psychological flexibility (Acceptance and Action Questionnaire - AAQ-2) before, during and after the treatment. At post-treatment, the participants reported significant improvements in all outcome measures, with large effects (Cohen’s d between 0.73 and 1.98). The mean reduction in anxiety symptoms was 45%. At post-treatment, 96% of the patients were classified as responders on at least one of the outcome measures. A limitation is that the trial is uncontrolled. The results suggest that ACT has the potential to be an effective treatment for BD patients with co-existing anxiety. Further randomized studies are warranted.     

Getting a grip on your feelings: effects of action orientation and external demands on intuitive affect regulation

The authors propose that volitional action is supported by intuitive affect regulation, defined as flexible, efficient, and nonrepressive control of own affective states. Intuitive affect regulation should be most apparent among action-oriented individuals under demanding conditions. Consistent with this, a demanding context led action-oriented individuals to down-regulate negative affect in self-reports (Study 1), in an affective Simon task (Study 2), and in a face discrimination task (Study 3). In line with the idea that intuitive affect regulation is guided by top-down self-regulation processes, intuitive affect regulation in a face discrimination task was mediated by increases in self-accessibility (Study 3). No parallel effects emerged among action-oriented participants in a nondemanding context or among state-oriented participants.     

Author Index Volume 5

Authors Index

Author Index Volume 5