Brief Counseling for Alcohol Misuse Among Trauma Patients: Two Interventions and Influence of Baseline Use

This study examined whether baseline trauma patient characteristics and randomized participation in 1 of 2 brief interventions predicted changes in alcohol use at 6 months postintervention. Higher total Alcohol Use Disorders Identification Test (AUDIT) scores predicted greater changes, and specific AUDIT items were significant predictors.     

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.     

New Directions in the Cognitive-Behavioral Treatment of OCD: Theory,Research, and Practice

The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.     

Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

Effects of exposure to alcohol‐related cues on racial discrimination

Prior research has shown that exposure to alcohol‐related images exacerbates expression of implicit racial biases, and that brief exposure to alcohol‐related words increases aggressive responses. However, the potential for alcohol cue exposure to elicit differential aggression against a Black (outgroup) relative to a White (ingroup) target—that is, racial discrimination—has never been investigated. Here, we found that White participants (N = 92) exposed to alcohol‐related words made harsher judgments of a Black experimenter who had frustrated them than participants who were exposed to nonalcohol words. These findings suggest that exposure to alcohol cues increases discriminatory behaviors toward Blacks.     

Impulsive choice and pre‐exposure to delays: iv. effects of delay‐ and immediacy‐exposure training relative to maturational changes in impulsivity

Impulsive choice describes preference for smaller, sooner rewards over larger, later rewards. Excessive delay discounting (i.e., rapid devaluation of delayed rewards) underlies some impulsive choices, and is observed in many maladaptive behaviors (e.g., substance abuse, gambling). Interventions designed to reduce delay discounting may provide therapeutic gains. One such intervention provides rats with extended training with delayed reinforcers. When compared to a group given extended training with immediate reinforcers, delay‐exposed rats make significantly fewer impulsive choices. To what extent is this difference due to delay‐exposure training shifting preference toward self‐control or immediacy‐exposure training (the putative control group) shifting preference toward impulsivity? The current study compared the effects of delay‐ and immediacy‐exposure training to a no‐training control group and evaluated within‐subject changes in impulsive choice across 51 male Wistar rats. Delay‐exposed rats made significantly fewer impulsive choices than immediacy‐exposed and control rats. Between‐group differences in impulsive choice were not observed in the latter two groups. While delay‐exposed rats showed large, significant pre‐ to posttraining reductions in impulsive choice, immediacy‐exposed and control rats showed small reductions in impulsive choice. These results suggest that extended training with delayed reinforcers reduces impulsive choice, and that extended training with immediate reinforcers does not increase impulsive choice.     

Public concerns about violent video games are moral concerns—How moral threat can make pacifists susceptible to scientific and political claims against violent video games

Public discussions about the harmfulness of violent media are often held in the aftermath of violent felony. At the same time, we know little about whether and how experiencing real‐life violence impacts the way laypersons perceive and evaluate debates about virtual violence. In Study 1, we provided data indicating that both real‐life violence and violent video games are perceived as morally threatening by people who regard nonviolence to be an important moral value (i.e., pacifists). In Study 2, we hypothesized and found that when pacifists perceive threat from the presence of real‐life violence, they are especially susceptible to scientific and political claims indicating that violent video games are harmful. Our findings are in line with the value protection model and research on the psychological consequences of threat. Implications of the present findings are discussed with regard to a better understanding of the violent video games debate in the general public.     

Exposure,Agency, Perceived Threat,and Guilt as Predictors of Posttraumatic Stress Disorder in Veterans

Using a sample of 289 Iraq/Afghanistan veterans, this study examined the contributions of combat exposure, agency, perceived threat, and guilt to posttraumatic stress disorder (PTSD) symptoms. Regression analyses indicated the four variables (together with demographic variables) accounted for 79% of the variance in PTSD symptoms. Guilt was the most important predictor. In addition, guilt mediated between exposure and PTSD symptoms, perceived threat and PTSD symptoms, and agency and PTSD symptoms. Implications of these findings are discussed.     

Effects of exposure to muscular and hypermuscular media images on young men's muscularity dissatisfaction and body dissatisfaction

This study examined the effects of exposure to muscular and hypermuscular media images on young men's body images, and the moderating roles of baseline body dissatisfaction (BD) and muscularity dissatisfaction (MD). Men (M age = 21.9, SD = 2.8) were exposed to pictures of muscular (n = 34) or hypermuscular (n = 29) male physiques throughout a 30-min health seminar. In support of the study hypotheses, higher levels of baseline BD and MD were associated with greater post-seminar BD and MD. In addition, MD moderated the effects of the exposure conditions on BD; greater baseline MD was associated with greater post-seminar BD, but only among men who viewed the muscular images. These results speak to the importance of pre-existing muscularity concerns in determining men's reactions to muscular physique images, and suggest that exposure to the media ideal of muscularity, and not muscularity per se, elicits body dissatisfaction in men with pre-existing muscularity concerns.     

Responses to symptom induction exercises in panic disorder

Exposure to panic symptoms (interoceptive exposure) is often included as part of treatment for panic disorder (PD), although little is known about the relative effects of particular symptom induction exercises. This study describes responses of individuals with PD and nonclinical controls to 13 standard symptom induction exercises and 3 control exercises. Generally, individuals with PD responded more strongly to symptom induction exercises than did controls. The exercises producing the most fear included spinning, hyperventilation, breathing through a straw, and using a tongue depressor. This study also reports findings regarding specific symptoms triggered by each exercise, the percentage of participants reporting fear during each exercise, and predictors of fear.