Conducting Prolonged Exposure for PTSD During the COVID-19 Pandemic: Considerations for Treatment

The unprecedented effects and duration of the COVID-19 crisis are likely to elevate the population’s level of anxiety due to psychological stress, economic hardship, and social isolation. This effect may be especially potent for individuals with preexisting mental health conditions, such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) therapy is a highly effective treatment for PTSD across trauma-exposed populations, and has been implemented effectively via telehealth. Nevertheless, PE implementation via telehealth may require specific adaptations during the COVID-19 crisis due to public health mandates calling for sheltering in place and physical distancing. This paper discusses strategies for implementing PE for PTSD during the COVID-19 pandemic, which may also be applied to other situations in which physical distancing must be considered.     

即刻消退缺损的原因分析及其神经生物学机制

即刻消退缺损(immediate extinction deficit, IED)是指在条件性恐惧习得后, 立即进行的消退训练不能长期抑制恐惧记忆的现象。IED可能与消退起始时的应激水平和事件分割等因素有关。在高应激水平下, 消退记忆的巩固受损导致IED; 而在中等或较低的应激水平条件下, 即刻消退有效但效果可能容易受事件分割的影响。IED的神经生物学机制涉及应激激活蓝斑去甲肾上腺素能系统, 去甲肾上腺素引起杏仁核基底外侧核(basolateral amygdala, BLA)过度兴奋, 然后BLA通过投射突触抑制在恐惧消退中起核心作用的内侧前额叶神经元的活动。未来研究应注意即刻消退缺损引起的长期后果, 并深入探讨如何优化即刻消退在临床上的应用。     

A person-centred approach to understanding dark-side antecedents and students’ outcomes associated with physical education teachers’ motivation

The present study firstly establishes physical education (PE) teachers’ motivational profiles based on their autonomous motivation, controlled motivation and amotivation and, secondly, investigates how different PE teachers’ motivational profiles differ in terms of certain maladaptive antecedents (i.e. psychological need frustration, pressures perceived at work and burnout). It also addresses the differences in their students’ perception of autonomy support, psychological need satisfaction and autonomous motivation. A total of 105 PE teachers and their 2164 students completed validated questionnaires. Four profiles were retained in the cluster analysis. Results showed that teachers who were high on autonomous motivation displayed the most optimal pattern of outcomes, whereas teachers who were high on amotivation showed the opposite pattern. Analysis of the established profiles suggested that the experience of controlled motivation was linked with maladaptive outcomes among both teachers and students. Implications for educational policy and practice are discussed.     

青少年创伤后应激障碍症状与网络成瘾症状的关系：惩罚敏感性和孤独感的中介及性别的调节

汶川地震9.5年后,对汶川县和都江堰市767名中学生进行调查,考察惩罚敏感性和孤独感在创伤后应激障碍症状和网络成瘾症状之间的多重中介作用及性别差异。结果发现：（1）PTSD症状正向预测网络成瘾症状,并分别通过惩罚敏感性、孤独感的单独中介作用及两者的链式中介作用显著预测网络成瘾症状;（2）女性的PTSD症状显著正向预测网络成瘾症状,并分别通过惩罚敏感性和孤独感间接影响网络成瘾症状;男性的网络成瘾症状仅被PTSD症状正向预测。     

四周简易正念减压训练对初中生焦虑的影响

选取68名初一学生并以班级为单位分为四周正念减压(mindfulness-based stress reduction,MBSR)训练组和对照组,探讨四周MBSR对初中生焦虑和正念水平的影响,以及训练效果是否存在基线效应与性别差异。结果发现:(1)四周MBSR可以提高初中生的正念水平,缓解其焦虑情况;(2)“不判断”和“特质焦虑”基线水平影响正念训练的效果;(3)四周MBSR对初中生的训练效果不存在性别差异。     

Pregrouping aggression and defense scores influences alcohol consumption for dominant and subordinate rats in visible burrow systems

Five male/two female rat colonies were established in visible burrow systems, with males selected for pregrouping attack scores and also evaluated in open field and cat odor tests. Dominant-subordinate pregrouping attack differences suggested that the males becoming dominant are those showing more persistent and higher level attack. For six colonies showing dominant-subordinate behavioral differences, pregrouping defense tests failed to predict subordinate status. However, pregrouping defense scores were reliably correlated with subordinate pre-postgrouping change scores for voluntary ethanol consumption. Subordinates showed higher ranked ethanol consumption than dominants, but these groups were not different on pregrouping ethanol consumption. Subordinate postgrouping ethanol consumption was positively correlated with pregrouping attack toward an adult intruder, consonant with previous findings that highly aggressive subordinates are the targets of more intense attack by dominants. These results provide further support for a view that subordination stress increases voluntary ethanol consumption in male rats and suggest some additional individual differences factors that may be involved in increased ethanol consumption for male subordinates. © 1992 Wiley-Liss, Inc.     

Fighting experiences and natural killer cell activity in male laboratory mice

There is currently much interest in the potential impact of psychological factors on immune responses. An attempt was made to assess the effects of dominant/subordinate polarity in male mice on the cytotoxic activities of their natural-killer (NK) cells. On the basis of repeated agonistic encounters, categories of subordinate and dominat animals were selected. These animals were compared with manipulated controls (introduced to a novel test cage without an opponent on each occasion) and undisturbed controls (who remained in isolation without manipulation). In terms of NK activity, immunosuppression was observed in both dominant and subordinate categories when compared to undisturbed controls. There were, however, no differences between the fighting exposed subjects and the manipulated controls, suggesting that stress accounts for any changes. © 1994 Wiley-Liss, Inc.     

Hungry people prefer larger bodies and objects: The importance of testing boundary effects

Several lab-based studies have indicated that when people are hungry, they judge larger women's bodies as more attractive, compared to when they are satiated. These satiety-dependent judgements are assumed to provide explanatory power when it comes to the noted cross-cultural differences in attitudes towards women's adiposity, whereby people who live in regions that are under greater nutritional stress tend to have more favourable attitudes towards bigger bodies. However, it is premature to assume that women's bodies are the proper or actual domain of the satiety-dependent judgement shifts found within research study testing contexts until stimuli other than female bodies have also been tested: The research programme falls into the trap of confirmation bias unless we also seek out disconfirmatory evidence and test the boundaries of the effects of hunger. Accordingly, we collected attractiveness judgements of female and male bodies manipulated to vary in size by varying level of adiposity, and objects manipulated to vary in size, from 186 participants who also reported their current hunger level. We found that larger sizes of stimuli in general, and women's bodies in particular, especially when judged by women, were judged as more attractive by the hungrier participants. We discuss these patterns in the context of the Insurance Hypothesis, the Environmental Security Hypothesis, and the impact of hunger on acquisition.     

Paths from core belief disruption to post-traumatic stress symptoms and post-traumatic growth among Korean undergraduates: The mediating role of rumination

The post-traumatic growth (PTG) model proposes that cognitive processing is a key mechanism that leads to growth in the aftermath of traumatic events. Building upon the PTG model, the present study examined the paths from the disruption of core beliefs to post-traumatic stress symptoms (PTSS) and PTG via intrusive and deliberate rumination. The sample includes 370 Korean undergraduate students who reported at least one highly stressful experience in their lifetime. Structural equation modeling demonstrated that disruption of core beliefs predicted PTG both directly and indirectly through multiple pathways: via deliberate rumination, intrusive rumination, and the path from intrusive to deliberate rumination. The disruption of core beliefs positively predicted PTSS only through intrusive rumination. No bivariate relationship was found between PTSS and PTG. These findings support the different roles of intrusive rumination and deliberate rumination in mediating the paths from disruption of core beliefs to PTSS and PTG. Implications and limitations of this study were discussed.     

Regression II. Development through regression

As shown in our previous paper (‘Regression I. Experimental approaches to regression’, JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung’s view that regression is not only a ‘return’ to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.