Augmenting treatment efficiency in exposure therapy for PTSD: a randomized double-blind placebo-controlled trial of yohimbine HCl

The alpha-2 adrenergic receptor antagonist, yohimbine, can facilitate fear extinction in animals and humans. One potential mechanism is increased noradrenergic activity and associated arousal in the presence of conditioned stimuli. Accordingly, yohimbine might augment prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD), where heightened exposure-oriented arousal is a theorized driver and empirical predictor of treatment success. A double-blind placebo-controlled randomized trial (NCT 01031979) piloted yohimbine augmentation in 26 males with combat-related PTSD. Participants were given one-time dose of yohimbine or placebo prior to the first imaginal exposure. Subsequently, both arms completed standard PE. The primary outcome was trauma-cued heart-rate reactivity a week after the drug/exposure visit, a highly specified, objective measure sensitive to incremental change. Secondary outcomes included arousal during the drug/exposure visit and slope of distress, PTSD, and depression over the course of PE. Consistent with hypothesis, yohimbine led to higher objective and subjective arousal during the drug/exposure visit and to lower trauma-cued heart-rate reactivity one-week later. One dose of yohimbine also led to greater between-session habituation and more rapid improvement on depression, but not PTSD, over the course of care. Results of this controlled pilot indicate support for continued investigation of yohimbine-augmented exposure therapy for PTSD.     

情绪性记忆的定向遗忘效应

刺激的情绪性具有增强记忆的效果,那么,带有情绪信息的刺激对遗忘又会产生怎样的影响？已有研究从行为及认知神经机制层面探讨了情绪性刺激对定向遗忘效应的影响,但结果并不一致。总结已有文献发现,以情绪性刺激的材料类型、情绪效价、唤醒度和熟悉度为主的客观因素和以被试的情绪状态为主的主观因素均为影响定向遗忘效应产生及其稳定性的重要原因。这类研究是对有意遗忘研究领域的重要补充,也加深了人们对有意遗忘机制的理解。     

贵州少数民族儿童青少年SNARC效应的发展

采用奇偶判断任务,考察二年级至大学阶段贵州民族儿童青少年SNARC效应的发展状况。结果显示：三年级开始出现SNARC效应（包括正确率SNARC效应）;各阶段SNARC效应无显著差异;高、低年级正确率存在显著差异,六年级以后各阶段正确率无显著差异。结论：民族儿童三年级开始形成数字的空间表征。SNARC效应的大小不因年龄而发生变化;被试对奇偶知识的掌握存在发展过程,三年级可能基本理解奇偶信息,六年级后熟练掌握奇偶信息。     

羞怯与受欺负:社交回避与被他人容纳的多重中介效应

采用大学生羞怯量表、被他人容纳量表、大学生社交回避及苦恼量表和欺负问卷测量了369名大学生,探讨社交回避和被他人容纳在羞怯与受欺负之间的作用。结果表明:(1)羞怯、社交回避和受欺负三个变量彼此之间均呈显著正相关,这三个变量与被他人容纳均呈显著负相关;(2)羞怯不仅直接影响受欺负,也通过社交回避-被他人容纳的链式中介作用间接影响受欺负。     

社会支持对大学生社会幸福感的影响—希望的中介作用

基于积极心理学,采用问卷调查法,对1098名大学生进行调查,探讨社会支持对社会幸福感的影响,并基于希望进行中介效应检验,借此构建三个变量之间的关系模型,探索促进大学生心理健康发展的内在机制。结果表明:社会支持、希望与社会幸福感之间两两相关显著; 社会支持和希望及其各维度,显著正向影响大学生的社会幸福感; 社会支持通过希望影响大学生社会幸福感水平。研究结果证实了希望在社会支持影响社会幸福感中起部分中介作用的心理机制,为大学生心理健康教育提供了参考建议。     

应急救援团队的个体与团队情境意识：社会网络关系的调节作用

采用地震后建筑物倒塌,被困人员转运的任务情景,以99名消防指挥系大四学员为被试,研究个体情境意识和团队情境意识的关系,以及社会网络关系中的网络密度和结构洞指标在其中的调节作用。结果表明：(1)个体情境意识与团队情境意识不相关,即团队情境意识不是个体情境意识的简单相加;(2)共享情境意识对团队情境意识有负向影响：个体情境意识之间的差异越大,团队情境意识就越高;(3)对于网络密度较大的团队,结构洞对共享情境意识和团队情境意识的关系起到正向调节的作用;(4)对于网络密度较小的团队,结构洞对共享情境意识和团队情境意识的关系起到负向调节的作用。     

Perceptual experience shapes our ability to categorize faces by national origin: A new other-race effect

People are better at recognizing own-race than other-race faces. This other-race effect has been argued to be the result of perceptual expertise, whereby face-specific perceptual mechanisms are tuned through experience. We designed new tasks to determine whether other-race effects extend to categorizing faces by national origin. We began by selecting sets of face stimuli for these tasks that are typical in appearance for each of six nations (three Caucasian, three Asian) according to people from those nations (Study 1). Caucasian and Asian participants then categorized these faces by national origin (Study 2). Own-race faces were categorized more accurately than other-race faces. In contrast, Asian American participants, with more extensive other-race experience than the first Asian group, categorized other-race faces better than own-race faces, demonstrating a reversal of the other-race effect. Therefore, other-race effects extend to the ability to categorize faces by national origin, but only if participants have greater perceptual experience with own-race, than other-race faces. Study 3 ruled out non-perceptual accounts by showing that Caucasian and Asian faces were sorted more accurately by own-race than other-race participants, even in a sorting task without any explicit labelling required. Together, our results demonstrate a new other-race effect in sensitivity to national origin of faces that is linked to perceptual expertise.     

Safety Behavior After Extinction Triggers a Return of Threat Expectancy

Safety behavior is involved in the maintenance of anxiety disorders, presumably because it prevents the violation of negative expectancies. Recent research showed that safety behavior is resistant to fear extinction. This fear conditioning study investigated whether safety behavior after fear extinction triggers a return of fear in healthy participants. Participants learned that two stimuli (A and C) were followed by an aversive loud noise (“threat”), and one stimulus (B) was not. Participants then learned to use safety behavior that prevented the loud noise. Next, A and C were no longer followed by the loud noise, which typically led to extinction of threat expectancy. Safety behavior then became available again for C, but not for A and B. All participants used safety behavior on these C trials. In a final test phase, A, B, and C were presented once without the availability to use safety behavior. At each stimulus presentation, participants rated threat expectancy by indicating to what extent they expected that the loud noise would follow. Compared with the last extinction trial, threat expectancy increased for C in the test phase, whereas it did not increase for A and B. Hence, safety behavior after the extinction of classically conditioned fear caused a partial return of fear. The findings suggest that safety behavior may be involved in relapse after exposure-based therapy for anxiety disorders.     

New Directions in the Cognitive-Behavioral Treatment of OCD: Theory,Research, and Practice

The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.     

Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.