Vulnerability to mental contamination

Mental contamination refers to feelings of contamination that arise without physical contact with a contaminant. Mental contamination has been documented among sexual assault victims, some of whom report feeling dirty and wanting to wash in response to memories of the assault. This study examined variables associated with increased vulnerability to mental contamination. Female undergraduates (n=100) filled out a series of questionnaires and listened to an audiotape that instructed them to imagine experiencing a forced kiss by an undesirable male. Controls (n=20) imagined a consensual kiss by a desirable male. Women in the non-consensual condition reported stronger feelings of dirtiness and urge to wash than those in the consensual condition. Twenty-seven women in the non-consensual condition spontaneously rinsed in order to alleviate physical sensations evoked by the tape. Regression analyses revealed that significant predictors of dirtiness included contact contamination fear and disgust sensitivity, and there was a trend for anxiety sensitivity to predict dirtiness. Contact contamination fear was also a significant predictor of urge to wash. Prior experience with unwanted sexual contact was a significant predictor of rinsing, and there was a trend for fear of negative evaluation to predict rinsing. Discussion focuses on the implications of these findings for our understanding of mental contamination.     

Is amenorrhea a clinically useful criterion for the diagnosis of anorexia nervosa?

Aim of the study was to evaluate the clinical characteristics and the treatment outcome of underweight patients with eating disorder (ED) not otherwise specified without amenorrhea (EDNOS-WA), compared with classical anorexia nervosa (AN) cases. Seventy-three consecutive female patients (57 AN, and 16 EDNOS-WA) were evaluated before and after a 20-week cognitive behaviour inpatient treatment (CBT-I). Assessment included anthropometry, the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Temperament and Character Inventory (TCI). At logistic regression analysis, amenorrhea was only predicted by baseline BMI and intense exercise, not by psychopathological variables. Response to CBT-I was good and similar between groups, without differences in the dropout rate or time-to-dropout. Our data lend support to the hypothesis that the criterion “amenorrhea” is of no clinical utility in the diagnosis and treatment of AN and could be removed in the forthcoming DSM-V proposal.     

Mental imagery as an emotional amplifier: application to bipolar disorder

Cognitions in the form of mental images have a more powerful impact on emotion than their verbal counterparts. This review synthesizes the cognitive science of imagery and emotion with transdiagnostic clinical research, yielding novel predictions for the basis of emotional volatility in bipolar disorder. Anxiety is extremely common in patients with bipolar disorder and is associated with increased dysfunction and suicidality, yet it is poorly understood and rarely treated. Mental imagery is a neglected aspect of bipolar anxiety although in anxiety disorders such as posttraumatic stress disorder and social phobia focusing on imagery has been crucial for the development of cognitive behavior therapy (CBT).In this review we present a cognitive model of imagery and emotion applied to bipolar disorder. Within this model mental imagery amplifies emotion, drawing on Clark's cyclical panic model [(1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470]. We (1) emphasise imagery's amplification of anxiety (cycle one); (2) suggest that imagery amplifies the defining (hypo-) mania of bipolar disorder (cycle two), whereby the overly positive misinterpretation of triggers leads to mood elevation (escalated by imagery), increasing associated beliefs, goals, and action likelihood (all strengthened by imagery).Imagery suggests a unifying explanation for key unexplained features of bipolar disorder: ubiquitous anxiety, mood instability and creativity. Introducing imagery has novel implications for bipolar treatment innovation - an area where CBT improvements are much-needed.     

The borderline empathy effect: Do high BPD individuals have greater empathic ability? Or are they just more difficult to “read”?

Clinical psychologists have suggested that patients with borderline personality disorder (BPD) are unusually accurate at “reading” other people. We investigated this claim by obtaining measures of trait accuracy and empathic accuracy in 38 same-sex dyads, each composed of one high BPD and one low BPD member. At first glance, the results suggested that the high borderline dyad members displayed both better trait accuracy and better empathic accuracy. Additional analyses revealed, however, that these effects were instead a consequence of the high BPD participants having more unusual, harder-to-predict personalities and more difficult-to-infer thoughts and feelings than those of their low BPD counterparts. We conclude that the relative empathic advantage displayed by high BPD individuals does not reflect greater ability; instead, they are simply more difficult to “read” than low BPD individuals are.     

Quality of Life and General Health Perception in Women with Obesity

The purpose of this study was to determine the differences in general health status and quality of life between patients who present “non-normative eating behaviours” (namely, binge eating disorder, night eating syndrome, sweet /fat food cravings and continuous nibbling) and patients without these eating behaviour characteristics. A cohort of 168 women with obesity, all candidates to bariatric surgery, aged between 15 and 65 (M = 39.04; SD = 10.86), with a body mass index ranging between 30.37 and 80.65 (M = 48.79; SD = 8.37), was studied. Participants answered to a clinical interview, to SF-36 and to ORWELL-97, after their informed consent. Results suggest that women with obesity reporting binge eating disorder, night eating syndrome and continuous nibbling show poorer general health status and worst quality of life than those who do not present these “non-normative eating behaviours”. Moreover, the general health status and the quality of life of patients with sweet/fat food cravings do not differ from those who do not report this eating behaviour. Nevertheless, patients reporting the eating behaviours studied do not differ from the others regarding their body mass index.     

抑郁障碍和焦虑障碍治疗的神经心理机制——脑成像研究的ALE元分析

抑郁障碍和焦虑障碍是两种最常见的精神障碍。使用激活似然估计(activation likelihood estimation,ALE)元分析对抑郁和焦虑障碍患者治疗后出现的一致脑区激活改变进行评估,并考察不同条件下这一改变的差异。研究共纳入25篇文献,结果发现:(1)抑郁和焦虑障碍接受治疗后,枕下回(inferior occipital gyrus,IOG)等脑区激活增加;豆状核(lentiform nucleus)等激活减少。(2)a.心理治疗产生的脑激活改变为豆状核活动的减少;药物治疗则在于扣带回(cingulate gyrus)等活动增加,而楔前叶(precuneus)等活动减少。b.任务下成像治疗后激活增加的脑区为扣带回等,减少的脑区为楔前叶等;静息下成像,治疗后枕下回等激活增加,额内侧回(medial frontal gyrus,MFG)等激活减少。c.抑郁障碍治疗后的脑激活变化为扣带回等活动增加,楔前叶等活动减少;焦虑障碍在于前扣带回/额内侧回(anterior cingulate/MFG)活动减少。研究表明治疗会给抑郁和焦虑障碍带来一致的脑区激活改变;治疗方法、成像状态和障碍类型不同,治疗后脑区激活改变也存在差异。     

Cognitive behavioral management of Tourette's syndrome and chronic tic disorder in medicated and unmedicated samples

Objective

Cognitive behavior therapy (CBT) and medication can be administered in combination in treating tic disorders but there are no studies evaluating the effectiveness of CBT with and without medication. The current study compares the efficacy of CBT in combination with medication and without medication.

Method

CBT was administered in a consecutively referred sample of 76 people diagnosed either with Gilles de la Tourette Syndrome or chronic tic disorder. The sample was divided into a medicated and a non-medicated group. Twenty three were stabilized on medication and 53 were not receiving medication. Measures administered pre- and post-CBT in both groups included: main outcome measure of Tourette Syndrome Global Scale and measures of mood.

Results

Repeated measures analysis of variance on the initial sample revealed no difference between medicated and non-medicated groups in outcome. A further analysis comparing the 23 receiving medication with 23 not receiving medication matched on baseline clinical variables also yielded no significant group differences, either in treatment outcome on main tic outcome measures or on other clinically relevant questionnaires.

Discussion

CBT for tic disorders is an effective treatment administered either in combination with medication or alone.     

Forced choice reaction time paradigm in children with separation anxiety disorder, social phobia, and nonanxious controls

Cognitive distortions refer to cognitive processes that are biased and therefore yield dysfunctional and maladaptive products (e.g., interpretation bias). Automatic aspects of information processing need to be considered and investigating these aspects requires forms of assessment other than self-report. Studies focussing on the specificity of cognitive biases across different types of anxiety disorders in childhood are rare. Thus, a forced choice reaction time paradigm with picture stimuli was used to assess the interpretation bias in anxious children online. The study investigated disorder-specific interpretation bias in 71 children with separation anxiety disorder (SAD), 31 children with social phobia, and 42 children without mental disorders, aged 5–13 years. Results indicated that children with SAD rated ambiguous separation pictures as significantly more unpleasant and more arousing than nonanxious children. However, no support was found that children with SAD and social phobia interpret ambiguous separation or social pictures in a more negative way than nonanxious children. Furthermore, no group differences were found in reaction times to all picture categories.     

Differences in feedback- and inhibition-related neural activity in adult ADHD

The objective of this study was to examine response inhibition- and feedback-related neural activity in adults with attention deficit hyperactivity disorder (ADHD) using event-related functional MRI. Sixteen male adults with ADHD and 13 healthy/normal controls participated in this study and performed a modified Go/NoGo task. Behaviourally, attention and inhibition problems in the ADHD group were observed; no feedback-related differences between the groups were detected. The neuroimaging data showed that the ADHD group displayed more activation in the inferior frontal gyrus and putamen during response inhibition. During feedback-related processes, the ADHD group displayed less activation in the inferior frontal/orbitofrontal cortex, hippocampus/nucleus accumbens, and caudate nucleus, but more activity in the inferior frontal gyrus. These results indicate that at least two distinguishable underlying brain networks related to response inhibition and feedback are altered in adults with ADHD.