Development and Feasibility of a Group Cognitive-Behavioral Therapy for Fear of Cancer Recurrence

This paper describes the development, content, and preliminary results of a group cognitive-behavioral therapy (CBT) for fear of cancer recurrence (FCR). A manualized CBT intervention was developed and offered to 38 patients with various cancer types and stages in two hospitals. Four weekly group CBT sessions were administered by two licensed psychologists as part of routine care. Patients completed self-report scales before the first treatment session and, a second time, 1 month after the last session.Overall, 33 patients had clinical levels of FCR at baseline. The participants’ satisfaction toward the group CBT for FCR was high. Significant reductions on the total score and most subscales of the Fear of Cancer Recurrence Inventory (FCRI) were observed, as well as significant improvements on most of the other psychological variables measured (i.e., insomnia, anxiety, depression, dysfunctional beliefs about cancer, and intolerance of uncertainty). In addition, 52% of the patients with clinical levels of FCR (FCRI-severity subscale score ≥ 13) at baseline no longer reached this clinical threshold at posttreatment.These preliminary results suggest that our group CBT for FCR is well accepted and feasible, and shows promising efficacy for decreasing FCR and improving other psychological variables among cancer patients. The next step is to investigate the efficacy of this minimal intervention in larger and controlled clinical trials, as well as its usefulness as part of a stepped care approach.This low-cost intervention is easy to implement in various clinical settings and has a strong potential to help large numbers of patients with FCR.     

Constructing the stereotype of immigrants' criminality: Accounts of fear and risk in talk about immigration to Greece

This paper explores the discursive construction of immigrants' criminality in interview accounts obtained by a sample of Greek people in Thessaloniki (Northern Greece). Analysis, which adopts a discursive approach to stereotypes and category construction, indicates that fear and insecurity on the part of Greek people are represented as a sine qua non consequence of immigration to Greece. Two different lines of argument are used to account for the arousal of fear. According to the first, fear constitutes a corollary of a widespread stereotypical representation of immigrants as criminals. The stereotype of immigrants' criminality is considered to be ill‐warranted and it is attributed to the media or to other unspecified people. According to another, more regularly used, line of argument, however, fear is predicated upon the sordid living conditions of immigrants in Greece which make the probability of them being involved in illegal acts particularly high. In this case, fear is seen to derive from a ‘rational estimate’ of the probability of immigrant's involvement in criminal acts. Nested within the discourse of ‘risk’ the stereotypical image of immigrants' criminality is sustained and used to account for the need to protect the ‘ingroup’ from ‘immigrant groups’ through immigration control and surveillance. Copyright © 2011 John Wiley & Sons, Ltd.     

The spread of fear: Symbolic generalization mediates graded threat-avoidance in specific phobia

Overgeneralization of fear and threat-avoidance represents a formidable barrier to successful clinical treatment of anxiety disorders. While stimulus generalization along quantifiable physical dimensions has been studied extensively, less consideration has been given to symbolic generalization, in which stimuli are indirectly and arbitrarily related. The present study examined whether the magnitude and extent of symbolic generalization of threat-avoidance and threat-beliefs differed between spider-phobic and nonphobic individuals. Initially, participants learned two sets of stimulus equivalence relations (A1?=?B1?=?C1; A2?=?B2?=?C2). Next, one cue (B1) was established as a conditioned stimulus (CS?+?; threat) that signalled onset of spider images and prompted avoidance, and another cue (B2) was established as a CS– (safety cue) that signalled the absence of such images. Subsequent testing showed that phobics compared to nonphobics exhibited greater symbolic generalization of threat-avoidance to threat cues A1 and C1 (indirect CS+ threat cues related via symmetry and equivalence, respectively), while all individuals showed nonavoidance to indirect safety cues A2 and C2. The enhanced symbolic generalization of threat-beliefs and avoidance behaviour observed in spider phobics warrants further investigation.     

阻碍条件性恐惧记忆消退的原因分析

创伤后应激障碍是个体经历严重应激后形成的一种焦虑障碍,对其治疗的关键是消退由创伤应激导致的条件性恐惧记忆,但目前最有效的暴露疗法并不能真正有效地抑制患者恐惧记忆的表达.对条件性恐惧的动物模型研究发现情绪性增强效应、恐惧记忆二级条件化与再巩固、内侧前额叶皮层功能不足等均能够阻碍条件性恐惧记忆的消退.针对这几个方面可以探索治疗创伤后应激障碍的相应方法.     

大学生社会排斥对社交焦虑的影响：负面评价恐惧与人际信任的作用

为探讨大学生社会排斥对社交焦虑的影响以及负面评价恐惧和人际信任在二者之间的作用机制,研究采用大学生社会排斥问卷（SEQU）、社交焦虑量表（SASSCS）、负面评价恐惧量表（BFNES）及人际信任量表（ITS）对450名大学生进行测试。结果表明：（1）大学生社会排斥不仅对个体的社交焦虑水平产生影响,还会通过负面评价恐惧的中介作用对社交焦虑产生影响;（2）人际信任能够调节大学生社会排斥对社交焦虑的直接作用,具体而言,与高人际信任的大学生相比较,较低人际信任的大学生的社会排斥对社交焦虑的预测作用更加显著。     

The Confusion of Fear and Surprise: A Developmental Study of the Perceptual-Attentional Limitation Hypothesis Using Eye Movements

The goal of the present study was to test the Perceptual-Attentional Limitation Hypothesis in children and adults by manipulating the distinctiveness between expressions and recording eye movements. Children 3–5 and 9–11 years old as well as adults were presented pairs of expressions and required to identify a target emotion. Children 3–5 years old were less accurate than those 9–11 years old and adults. All children viewed pictures longer than adults but did not spend more time attending to the relevant cues. For all participants, accuracy for the recognition of fear was lower than for surprise when the distinctive cue was in the brow only. They also took longer and spent more time in both the mouth and brow zones than when a cue was in the mouth or both areas. Adults and children 9–11 years old made more comparisons between the expressions when fear comprised a single distinctive cue in the brow than when the distinctive cue was in the mouth only or when both cues were present. Children 3–5 years old made more comparisons for brow only than both. The results of the present study extend on the Perceptual-Attentional Limitation Hypothesis showing an importance of both decoder and stimuli, and an interaction between decoder and stimuli characteristics.     

Eating Disorder Symptom and Fear Change Trajectories During Imaginal Exposure Therapy: A Slope Network Analysis

Eating disorders (EDs) are characterized by fears related to food, body image, and social evaluation. Exposure-based interventions hold promise for targeting a range of ED fears and reducing ED psychopathology. We investigated change mechanisms and optimal fear targets in imaginal exposure therapy for EDs using a novel approach to network analysis. Individuals with an ED (N = 143) completed up to four online imaginal exposure sessions. Participants reported ED symptoms and fears at pretreatment, posttreatment, and 6-month follow-up. We constructed networks of symptoms (Model 1), fears (Model 2), and combined symptoms and fears (Model 3). Change trajectory networks from the slopes of symptoms/fears across timepoints were estimated to identify how change in specific ED symptoms/fears related to change in other ED symptoms/fears. The most central changing symptoms and fears were feeling fat, fear of weight gain, guilt about one’s weight/shape, and feared concerns about consequences of eating. In Model 3, change in ED fears bridged to change in desire to lose weight, desiring a flat stomach, following food rules, concern about eating with others, and guilt. As slope networks present averages of symptom/fear change slopes over the course of imaginal exposure therapy, further studies are needed to examine causal relationships between symptom changes and heterogeneity of change trajectories. Fears of weight gain and consequences of eating may be optimal targets for ED exposure therapy, as changes in these fears were associated with maximal change in ED pathology. Slope networks may elucidate change mechanisms for EDs and other psychiatric illnesses.     

Specifying factors in radiation risk perception

This is a study of risk perception and a test of a model of perceived risk. A scale measuring fear was factor analyzed and the resulting five fear factors were related to a large number of risk dimensions, both personal and general. Fear was only rather weakly related to perceived risk. Furthermore, perceived risk of two ionizing radiation hazards (nuclear power, X-rays) were investigated in more detail. These risk ratings were modelled on the basis of attitude, risk sensitivity, specific perceived risk of radiation, trust and an extended version of the traditional Psychometric Model, enhanced by the introduction of a factor of Tampering with Nature. It was found that risk perception could be well explained with this approach and the importance of Tampering with Nature, as well as specific perceived risk, were stressed.     

Effects of multiple exposures to D-cycloserine on extinction of conditioned fear in rats

Previous research has shown that an acute, post-training injection of D-cycloserine (DCS) facilitates extinction of conditioned fear in rats; however, the effects of multiple exposures to DCS in this situation are not known. In Experiment 1, rats were conditioned (light-shock pairings) and 24 h later given six extinction (light-alone) trials followed by an injection of DCS (15 mg/kg) or saline. The next day, all rats were tested for light-elicited freezing. In Experiment 2, the effect of DCS on extinction was tested in the same manner, except that rats were pre-exposed to DCS (0, 1, or 5 injections) just prior to conditioning. In Experiment 3, rats received five pre-exposures of DCS but conditioning occurred either 2 or 28 days after the last pre-exposure. The results showed that DCS facilitated extinction of conditioned freezing to the light CS when no drug pre-exposure had occurred, but pre-exposure to DCS just prior to conditioning disrupted the facilitation of extinction effect. When 28 days were interposed between pre-exposure and conditioning, the facilitatory effects of DCS on extinction were restored. These findings suggest that DCS has significant clinical value but that behavioral desensitization may occur with multiple exposures; however, desensitization is not permanent and is reduced by the passage of time.