Hemodynamic responses to active and passive coping tasks and the prediction of future blood pressure in Thai participants: A preliminary prospective cohort study

Cardiovascular responses to mental stress tests have been related to future blood pressure (BP) levels. However, most studies have been completed in North America and Europe; only one study has been conducted in Asia. Therefore, the study explored whether cardiovascular responses to mental stress predict future resting BP in Thailand. Hemodynamic measures were obtained from 101 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. A follow‐up assessment of resting BP was undertaken 1 year later. Results showed that Thais responded to standardized mental stress tasks with large and significant cardiovascular reactivity. Regression analyses indicated that, after adjustment for baseline BP and traditional risk factors, heightened systolic blood pressure (SBP) responses to mental arithmetic were associated with increased future SBP (ΔR² = .045). These findings suggest that BP reactivity predicts future BP and may play a role in the development of hypertension. In addition, Thais displayed large cardiovascular responses to standardized mental stress tasks, of a similar magnitude to previous studies of North Americans and Europeans.     

How does mindfulness-based cognitive therapy work?

Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression ( [Kuyken et?al., 2008], [Ma and Teasdale, 2004] and [Teasdale et?al., 2000]). To date, no compelling research addresses MBCT’s mechanisms of change. This study determines whether MBCT’s treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with ≥3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction.MBCT’s effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group.MBCT’s treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.     

Ambulatory emotional reactivity to negative daily life events predicts remission from major depressive disorder

Major depressive disorder (MDD) is often associated with altered emotional reactivity. However, the functional significance of altered emotional reactivity in MDD is uncertain. This study was the first to examine the predictive relationship between intensely sampled ambulatory emotional reactivity and the clinical course of MDD. Forty-six outpatients who met criteria for MDD underwent six days of experience sampling of their ambulatory reactivity to everyday negative and positive life events. After experience sampling, all outpatients received pharmacotherapy with supportive psychotherapy and were followed clinically for 18 months. At one month, less emotional reactivity to negative and positive daily events predicted higher depressive symptom severity. Importantly, patients who exhibited less negative emotional reactivity to daily negative life events were less likely to recover from MDD over the 18 month follow-up. Relationships between ambulatory emotional reactivity and MDD course were not accounted for by the duration or the severity of initial MDD symptoms. Diminished ambulatory emotional reactivity appears to be functionally significant in depression. Intensive sampling of ambulatory emotions may have utility for predicting the clinical course of MDD.     

Play-Based Activities in Family Counseling

Traditional family therapists often work with family members of similar cognitive levels and exclude small children from the therapeutic process. Recent research indicates that children and families benefit when all family members can be involved in counseling (e.g., Thompson, Bender, Cordoso, & Flynn, 2011). Using an integrative intervention model, this article will focus on specific play-based activities which can be used to effectively include children in family therapy. A developmental, step-by step protocol is introduced and specific play-based activities are discussed.     

When emotion does and does not impair performance: A Garner theory of the emotional Stroop effect

It takes people longer to name the ink colour of emotion or threat words than that of neutral words, the emotional Stroop effect (ESE). In three experiments with normal and patient populations, we show that the ESE is a special case of a generic attention model and effect entailed in Garner's speeded classification paradigm. Guided by the Garner model we demonstrate that task-irrelevant dimensions that differ in salience can produce the ESE and mimic it with neutral stimuli. When each word appears in a constant colour, as mandated in the correlation condition of the Garner design, the ESE is eliminated. This important result is consistent with the attention account of the ESE. We conclude that when emotion stimuli appear in a random fashion they interfere with task performance. However, when emotion stimuli are correlated with features of the ongoing task they help task performance not least due to their extreme salience.     

Emotional reactivity,self-control and children's hostile attributions over middle childhood

Hostile attribution bias, a child's tendency to interpret ambiguous social information as threatening or hostile, has been discussed as an important point in which social, emotional and cognitive information intersect. This study explores the natural changes that occur in children's hostile attributions across three grades during middle childhood and examines how emotional reactivity and self-control at third, fourth and fifth grade independently and interactively relate to these trajectories. Participants included 919 children whose mothers reported on their emotional reactivity, whose teachers reported on their self-control and who completed an attribution bias interview, all at grades 3, 4 and 5. Results revealed that among children with a greater tendency to make hostile attributions at third grade, lower self-control at third grade was associated with greater initial hostile attribution bias and less decline in biases over time. Additionally, greater emotional reactivity at fourth grade was associated with declines in these children's hostile attributions, but only when self-control was also higher at fourth grade.     

Infant temperament and maternal parenting self-efficacy predict child weight outcomes

Relationships between infant negative reactivity and self-regulation, parenting self-efficacy, and child weight outcomes were examined. Greater observed negative reactivity predicted more child weight gain when mothers had lower parenting self-efficacy. Lower mother-reported self-regulation predicted a greater child weight status. Results highlight potential early risk/protective factors.     

Cortisol reactivity in the laboratory predicts ineffectual attentional control in daily life

Objective: The objective was to examine an executive control difficulty perspective on individual differences in cortisol reactivity using a daily protocol.

Design: Fifty participants competed a laboratory stressor task and individualdifferences in cortisol reactivity were quantified.

Main outcome measures: Daily attentional control, conflicting thoughts, error reactivity, worry and mindfulness were assessed.

Results: The findings support the idea that as cortisol responses to stress get larger (as an individual difference), attentional control ceases to function as it should in terms of variables that should predict (mindfulness) and follow from (e.g. worry) it.

Conclusion: The findings support the idea that individual differences in cortisol reactivity can be conceptualised in terms of ineffectual attentional control.     

Anxiety reactivity and anxiety perseveration represent dissociable dimensions of anxiety vulnerability: A replication and extension

Trait anxiety is a unitary construct reflecting individual differences in the tendency to experience anxious symptomatology, typically measured with questionnaires such as the Spielberger Trait Anxiety Inventory (STAI‐T). Recent research by Rudaizky, Page, and MacLeod has found evidence that two different dimensions of trait anxiety account for independent variance in trait anxiety scores. These dimensions are anxiety reactivity (AR), reflecting the probability of experiencing an anxious reaction, and anxiety perseveration (AP), reflecting the persistence of anxious symptoms once elicited. There are two key issues addressed in this study: first, the replicability of Rudaizky et al.'s findings and second, the ability of the measures of AR and AP developed by Rudaizky et al. to predict independent variance in STAI‐T scores after statistically controlling for variance shared with a measure of depression. Regression analysis determined that AR and AP do account for independent variance in STAI‐T trait anxiety scores even after statistically controlling for depression. The implications of these findings for the understanding of anxiety vulnerability are discussed.     

Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia

Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction.