Information Processing and Decision-Making in Pathological Worriers and their Potential Role in Mechanisms of Generalized Anxiety Disorder

Systematic information processing and decision-making under uncertainty are key constructs of new conceptions explaining the severity of pathological worry. The current study attempted to analyze their usefulness in subclinical and clinical groups. In the first phase of the study (N = 251) participants were examined with the Penn State Worry Questionnaire (PSWQ), a GP consultationrelated survey, and a screening survey for generalized anxiety disorder (GAD). In the second phase (N = 220), the State-Trait Anxiety Inventory, the PSWQ, and tasks measuring systematic information processing (SIP) versus heuristic reasoning (HR) were applied. In the third phase (N = 60), GAD (n = 30) and healthy control (n = 30) groups were examined with the above methods and the Iowa Gambling Task (IGT). In the low risk group, a relationship between mood and the representativeness heuristic (ρ = 0.50), as well as anchoring and adjustment heuristic (anxiety-related stimuli) was found (ρ = −0.53). In the GAD group, significant correlations between the PSWQ score, the IGT loss avoidance score (ρ = 0.40), and total IGT score (ρ = 0.48) were found. The results did not confirm a particular usefulness of the systematic/heuristic information processing construct in subclinical and clinical groups. Theory-consistent results were rather found in the nonclinical groups. Nevertheless, the data revealed some interesting findings supporting potential explanatory power of some theoretical models.     

反刍思维与社交焦虑的关系:来自元分析的证据

反刍思维与社交焦虑的关系一直存在争议,为探究这些研究结论不一致的原因,本研究采用元分析技术研究反刍思维与社交焦虑的关系.综合国内国外研究42篇,中文文献8篇,英文文献34篇,共53个独立样本,总样本23032人.研究结果显示,反刍思维与社交焦虑呈高度正相关(r=0.42),反刍思维与社交焦虑的关系受到年龄段、反刍思维使...     

A hermeneutic study of integrating psychotherapist competence in postnatal Child Health Care: Parents’ perspectives

A child's emotional and social development depends on the parents’ provision of optimal support. Many parents with perinatal distress experience difficulties in mastering parenthood and seek help from professionals within primary healthcare. A clinical project was launched in Stockholm, where psychodynamic psychotherapists provided short-term consultations at Child Health Centers. This study qualitatively explored parents’ experiences of perinatal distress and of receiving help by nurses and therapists in the project. Thirteen parents were interviewed, and their responses were analyzed with a hermeneutical method. Three main themes crystallized; accessibility of psychological help and detection of emotional problems; experiences of therapy at the Child Health Center; and the therapists’ technique. Parents were also clustered into three so-called ideal types: the insecure; parents in crisis; and parents with lifelong psychological problems. Parents experienced obstacles in accessing psychological care within primary healthcare. Psychotherapists with a holistic family perspective and who managed to oscillate between insight-promoting and supportive interventions were especially appreciated. Patient categories who benefitted from insight promotion and support, respectively, were identified.     

数学焦虑个体近似数量加工的神经机制:一项EEG研究

近似数量加工是对大数目物体数量在不依赖逐个数数前提下的估计。行为学研究提示高数学焦虑人群近似数量加工能力下降, 但神经机制未明。本研究探讨高数学焦虑个体近似数量加工的神经机制, 比较高低数学焦虑脑电活动的差异:(1)行为上无显著组间差异; (2)高数学焦虑组的P2p成分波幅增加; (3) δ频段ERS及β频段ERD无显著数量比例效应, 而低数学焦虑组在上述指标的数量比例效应显著。本研究为高数学焦虑人群近似数量加工能力下降提供了电生理学的证据。     

Psychometric properties of the Driving Behaviour Scale (DBS) among polish drivers

Anxiety can negatively affect an individual’s psychological wellbeing and lead to mild-to-moderate functional impairment in various areas of their lives. Despite this, the relationship between anxiety and driving performance has received very little empirical attention. The Driving Behaviour Scale (Clapp, Olsen, Beck, et al., 2011, Clapp, Olsen, Danoff-Burg, et al., 2011) was developed as a measure of anxious driving behaviours to support research in this area. The current study details adaptation and validation of the Driving Behaviour Scale (DBS; Clapp, Olsen, Beck, et al., 2011, Clapp, Olsen, Danoff-Burg, et al., 2011) in 310 university students in Poland. The overall internal consistency for the DBS was 0.76, while the two subscales demonstrated acceptable internal consistency (safety/cautious = 0.75 and hostile/aggressive behaviours = 0.85). The reliability estimates for performance deficit returned a lower coefficient of 0.65. Factor analysis produced a three-factor solution that supported the original structure of the DBS. The DBS may be utilised as a measure of driving anxiety in samples drawn from the general population.     

Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

Sculpting the Body Beautiful: Attachment Style,Neuroticism, and Use of Cosmetic Surgeries

Use of cosmetic surgeries has increased steadily over the last decade, and continues to rise in young and old alike. The purpose of present research was to investigate the relationship of personality to use of cosmetic procedures of various kinds. It was expected that adult attachment style, in particular attachment anxiety, would be positively related to use of cosmetic procedures. Attachment anxiety involves excessive approval seeking and concern over achieving and maintaining the love of significant others (such as romantic relationship partners). Such concerns could, in turn, lead to use of a variety of strategies for maintaining positive regard, including cosmetic surgeries to enhance physical appearance. Results supported this hypothesis, particularly among women. Neuroticism was also related to some procedures, though the relationships were generally weaker than those for attachment anxiety, and largely disappeared in regression analyses that controlled for the separate influence of the two variables.     

Family Unification with Reactive Attachment Disorder Children: A Brief Treatment

This is a case study of a family with a child (age eight) with reactive attachment disorder and the subsequent individual and family therapy. Treatment of choice for the child was Eye Movement Desensitization and Reprocessing (EMDR) and supportive educational counseling for the parents and family. Qualitative evaluation of the process demonstrated that the parents observed an instant change in the child's attitude. The child reported that she felt better about family, school, and truthfulness, and stated about the therapy: It opened a window for me. A 12-month evaluation demonstrated continued positive effects.     

Touching Mortality, Touching Strength: Clinical Work with Dying Patients

This paper outlines some of the special stresses that must be shouldered by clinicians—physicians, nurses, chaplains, social workers, pastoral staff, and others—whose work focuses on dying and extremely vulnerable patients. The utility of a theory of generative death anxiety as a framework for interpreting the nature of these special stresses is suggested. Three common burnout reactions are examined. The paper concludes that positive acceptance of personal mortality may help clinicians avoid burnout and lead to better therapeutic practice. This framework for interpreting therapeutic practice demonstrates the integral role spirituality plays in work with this particular patient group.     

A case study of borderline anxiety andthe process of analytic transformation

Borderline patients present particular treatment problems and require close, devoted understanding of their often chaotic and shifting intrapsychic conflicts. Many of these patients act out, making it difficult to maintain an analytic process. In fact, many terminate early on. When they do stay for longer periods, they exhibit particular constellations of defense, anxiety, and conflict. One extensive case report is used to examine the overlapping cycles of treatment with this population. Frequently, self-destructive acting-out is present in the transference and extratransference. This acting-out is often followed by the self-destructive, antichange attitude of the death instinct. These ways of relating to the self and the object are mobilized within the vehicle of projective identification and are best understood as primitive defenses against core fantasies of loss and persecution. These issues of loss and fear are the final and vital phase of treatment with borderline patients, who are often able to make major fundamental changes in their internal sphere, but only if patient and analyst can tolerate and understand these three levels of intrapsychic experience.