And one more for the road: Commentary on the Special Issue on alcohol and eyewitness memory

Studies examining the influence of alcohol intoxication have reported mixed findings on whether it impairs eyewitness memory. Although the studies in this Special Issue investigated different questions and tested different variables, the findings of these studies collectively provide insight into mechanisms and methodological issues that may explain the ambiguous findings of alcohol intoxication and eyewitness memory. In this commentary, we first describe the experimental studies of this Special Issue. We then discuss four mechanisms that could underlie those mixed findings (alcohol myopia, disinhibition, hypervigilance, and metacognitive processes at retrieval). Last, we address methodological issues that may have contributed to those ambiguous findings (i.e., alcohol intoxication levels, automatic processing of stimuli, sensitivity of dependent variables, and possible interactions with arousal) and provide suggestions for future research to address these issues.     

When Is Seeking Safety Functional? Taking a Pragmatic Approach to Distinguishing Coping From Safety

Currently, most exposure-based treatments call for clinicians to assess for and remove all safety behaviors during exposure tasks. However, the notion that safety behaviors are detrimental across all scenarios has recently been challenged, and research regarding the effects of safety behaviors on exposure outcomes is limited and inconsistent. In clinical practice, classifying a strategy as a safety behavior can be a complex and challenging endeavor, particularly when distinguishing between harmful safety behaviors and helpful coping behaviors. We outline an approach that emphasizes the pragmatic truth criterion and uses functional outcomes to classify behaviors as serving either safety or coping functions. Our focus on doing what “works” simplifies decision-making for clinicians and maintains the focus of treatment on enhancing functioning. We propose a model for using functional outcomes to distinguish between safety and coping behaviors and illustrate our approach through case examples.     

The interplay between relationship effectiveness,life stress,and sleep: A prospective study

Research has shown that greater stress responses predict worse sleep and that the quality of one's current romantic relationship predicts one's sleep. Despite these established links, research has not examined connections between ongoing patterns of interpersonal experiences and competencies (relationship effectiveness) and stress exposure on sleep. Participants in the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) completed measures assessing relationship effectiveness and stress exposure at ages 23 and 32 years, as well as sleep quality/duration at age 37 years. Analyses demonstrate that relationship effectiveness at age 23 years positively predicts sleep quality—but not sleep duration—at age 37 years via reduced stress exposure at age 32 years. These findings highlight the effects of relationship effectiveness and stress exposure across early to middle adulthood on sleep.     

Efficacy of a Brief,School‐Based Bystander Bullying Intervention on High School Students' Alcohol Use

The authors examined the efficacy of a brief bystander bullying intervention on reducing alcohol use among high school students (N = 61). As hypothesized, high‐risk drinkers in the intervention group reported reduced drinking compared with control students at a 30‐day follow‐up.     

Inhibitory Learning for Anxiety-Related Disorders

This article reviews the articles in this issue that describe the strategies derived from the inhibitory learning model as applied to exposure therapy for anxiety disorders. The major principles of inhibitory learning are to create and strengthen nonthreat associations in memory (largely by engaging prefrontal cortical regions), and to effectively retrieve those nonthreat associations in the long term. Several case vignettes are provided that demonstrate how the principles of inhibitory learning (which include maximizing expectancy violations, limiting distraction, fear antagonistic actions, deepened extinction, elimination of safety behaviors, occasional reinforced extinction, increasing variability of exposures and offsetting reinstatement and context renewal effects) can be applied in clinical practice.     

Using Multiple Contexts and Retrieval Cues in Exposure-Based Therapy to Prevent Relapse in Anxiety Disorders

The benefits of exposure-based interventions for anxiety disorders are substantial but not stable for everyone, given that these interventions are often followed by relapse of symptoms. A body of research provides a background on how to add certain strategies in exposure-based therapy to prevent relapse in anxiety disorders. This review summarizes some of these strategies and provides clear-cut clinical implications. Studies that provide support for two types of strategies to prevent relapse have been reviewed—the use of multiple contexts and the use of retrieval cues. The use of multiple contexts reduces context and stimulus specificity of extinction learning during exposure, while the use of retrieval cues enhances memory (re)consolidation and retrieval after exposure. The described strategies to enhance the accessibility and therefore the retrievability of exposure-based learning to prevent relapse in anxiety disorders can be summarized as advice to conduct exposure under variable conditions. This way, the generalizability of what is learned during exposure to the patients’ daily life after treatment improves. Therefore, adding these strategies in the course of exposure-based treatment of anxiety disorders seems beneficial. However, future replications and translational studies are needed to verify ecological validity.     

Dropping Safety Aids and Maximizing Retrieval Cues: Two Keys to Optimizing Inhibitory Learning During Exposure Therapy

The inhibitory learning model of exposure therapy posits that clinical anxiety is most effectively treated when clinicians employ strategies that maximize the (a) violation of negative expectancies and (b) generalization of nonthreat associations. Translation of basic learning research to exposure therapy via this explanatory model underscores two keys to optimizing inhibitory learning during exposure: dropping safety aids and maximizing retrieval cues. Although topographically similar, safety aids and retrieval cues are functionally distinct as well as therapeutically incompatible. In the present article, we delineate safety aids and retrieval cues in the context of exposure therapy from an inhibitory learning perspective, providing illustrative case examples of how clinicians may address the two when treating patients with clinical anxiety.     

The relationship between religion and health-related behaviours in patients with borderline personality disorder

With addictive disorders frequently co-occurring among patients with borderline personality disorder (BPD), exploring factors that may influence health-related behaviours, like religious involvement, is important. This study assesses whether religious involvement is associated with smoking and alcohol use disorders (AUDs) in BPD subjects. This study used data from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), which used the Alcohol Use Disorder and Associated Disabilities Interview Schedule–DSM-IV (AUDADIS-IV) as its assessment instrument. The AUDADIS-IV assessed personality disorders, tobacco usage, the presence of AUDs, and religious involvement. Attending a place of worship and weekly or more frequent worship attendance were significantly associated with reduced likelihood of current smoking and AUDs among BPD subjects. AUDs were also significantly less common in those reporting higher subjective religiousness. In conclusion, people with BPD who are religiously inclined are less likely to engage in addictive behaviours, specifically smoking and AUDs.     

Depression and resilience mediate the relationship between traumatic life events and ill physical health: results from a population study

We set out to investigate the mediating roles of depression, resilience, smoking, and alcohol use, in the relationship between potentially traumatic life events and objective and subjective, physical and mental health in a single study. A face-to-face, population-based survey was conducted in Hong Kong (N = 1147). Information on health conditions and traumatic life events was obtained, and participants completed measures of subjective physical and mental health, depression, and resilience. Smoking and drinking were not significant mediators of the relationship between life events and both objective and subjective health. Depressive symptomatology was found to mediate the relationship between life threatening illness and subjective physical health, the relationship between abuse (physical and sexual) and subjective mental health, and the relationship between the death of a parent/partner and subjective mental health. Resilience was found to mediate the relationships between multiple traumatic life events and subjective physical and mental health. Our results indicate that psychological factors rather than biological are important mediators of the relationship between life events exposure and health. Our findings provide evidence that depressive symptomatology has a mediating role only in the case of specific potentially traumatic life events and that resilience is only a critical factor in the face of exposure to multiple traumatic events, rather than single events. Our results also indicate that behavioural factors, such as smoking and drinking, are not significant mediators of the relationship between life events and health.