Belief disconfirmation versus habituation approaches to situational exposure in panic disorder with agoraphobia: a pilot study

Exposure therapy and cognitive behaviour therapy (CBT) are both effective in the treatment of panic disorder with agoraphobia. Cognitive theories suggest that the way in which exposure to avoided situations is implemented in either treatment may be crucial. In particular, it is suggested that clinical improvement will be greatest if opportunities for disconfirmation of feared catastrophes are maximized. In a small pilot study, 16 patients with panic disorder and (moderate or severe) agoraphobia were randomly allocated to either habituation based exposure therapy (HBET) or exposure planned as a belief disconfirmation strategy and accompanied by dropping of safety-seeking behaviours. Both treatments were brief (total of 3.25 h of exposure) and were similar in terms of expectancy of change. Patients in the CBT condition showed significantly greater improvements in self-report measures of anxiety, panic and situational avoidance. They also completed significantly more steps in a standardized behavioural walk, during which they experienced significantly less anxiety. The controlled effect sizes for CBT were substantial (range 1.7-2.7), which suggests it may be a particularly efficient way of managing therapeutic exposure to feared situations in panic disorder with agoraphobia. Further research is needed to clarify the mechanism of change involved.     

Intrusive images and memories in major depression

Individuals with current major depression were interviewed to investigate the prevalence of distressing intrusive mental imagery among depressed patients and study the phenomenology of these intrusions. Of the 39 currently depressed patients, 17 experienced some form of repetitive intrusive imagery (i.e., either an intrusive memory or image), with intrusive memories being more common than images. The intrusive imagery was experienced as highly uncontrollable and interfered significantly with patients' everyday lives. The intrusions were experienced with a sense of 'nowness', as well as physical and emotional re-experiencing. Despite high levels of re-experiencing, levels of dissociation were very low. The intrusive imagery was in some patients part of a wider network of key defining autobiographical memories, consistent with the idea that it is likely to play a significant role in maintaining the patient's depressive mood. Interventions targeting these intrusions could potentially result in a positive shift in depressed mood.     

Relationship of temporal lobe volumes to neuropsychological test performance in healthy children

Ecological validity of neuropsychological assessment includes the ability of tests to predict real-world functioning and/or covary with brain structures. Studies have examined the relationship between adaptive skills and test performance, with less focus on the association between regional brain volumes and neurobehavioral function in healthy children. The present study examined the relationship between temporal lobe gray matter volumes and performance on two neuropsychological tests hypothesized to measure temporal lobe functioning (visual perception-VP; peabody picture vocabulary test, third edition-PPVT-III) in 48 healthy children ages 5-18 years. After controlling for age and gender, left and right temporal and left occipital volumes were significant predictors of VP. Left and right frontal and temporal volumes were significant predictors of PPVT-III. Temporal volume emerged as the strongest lobar correlate with both tests. These results provide convergent and discriminant validity supporting VP as a measure of the "what" system; but suggest the PPVT-III as a complex measure of receptive vocabulary, potentially involving executive function demands.     

The Values and Lifestyles of Idiocentrics and Allocentrics in an Individualist Culture: A Descriptive Approach

A considerable degree of research in cross‐cultural consumer psychology has focused on the effects of individualism–collectivism on consumer preference for advertising appeals. Recently, psychologists have demonstrated a growing interest in the individual‐level manifestations of individualism–collectivism. Idiocentrism refers to person‐level individualism, whereas allocentrism refers to person‐level collectivism. Drawing on individualism–collectivism theory, in this article we look at the lifestyle of idiocentrics and allocentrics. Our findings suggest a convergence between the etic‐ and emic‐level approaches, thus strengthening individualism–collectivism theory. The emic‐level findings of this study also suggest additional questions to be explored at the etic level. Finally, we make suggestions for applications in consumer communication.     

Negative Emotions and Alcohol Use Initiation in High-Risk Boys: The Moderating Effect of Good Inhibitory Control

Studies on the relation between negative affect and later alcohol use have provided mixed results. Because definitions of negative affect often include diverse emotions, researchers have begun to dismantle this higher-order construct in an attempt to explain these inconsistent findings. More recent evidence also indicates that good inhibitory control may moderate the relation between negative emotions and alcohol use. The current longitudinal investigation examined the independent relation between three components of negative affect (i.e., depressed mood, fear, and anger) and alcohol use initiation in a sample of aggressive boys. The moderating effect of good inhibitory control was also examined. Results indicated that increased anger and decreased fearfulness are associated with an increased risk for alcohol use initiation only for boys with moderate to low levels of inhibitory control. However, depressed mood predicted alcohol use initiation for boys with good inhibitory control. The potential implications for substance use prevention efforts are discussed.     

A comparison of metacognitions in patients with hallucinations,delusions, panic disorder,and non-patient controls

This study tested the hypothesis that metacognitions are a general vulnerability factor for psychological disorder. It was predicted that patients with psychosis (hallucinations or delusions), and patients with panic disorder would score higher than non-patients on measures of metacognition. Moreover, it was hypothesised that patients showing most dysregulation of thinking (voice-hearers) would endorse significantly higher metacognition scores than individuals in the other groups. The Meta-Cognitions Questionnaire (MCQ: ) was administered to patients who met DSM-IV criteria for schizophrenia spectrum disorders with auditory hallucinations, patients who met DSM-IV criteria for schizophrenia spectrum disorders with persecutory delusions, patients who met DSM-IV criteria for panic disorder and non-patients. The results showed that psychotic patients who experience auditory hallucinations tended to exhibit higher levels of dysfunctional metacognitive beliefs than other patient groups, scoring significantly higher than at least two of the three control groups on positive beliefs about worry, negative beliefs about uncontrollability and danger, cognitive confidence and negative beliefs including superstition, punishment and responsibility. It was also found that the metacognitive beliefs of patients with persecutory delusions and panic patients were often similar to each other, and elevated in comparison to non-patients, suggesting that such beliefs are generic vulnerability factors. The theoretical and clinical implications of these findings are discussed.     

Doing better but feeling worse. Looking for the "best" job undermines satisfaction

Expanding upon Simon's (1955) seminal theory, this investigation compared the choice-making strategies of maximizers and satisficers, finding that maximizing tendencies, although positively correlated with objectively better decision outcomes, are also associated with more negative subjective evaluations of these decision outcomes. Specifically, in the fall of their final year in school, students were administered a scale that measured maximizing tendencies and were then followed over the course of the year as they searched for jobs. Students with high maximizing tendencies secured jobs with 20% higher starting salaries than did students with low maximizing tendencies. However, maximizers were less satisfied than satisficers with the jobs they obtained, and experienced more negative affect throughout the job-search process. These effects were mediated by maximizers' greater reliance on external sources of information and their fixation on realized and unrealized options during the search and selection process.     

The confidence-accuracy relationship in eyewitness identification: effects of lineup instructions, foil similarity, and target-absent base rates

Discriminating accurate from mistaken eyewitness identifications is a major issue facing criminal justice systems. This study examined whether eyewitness confidence assists such decisions under a variety of conditions using a confidence-accuracy (CA) calibration approach. Participants (N = 1,200) viewed a simulated crime and attempted 2 separate identifications from 8-person target-present or target-absent lineups. Confidence and accuracy were calibrated for choosers (but not nonchoosers) for both targets under all conditions. Lower overconfidence was associated with higher diagnosticity, lower target-absent base rates, and shorter identification latencies. Although researchers agree that courtroom expressions of confidence are uninformative, our findings indicate that confidence assessments obtained immediately after a positive identification can provide a useful guide for investigators about the likely accuracy of an identification.     

Accuracy of a Rationally Derived Method for Identifying Treatment Failure in Children and Adolescents

Psychotherapy outcome can be enhanced by early identification of potential treatment failures before they leave treatment. In adults, compelling data are emerging that provide evidence that an early warning system that identifies potential treatment failures can be developed and applied to enhance outcome. The present study reports an analysis of early warning algorithms to identify treatment failures among child/adolescent patients (ages 3–18). The progress of 300 patients who had completed treatment was analyzed to see if algorithms could identify those children who ultimately had a negative outcome. Results indicated that the rationally derived method had a 77% success rate for identifying child/adolescent patients who were reliably worse or had deteriorated by the time that therapy was terminated.