Envy: the canker in the bud

This paper explores the relevance of the concept of moral masochism as a response to early trauma and the implications of this for psychotherapy.

Consideration is given to early conceptualisations of moral masochism within the psychoanalytic literature, in particular, the move from drive theory to object relations. More recent developments in relation to trauma and defences, such as disassociation, are explored. It is suggested that a more complex and fuller understanding requires thinking about the subtle and shifting interaction of both these levels. This allows the possibility of building a more nuanced understanding which can look at both behaviour, as described in the trauma literature, and meaning which is the core of a more classical psychoanalytic approach.

Case histories are used to illustrate the linkages between moral masochism and trauma and the transference and countertransference dynamics and challenges involved. Progress varied in these cases, with both positive and negative outcomes. This theoretical background is used to suggest why this may be so.     

Replication and Extension of a Hierarchical Model of Social Anxiety and Depression: Fear of Positive Evaluation as a Key Unique Factor in Social Anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.     

Why Young Men Drive Dangerously: Implications for Injury Prevention

Why is risk consistently underestimated, and why do young men in particular take exceptionally high risks and think of themselves as invulnerable? Two explanatory paths are proposed. The first is that risk taking in young males has been shaped by evolutionary forces to provide a fitness value. The second pathway is through myth and the other narrative forms that affirm the ego's immortality and invulnerability. Because of its evolutionary base, risk taking is emotionally driven: Emotions are preverbal and irrational, which means that persuasive prevention cannot be more than weakly successful. Three prevention challenges emerge from this analysis: to determine what it is that young drivers fear, to attach affectively experienced fears to defined driving behaviors, and to devise injury-prevention programs that acknowledge that young males' risk taking is not "stupid," but driven by adaptive needs that are as significant to today's young adults as they were to our distant ancestors.     

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.     

疼痛恐惧相关的注意偏向及其矫正

疼痛恐惧是影响和维持慢性痛的重要因素。不同材料和被试类型情况下, 疼痛恐惧均主要作用于个体对疼痛相关信息的早期注意加工阶段, 表现为注意警觉模式。该注意模式使个体将注意维持在疼痛上, 从而干扰了对非疼信息的注意能力。矫正疼痛恐惧相关注意偏向可以改善疼痛体验。未来研究应采用更具生态效度的任务测量疼痛恐惧相关的注意偏向及其神经基础, 进一步考察矫正疼痛恐惧相关注意偏向能否改善慢痛患者的忧郁和功能丧失等问题。     

疼痛恐惧的形成、泛化与消退

疼痛恐惧源于把疼痛等同于伤害的灾难化信念及对疼痛的负性解释, 它在慢性疼痛和能力丧失的发生和发展过程中起着重要作用。疼痛恐惧可以通过联合学习和观察学习等方式获得, 并且在具有相似特征的刺激中存在泛化现象。通过教育干预和等级暴露疗法等可以成功消退疼痛恐惧, 在消退过程中要控制安全信息等因素的不良影响。在疼痛恐惧的获得与消退中, 主要有杏仁核, 脑岛和前扣带皮层等脑区参与。未来的研究可以集中在深入探讨疼痛恐惧形成中的泛化及消退后的恢复、再巩固等现象, 加强其临床上的应用, 并综合心理、生物和认知神经科学, 研究疼痛恐惧的获得、泛化与消退的深层机制。     

Social anxiety and fear of bodily sensations in panic disorder and agoraphobia: A matched comparison

This study tests the hypothesis that social anxiety and fear of bodily sensations are associated with the development of agoraphobic avoidance behavior in panic disorder patients. Twenty patients with panic disorder were compared to 20 patients with panic disorder with agoraphobia, matched by sex and duration of disorder. The two groups did not differ on measures of fear and frequency of assertive social responses. However, the agoraphobics scored higher on measures of interpersonal sensitivity, depression, feelings of inadequacy, and hostility. They also reported higher fear of bodily sensations. Although definitive conclusions need to be postponed until prospective studies have been conducted, there is evidence suggesting that the development of agoraphobia in panic patients is associated with hypersensitivity to bodily sensations and interpersonal situations.This research was supported by Grant 560-268-009 of the Dutch Organization for Scientific Research.     

认知重评对负性效价的抑制促进条件性恐惧消退

认知重评能有效降低个体对情感刺激的负性情绪体验, 但指导性认知重评在恐惧记忆治疗中效果存在争议。本文将认知重评范式与辨别式条件恐惧反应范式结合, 以效价和US预期值为指标, 探讨指导性认知重评训练对恐惧情绪习得和消退的影响效果。以低认知重评能力个体为被试, 在实验前24 h进行指导性认知重评训练。条件性恐惧任务为期2天, 第一天完成条件性恐惧的习得和消退任务, 第二天完成条件性恐惧的再消退任务。结果显示, 经过重评训练后个体在条件性恐惧任务中的恐惧情绪效价显著较低, 说明认知重评有效降低低认知重评能力个体在急性应激状态下的负性情绪体验。所有被试均成功完成辨别式条件性恐惧的习得和消退任务, 因此重评训练并不削弱个体对危险或者安全信息的辨别能力。但在条件性恐惧的消退过程中, 认知重评指导训练加快了恐惧消退, 且24 h后测得的条件性恐惧程度显著较低, 说明指导性重评提高了条件性恐惧记忆的消退效率, 并减弱了条件性恐惧的消退返回。     

社交媒体使用与错失焦虑的关系：一项元分析

社交媒体使用与错失焦虑均是当下生活中较为常见的现象, 诸多研究探讨了两者间的内在联系, 但研究结果却存在很大差异。为明确两者之间的整体关系, 以及产生分歧的原因, 对检索后获得的65项研究(70个独立样本)使用随机效应模型进行了元分析。结果发现：社交媒体使用与错失焦虑存在显著正相关(r = 0.38, 95% CI [0.34, 0.41]); 二者的相关强度受社交媒体使用测量指标和社交媒体类型的调节, 但不受性别、年龄、错失焦虑测量工具和个体主义指数的调节。结果一定程度上澄清了大众传播的社会认知理论和数字恰到好处假说的争论, 表明社交媒体使用程度越高的人往往也会伴随着较高水平的错失焦虑。防止社交媒体过度使用, 尤其是引导大众合理使用以图像为中心并且开放度较高的社交媒体有助于错失焦虑的缓解。