Individual response patterns and the effects of different behavioral methods in the treatment of claustrophobia

The importance of individual response patterns in claustrophobic patients was examined in the present study. Thirty-four psychiatric outpatients with a phobia of enclosed spaces were assessed in a small test chamber. During the test their overt behavior was video-taped, heart-rate was measured continuously, and self-ratings of experienced anxiety were made at certain intervals. On the basis of their reactions in the test situation, the patients were divided into two groups showing different response patterns—behavioral and physiological reactors. Within each group the patients were randomly assigned to one behaviorally-focused method (exposure), one physiologically-focused method (applied relaxation) and a waiting-list control group. The patients were treated individually in eight sessions. The between-group comparisons showed that both exposure and applied relaxation were significantly better than the waiting-list condition. Furthermore, exposure yielded better results than applied relaxation for the behavioral reactors, while applied relaxation was better than exposure for the physiological reactors. The improvements were maintained at a follow-up assessment 14 months after the end of treatment. The results support the hypothesis that greater effects are achieved when the method used fits the patient's response pattern than when it does not.     

Subjectively rated physiological and cognitive symptoms in six different clinical phobias

The purpose of the present study was an attempt to describe clinical symptoms in terms of physiological reactions and negative cognitions experienced by phobic patients. A total of 267 clinical phobic patients divided among blood phobia, small animals phobia, dental phobia, claustrophobia, social phobia and agoraphobia, participated in the study. The patients within each phobic category were separated into a Conditioned and an Indirect Acquisition group, based on their answers to a set of specific questions concerning the etiology of the phobia. All patients rated (0–4) how intensively they experienced 11 specified physiological reactions and 10 negative cognitions when confronted with their phobic situation in vivo. A mean score was calculated for each item within each group, and an item rank-order hierarchy was set up for each group. Differences between items within each hierarchy were statistically evaluated by one-way ANOVAs and Turkey's HSD-tests. Results showed particular idiosyncratic patterns of responding for the blood phobic, agoraphobic and social phobic groups as well as several commonalities among all the groups concerning activation of specific physiological reactions and negative cognitions. A more fine-grained analysis of the data is best made by direct visual inspection of the figures in this paper.     

Remembering successes and failures: rehearsal characteristics influence recollection and distancing

We investigated the relationship between components of rumination, brooding and reflection, and autobiographical remembering by testing whether voluntary and involuntary rehearsal mediated rumination-related variation in the sensory-affective and metacognitive features of memory experience. We focused on achievement and failure memories as both are goal-related events, yet they represent distinct experiences in terms of valence and functionality. For failure memories, brooding was associated with intense recollection and reduced psychological distance. Brooding was related to enhanced distance of achievements, indicating the disruptive effects of brooding on remembering. Although reflection attenuated the recollective experience for both achievement and failure memories, it brought achievement memories to a subjective closer past. Structural equation modelling demonstrated the mediating role of involuntary remembering on the pattern of remembering experience.     

Midwives’ Approach to Genetic Diseases and Genetic Counseling in Denizli, Turkey

The purpose of this study was to evaluate Denizli midwives’ self-reported knowledge of genetic diseases and genetic counseling. Data was collected on forms that obtained information about midwives approaches to basic genetics, genetic disorders, and genetic counseling (response rate = 70.1%). The highest response rate of midwives describing themselves as “knowledgeable” about basic genetic information was for mitosis and meiosis with 4.8%, about genetic disorders was for phenylketonuria with 61.1%, and about genetic counseling was for recommending ultrasonography during pregnancy with 98.1%. The source for basic genetics information for 56.4% of participants was in their school level classes. None of the midwives felt that they had sufficient knowledge about genetic counseling or screening and 76.4% would like to attend an educational course. Even though the midwives have recognized their knowledge deficit they occasionally give genetic counseling. As a result of this study a genetics course is planned for midwives so they can actively participate in the prevention and early diagnosis of genetic diseases.     

Acquisition of phobias and anxiety response patterns in clinical patients

The ways in which phobic patients (N = 106; animal-, social- and claustrophobics) acquired their phobias were investigated in the present study. The results showed that a large majority (58%) of the patients attributed their phobias to conditioning experiences, while 17% recalled vicarious experiences, 10% instructions/information and 15% could not recall any specific onset circumstances. There was no clearcut relationship between the ways of acquisition and anxiety components (subjective, behavioral, physiological), nor did the conditioning and indirectly acquired phobias differ in severity. However, some interesting trends emerged in the data, showing that animal phobics who recalled conditioning experiences to a larger extent also responded physiologically. For patients with indirect onset experiences (for all three types of phobias) the reverse was true, i.e. they responded to a larger extent in a cognitive-subjective way, rather than with increased physiological arousal.     

Characteristics of personally important episodic memories,counterfactual thoughts,and future projections across age and culture

We have limited knowledge as to whether the phenomenological differences between episodic memories, counterfactuals, and future projections show the same pattern across age groups and diverse samples. Here we compared the characteristics of these mental events, reported by younger and older participants in a Turkish (Study 1) and in an American sample (Study 2). In both studies, memories contained more sensory-perceptual-spatial details, were easier to bring to mind, and more specific. Future projections were the most positive, whereas counterfactuals were the least emotionally intense. In Study 1, older participants rated the events more positively and experienced them with more perceptual detail, whereas younger participants reported the future to be more voluntarily rehearsed, important, and central. These age differences did not replicate in Study 2. Overall, phenomenological differences between the events are robust and replicate across diverse samples. However, age differences are more sensitive to cultural or individual differences.     

A new quantile estimator with weights based on a subsampling approach

Quantiles are widely used in both theoretical and applied statistics, and it is important to be able to deploy appropriate quantile estimators. To improve performance in the lower and upper quantiles, especially with small sample sizes, a new quantile estimator is introduced which is a weighted average of all order statistics. The new estimator, denoted NO, has desirable asymptotic properties. Moreover, it offers practical advantages over four estimators in terms of efficiency in most experimental settings. The Harrell–Davis quantile estimator, the default quantile estimator of the R programming language, the Sfakianakis–Verginis SV2 quantile estimator and a kernel quantile estimator. The NO quantile estimator is also utilized in comparing two independent groups with a percentile bootstrap method and, as expected, it is more successful than other estimators in controlling Type I error rates.     

Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial

The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder.     

Do changes in threat salience predict the moral content of sermons? The case of Friday Khutbas in Turkey

We analyzed the content of “Friday Khutbas” delivered in Turkish mosques between January 2001 and December 2018 to test the prediction of moral foundations theory (MFT) literature that threat salience would lead to an increased endorsement of binding moral foundations. As societal-level indicators of threat, we examined (a) historical data on the proportion of terrorism-related news published in a Turkish newspaper, (b) the geopolitical risk score of Turkey as measured by Geopolitical Risk Index, and (c) Google Trends data on the search frequency of words “terror”, “terrorism”, or “terrorist”. To measure the endorsement of moral foundations, we built a Turkish Moral Foundations Dictionary and counted the relative frequency of morality-related words in the khutbas delivered in Istanbul, Turkey. Time series analyses showed that risk salience in a certain month was positively related to endorsement of the loyalty/betrayal foundation in that month’s Friday Khutbas. There were mixed results for the other moral foundations.