“Phobie à deux” and other reasons why clinicians do not apply exposure with response prevention in patients with obsessive–compulsive disorder

Meta-analyses suggest that exposure with response prevention (ERP) is the most efficacious treatment for obsessive–compulsive disorder (OCD) and treatment guidelines for the disorder accordingly recommend ERP. Despite this, many therapists, including those with a cognitive-behavioral therapeutic background, do not perform ERP in patients with OCD. The present study aimed to elucidate the reasons why. German therapists (N = 216) completed an anonymous online survey, the newly developed Reasons for Not Performing Exposure in OCD Scale (REPEX), that inquired whether, to what extent, and how they perform ERP in the treatment of OCD. We also asked their reasons for not applying ERP in the past. Most therapists considered ERP an efficient treatment for OCD. Marked differences emerged between physicians and psychologists, however. The former used exposure less often and for a shorter period, preferred in sensu to in vivo exposure, and conducted exposure less often in the personal environment of the patient than did psychologists. Both groups were familiar with clinical guidelines to a similar extent. A factor analysis of the REPEX scale revealed five factors. Patient lack of motivation, preference for exposure to be self-help as well as alleged organizational difficulties were endorsed most often. The latter was correlated with the age of the therapist and was far more often affirmed by physicians. Fear of side effects was named by a subgroup of clinicians; in the context of patient ambivalence, this may foster “phobie à deux”. Unlike prior research, lack of expertise was rarely identified as a reason not to use ERP. Recommendations for improving adherence to guidelines are discussed.     

What Mediates the Relationship Between Religious Service Attendance and Aspects of Well-Being?

Religious service attendance predicts increased well-being across a number of studies. It is not clear, however, whether this relationship is due to religious factors such as intrinsic religiosity or due to nonreligious factors such as social support or socially desirable responding. The purpose of the present study was to examine the relationship between religious service attendance and well-being while simultaneously examining intrinsic religiosity, social support, and socially desirable responding as potential mediators of the relationship. A sample of 855 participants (71 % female, average age 19.5) completed questionnaires assessing religiosity, social support, socially desirable responding, and well-being. Path models were estimated using maximum likelihood estimation to analyze the data. Intrinsic religiosity was the strongest mediator of the relationship between religious service attendance and depressive and anxiety symptoms. This suggests that the mental health benefits of religious service attendance are not simply the result of increased social support or a certain response style on questionnaires; rather, it appears that the relationship is at least partly the result of people trying to live their religion in their daily lives.     

A motivated information processing perspective on the antecedents of empowering leadership

Empowering leadership is an important influence on team effectiveness. This makes the question of what the antecedents of team empowering leadership are an important issue to consider. To address this question, we propose a motivated information processing perspective that holds that engaging in empowering leadership is based on social information processing, and that there are individual differences in how elaborate that information processing is. We argue that a key consideration in shifting control from the leader to the team is the extent to which empowering leadership is driven by leaders’ consideration of their trust in the team (i.e., an instance of social information processing), and that leader need for closure (a trait capturing the disposition to carefully consider decisions and actions) moderates the relationship between leader trust in team and empowering leadership. A survey of N = 156 work teams supported these hypotheses.     

Making faces: Creating three-dimensional parameterized models of facial expression

Previous studies of the perceptual processing and dynamics of emotional expression in faces have been limited by the lack of realistic yet controlled stimuli. The present work offers researchers a method for creating such stimuli for exploring these phenomena. We describe the creation of the stimuli and a series of experiments testing the validity of these stimuli with respect to emotional expressions in humans. Participants evaluated synthesized facial images and standardized photographs of six basic emotional expressions for intensity and accuracy of perceived emotion. Comparisons of these measures were qualitatively similar for synthesized and photographed faces. A manipulation of the magnitude of the synthesized expressions yielded a significant effect on the perceived intensity of expression. In a subsequent multidimensional scaling study, no systematic differences were uncovered in the derived configurations of the synthesized expressions and the photographs. These results are discussed in the context of possible future research applications.     

Avatar-based therapy within prison settings: pilot evaluation

The paper presents an introduction of a newly developed, avatar-based virtual reality therapy, as an addition to the therapeutic programme, within a therapeutic community prison in the UK. The participants had six group sessions facilitated by a counsellor. The aim of the project was to investigate whether this approach would improve mental health outcomes for the prisoners, interpersonal relationships within the prison and facilitate the achievement of personal goals for the prisoners. The sample size (n?=?4) was insufficient to make firm conclusions about the mental health outcomes. However, the qualitative analysis showed a strong engagement with the programme in addressing personal issues, the development of insight and empathy, and improvements in relationships within the participants and with the counsellor. Further research with a larger sample is needed to establish efficacy of this type of therapy with the prison population.     

Understanding (in) Newton’s Argument for Universal Gravitation

In this essay, I attempt to assess Henk de Regt and Dennis Dieks recent pragmatic and contextual account of scientific understanding on the basis of an important historical case-study: understanding in Newton’s theory of universal gravitation and Huygens’ reception of universal gravitation. It will be shown that de Regt and Dieks’ Criterion for the Intelligibility of a Theory (CIT), which stipulates that the appropriate combination of scientists’ skills and intelligibility-enhancing theoretical virtues is a condition for scientific understanding, is too strong. On the basis of this case-study, it will be shown that scientists can understand each others’ positions qualitatively and quantitatively, despite their endorsement of different worldviews and despite their convictions as what counts as a proper explanation.     

No evidence for object alternation impairment in obsessive-compulsive disorder (OCD)

Recent neuroimaging studies have consistently ascribed the orbito-frontal cortex (OFC) a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). Cognitive tests presumed sensitive to this region, such as the Object Alternation Task (OAT), are considered important tools to verify this assumption and to investigate the impact of cortical dysfunction on behavior. The aim of the present study was to assess if patients with OCD show enhanced perseveration errors on the OAT relative to healthy controls taking into account several potential moderators, especially comorbid depression and OCD subtype. Thirty-five OCD patients and 18 healthy controls underwent the OAT as well as the Trail-Making Tests (TMT) A and B. In line with prior studies, OCD patients were slowed on both TMT tasks. In contrast, samples performed similarly on the OAT. While the latter finding does not invalidate the assumption that the OFC is affected in OCD, dysfunctions involving this region may be more subtle than often claimed and likely encompass only a small subset of functional domains hosted in the OFC.