Cognitions related to anxiety: a pilot study of treatment

In general, where anxiety appears to have a specific external focus, such as the situations which are avoided by phobic patients, treatment involving systematic exposure to those situations seems to be effective. This is less appropriate, or even impossible, where anxiety is not dependent on any external circumstance, but is described by the patient as occurring at any time or place, either chronically over long periods, or acutely in the form of ‘panic attacks’. These patients with ‘generalised’ anxiety often describe internal cues for anxiety either in the form of thoughts (e.g. worry over a current problem) or somatic (e.g. chest sensations interpreted as possible heart disease). Beck et al. (1974) has suggested that on interview, all patients diagnosed as suffering from diffuse or generalised anxiety can report specific ideas or other cognitive cues which are associated with anxiety. These usually concern possible traumatic events, such as illness and death, or social rejection. Clearly Beck has in mind the possibility that these cognitions have the effect of inducing anxiety, although even if the validity of the subjective reports were to be accepted, the problem remains of whether the relationship between mood state and cognitions is causal and if so, in which direction it operates. Obviously a causal relationship may also operate in both directions simultaneously, to form a ‘vicious circle’ in which each exacerbates the other. To establish whether there is a sense in which particular cognitions contribute causally to anxious mood, it would be necessary to find a method of manipulating the type or frequency of cognitions thought to be operating in this way.

One obvious possibility is that of ‘thought-stopping’: that is, patients could be taught to identify thoughts which are associated with anxiety and stop them in the usual way (Wolpe, 1973, p. 211) e.g. by' shouting stop, and substituting an alternative thought. The present study was planned as a pilot experiment to determine (i) if appropriate anxiety related cognitions could be elicited from a series of patients with generalised anxiety, (ii) if the reported frequency of such thoughts could be modified by a thought-stopping technique, and (iii) if any changes in thought frequency were associated with improvements in mood.

Clearly there are many ‘non-specific’ features involved in thought-stopping which could also have therapeutic effects on mood. For this reason it was necessary to include an alternative procedure, not directed at reducing thought frequency, but having the same degree of plausibility to patients, and preferably to therapists. The control procedure chosen for this purpose was modelled on desensitisation, in which patients were encouraged to allow the supposedly anxiety-provoking thoughts into their mind and tolerate them, rather than attempt to stop them. In summary, the study employed a relaxation training phase as a base-line, followed by a cross-over design in which the two treatment phases of thought-stopping and ‘cognitive desensitisation’ were given to each patient, in balanced order.     

Treatment of dental fears by imaginal flooding and rehearsal of coping behaviour

All combinations of high versus low arousal imaginal flooding, and coping versus no-coping imaginal rehearsal, were compared in the modification of dental fear. About one half of all subjects seen successfully completed dental treatment, although significant differences were found between groups in anxiety reduction before and during dental examination, which favoured the low arousal flooding groups. Coping rehearsal did not influence anxiety, but interacted with arousal level of flooding to determine subsequent dental attendance. The results suggest that flooding without coping rehearsal had little effect at high levels of arousal, but good results at low levels. Flooding with coping rehearsal on the other hand, had mixed results. At high arousal levels avoidance was reduced but not anxiety, while at low levels anxiety was reduced but not avoidance. The implications for further research on coping rehearsal are discussed.     

Forest before trees: The precedence of global features in visual perception

The idea that global structuring of a visual scene precedes analysis of local features is suggested, discussed, and tested. In the first two experiments subjects were asked to respond to an auditorily presented name of a letter while looking at a visual stimulus that consisted of a large character (the global level) made out of small characters (the local level). The subjects' auditory discrimination responses were subject to interference only by the global level and not by the local one. In Experiment 3 subjects were presented with large characters made out of small ones, and they had to recognize either just the large characters or just the small ones. Whereas the identity of the small characters had no effect on recognition of the large ones, global cues which conflicted with the local ones did inhibit the responses to the local level. In Experiment 4 subjects were asked to judge whether pairs of simple patterns of geometrical forms which were presented for a brief duration were the same or different. The patterns within a pair could differ either at the global or at the local level. It was found that global differences were detected more often than local differences.     

Development of visual,name, and conceptual memory codes for pictures

In a recognition memory task, 4-, 8-, and 16-year-olds quickly decided whether or not probe pictures were identical to remembered study pictures. Conceptual and visual, but not acoustic, confusion were evidenced by the longer latencies when probes were visually or conceptually related to study items than when unrelated or rhyming. Visual confusion arose only when seven or fewer pictures intervened between study and probe items, and the kinds of visual similarity that produced confusion changed with age. Conceptual confusion resulted only at longer lags, and the same kinds of conceptual relationships produced confusion at all ages. These findings are discussed in terms of the development of visual and semantic encoding processes.     

Some motivational properties of sensory stimulation in psychotic children

The purpose of this experiment was to assess the reinforcing properties of sensory stimulation for autistic children. Three different types of sensory stimulation were used: music, visual flickering stimulation (e.g., strobe light), and visual movement (e.g., windshield wiper). In a given session, one of the three kinds of sensory stimulation was presented for 5 sec contingent upon the children's bar pressing (FR5). In Phase I, which was designed to assess the differential reinforcement value of these events, four children participated in sessions with each of the sensory events. In Phase II, designed to assess variables influencing the maintenance of responding for the sensory events, two children continued to participate in sessions with their preferred sensory event until satiation occurred. The results showed the following: (1) Sensory events could be used as reinforcing stimuli to produce a high rate of responding which was relatively durable over time: (2) the reinforcement function of the sensory events was idiosyncratic across children. with one child preferring one kind of sensory event, and another child preferring a different kind; (3) there was substantial variability in daily response rates: and (4) when a child satiated on a particular sensory event, a relatively small change in the sensory event was sufficient to recover a high rate of responding. The results of this study suggest that sensory reinforcers can profitably be used in behavior therapy with autistic children.     

Infants and I scales: Inferring change from the ordinal stimulus selections of infants for configural stimuli

The analysis of I-scale preference orders of 71 infants 2 to 9 months old to four face-like stimuli suggested a common J-scale stimulus ordering for each of the four age groups. Changes in I-scale frequencies were used as a measure of age-related changes in preference orders. Results revealed no change in preference for the age period studied. Together with other data these results suggest an ageinvariant preference for organized face-like forms from at least as early as five weeks through 9 months. This finding is at variance with some theoretical expectations. A Thurstone analysis is provided as a contrast to the J-scale analysis. Assumptions of different data analyses are considered as the basis for varying results reported in the literature.     

Phallometric diagnosis with 'nonadmitters'

The phallometric method of assessing erotic value of presented stimuli has two main tasks, one is in the breaking down of complex (potentially) sexual stimuli into components, the other is in diagnosing anomalous erotic preferences in ‘Nonadmitters’, i.e. in persons whose behaviour would imply there is such an anomaly, but who deny its presence. Differentiation between Admitters and Nonadmitters was attained by two verbal Admitter scales. Comparison of the scores on these scales with results of phallometric assessment showed (by mutual validation) that the phallometric method diagnoses Admitters more accurately than Nonadmitters. After that, the validity was tested of a new mode of the phallometric method, designed for diagnosing pedo- or hebephilia in Nonadmitters. In cases of homosexual pedophilia or hebephilia (but not in the heterosexual cases) the new Nonadmitter mode was superior to the Standard procedure.