Sleep disturbance and emotion dysregulation as transdiagnostic processes in a comorbid sample

Sleep disturbance and emotion dysregulation have been identified as etiologic and maintaining factors for a range of psychopathology and separate literatures support their relationships to anxiety, depression, PTSD, and alcohol dependence (AD) symptom severity. Previous studies have examined these relationships in isolation, failing to account for the high rates of comorbidity among disorders. It is not yet known whether these processes uniquely predict symptom severity in each of these domains. Participants were 220 patients in residential substance abuse treatment, who had experienced a potentially traumatic event and exceeded screening cutoffs for probable PTSD and problematic alcohol use. Controlling for emotion dysregulation and the interrelationships among the outcome variables, insomnia was uniquely associated with anxiety (B = .27, p < .001), depression (B = .25, p < .001), PTSD (B = .22, p < .001), and AD (B = .17, p = .01) symptom severity. Similarly, controlling for insomnia, emotion dysregulation was uniquely associated with anxiety (B = .40, p < .001), depression (B = .47, p < .001), PTSD (B = .38, p < .001), and AD (B = .26, p < .001) symptom severity. Insomnia and emotion dysregulation appear to be transdiagnostic processes uniquely associated with symptom severity across a number of different domains and might be important treatment targets for individuals with PTSD and AD.     

What harm can it do?: A discussion of the potential for harm inherent in psychodynamic work

Abstract

This paper examines some of the ethical issues raised by the nature of psychodynamic work. It suggests that both the aims and the process of psychodynamic therapy raise ethical issues which we cannot responsibly ignore, but that if the work is to be effective it cannot be made wholly safe. That, however, does not absolve us from the requirement for taking care, and for thinking about what we are doing and what we are risking.     

Intraclass Correlation Associated with Therapists: Estimates and Applications in Planning Psychotherapy Research

It is essential that outcome research permit clear conclusions to be drawn about the efficacy of interventions. The common practice of nesting therapists within conditions can pose important methodological challenges that affect interpretation, particularly if the study is not powered to account for the nested design. An obstacle to the optimal design of these studies is the lack of data about the intraclass correlation coefficient (ICC), which measures the statistical dependencies introduced by nesting. To begin the development of a public database of ICC estimates, the authors investigated ICCs for a variety outcomes reported in 20 psychotherapy outcome studies. The magnitude of the 495 ICC estimates varied widely across measures and studies. The authors provide recommendations regarding how to select and aggregate ICC estimates for power calculations and show how researchers can use ICC estimates to choose the number of patients and therapists that will optimize power. Attention to these recommendations will strengthen the validity of inferences drawn from psychotherapy studies that nest therapists within conditions.     

Functional Somatic Syndromes and Childhood Physical Abuse in Women: Data From a Representative Community-Based Sample

This study investigated whether childhood physical abuse was associated with functional somatic syndromes (FSS) in women while controlling for age, race, and four clusters of potentially confounding factors: (a) Other childhood adversities, (b) adult health behaviors, (c) socioeconomic status and stressors, and (d) mental health. A regional subsample of the 2005 Canadian Community Health Survey of 7,342 women was used. Women reported whether they had been diagnosed with chronic fatigue syndrome (CFS), fibromyalgia (Fm), irritable bowel syndrome (IBS), or multiple chemical sensitivities (MCS). Fully 749 reported having been physically abused by someone close to them during their youth. When controlling for potentially confounding factors, childhood physical abuse was significantly associated with CFS (OR = 2.11; 95% CI = 1.22, 3.65), Fm (OR = 1.65; 95% CI = 1.08, 2.52), and MCS (OR = 2.82; 95% = CI 1.90, 4.17). Clinicians using reattribution and stepped care approaches in the management of FSS should assess for a history of abuse.     

The benefits of self-compassion and optimism exercises for individuals vulnerable to depression

The effectiveness of two online exercises intended to help individuals experience (1) self-compassion (n?=?63) and (2) optimism (n?=?55) were compared to a control intervention where participants wrote about an early memory (n?=?70). A battery of tests was completed at 1 week following the exercise period, and at 1-, 3-, and 6-month follow-ups. Both active interventions resulted in significant increases in happiness observable at 6 months and significant decreases in depression sustained up to 3 months. The interventions were examined in relationship to dependency and self-criticism, both related to vulnerability to depression. Individuals high in self-criticism became happier at 1 week and at 1 month in the optimism condition in the repeated measures analysis. A sensitivity test using multi-level modeling failed to replicate this effect. More mature levels of dependence (connectedness) were related to improvements in mood up to 6 months in the self-compassion condition. This study suggests that different personality orientations may show greater gains from particular types of positive psychology interventions.     

Self-Other Discrepancies in Waiting Time Decisions

Both anecdotal evidence and recently reported research suggest that people are risk-averse when faced with waiting time decisions. Four studies investigate whether there is a self-other discrepancy in how people make waiting time decisions themselves and how they predict others will make similar decisions. People are found to believe that others have valuations of time similar to their own. However, when faced with alternatives that involve risk in the duration of the wait, the results point to a self-other discrepancy, in that people report greater risk-aversion themselves than they think others would. Further, when faced with waiting time gains, people are themselves more risk-averse than they think others would be. Conversely, when faced with waiting time losses, people are themselves more risk-seeking than they think others would be. Overall, the results are consistent with the recently proposed risk-as-feelings hypothesis.     

An investigation of the interaction between cognitive style and context reinstatement on the memory performance of eyewitnesses

The power of context reinstatement to improve recall is well established, but the degree of effect obtained varies widely between studies. Exploring possible causes for this variation, this paper examines the relationship between cognitive style and the efficacy of context reinstatement in improving free and cued recall in an eyewitness paradigm. Experiment 1, using a live staged event and a 1 week delay, indicated a significant improvement in free recall with the reinstatement of context and, as expected, no such improvement in cued recall. However, analysis of the data according to field dependency, as measured by Witkin, Oltman, Raskin, and Karp's [A manual for the Embedded Figures Test (1971) Palo Alto, CA: Consulting Psychologists Press] Group Embedded Figures Test (GEFT) revealed that, in free recall, field dependent witnesses' scores improved significantly with context reinstatement, whilst the scores of field independent witnesses did not. In cued recall, however, the field independent witnesses scored significantly higher overall than field dependent witnesses. Experiment 2 sought replication of these findings again utilised the GEFT and the Riding [Cognitive Styles analysis (1991) Birmingham: Learning and Training Technology] Cognitive Styles Analysis (CSA). Analysis of the data according to the Wholist-Analytic (W-A) dimension of the CSA, indicated no interaction with either context reinstatement or memorial performance. However the GEFT analysis produced similar results to that obtained in Experiment 1. The meaning of the interaction between the GEFT and both free and cued recall, and the failure of the CSA to similarly interact are discussed, together with the implication of these findings for establishing the value of reinstating context for individual eyewitnesses.     

Personality characteristics in primary benzodiazepine-dependent patients: Comparison with controls and polydrug users

The present study applied Karolinska Scales of Personality (KSP) to study (i) if patients with benzodiazepine dependence have a characteristic personality profile, (ii) if the personality characteristics in patients with benzodiazepine dependence differ from those of polydrug users and normal controls, (iii) if differences in treatment outcome existed between the groups, and (iv) if the possible difference in treatment outcome was associated with any particular personality characteristic shown by the patients. The personality characteristics of primary benzodiazepine dependent patients (BDZ) and a group of polydrug users (MIX) were studied initially (during the first week in project as an inpatient) and approximately one year after drug discontinuation, and a comparison was made with healthy controls on both test occasions. The results showed that the personality of both groups of patients differed significantly from the Controls in the following characteristics: Detachment, Socialization, Somatic Anxiety, Muscular Tension, Psychic Anxiety, and Psychasthenia. Significant differences existed between the polydrug and benzodiazepine users in Somatic and Psychic Anxiety as well as in Socialization. The MIX group differed significantly from the BDZ group and from the Controls in Suspicion. Results of treatment outcome indicated that the benzodiazepine dependent patients were significantly more successful in quitting their drug use compared to polydrug users. Further, the results demonstrated that patients scoring high in the investigated personality characteristics are those who fail the treatment goal of quitting their drug use, especially the patients with a high level of anxiety and detachment.     

Do We Need Grounding?

Many have been tempted to invoke a primitive notion of grounding to describe the way in which some features of reality give rise to others. Jessica Wilson argues that such a notion is unnecessary to describe the structure of the world: that we can make do with specific dependence relations such as the part–whole relation or the determinate–determinable relation, together with a notion of absolute fundamentality. In this paper I argue that such resources are inadequate to describe the particular ways in which some parts of reality give rise to others, and thus that we do in fact need grounding.     

反馈评估的局部背景依赖效应：ERP研究

人脑对反馈的评估依赖于其所处背景。但是只能依赖整体背景(整个组块的结果范围), 还是可以依赖局部背景(单个试次的结果范围)进行评估, 目前并不清楚。本研究通过获益/损失线索操纵所在试次的反馈背景, 探讨反馈评估仅依赖整体背景, 还是可延伸到局部水平。25名被试参与实验。结果发现, 背景试次间变化时, 在获益背景下, ￥0 (负反馈)比+ ￥4 (正反馈)引发更负的FRN (feedback-related negativity); 在损失背景下, - ￥4 (负反馈)比￥0 (正反馈)引发更负的FRN。这一结果说明反馈评估以某线索背景中可能的结果为参考对象, FRN的背景依赖可以延伸到局部水平。结合前人研究, 推测任务类型和反馈真实性会调节背景依赖水平。在含真实反馈的主动性任务中, FRN的背景依赖效应可延伸至局部水平。