New Directions in the Cognitive-Behavioral Treatment of OCD: Theory,Research, and Practice

The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.     

Cognitive diagnosis modelling incorporating item response times

To provide more refined diagnostic feedback with collateral information in item response times (RTs), this study proposed joint modelling of attributes and response speed using item responses and RTs simultaneously for cognitive diagnosis. For illustration, an extended deterministic input, noisy ‘and’ gate (DINA) model was proposed for joint modelling of responses and RTs. Model parameter estimation was explored using the Bayesian Markov chain Monte Carlo (MCMC) method. The PISA 2012 computer-based mathematics data were analysed first. These real data estimates were treated as true values in a subsequent simulation study. A follow-up simulation study with ideal testing conditions was conducted as well to further evaluate model parameter recovery. The results indicated that model parameters could be well recovered using the MCMC approach. Further, incorporating RTs into the DINA model would improve attribute and profile correct classification rates and result in more accurate and precise estimation of the model parameters.     

The basis of behavioral momentum in the nonlinearity of strength

The persistence of operant responding in the context of distractors and opposing forces is of central importance to the success of behavioral interventions. It has been successfully analyzed with Behavioral Momentum Theory. Key data from the research inspired by that theory are reanalyzed in terms of more molecular behavioral mechanisms: the demotivational effects of disruptors, and their differential impacts on the target response and other responses that interact with them. Behavioral momentum is regrounded as a nonlinear effect of motivation and reinforcement rate on response probability and persistence. When response probabilities are high, more energy is required to further increase or to decrease them than when they are low. Classic Behavioral Momentum Theory effects are reproduced with this account. Finally, it is shown how the new account involving motivation and competition is closely related to the metaphor of force and action that is at the core of Behavioral Momentum Theory.     

Response acquisition by zebrafish (Danio rerio) with delayed reinforcement

Zebrafish (Danio rerio) is a common vertebrate animal model in biomedical research and is a promising species for studying how genes interact with environmental factors in determining behavior. The present study investigated how reinforcement parameters affect zebrafish behavior by assessing response acquisition with delayed reinforcement, which has been studied with other species (e.g., rats, pigeons, humans, etc.) but not with zebrafish. Twenty‐four experimentally naïve subjects were exposed to a tandem fixed‐ratio 1 differential‐reinforcement‐of‐other‐behavior x‐s schedule of reinforcement, where x varied across subjects. There were six different delay‐to‐reinforcement durations and sets of four fish were assigned to each delay duration. All of the fish assigned to a 0‐, 0.5‐, or 1‐s delay acquired responding. Two fish acquired responding with a 3‐s delay and one fish appeared to have acquired it with a 6‐s delay although the latter result was less clear. None acquired responding with a 12‐s delay. These results suggest that zebrafish behavior is sensitive to delays to reinforcement and the time frame over which reinforcement is effective may be limited approximately to 6 s. This time frame is shorter than that found with other species. Practical and theoretical implications of the present finding are discussed.     

Subjective,physiological, and behavioural responses towards evaluatively conditioned stimuli

Evaluative Conditioning (EC) is commonly defined as the change in liking of a stimulus (conditioned stimulus, CS) due to its pairings with an affective unconditioned stimulus (US). In Experiment 1, we investigated effects of repeated stimulus pairings on affective responses, i.e. valence and arousal ratings, pupil size, and duration estimation. After repeatedly pairing the CSs with affective USs, a consistent pattern of affective responses emerged: The CS_negative was rated as being more negative and more arousing, resulted in larger pupils, and was temporally overestimated compared to the CS_neutral. In Experiment 2, the influence of a mere instruction about the contingency between a CS and US on affective responses was examined. After mere instruction about upcoming pairings between the CS and US, subjective ratings also changed, but there was neither evidence for differential pupillary responses nor for differential temporal processing. The results indicate that EC via pairings or instructions can change the affective responses towards formerly neutral stimuli and introduce pupil size as a physiological measure in EC research. However, Experiment 2 suggests that there might be moderating factors based on the type of EC procedure involved.     

反应抑制的训练:内容、效果与机制

近期的研究发现,个体的反应抑制能力具有一定的可塑性。研究者多采用双盲随机对照实验设计,训练的对象包括儿童、成人和特殊群体,研究者通过Go/Nogo、Stop-signal等任务进行为期1周至3周,45至7200试次不等的抑制控制能力训练,并结合行为、脑电以及脑成像等技术对训练效果进行评估,研究结果发现,接受了抑制控制训练的个体其抑制能力得到提升,并伴随脑神经活动的变化。另外,研究者发现,抑制控制能力的训练效果还可以迁移至个体日常生活中的表现。但是,也有些研究并未发现抑制控制训练的效果。训练任务的设置,评估任务的选择以及被试反应策略的差异等因素可能会影响训练的效果。抑制控制训练引发行为与大脑活动的变化可能是由于训练导致了个体建立了自上而下有意识的抑制控制模式和自下而上的自动抑制模式。反应抑制和冲突抑制可塑性的比较,儿童与老年人抑制功能的训练以及训练效果的追踪研究将成为该领域日后研究的重点问题。     

The Situational Test of Emotional Management – Brief (STEM-B): Development and validation using item response theory and latent class analysis

This study uses a 3-Parameter Logistic item response theory (IRT) model to develop an 18-item short-form of the Situational Test of Emotion Management (STEM). In a sample of 900 people, the short form showed acceptable reliability (reliability index = .87; Cronbach’s alpha = .84) and a meaningful correlation with another indicator of emotional intelligence (i.e., r = .30 with the Situational Test of Emotional Understanding). Latent class analysis of the short-form detected two classes. For all items, participants in Class 2 had a higher probability of selecting the best option than Class 1. When response options were coded to represent different emotion regulation strategies, Class 2 had a higher probability of endorsing “situation modification” and Class 1 had a higher probability of endorsing “no regulation”. These results provide validity evidence for the STEM-B as an assessment of emotion regulation.