Virtual Reality and Cognitive-Behavioral Therapy for Driving Anxiety and Aggression in Veterans: A Pilot Study

Within the U.S. military, motor vehicle accidents (MVAs) are the leading cause of preventable morbidity and mortality. Prior combat exposure and anxiety symptoms are associated with risky and aggressive driving, which is responsible for over half of MVA fatalities. Therefore, interventions are needed to reduce driving anxiety and aggression in veterans in order to mitigate the public health impact of MVAs. Virtual reality exposure therapy (VRET) offers safe, controlled exposure to distressing stimuli. The current study piloted a novel virtual reality and cognitive behavioral intervention (VRET + CBT) for veterans that integrated both anxiety and anger management components. Virtual reality driving scenarios were delivered in a driving simulator and tailored for the military population. Six previously deployed veterans completed eight intervention sessions, as well as pre/post, one month follow-up and six to nine month follow-up assessments. Repeated measures ANOVAs demonstrated significant decline and large effect sizes for PTSD symptoms, driving phobia, hyperarousal in driving situations, anxiety/anger-related thoughts and behaviors, and risky driving. Hyperarousal in driving situations declined by 69%, aggressive driving declined by 29%, and risky driving declined by 21%. Treatment gains were maintained at follow-up. Recruitment, retention, immersion, simulator sickness scores, and qualitative feedback demonstrated feasibility of the intervention. Implications for future research and adaptation are discussed.     

Attentional biases to threat in social anxiety disorder: time to focus our attention elsewhere?

Background: Cognitive models propose that attentional biases to threat contribute to the maintenance of social anxiety disorder (SAD). However, the specific characteristics of such biases are still object to debate.

Objectives: The current study aimed to disentangle effects of trait and state social anxiety on attention allocation towards social stimuli.

Methods: Participants with SAD (n?=?67) and healthy controls (n?=?62) completed three visual search tasks while their eye movements were recorded. Half of the participants in each group were randomly assigned to a state anxiety induction.

Results: Contrary to our predictions, neither trait nor state social anxiety was associated with a facilitated attention to or a delayed disengagement from threat. However, participants with SAD did show reduced fixation durations for threatening stimuli, indicating an avoidance of threat. Induction of state anxiety led to an increased distractibility by threat.

Conclusions: We suggest that attention allocation in SAD is characterized by an avoidant rather than a vigilant attentional bias. Accordingly, our results contradict previous results that associate SAD with facilitated attention to threat and existing approaches to modify attentional biases, that aim to decrease attention towards threatening stimuli.     

Ideology,inquiry, and antiquity: a critical notice of Lloyd's The Ideals of Inquiry: An Ancient History

A discussion of Lloyd's Tarner Lectures at Trinity College. The importance of Lloyd's previous scholarship is characterized and these sweeping, erudite lectures are placed in the context of that scholarship. In the broadest terms, the lectures are a call to culturally and historically comparative study of human reasoning. At their heart is a comparative history of scientific theorizing from the ancients through to modern science. Lloyd rejects the positivist picture, and the view of modern and ancient science as discontinuous; he urges scholars to undertake comparative work on the ancient sciences in different traditions. This critical notice evaluates Lloyd's view and raises several questions for further reflection.     

Keeping It Going: Evidence of Long-Term Improvements After Implementation of the 1-2-3 Magic Parenting Program

This study builds upon a pilot evaluation of the 1-2-3 Magic Program (Bailey, van der Zwan, Phelan, &; Brooks, 2012 Bailey, E. L., van der Zwan, R., Phelan, T. W., &; Brooks, A. (2012). The 1–2-3 Magic Program: Implementation outcomes of an Australian pilot evaluation with school-aged children. Child &; Family Behavior Therapy, 34(1), 53–69. doi:10.1080/07317107.2012.654455[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]), by investigating its long-term efficacy as a brief parenting intervention for families with a school-aged child. Twelve Australian families participated in a randomized controlled trial, assigned either to a wait-listed control group or to one that received immediate training. Consistent with the pilot evaluation, only families who had received training reported significant improvement in child and parenting behavior at an 8-week follow-up assessment. These improvements were maintained for 12-month posttraining, supporting the long-term efficacy of the 1-2-3 Magic Program for Australian families.