Clinical perspectives on the combination of D-cycloserine and cognitive-behavioral therapy for the treatment of anxiety disorders

In a particular success for translational research agendas, characterization of the neuronal circuits underlying fear extinction, and basic research in animal extinction paradigms, has led to intervention studies examining the use of D-cycloserine (DCS) to enhance therapeutic learning from exposure-based cognitive-behavioral therapy (CBT). In this article, we review these intervention studies, and discuss DCS augmentation of CBT relative to more traditional combination-treatment strategies in the treatment of anxiety disorders. We offer an accounting, based on evidence for internal context effects, of current limitations in the combination of antidepressant or benzodiazepine medications with CBT and discuss the advantages of isolated-dosing strategies with DCS relative to these limitations. This strategy is contrasted with the chronic-dosing applications of DCS for schizophrenia and Alzheimer's disease, and future directions for isolated-dosing strategies are discussed.     

On pedagogy

Humans are adapted to spontaneously transfer relevant cultural knowledge to conspecifics and to fast-learn the contents of such teaching through a human-specific social learning system called 'pedagogy' (Csibra & Gergely, 2006). Pedagogical knowledge transfer is triggered by specific communicative cues (such as eye-contact, contingent reactivity, the prosodic pattern of 'motherese', and being addressed by one's own name). Infants show special sensitivity to such 'ostensive' cues that signal the teacher's communicative intention to manifest new and relevant knowledge about a referent object. Pedagogy offers a novel functional perspective to interpret a variety of early emerging triadic communicative interactions between adults and infants about novel objects they are jointly attending to. The currently dominant interpretation of such triadic communications (mindreading) holds that infants interpret others' object-directed manifestations in terms of subjective mental states (such as emotions, dispositions, or intentions) that they attribute to the other person's mind. We contrast the pedagogical versus the mindreading account in a new study testing 14-month-olds' interpretation of others' object-directed emotion expressions observed in a communicative cueing context. We end by discussing the far-reaching implications of the pedagogical perspective for a wide range of early social-cognitive competences, and for providing new directions for future research on child development.     

Executive disorders and perceived socio‐emotional changes after traumatic brain injury

Although socio‐emotional changes are very frequently encountered after traumatic brain injury (TBI), the psychological mechanisms underlying these disorders are still poorly understood. This study aimed to explore the relationships between dysexecutive syndrome (assessed with the Behavioural Assessment of the Dysexecutive Syndrome [BADS]) and socio‐emotional changes assessed by the Iowa scales of personality change (ISPC) in patients with TBI. The BADS was thus administered to 25 patients with TBI and to 25 healthy controls. Simultaneously, a close relative of each patient was given the ISPC in order to assess socio‐emotional changes. Results indicated that patients displayed significantly lower executive performances than controls and experimented significant socio‐emotional changes. The Modified Six Elements Test was the only subtask of the BADS to be significantly related to behavioural changes, and more specifically to externalizing disorders. It is concluded that executive functions, and especially multitasking, encompass processes whereby one can consciously control one's emotional reactions and behaviours.     

Diagnostic Discrimination of Patients with Different OCD Main Symptom Domains from each Other and from Anxious and Depressive Controls

The extent to which the subscales of multidimensional OCD measures accurately distinguish patients with specific OCD main symptom domains from controls at different cutscores has not yet been examined. Diagnostic accuracy of OCD measures usually is determined by comparing the total scores of heterogeneous OCD samples and controls and therefore may underestimate the measures’ discrimination potential. In the current study, subtype-specific diagnostic accuracy and criterion-related validity of the Obsessive-Compulsive Inventory-Revised (OCI-R) subscales were examined in 327 patients with OCD, anxiety, and/or depressive disorders. All subscales demonstrated good to excellent criterion-related validity and diagnostic accuracy for distinguishing patients with specific OCD main symptom domains from controls. As expected, the single OCI-R subscales lead to more accurate diagnostic decisions than the total scale. Thus, the subscale-specific cutscores significantly improve the OCI-R’s utility for subtype-specific treatment planning and outcome measurement. Furthermore, an alternative classification algorithm distinguishing patients with OCD from controls based on subscale cutscores leads to a better sensitivity, but also to a lower specificity than discrimination based on the total scale cutscore.     

Evaluating a dual‐process model of risk: affect and cognition as determinants of risky choice

In three studies we addressed the impact of perceived risk and negative affect on risky choice. In Study 1, we tested a model that included both perceived risk and negative affect as predictors of risky choice. Study 2 and Study 3 replicated these findings and examined the impact of affective versus cognitive processing modes. In all the three studies, both perceived risk and negative affect were shown to be significant predictors of risky choice. Furthermore, Study 2 and Study 3 showed that an affective processing mode strengthened the relation between negative affect and risky choice and that a cognitive processing mode strengthened the relation between perceived risk and risky choice. Together, these findings show support for the idea of a dual‐process model of risky choice. Copyright © 2008 John Wiley & Sons, Ltd.     

Falsificationism and Statistical Learning Theory: Comparing the Popper and Vapnik-Chervonenkis Dimensions

We compare Karl Popper’s ideas concerning the falsifiability of a theory with similar notions from the part of statistical learning theory known as VC-theory. Popper’s notion of the dimension of a theory is contrasted with the apparently very similar VC-dimension. Having located some divergences, we discuss how best to view Popper’s work from the perspective of statistical learning theory, either as a precursor or as aiming to capture a different learning activity.     

Psychotherapeutenausbildung aus Sicht der Absolventen

Background

A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the psychotherapy act in Germany.

Methods

In August 2008 all non-medical psychotherapists who had graduated since 2002 according the psychotherapy act were invited to take part in the survey and a total of 863 persons participated. The answers from 666 could be evaluated corresponding to a participation rate of 20%.

Results

A total of 57.6% of the graduates had completed a full-time training and approximately 50% of the graduates had completed the training within the allotted time. In the majority of cases evaluation occurred only for the theoretical courses. During the practical work (PT I) 36.8% of the graduates did not receive any salary or remuneration, 82% had their own field of activity and of these 38% treated patients without the presence of qualified tutor.

Conclusions

The training often lasts longer than intended, the financial situation in the PT I is exceptionally critical and in clear contrast to the field of activity in this section of training. Further detailed results will be presented and discussed.     

Beliefs About Psychological Services (BAPS): development and psychometric properties

A scale to measure attitudes towards seeking psychological help was developed (Beliefs About Psychological Services [BAPS]) and evaluated. This scale was based on items gathered from students, colleagues, and the authors when asked about common positive and negative attitudes toward psychologists and their services. Items were also based on the Fischer and Turner (1970 Fischer, EH and Turner, JLeB. 1970. Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35: 79–90. [Crossref], [PubMed], [Web of Science ®] [Google Scholar]) Attitudes Toward Seeking Professional Psychological Services (ATSPPH) measure. Three studies are reported describing the construction and evaluation of the psychometric properties of the BAPS. The BAPS is an 18-item measure consisting of three subscales: Intent, Stigma Tolerance, and Expertness. Support was found for the reliability and validity of the measure.