The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation

We examined the effects of safety-seeking behavior and guided threat focus and reappraisal on fear reduction during exposure. Participants (N=46) displaying marked claustrophobic fear were randomized to one of three 30-min exposure conditions: (a) guided threat focus and reappraisal; (b) safety-behavior utilization; or (c) exposure only control. Tripartite outcome assessments during a behavioral approach test, along with measures of suffocation and restriction fears were obtained at pre- and post-treatment, and at a 2-week follow-up. Treatment process measures were collected throughout treatment and consisted of indices of fear activation; within and between-trial fear habituation; and suffocation and entrapment expectancies. Measures of safety behavior utilization and attentional focus were also collected to assess the integrity of the experimental manipulations. Consistent with prediction, those encouraged to utilize safety-behaviors during exposure showed significantly more fear at post-treatment and follow-up relative to those encouraged to focus and reevaluate their core threat(s) during exposure. Moreover, growth curve analyses of treatment process data analyses revealed that safety-behavior utilization exerted a detrimental effect on between-trial habituation; whereas guided threat reappraisal enhanced between-trial habituation.     

降低剖宫产率 维护母婴利益

剖宫产作为一种生产方式,其比率居高不下,已经引起医学界和卫生管理部门的重视。分析其原因,开展相应的对策研究,已成为当务之急。通过健康教育使产妇走出认识误区;加强医务人员职业道德建设;加强医疗卫生法制建设;完善医疗卫生管理体制;建立和谐的医患关系是降低剖宫产比率,维护母婴利益的重要保证。     

The recognized benefits of negative thinking/affect in depression and anxiety: Developing a scale

Negative thinking/affect (NTA) in depression and anxiety is an important target of clinical intervention. However, individuals recognize the benefit of NTA. There is a need to develop a scale for empirical studies of NTA. Two‐hundred and fifty‐nine Japanese university students were assigned to answer: (a) the state in the past week (positive affect (PA) and Center for Epidemiologic Studies Depression Scale), (b) the current state (PA and State‐Trait Anxiety Inventory‐State (STAI‐S)), and (c) the usual state (PA and STAI‐Trait), after completing the Recognized Benefit of NTA Scale (RBNTA). Another 291 students completed the Rosenberg Self‐Esteem Scale and the Revised Life Orientation Test, after completing the RBNTA. Two weeks later, 76 participants completed the RBNTA. The RBNTA with nine subscales was developed after comparing the indices of fitness from 14 different factor solutions. The internal and test‐retest reliability and content validity were confirmed. Correlation analyses revealed that the recognition of trying to obtain benefits/avoid costs tends to associate with positive/negative affect and that most of such recognitions did not associate with self‐esteem and optimism.     

Failure to replicate the deleterious effects of safety behaviors in exposure therapy

The current study attempted to replicate the finding obtained by Powers, Smits, and Telch (2004; Journal of Consulting and Clinical Psychology, 72, 448–545) that both the availability and utilization of safety behaviors interfere with the efficacy of exposure therapy. An additional goal of the study was to evaluate which explanatory theories about the detrimental effects of safety behaviors best account for this phenomenon. Undergraduate students (N = 58) with high claustrophobic fear were assigned to one of three treatment conditions: (a) exposure only, (b) exposure with safety behavior availability, and (c) exposure with safety behavior utilization. Participants in each condition improved substantially, and there were no significant between-group differences in fear reduction. Unexpectedly, exposure with safety behavior utilization led to significantly greater improvement in self-efficacy and claustrophobic cognitions than exposure only. The extent to which participants inferred danger from the presence of safety aids during treatment was associated with significantly less improvement on all outcome measures. The findings call into question the hypothesized deleterious effects of safety behaviors on the outcome of exposure therapy and highlight a possible mechanism through which the mere presence of safety cues during exposure trials might affect treatment outcomes depending on participants’ perceptions of the dangerousness of exposure stimuli.     

Differential effects of safety behaviour subtypes in social anxiety disorder

Clinical observations indicate that individuals with Social Anxiety Disorder (SAD) use a variety of safety behaviours; however, virtually no research has examined the functional effect of different safety-seeking strategies. Accordingly, we conducted two studies to address this issue. Study 1 measured global patterns of safety behaviour use in a large analogue sample. Factor analysis revealed two primary safety behaviour categories, avoidance and impression management. Study 2 assessed situational use of safety behaviours during a controlled social interaction in a clinical sample of 93 patients with Generalised SAD. Factor analysis again revealed support for avoidance and impression-management subtypes. Notably, the two types of safety behaviours were associated with different social outcomes. Avoidance safety behaviours were associated with higher state anxiety during the interaction and negative reactions from participants’ interaction partners. Impression-management strategies appeared to impede corrections in negative predictions about subsequent interactions. These findings suggest that it may be beneficial to consider the unique effects of different safety-seeking strategies when assessing and treating SAD.     

Does integral affect influence intentions to use artificial intelligence for skin cancer screening? A test of the affect heuristic

Objective: This study investigated how affect influences people’s processing of messages about risks and benefits of using autonomous artificial intelligence (AI) technology to screen for skin cancer. We examined integral affect (emotion derived during decision making) separately from incidental affect (extraneous mood states).

Design: Using the affect heuristic framework, we randomly assigned 273 participants to conditions featuring risk (high, low, uncertain) or benefit (high, low, uncertain) messages about AI. Following ‘affect-as-spotlight’, we also explored whether people’s integral affect towards skin cancer moderated the relationship between risk/benefit messages and AI screening intentions.

Outcomes: Perceived risk, perceived benefit, positive and negative affect toward AI, intention to use AI screening.

Results: After controlling for incidental affect and risk perceptions, we found that compared to low risk messages, uncertain risk messages increased participants’ negative affect toward AI, decreased positive affect toward AI, increased AI risk evaluations and reduced AI benefit evaluations. Perceptual variables significantly mediated participants’ intentions to use AI for risk messages but not benefit messages. No moderation effects were found.

Conclusions: Results suggest extending the affect heuristic framework to include uncertain risk conditions. Integral AI affect influenced people’s interpretation of messages, which then impacted likelihood to use AI technology for health.     

Positive Public Health Ethics: Toward Flourishing and Resilient Communities and Individuals

Abstract

The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the COVID-19 pandemic is a global health injustice due to moral failures of national governments and international organizations to prepare for, prevent and control it. Global and national health communities had a moral obligation to act in accordance with the current state of knowledge of pandemic preparedness. This obligation—a positive duty to develop and implement systems to reduce threats to and safeguard individuals’ and, communities’ abilities to flourish—stems from theories of global health justice and governance. The COVID-19 pandemic revealed and amplified the fragility and deficiencies in our global and domestic health institutions and systems. Moving forward, positive public health ethics is needed to set ethical standards for building and operating robust public health systems for resilient individuals and communities.     

Novel use of a virtual driving assessment to classify driver skill at the time of licensure

Motor vehicle crash rates are highest immediately after licensure, and driver error is one of the leading causes. Yet, few studies have quantified driving skills at the time of licensure, making it difficult to identify at-risk drivers before independent driving. Using data from a virtual driving assessment implemented into the licensing workflow in Ohio, this study presents the first population-level study classifying degree of skill at the time of licensure and validating these against a measure of on-road performance: license exam outcomes. Principal component and cluster analysis of 33,249 virtual driving assessments identified 20 Skill Clusters that were then grouped into 4 major summary “Driving Classes”; i) No Issues (i.e. careful and skilled drivers); ii) Minor Issues (i.e. an average new driver with minor vehicle control skill deficits); iii) Major Issues (i.e. drivers with more control issues and who take more risks); and iv) Major Issues with Aggression (i.e. drivers with even more control issues and more reckless and risk-taking behavior). Category labels were determined based on patterns of VDA skill deficits alone (i.e. agnostic of the license examination outcome). These Skill Clusters and Driving Classes had different distributions by sex and age, reflecting age-related licensing policies (i.e. those under 18 and subject to GDL and driver education and training), and were differentially associated with subsequent performance on the on-road licensing examination (showing criterion validity). The No Issues and Minor Issues classes had lower than average odds of failing, and the other two more problematic Driving Classes had higher odds of failing. Thus, this study showed that license applicants can be classified based on their driving skills at the time of licensure. Future studies will validate these Skill Cluster classes in relation to their prediction of post-licensure crash outcomes.     

Women as a key to enhancing road safety in ultraorthodox communities in Israel

The ultraorthodox sector in Israel, while an integral part of society, has unique cultural characteristics along with limited media exposure. Both these features impact the perceptions of driving and road safety, as well as the ability to influence them. In view of the scarcity of research literature on these issues, the present study sought to gain further insight into the community in an attempt to find a creative way to leverage road safety among ultraorthodox road users in Israel.Using the phenomenological qualitative method, 60 face-to-face in-depth interviews were conducted with women and men of different ages and backgrounds from the major ultraorthodox communities. Findings reveal that for the ultraorthodox, driving is a controversial subject that represents much more than its normative practical function in modern Western societies. It is subject to sociocultural restrictions that are reflected, inter alia, in limited public discourse on road safety. Moreover, the findings highlight the prominent educational role of women in this sector: they are exclusively responsible for raising young children, and are the sole educators of girls of all ages. In addition, as people tend to marry young, and men do not generally drive before marriage, women can influence the safety habits of their spouse as well as their children. The authors suggest building on this potential to increase awareness of road safety by empowering ultraorthodox women to serve as agents of social change in their family and community.