Excessive self-focused attention and defensiveness among psychiatric patients: a vicious cycle?

The contribution of defensive coping to the phenomenon of excessive self-focused attention was studied in 20 depressed or anxious psychiatric outpatients comprising the negative affect group, 20 patients with psychotic disorders, and a control group of 21 patients of an orthopaedic clinic. Self-focused attention was assessed using the Self-reflectiveness and Internal State Awareness subfactors of the Private Self-consciousness Scale. In accordance with other research on self-focused attention, the negative affect group obtained higher scores on the Self-reflectiveness scale than the control group (t39=2.40, p<.03). To examine the relationship between self-focus and defensiveness, Weinberger, Schwartz, and Davidson's approach was employed, using median splits of short forms of the Taylor Manifest Anxiety Scale and the Marlowe-Crowne scale to differentiate among four groups of subjects. The highest self-reflectiveness was found for those participants who were high in both defensiveness and anxiety. This group scored higher than the nondefensive high anxious group (t30= -2.31, p<.03). The heightened self-focused attention might result from automatically instigated states of self-focused attention and paradoxical effects of defensive efforts to avoid self-focus.     

An examination of the psychometric properties of the Rosenberg Self-Esteem Scale (RSES) in Chinese acute coronary syndrome (ACS) patients

The psychometric properties of the Rosenberg Self-Esteem Scale (RSES) as a clinical research instrument for acute coronary syndrome (ACS) patients were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis was conducted on the RSES to establish its psychometric properties in 128 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test-retest reliability of the RSES-TOT (all-items) and RSES-POS sub-scale (positively valenced items) were found to be acceptable. The RSES-NEG sub-scale (negatively valenced items) lacked acceptable internal reliability. The underlying factor structure of the RSES comprised two distinct but related factors, though there was inconsistency in best model fit indices at the 1-week observation point. The use of the RSES as two sub-scales (RSES-POS and RSES-NEG) may be clinically useful in evaluating the influence of this important psychological construct on the health outcomes of patients with ACS. Directions for future research are indicated.     

Induced mood change and dysfunctional attitudes in remitted bipolar I affective disorder

This study investigated the possibility that, in remitted bipolar I affective disorder, dysfunctional attitudes are mood-state dependent. Participants were 120 individuals with remitted bipolar I disorder, remitted unipolar depression, or no history of affective disorder. The Dysfunctional Attitudes Scale (DAS; Weissman, 1979) was completed before and after positive or negative mood challenge. Following mood increase, the bipolar group changed significantly less in DAS total score than did the other 2 groups, and in goal-striving and achievement attitudes relative to the unipolar group. These findings did not provide clear support for the mood-state dependency theory in bipolar disorder, arguing instead for the presence in bipolar I disorder of dysfunctional cognitions that show characteristic resilience in the face of minor positive mood increase.     

Effect of trait anger on cognitive processing of emotional stimuli

In the present experiment, the authors examined whether trait anger was associated with cognitive biases for anger-related semantic stimuli. Fifty-two undergraduate students completed the Trait Anger Scale (TAS; C. D. Spielberger, G. Jacobs, S. Russell, & R. Crane, 1983), and those reporting TAS scores in the upper (n = 17) or lower (n = 13) quartiles of the sample were assigned to high- and low-anger groups, respectively. The 30 participants then engaged in a lexical decision task that presented various emotion words, neutral words, and nonwords. Results indicated that individuals who reported high levels of trait anger displayed facilitative biases in the processing of semantic anger-related stimuli. This predisposition to more readily process anger-related information may underlie their propensity to experience intense feelings of anger when provoked.     

The Psychophysiology of Social Action: Facial Electromyographic Responses to Stigmatized Groups Predict Antidiscrimination Action

We introduced facial electromyography as a tool for predicting advantaged group members' engagement in antidiscrimination action on behalf of a disadvantaged outgroup. Heterosexual men's corrugator supercilii (brow “frowning” muscles) activity while viewing videos of male–male and male–female couples interacting was measured. Corrugator (negative affect) response to male–male versus male–female targets, but not self-reported attitudes toward gay men, predicted number of flyers calling for action to reduce antigay violence and discrimination that participants privately took to distribute. Our discreet behavioral measure mirrored real-life collective action possibilities such as voting against laws prohibiting same-sex marriage in the privacy of one's voting booth.     

Trauma-Related Negative Cognitions Mediate the Relationship Between Avoidant Personality Beliefs and Impeded Response to Psychotherapy for PTSD

There is strong research evidence for the association of personality pathology and posttraumatic stress disorder (PTSD), as well as trauma-related negative cognitions (TRNC) and PTSD symptoms. However, the relationship between personality pathology and TRNC in the context of PTSD is mostly unknown. In the present study, we aimed to examine whether avoidant and borderline personality beliefs (PB, indicator of personality pathology) could predict therapy outcome in PTSD, and whether the relationship between PB and therapy outcome could be mediated by TRNC. Sixty patients with PTSD were assessed for PB, TRNC and PTSD symptoms at baseline, and for PTSD symptoms at the termination of Prolonged Exposure Therapy. Baseline avoidant PB predicted significant variance in PTSD symptoms at termination over and above baseline PTSD symptoms (16% reduction in treatment effect per SD on avoidant PB). Moreover, TRNC at baseline fully mediated the relationships between baseline avoidant PB and PTSD symptoms at termination. This is the first study to show that avoidant PB predicts treatment response in PTSD, and that patients with avoidant beliefs are more vulnerable to have TRNC, which are associated with impeded therapy response. Our results highlight the importance of targeting both dysfunctional PB and TRNC in PTSD interventions.     

A preliminary study of autobiographical memory in remitted bipolar and unipolar depression and the role of imagery in the specificity of memory

Autobiographical memory was investigated in a sample of 19 individuals with remitted bipolar affective disorder and a community sample of 16 individuals with remitted unipolar depression who had similar low levels of current symptoms. Each participant was prompted to recall one positive memory and one negative memory, to rate it on several scales, and to describe it in detail. Relative to the remitted unipolar group, the remitted bipolar group reported more general than specific negative memories and more frequent recollections of the negative memory during their everyday life. Across the sample, 95% of all specific memories involved a mental image, whereas only 56% of all general memories involved a mental image, suggesting a role of imagery in the retrieval of a specific memory. Characteristic examples of memories are provided. These results are preliminary yet they suggest that patients with bipolar disorder in remission may show memory characteristics that are often associated with symptomatic unipolar depression.     

Being a non-drinking student: An interpretative phenomenological analysis

Recent research suggests that safer student alcohol consumption might be assisted by understanding how social occasions are managed by non-drinkers. In-depth, semi-structured interviews with five 19 – 22 year old non-drinking English undergraduates were subjected to interpretative phenomenological analysis. We present five inter-linked themes: ‘living with challenges to non-drinking’; ‘seeing what goes on in drinking environments’; ‘dealing with conversations about non-drinking (making excuses vs. coming out)’; ‘knowing which friends care about you’; and ‘the importance of minimising “legroom” for peer pressure’. Participants felt under persistent peer scrutiny (as a form of peer pressure) and could feel alienated in drinking environments. Talking about non-drinking was characterised by whether to ‘come out’ (as a non-drinker) or ‘fake it’ (e.g. ‘I’m on antibiotics’). Loyal friendships were reported as particularly important in this context. The decision not to drink was experienced as providing a successful buffer to peer pressure for former drinkers. Our findings unsettle traditional health promotion campaigns which advocate moderate drinking among students without always suggesting how it might be most successfully accomplished and offer tentative guidance on how non-drinking during specific social occasions might be managed more successfully. Findings are discussed in relation to extant literature and future research directions are suggested.