Behavioural group therapy for obsessive-compulsive disorder in Norway. An open community-based trial

The aim of the current study was to test the effectiveness of ERP-based 12 weeks group therapy for OCD patients in a community-based, general Norwegian outpatient clinic. The sample consisted of 54 patients diagnosed with OCD. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI) and the Spielberger State Anxiety Inventory (STAI-S) were administered before treatment, after treatment and at 3- and 12-month follow-ups. Analyses with mixed models for repeated measurements showed that group behavioural therapy offered to OCD patients significantly improved ratings of obsessive-compulsive symptoms, depression and anxiety. These improvements were maintained at 3- and 12-month follow-ups and an additional reduction in obsessive-compulsive symptoms was observed from post-treatment to 3-month follow-up. However, the delayed effect of therapy was no longer present at 12-month follow-up. The results also revealed that the patients had a lower chance for an increased outcome category (e.g. from unchanged to improved or recovered) with high scores on STAI-S at the given observation times (post-treatment, 3- and 12-months follow-ups). Depressive symptoms (BDI) at post-treatment and follow-ups had no significant influences on the three categories of outcome for OCD. In conclusion, the results indicate that behavioural group therapy can successfully be delivered to patients with considerable comorbidity in a real world setting conducted by therapists with limited training in the CBT.     

The association between reality-based beliefs and indirectly experienced traumatization

The purpose of the study was to examine the association between belief types and the magnitude of indirect traumatization. Specific types of beliefs were defined in terms of the cognitive orientation theory, which is a cognitive-motivational approach to the understanding, predicting, and changing of behaviors. Belief types that were analyzed included beliefs about self, general beliefs, beliefs about norms, and goal beliefs as they relate to personal growth. Study participants included 38 rescuers (body handlers), 37 nurses, and 31 rehabilitation workers who treated injured civilians that had been exposed to politically motivated violence. The Cognitive Orientation for Posttraumatic Growth Scale was used to assess beliefs about personal growth. The Revised Posttraumatic Stress Disorder Inventory was administered to evaluate indirect traumatization. The results indicate that three of the four belief types related to personal growth were associated with the level of indirect traumatization. Optimistic and positive beliefs about self and general beliefs were associated with a lower level of indirect traumatization symptomatology, suggesting that these types of beliefs may counteract indirect traumatization. On the other hand, stronger goal beliefs were associated with greater indirect traumatization. The negative association between positive goal beliefs and indirect trauma may be related to the gap the individual perceives between the hoped-for ideals and the trauma-stricken reality. These results indicate the importance of cognitive beliefs and their possible role in determining the response to indirect traumatization.     

The impact of advertisements featuring ultra‐thin or average‐size models on women with a history of eating disorders

Previous research demonstrates that exposure to ultra‐thin media models leads to increased body image concerns amongst women (Groesz, Levine, & Murnen, 2002 ). There is emerging evidence that attractive, average‐size models do not have this negative effect and can be effective in advertising (e.g. Halliwell & Dittmar, 2004 ). The present study investigates these factors amongst women with a history of eating disorders. Participants either viewed advertisements featuring ultra‐thin, average‐size or control images. Immediately after exposure, they reported their body‐focused anxiety and rated the effectiveness of the advertisements. Whereas exposure to ultra‐thin models did not lead to increased body‐focused anxiety, exposure to average‐size models produced a relief effect, whereby women reported lower levels of body‐focused anxiety. Advertisements featuring ultra‐thin and average‐size models were equally effective. The results suggest that average‐size, attractive models could be used effectively in advertising, which may help to relieve body image concerns amongst these women. Copyright © 2005 John Wiley & Sons, Ltd.     

Who is who in dissociation?: A plea for psychodynamics in a time of trauma1

Contemporary theories of dissociation and trauma for the most part have evolved outside of psychoanalysis. Psychoanalytic writings have also been regarded as being in opposition to trauma‐based notions of human psychopathology. The specific psychoanalytic contribution—the emphasis on unconscious conflict and meaning—is for the most part excluded from the discourse on dissociation, often resulting in a mechanic conceptualisation of trauma. In this paper, based on clinical material, the author argues in favour of including conflict, unconscious intention and personal meaning in understanding the kind of dissociation we see in cases of multiple personality pathology. Textual analysis of letters written to the analyst illustrates how events of abuse are defensively elaborated. The author demonstrates that patterns of affect regulation and dominant object–relational strategies can be captured through analysis of the discourse structure. She focuses on how an organised character pattern, revealed mainly through narrative style and the analyst's countertransference, serves protective purposes as well as wishfulfillment. She argues that dissociation in the form of multiple personalities may imply an active, strategic agent.     

Facilitation of Extinction of Conditioned Fear by D-Cycloserine

Abstract— Excessive fear and anxiety are characteristic of disorders such as post-traumatic stress disorder (PTSD) and phobias and are believed to reflect abnormalities in neural systems governing the development and reduction of conditioned fear. Conditioned fear can be suppressed through a process known as extinction, in which repeated exposure to a feared stimulus in the absence of an aversive event leads to a gradual reduction in the fear response to that stimulus. Like conditioned fear learning, extinction is dependent on a particular protein (the N-methyl-D-aspartate or NMDA receptor) in a part of the brain called the amygdala. Blockade of this receptor blocks extinction and improving the activity of this receptor with a drug called D-cycloserine speeds up extinction in rats. Because exposure-based psychotherapy for fear disorders in humans resembles extinction in several respects, we investigated whether D-cycloserine might facilitate the loss of fear in human patients. Consistent with findings from the animal laboratory, patients receiving D-cycloserine benefited more from exposure-based psychotherapy than did placebo-treated controls. Although very preliminary, these data provide initial support for the use of cognitive enhancers in psychotherapy and demonstrate that preclinical studies in rodents can have direct benefits to humans.     

关于大学生心理障碍干预模式的理论建构

本文在已有研究的基础上,根据大学生心理发展与心理素质的特点和不同心理学派的理论观点建构了大学生心理障碍干预模式,该模式由多维系统的干预途径、多样渗透的干预方法、丰富全面的干预工作内容和完善化人性化的干预机制组成,它们之间的关系既是独立的,又是相互协调和影响的。体现了大学生心理障碍干预模式的系统完整性及实施干预的灵活多样性和明确针对性。     

Disinhibitory trait profile and its relation to Cluster B personality disorder features and substance use problems

Certain personality and motivational traits may present vulnerability towards disinhibitory psychopathology (e.g. antisocial personality disorder, substance abuse). Cluster analysis was used to separately group 306 women and 274 men on impulsivity, Constraint, Negative Emotionality, behavioural activation system (BAS), and behavioural inhibition system (BIS) scores. As expected, a ‘disinhibited’ group with low Constraint, high impulsivity, weak BIS, and strong BAS emerged that showed elevated drug use problems, and histrionic and antisocial personality disorder features across gender. A ‘high affectivity’ group with high Negative Emotionality and strong BIS also showed elevated drug use problems and personality disorder features. Results suggested that two different trait profiles are associated with disinhibitory psychopathology and both may present vulnerability toward the development of such disorders. Copyright © 2006 John Wiley & Sons, Ltd.     

网络成瘾症治疗方法研究进展

利用文献分析方法分析和总结了目前国内关于网络成瘾治疗方法的研究进展。简要回顾了网络成瘾症的概念、症状、诊断标准、分类和病因研究现状;介绍和分析了现有文献已报道的心理治疗、药物治疗、整合治疗单元、家庭治疗、社会支持治疗等方法;对网络成瘾治疗方法研究现状进行了讨论并提出了几点研究建议。     

Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention

A large and growing empirical literature reveals a robust relationship between alcohol use and the occurrence of intimate partner violence (IPV). However, the role of alcohol use and intoxication in episodes of IPV, particularly with respect to alcohol's potential causal or facilitative function in the occurrence of partner aggression, remains a source of much controversy and considerable debate. The purpose of this review is to (a) describe briefly IPV and the types of behaviors subsumed under this label, (b) examine evidence for the link between alcohol use and IPV, (c) explicate factors (e.g., antisocial personality disorder) that may moderate this relationship, and (d) discuss the primary conceptual models put forth to explain this association. Recommendations for interventions that consider the relationship between alcohol use and IPV are also provided.     

Emotion Regulation Therapy: An Integrative Approach to Treatment-Resistant Anxiety Disorders

Cognitive-behavioral, psychodynamic, and experiential approaches have historically been characterized by differing definitions of emotions and beliefs concerning their role in psychopathological process and treatment. However, given recent advances in the basic psychological sciences of emotion and emotion regulation, theoretical orientations are converging on similar viewpoints as to the functional role of emotions in conceptualizing and treating of a variety of disorders. One such area where emotions and their regulation may play a significant role is in chronic, complex, and treatment-resistant forms of anxiety disorders such as generalized anxiety disorder (GAD). A review of the historical approaches to emotions in the major theoretical orientations is presented. Following this, a model of emotion disruption and dysregulation is presented as it relates to anxiety disorders and GAD, in particular. Finally, a new treatment for GAD, emotion regulation therapy, aimed at ameliorating dysfunctional affective processes, is described.