Treating Childhood Social Anxiety Disorder With Virtual Environments and Serious Games: A Randomized Trial

Disseminating efficacious psychological treatments remains a challenge for researchers and clinicians. In the case of social anxiety disorder (SAD), Social Effectiveness Therapy for Children (SET-C) has been demonstrated as an efficacious intervention, but elements of the protocol, such as peer generalization sessions, remain challenging to conduct in typical clinical settings. To address this need, we developed an artificially intelligent, web-based application, Pegasys-VR™, designed to replace peer generalization sessions and enhance homework compliance. The feasibility of Pegasys-VR™ was tested in a randomized controlled trial in comparison to SET-C. The results indicated that both programs were equally efficacious in decreasing anxiety and improving social skill in social encounters. Sixty-three percent (63%) of children treated with SET-C and 60% treated with Pegasys-VR™ did not meet diagnostic criteria for SAD at posttreatment. Pegasys-VR™ is a feasible, efficacious, and dissemination-friendly element of a comprehensive treatment program for social anxiety disorder in children.     

Psychosis,symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo’s Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung’s conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.     

Application of Yoga as a Spiritual Practice to Enhance Counselor Wellness and Effectiveness

In this article, we explore potential benefits of yoga, an ancient Indian tradition for spiritual growth and development, for counselors. Counselors use themselves as instruments to support clients and are constantly exposed to the traumatic experiences of clients, which may leave them susceptible to secondary traumatic stress or compassion fatigue (Shallcross, 2011). Yoga can help counselors not only in achieving holistic wellness but also in developing a way of being consistent with the characteristics of an effective counselor. Furthermore, yoga, as a spiritual practice, can empower counselors to embark on a spiritual journey driven by their own personal experiences.     

General vs health‐specific consideration of immediate and future consequences to explain eating and exercise behavior in a Norwegian student population: A randomized survey experiment

Over several decades, the consideration of future consequences (CFC) construct has been used to explain and predict health behaviors. However, the reported associations between CFC and health behaviors are relatively weak, leading to the low explanatory power of the models. Recent research suggests that CFC can be a domain‐specific construct. In this study, we explored the psychometric properties of the Norwegian CFC‐general and CFC‐health questionnaires in terms of factor structure and discriminant and convergent validity and tested the association between the general and domain‐specific CFC and exercise and eating behaviors. In a randomized survey experiment, 1,001 university students were assigned to either a CFC‐general or a CFC‐health questionnaire. In the tested models, two dimensions of CFC, consideration of immediate consequences (CFC‐I) and consideration of future consequences (CFC‐F), were independent variables. The exercise and eating behaviors, measured both as self‐evaluated behaviors and self‐reported frequency measures, were dependent variables. The results showed that in both CFC‐general and CFC‐health, CFC‐I and CFC‐F are distinct dimensions that differentially explain variance in health behaviors. A domain‐specific CFC‐health explained a significantly higher amount of variance in self‐reported eating and exercising behaviors than a general CFC. Self‐evaluated health behaviors were better explained by CFC than self‐reported behavioral frequencies. Practical implications of the findings and avenues for future research are discussed.     

What is agentic about the Spatial Agency Bias? How pragmatic relevance contributes to the spatial representations of actions

The mental imagination of (social) actions has been shown to follow a left‐to‐right trajectory, with the thematic agent associated with the left position (Spatial Agency Bias, Suitner & Maass in Advances in Experimental Social Psychology, 53, 2016, p. 245–301). For example, individuals asked to choose a picture that visualizes the sentence “Tom kicks George” tend to choose an image where the agent, Tom, is positioned on the left‐hand side rather than on the right‐hand side. However, as an alternative to the thematic role of the agent, such findings may reflect a mental representation following pragmatic relevance. Specifically, a pragmatic perspective holds that word order and syntactic functions are strategic devices to communicate that the element is important for the sentence. Thus, positioning in the described picture‐matching task may actually reflect the agent's pragmatic relevance instead of agency per se. As a test, we vary whether sentences are written in the active versus the passive voice. Results from five studies indicate that the passive voice results in the tendency to place the agent on the right‐hand side rather than on the left‐hand side of a picture. Instead, the acted‐upon person is positioned on the left‐hand side of a picture. A sixth experiment reveals that for the passive voice, the agent is still seen as more agentic than the receiver, but is considered less relevant. The findings are congruent with the proposed pragmatic relevance account. Implications for the Spatial Agency Bias as well as for building mental representations in general are discussed.     

Computer‐based training to teach observers to accurately score problem behavior using fast forwarding at 5x normal speed

The current study evaluated whether a computer‐based training program could improve observers' accuracy in scoring discrete instances of problem behavior at 5x normal speed using a multiple‐baseline design across subjects. During pretraining and posttraining, observers attempted to score multiple examples of problem behavior at 5.0x without feedback. During training, participants scored multiple examples of problem behavior at 5.0x with automated feedback. Researchers measured omission (missing problem behavior) and commission (scoring other behavior as problem behavior) errors and the total duration of scoring time to determine the observers' accuracy and efficiency, respectively. After training, all participants scored instances of problem behavior with less than 11% error using 5.0x. The time required to score the videos across 90‐min observations was reduced by 66%. Results extend previous evaluations of fast forwarding by demonstrating that the training program could be used to teach observers to accurately score problem behavior using a speed faster than 3.5x.     

Reflections on the role of the analytic setting in the light of COVID-19

There have been many reflections, both individual and collective within our Institutes, on the effects on our work with patients caused by COVID-19 and the requirement to move suddenly from the setting of our own consulting rooms to working with patients online (see also, the previous issue of this Journal). This paper focuses on what we have learned from these experiences that can add to our knowledge about the role of the setting in analytic work. Drawing on Bleger’s (1967) seminal paper highlighting the usual setting as a mute projection carrier for primitive wishes and affects, the paper explores how different patients have reacted to the loss of the analyst as the guardian of the setting and in particular as an embodied presence. Some key questions and challenges for both patients and analysts during the pandemic, when ‘the setting begins to weep’, are explored.     

价值观的稳定性与可变性

价值观是人们区分好坏、善恶、美丑、损益、是非的信念系统,通常是充满情感的。价值观具有稳定性与可变性的特点。价值观的稳定性表现为:基本价值观具有跨时间的稳定性和跨情境的一致性; 特别是保护性价值观和人生价值观具有较强的稳定性。个人的发展、经历重大事件以及实验干预可导致价值观的改变,可变性主要表现为价值观的重要性发生变化。从我国的实际出发,探讨个人的核心价值观问题、以及价值观研究中国化、价值观研究对价值观教育的启示,乃是我们今后研究的关注点。     

Driver conflict response during supervised automation: Do hands on wheel matter?

Securing appropriate driver responses to conflicts is essential in automation that is not perfect (because the driver is needed as a fall-back for system limitations and failures). However, this is recognized as a major challenge in the human factors literature. Moreover, in-depth knowledge is lacking regarding mechanisms affecting the driver response process. The first aim of this study was to investigate how driver conflict response while using highly reliable (but not perfect) supervised automation differ for drivers that (a) crash or avoid a conflict object and (b) report high trust or low trust in automation to avoid the conflict object. The second aim was to understand the influence on the driver conflict response of two specific factors: a hands-on-wheel requirement (with vs. without), and the conflict object type (garbage bag vs. stationary vehicle). Seventy-six participants drove with highly reliable but supervised automation for 30 min on a test track. Thereafter they needed to avoid a static object that was revealed by a lead-vehicle cut-out. The driver conflict response was assessed through the response process: timepoints for driver surprise reaction, hands-on-wheel, driver steering, and driver braking. Crashers generally responded later in all actions of the response process compared to non-crashers. In fact, some crashers collided with the conflict object without even putting their hands on the wheel. Driver conflict response was independent of the hands-on-wheel requirement. High-trust drivers generally responded later than the low-trust drivers or not at all, and only high trust drivers crashed. The larger stationary vehicle triggered an earlier surprise reaction compared to the garbage bag, while hands-on-wheel and steering response were similar for the two conflict object types. To conclude, crashing is associated with a delay in all actions of the response process. In addition, driver conflict response does not change with a hands-on-wheel requirement but changes with trust-level and conflict object type. Simply holding the hands on the wheel is not sufficient to prevent collisions or elicit earlier responses. High trust in automation is associated with late response and crashing, whereas low trust is associated with appropriate driver response. A larger conflict object trigger earlier surprise reactions.