Modification of Hostile Interpretation Bias in Depression: A Randomized Controlled Trial

Interpretation Bias Modification (IBM) is gaining attention in the literature as an intervention that alters cognitive biases and reduces associated symptoms. Forty, primarily college-aged, non-treatment-seeking adults with major depressive disorder (MDD) were randomly assigned to receive either IBM targeting hostile interpretation bias (IBM-H) or a healthy video control (HVC) condition. Compared to those in HVC, participants in IBM-H reported more benign interpretations and fewer hostile interpretations at posttreatment. No difference in depressive interpretation bias was found between groups at posttreatment. IBM-H led to improved anger control at posttreatment and follow-up compared to HVC, though no effects of condition were found on trait anger or depressive symptoms. The IBM-H group perceived their treatment as less credible than the HVC group. For individuals with high expectancy of treatment success, IBM-H led to lower posttreatment depressive symptoms compared to HVC, while findings trended in the opposite direction for those with low expectancy of success. Overall, these preliminary findings point to boundary conditions for the efficacy of IBM protocols for anger and depression and potential improvements to be made to future IBM protocols.     

The Relationship Between Attention,Interpretation, and Memory Bias During Facial Perception in Social Anxiety

Although cognitive theories suggest the interactive nature of information processing biases in contributing to social anxiety, most studies to date have investigated these biases in isolation. This study aimed at (a) testing the association between social anxiety and each of the threat-related cognitive biases: attention, interpretation, and memory bias; and (b) examining the relationship between these cognitive biases in facial perception. We recruited an unselected sample of 188 adult participants and measured their level of social anxiety and cognitive biases using faces displaying angry, disgusted, happy, and ambiguous versions of these expressions. All bias tasks were assessed with the same set of facial stimuli. Regression analyses showed that social anxiety symptoms significantly predicted attention avoidance and poorer sensitivity in recognizing threatening faces. Social anxiety was, however, unrelated to interpretation bias in our sample. Results of path analysis suggested that attention bias influenced memory bias indirectly through interpretation bias for angry but not disgusted faces. Our findings suggest that, regardless of social anxiety level, when individuals selectively oriented to faces displaying anger, the faces were interpreted to be more negative. This, in turn, predicted better memory for the angry faces. The results provided further empirical support for the combined cognitive bias hypothesis.     

A Pilot Feasibility Open Trial of an Interpretation Bias Intervention for Parents of Anxious Children

Interpretation bias is a transdiagnostic mechanism underlying anxiety. Theoretical models highlight the role of parental interpretation bias in predicting and maintaining child anxiety. However, very few studies have examined parent interpretation bias as a treatment target. The current pilot study tested the feasibility and acceptability of an interpretation bias intervention delivered by a smartphone app, called HabitWorks, in parents of anxious children who self-reported at least mild symptoms of anxiety and negative interpretation bias.Parents of anxious youth (ages 8 to 16) were recruited from the waitlists of three child anxiety clinics. They were asked to complete interpretation modification exercises via the HabitWorks app 3 times per week for 1 month. Participants completed assessments at pre- and post-intervention and 1-month follow-up to assess changes in interpretation bias, anxiety symptoms, and overall perceptions of HabitWorks.Participants (N = 14) (M_age = 44.36; 14.29% men, 85.71% women) completed an average of 13.29 exercises out of the 12 prescribed. Acceptability ratings were high. Interpretation bias, as measured by an assessment version of the intervention exercise, significantly improved from pre- to posttreatment, and these improvements were maintained at the 1-month follow-up. Anxiety symptoms significantly improved from the “mild” severity range to the “none to minimal” range.In this pilot feasibility study in parents of anxious youth, HabitWorks was a feasible and acceptable low-intensity intervention. These preliminary results support a future controlled trial of HabitWorks for parents. Future studies are also needed to test whether targeting interpretation bias in parents has downstream effects on maladaptive parent behaviors and ultimately, child interpretation bias and anxiety.     

Exploring a patient's shift from relative silence to verbal expressiveness: Observations on an element of the analyst's participation

By tracing a portion of close process of a patient's shifts from a relatively silent and inhibited stance to one in which he is beginning to verbalize more about his experience and fantasy, I will illustrate some tensions between the analyst's role as facilitating expressiveness and as occupying a place in the patient's internalized world. Since the analyst's functions as facilitator and as internal object (often an obstacle to the patient's expressiveness) are sometimes in conflict with one another, it is important for the analyst to be able to work internally with this conflict as he works with his patient. Splitting processes between these two functions may provide the analyst with cues related to the patient's and the analyst's resistance to understanding the patient's communication of unconscious conflict and the patient's recruitment of the analyst into the patient's internalized world.     

How people make decisions about predictive genetic testing: An analogue study

Abstract

Persons scoring high on negative affectivity (NA) have more subjective health complaints. In this study, we tested the hypothesis that high NA persons are more likely to experience internal sensations as threatening signs of health problems. Low and high NA participants (N=44) were given four breathing trials: one room air trial followed by three trials containing 5.5% CO₂ which induced transient low intensity somatic sensations. Prior to each CO₂ trial, participants received either positive, negative or uncertain labelings of the sensations that might occur. Participants rated the (un)pleasantness of the experienced somatic sensations and the perceived intensity. Also respiratory responses were measured. During CO₂ trials, reliable main effects of information were found but no effects involving NA were observed, neither on pleasantness ratings nor on respiratory responses. However, during room air breathing, high NA participants reported more intense somatic sensations than low NA participants. Post-experimental data suggested that high NA participants had more negative meanings and worries about the consequences of the physical sensations. It is concluded that interpretational biases in high NA is situated at the level of attributional processes.     

Toward a Theory of Progressive Evolution (Large-Scale Stages of Evolutionary Progress)

Here I discuss the basic elements, major stages, and completion of progressive evolution. The cosmic world of self-realization is based on extensive self-development within a closed contour: temporal counter-transitions of spatial counter-elements (energy bonds and media and, basically, substance structures) form of local worlds within it through evolution of informational structures.

• The organic world of reproduction develops through the open informational path: the initial substance, through energy exchange and metabolism, reproduces similar substance; the latter interacts with the environment and, subsequently, reproduces its like, and so on.

• The animal world of self-regulation builds up a closed informational contour in the environment through the informational input and command output.

• The human world of self-cognition forms the intensive type of development within the internal closed informational contour of cognition. Counter-transitions of ideal images and signs relate to their real prototypes. In the course of cognition, abstractive thinking develops and brings man to the possibility of reflection of the initial world in its integrity (thus, elevates man to the infinite, by Hegel).

     

ISLAMIC BIOETHICS IN THE TWENTY‐FIRST CENTURY

Islamic bioethics is in good health, this article argues. During the twentieth century, academic researchers had to deal with a number of difficulties including the scarcity of available Islamic sources. However, the twenty‐first century witnessed significant breakthroughs in the field of Islamic bioethics. A growing number of normative works authored by Muslim religious scholars and studies conducted by academic researchers have been published. This nascent field also proved to be appealing for research‐funding institutions in the Muslim world and also in the West, such as the Qatar National Research Fund (QNRF) and the Netherlands Organization for Scientific Research (NWO). On the other hand, the article argues that contemporary Islamic bioethics is in need of addressing news issues and adopting new approaches for the sake of maintaining and improving this good health in the future.     

THE VALUE OF UNCERTAINTY

The author discusses some of the characteristics of Roy Schafer's contributions to psychoanalysis that he finds most valuable, such as his openness to uncertainty, his anti‐reductive view of analytic constructions, his unique formulation of the analyst's role, and his close attention to how the patient engenders particular emotional reactions in the analyst. The author also presents a clinical vignette illustrating the value of the analyst's tolerance of uncertainty in the face of the patient's push for interpretations, explanations, and reassurance.     

CONTAINING,TRANSLATING, AND INTERPRETIVE ACTING OUT

In analytic treatment, when patients project unspoken aspects of their internal self and object world, the analyst has to find ways to understand and communicate those expelled phantasies without the patient feeling accused, seduced, or persecuted; even when we do our best at interpreting such inner conflicts, the patient may experience our interpretations as assaults, forcing them to give up themselves or their hope for reconnecting with an object. The patient will resist or fight our efforts through the use of projective identification. Caught up in patient's projections, the analyst in turn may enact some of these phantasies by becoming the object rather than translating its presence in the transference, by overemphasizing one side over another of the patient's conflict, or by interpreting accurately but prematurely. These issues are illustrated in two case presentations and discussed in relation to the views of contemporary Kleinian writers on transference and countertransference.     

Moved by the Spirit: Theological Literatures of LGBT Advocacy

Debate over the question of how to effectively acknowledge and advocate for the presence of LGBT people as legitimate members of religious denominations and a population entitled to ministry has generated a substantial body of monographic literature within the field of theology. The earliest works were published during the era of the homophile movement in the 1960s prior to the Stonewall riot in 1969 that marks the beginning of the contemporary gay and lesbian civil rights movement. The subsequent decades have witnessed an expansion and diversification of this genre with the emergence of specific liturgies and ceremonies addressing significant LGBT life events, autobiographies and biographies of openly lesbian and gay clergy, and writings confronting issues of ethnicity and activism.