Safety Behaviour Enhances the Acceptability of Exposure

Compulsive washing and contamination fears are among the most common symptoms of obsessive-compulsive disorder (OCD). Research suggests that exposure and response prevention (ERP) is effective for OCD. However, ERP is prone to dropouts and refusals, and a substantial proportion of clients therefore do not receive the care they need. A proposed solution involves the judicious use of safety behaviour to enhance the acceptability of exposure-based interventions. The current study aimed to test this proposed solution. Participants were 70 undergraduate students who completed two exposure exercises for contamination fear, one with safety behaviour and one without. Participants then rated the acceptability of the two exercises. Exposure with safety behaviour (ESB) was rated as significantly more acceptable than ERP. Furthermore, subjective fear ratings were lower and behavioural approach to a series of contaminants was greater in the ESB condition. Results demonstrated the acceptability-enhancing potential of safety behaviour in exposure, and are discussed in terms of both theoretical and practical aspects of safety behaviour, exposure, and evidence-based interventions for anxiety disorders.     

Depth of processing and recall of threat material in fearful and nonfearful individuals

Abstract

Although many studies have examined the nature of memory distortions in anxious individuals, few have considered biases in specific memory processes, such as encoding or retrieval. To investigate whether the presentation of threat material facilitates encoding biases, spider fearful (n=63), blood fearful (n=73), and nonfearful (n=75) participants encoded spider related, blood related, and neutral words as a function of three levels of processing (i.e., structural, semantic, and self referent). Participants subsequently completed either a free recall or a recognition task. All participants demonstrated a partial depth of processing effect, such that they recalled more words encoded in the self referent condition than in the other two conditions, but groups did not differ in their recall of stimuli as a function of word type. Relative to participants in the other groups, spider fearful participants had fewer spider related intrusions in the recall condition, and they made fewer errors in responding to structural and semantic encoding questions when spider related words were presented. These results contribute to an increasingly large body of literature suggesting that anxious individuals are not characterized by a memory bias toward threat, and they raise the possibility that individuals with spider fears process threat-relevant information differently than individuals with blood fears.     

Effects of short‐term cosmetic versus long‐term health fear appeals in anti‐smoking advertisements on the smoking behaviour of adolescents

A field study exposed 235 high school students to anti‐smoking advertisements over a five‐month period to test the effectiveness of short‐term cosmetic versus long‐term health fear appeals in preventing or reducing smoking. The study was a longitudinal experiment with two experimental groups and a control group. Smoking behaviour was measured prior to message exposure on television, in magazines and on the internet, and at the end of the study period. The primary results were that average smoking declined for subjects exposed to either type of anti‐smoking fear appeal but not for the control group and short‐term cosmetic fear appeals were more effective for males but long‐term health fear appeals were more effective for females. Copyright © 2003 Henry Stewart Publications.     

A Quality Life in the Shadow of Terrorism

After the demise of the Soviet Union, many individuals felt a sigh of relief as fear was leaving them. Yet, over the years, counselors have seen a new fear—terrorism—demonstrated in drive-by shootings, hate crimes, and now, weapons of mass destruction. In helping clients deal with this all-too-real phenomenon, a reframing process is in order, one that views our lives not in permanence, but as constant change. Much needless suffering is due to clinging to permanent belief systems, which, in reality, are impermanent. Many clients I have worked with have found effective ways not only to deal with, but to flourish in whatever life brings, via a self-Being relationship.     

Do beliefs about aggression predict physical aggression to partners?

Three hypotheses concerning the association between instrumental (I) and expressive (E) beliefs about aggression and physical aggression were assessed among a sample comprising students (n=40), women from a domestic violence shelter (n=29), and male prisoners (n=46), all of whom had committed at least one act of physical aggression to a partner. Participants completed an adapted version of the EXPAGG [Archer and Haigh (1997a): British Journal of Social Psychology 35:1–23] to measure I and E beliefs about aggression, the Conflict Tactics Scale (CTS) [Straus (1979): Journal of Marriage and the Family 41:75–88] for themselves and their partner, and measures of fear and injuries resulting from partner violence. I beliefs predicted self‐reported physical aggression to the partner, most CTS acts of physical aggression, and injuries to the partner, with only minor and limited associations for E beliefs. Correlations for the student and prisoner samples, and for men and women, showed different strengths. The findings supported a general link between I beliefs and aggression but offered no support for the predictions that the link would be restricted to men or to men who showed a persistent pattern of violence to their partners. Aggr. Behav. 29:41–54, 2003. © 2003 Wiley‐Liss, Inc.     

Anaesthesia or psychotherapy: Eradicating thoughts or working them through

The author presents two sessions from the analysis of a depressive narcissistic doctor, which are characterised by a mixture of co-operation and pseudo-co-operation. The dialogue is in parts intellectualised, complicated, lifeless and schizoid. Points at which the patient shows surprising insights are then partly denigrated by him, on the basis that change is not to be expected. Semi-lifeless contact assists the defensive claustrophobia that he experiences in meaningful contact. It becomes very clear that he is then afraid of entering into an openly aggressive conflict that entails the existential threat of object loss. However, this has so far been avoided. The secret pleasure in an anal-narcissistic, sadomasochistic addiction to doubt persists in the partial denigration. The patient's artificially maintained self-doubt and doubt of the object reinforce a genuine confusion that consists in never knowing exactly what lies behind the helpful and needed object.     

The Anxiety of Strangers and the Fear of Enemies

In this paper I use a distinction between the "anxiety of strangers" and the "fear of enemies" to show how uncertainty and tension experienced in the face of what is other and different need not lead to a nationalist insularity, but can be the occasion for an existential philosophical education - an education in which the resolute acceptance of strangeness allows us to reflect on our taken-for-granted about the everyday.     

Critical reflection in midwifery practice: the protection motivation theory

Background: The aim of this paper is to shed light on the notion of fear and inter-personal working relationships, and to promote safe midwifery practice, by critically reflecting on our practice and being aware of fear appeals and the protection motivation theory (PMT).

Theory: PMT provides a general account of the impact of persuasive communication, emphasising the cognitive processes that mediate behaviour change and questions whether ‘fear appeals’ could influence behaviour. Discussion: It is possible that when a midwife decides on a particular care pathway, she determines the degree and perception of the four elements of the PMT; severity, vulnerability, response-efficacy and self-efficacy. If the midwife decides that both the degree of severity and her perception of vulnerability are high, whereas response and self-efficacy perceptions are low, she will probably decide against her original care pathway. For the PMT to be used safely, an appropriate judgement call is required and is based on full understanding of the situation, effective communication with the multidisciplinary team, full knowledge of the proposed care, and competence and confidence in the proposed care. Conclusion: By critically reflecting on their practice and using the PMT, the author believes that midwives will be able to work in partnership with obstetricians to provide safe and effective care within their sphere of practice and in the absence of fear.     

认知重评阻断条件化恐惧记忆的习得与表达——对恐惧反应的长程抑制作用

情绪调节是人类特有的、并能有效控制个体情绪反应的行为方式,认知重评是其中最有效的调节策略之一。恐惧记忆是参与情绪障碍形成的重要病理机制,且已习得的恐惧反应难消退、易复发。为了考察认知重评能否起到长久抑制恐惧反应的效应,本研究利用条件化恐惧范式,第一天进行条件化恐惧习得训练,并在习得后间隔24 h及31天进行恐惧记忆的表达及自发恢复测试。实验1中,随机将被试分为两组,要求其在恐惧习得过程中进行认知重评或自然感受;在实验2,同样随机将被试分为两组,但要求其在恐惧记忆表达过程中进行认知重评或自然感受。结果发现,习得阶段进行认知重评显著降低了恐惧记忆的习得、表达及自发恢复过程中的SCR水平。同样,表达阶段进行认知重评也降低了此阶段的恐惧水平,且显著抑制了恐惧记忆的自发恢复。结果提示,在面对应激时,个体如果能够成功地利用想象进行认知重评,就有可能避免应激事件对个体的心理或精神造成伤害。