Psychosocial effects associated with dental fear in adult dental patients with avoidance behaviours

Abstract

The most obvious consequence of a genuine dental phobic reaction is the avoidance of necessary dental care. Previous research has indicated that such avoidance has adverse effects on an individual's oral health status, and also reduces the quality of life. However, systematic investigations in this area of dentistry are few and clinical observations and interviews may often fail to elicit information regarding the impairment created outside the dental situation. The present investigation assessed the presence and levels of emotional and social life effects among dental phobic patients with regard to the prevalence of dental and general fears and the length of time for which dentistry had been avoided. It was shown that a majority of the patients felt that they had to curtail their social relations, and many, especially long-term avoiders, reported wide-spread negative social life effects. Often this had extended into feelings of loneliness or to overt social isolation. It remains to be seen whether fear of dentistry itself produces disadvantage or whether these effects are mainly related to personality factors, which can also promote the development of dental fear. Alternatively, poor dental health, which is probably more frequent in anxious patients, may be perceived by these patients and thus impair social relationships.     

Electrometric Studies of Sleep

The authors provided a differential test between stimulus-stimulus (S-S) and stimulus-response (S-R) theory predictions in regard to the roles that the constructs of expectancy and of fear play in maintaining classically conditioned fear responding within the context of a human conditioned-avoidance paradigm. After the participants had developed sustained avoidance responding, their shock electrodes and avoidance response apparatus were removed to enhance the cognitive expectancy that the conditioned stimulus (CS) would not be followed by the unconditioned stimulus (UCS). This manipulation of expectancy was successful in 96% of the participants. The study was conducted over a 2-day period and involved 1 experimental group and 3 control groups. During the test trials, the authors used autonomic and self-report indices of fear to assess the presence or absence of fear to the CS. The data disconfirmed the prediction of the S-S theory that fear to the CS would be extinguished. The authors discuss the implications of this finding for S-S theories and for approaches in cognitive behavior therapy.     

Validation of a TAI Short Form with an Adolescent Sample

Subjects who pretested high or low in hypnotic suggestibility took a creativity test either under hypnosis or in a waking state. All subjects made a global estimate of their general degree of creativity. Greater figural-spatial creativity was exhibited in the hypnosis condition than in the waking condition by both high and low suggestibles. Creativity self-reports were not corroborated by actual creative performance.     

Fight and Flight: Evidence of Aggressive Capitulation in the Face of Fear Messages from Terrorists

In an era of digital technology and the Internet, terrorists can communicate their threats directly to citizens of Western countries. Yet no research has examined whether these messages change individuals' attitudes and behavior or the psychological processes underlying these effects. Two studies (conducted in 2008 and 2010) examined how American, Australian, and British participants responded to messages from Osama bin Laden that threatened violence if troops were not withdrawn from Afghanistan. Heightened fear in response to the message resulted in what we call “aggressive capitulation,” characterized by two different group‐protection responses: (1) submission to terrorist demands in the face of threats made against one's country and (2) support for increased efforts to combat the source of the threat but expressed in abstract terms that do not leave one's country vulnerable. Fear predicted influence over and above other variables relevant to persuasion. Theoretical and practical implications are discussed.     

Fear,Functioning, and Coping During Exposure to a Continuous Security Threat

This study focused on the contribution of fear to mediating stress, as manifested in general stress reactions and impaired functioning resulting from exposure to a continuous security threat among 451 students from a college located in a confrontation zone. The findings indicated that the contribution of fear reactions was more significant than actual exposure. Married participants felt higher levels of fear than did single participants, and women were able to function despite their fear. In addition, coping patterns were both directly and indirectly related to all stress measures. The results are discussed in light of the literature on stress reactions, and practical recommendations for working in continuous threat situations are proposed.     

Post-traumatic stress symptoms in adolescents exposed to an earthquake: Association with self-efficacy,perceived magnitude,and fear

The objective of this study was to evaluate th×e relationship between the magnitude of an earthquake, the fear experienced, the self-efficacy beliefs, and post-traumatic stress symptoms in adolescents. We expected self-efficacy beliefs to predict post-traumatic stress symptoms, and this relation to be mediated by fear. We used data from a longitudinal project on adolescent normative development that was under way at the time of the 2010 earthquake in Chile. Six months before the earthquake, 218 adolescents responded to a self-efficacy beliefs scale; three months after the earthquake they reported the perceived magnitude of the event, the fear they experienced, and their post-traumatic stress symptoms. Results showed that perceived magnitude was not associated with fear or post-traumatic stress symptoms, but self-efficacy beliefs and fear were associated with post-traumatic stress symptoms. The hypothesized role of fear as a mediator in the relation between self-efficacy beliefs and post-traumatic stress symptoms was supported by the data. The results of the study, suggest that preventive interventions aimed to increase awareness of how to face a disaster may not only contribute to save lives but may also increase adolescentś sense of personal efficacy, reducing subsequent emotional reactivity associated with the event.     

Unfairness begets unfairness: Victim derogation bias in employee ratings

This research investigated criterion contamination in human resource evaluations, specifically victim derogation in which third parties (e.g., managers, co-workers) systematically undervalue the performance and potential of individuals who have previously suffered organizational injustices. A policy capturing design (Study 1) found that managers rated job applicants who had been treated unfairly by their previous employers as less suitable than fairly treated applicants, after objective performance information was controlled. In Study 2, the effect of unfair treatment on job applicant ratings was found to be moderated by managers’ just world beliefs, with applicant ratings reflecting more derogation among managers with higher (vs. lower) Belief in a Just World. In Study 3, the pattern of results from Study 2 was replicated in a performance evaluation context using peers as raters. Moreover, in Study 3 an intervention that activated raters’ moral identity was found to attenuate victim derogation bias.     

AN ANALYST'S UNCERTAINTY AND FEAR

The motivations for choosing psychoanalysis as a profession are many and differ depending on the psychology of the analyst. However, common to most psychoanalysts is the desire to forge a helpful relationship with the individuals with whom they work therapeutically. This article presents an example of what happens when an analyst is confronted by a patient for whom being in a relationship and being helped are intolerable.     

Comparing thought suppression and mindfulness as coping techniques for spider fear

The current study compared thought suppression, focused attention (mindfulness) and unfocused attention as strategies for managing spider fear. Spider fearful participants were exposed to a strategy induction before completing a Behavioural Approach Test (BAT). The BAT is a 10 step measurement of how close participants are willing to move towards a spider. Participants were instructed to use what they learned in the pre-BAT induction to help them advance through the steps of the BAT. The results of the study indicated that participants given the thought suppression or the unfocused attention induction moved through significantly less steps of the BAT than did those given the focused attention (mindful) induction. Additionally, the thought suppression group felt significantly more anxious than the focused and unfocused attention groups following completion of the BAT. These results are discussed in terms of the impact of thought suppression on avoidance behaviour in phobias.     

The Effect of Counterconditioning on Evaluative Responses and Harm Expectancy in a Fear Conditioning Paradigm

In fear conditioning, extinction targets harm expectancy as well as the fear response, but it often fails to eradicate the negative affective value that is associated with the conditioned stimulus. In the present study, we examined whether counterconditioning can serve to reduce evaluative responses within fear conditioning. The sample consisted of 70 nonselected students, 12 of whom were men. All participants received acquisition with human face stimuli as the conditioned stimuli and an unpleasant white noise as the unconditioned stimulus. After acquisition, one third of the sample was allocated to an extinction procedure. The other participants received counterconditioning with either a neutral stimulus (neutral tone) or a positive stimulus (baby laugh). Results showed that counterconditioning (with both neutral and positive stimuli), in contrast to extinction, successfully reduced evaluative responses. This effect was found on an indirect measure (affective priming task), but not on self-report. Counterconditioning with a positive stimulus also tended to enhance the reduction of conditioned skin conductance reactivity. The present data suggest that counterconditioning procedures might be a promising approach in diminishing evaluative learning and even expectancy learning in the context of fear conditioning.