Mental Imagery and Post-Event Processing in Anticipation of a Speech Performance Among Socially Anxious Individuals

The present study investigated whether post-event processing (PEP) involving mental imagery about a past speech is particularly detrimental for socially anxious individuals who are currently anticipating giving a speech. One hundred fourteen high and low socially anxious participants were told they would give a 5 min impromptu speech at the end of the experimental session. They were randomly assigned to one of three manipulation conditions: post-event processing about a past speech incorporating imagery (PEP-Imagery), semantic post-event processing about a past speech (PEP-Semantic), or a control condition, (n = 19 per experimental group, per condition [high vs low socially anxious]). After the condition inductions, individuals’ anxiety, their predictions of performance in the anticipated speech, and their interpretations of other ambiguous social events were measured. Consistent with predictions, high socially anxious individuals in the PEP-Imagery condition displayed greater anxiety than individuals in the other conditions immediately following the induction and before the anticipated speech task. They also interpreted ambiguous social scenarios in a more socially anxious manner than socially anxious individuals in the control condition. High socially anxious individuals made more negative predictions about their upcoming speech performance than low anxious participants in all conditions. The impact of imagery during post-event processing in social anxiety and its implications 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.     

A Randomized Trial of Attention Training for Generalized Social Phobia: Does Attention Training Change Social Behavior?

The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One significant limitation of current investigations is overreliance on self-report. In this investigation, we expanded on initial investigations by using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n = 31) were randomly assigned to eight sessions of attention training (n = 15) or placebo/control (n = 16). Participants were assessed at pre- and posttreatment via self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no differences between groups at posttreatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for patients with SAD.     

Anxiety Sensitivity and Interoceptive Exposure: A Transdiagnostic Construct and Change Strategy

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.     

Mindfulness and acceptance-based group therapy versus traditional cognitive behavioral group therapy for social anxiety disorder: A randomized controlled trial

Recent research has supported the use of mindfulness and acceptance-based interventions for Social Anxiety Disorder (SAD).     

Predictors of quality of life enjoyment and satisfaction in individuals living with HIV and AIDS in a resource-constrained setting in South Africa

The burden of HIV disease is concentrated in sub-Saharan Africa, particularly in South Africa (SA). Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of the study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) among individuals infected with HIV. A battery of questionnaires, which included the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), were administered to 121 participants. Data was analysed using SPSS. Of the total sample (n = 121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25–49 years old experienced psychological distress. Those who were not on antiretroviral treatment (ART) were significantly affected (66%). Psychological distress was significantly prevalent among HIV positive individuals and also the strongest predictor of Q-LES among these individuals.     

Debating the Theological Implications of New Technologies

In a recent report on focus group discussions of GMOs in Britain, Celia Deane Drummond et al. observed that public anxieties about emerging biotechnologies often reflect concerns that are ultimately theological in nature. Such concerns (whether in relation to biotechnology or other areas of technological development) may be easily dismissed as peripheral or irrelevant to the core secular issues of health, safety, environmental impacts, the politics of commercialization and research integrity. However, I shall argue that theological questions are actually integral to the ongoing development of technology and that there is a need for a public discourse that enables such questions to be articulated and debated.     

Releasing the Self: The Healing Legacy of Heinz Kohut

Paradoxically, the more powerful the USA has become the more that paranoia seems to mark its relation to itself and to others. In this article we argue that there is a connection between its denial of its own destructiveness, self-idealization expressed in the belief that America represents the end point of the civilizing process towards which all other societies are drawn, and the paranoid conviction that an enemy Other (communism, Islam) aims to corrupt or destroy ‘God's chosen people’. First Vietnam and now September 11th inflicted grievous injuries upon this narcissism and we suggest that the invasion of Iraq can be considered as an indication that the USA has failed to ‘work through’ this trauma, instead it has sought to reassert an imaginary omniscience. Just as the destruction of the Twin Towers was the breaking through of the Real upon the Imaginary, so the ‘Real’ war in Iraq has begun after the ‘Imaginary’ war was declared ‘over’ by Bush.     

Pandora's box: An investigation of essay anxiety in adolescents

Abstract

This paper is an investigation into possible causes of essay anxiety experienced by adolescent students. The three students are presented as being representative of three broader categories: the non-starter, the non-completer and the non-exhibitor. Parallels are drawn between the student essay and student family relationships, and essay anxiety is explored in terms of the utilization of defences against the anxiety of loss. In the process, there is an attempt to appreciate some of the deeply rooted, inter-related, developmental factors - in particular, tolerance of aggressive impulses and the experience of the good object as modifying container - which might affect the student's ability to deal productively with an essay.     

Sport and Thought. Football as therapy: A year in the life of an inner city project

‘Sport and Thought. Football as therapy, A year in the life of an inner city project’ is a paper based on a way of working that fuses football and psychodynamic thinking. The project was set up at inner city all-boys secondary school in London and was created in response to the growing need for a therapeutic intervention which was accessible to adolescent boys who would not engage via more traditional therapeutic routes. The project works with adolescents experiencing behavioural and emotional difficulties. Sport and Thought is a way of working with adolescents that fuses the sport of football, psychodynamic thinking and theory to create a space to encourage thought and act as a catalyst to promote emotional and behavioural change. Sport and Thought believes an individual’s reactions within a sporting context are no different to a societal one, and thus the sport of football can be used to enable participants to consider their own emotional and behavioural traits, and the underlying reasoning behind them.