Tactile orientation constancy: Do proprioception and attention affect the tactile vertical?1

Abstract: Tactile vertical, defined as the edge orientation that participants perceive to be vertical, was examined in four experiments. In Experiment 1, we touched the participants’ cheek, lips, or hand with an edge and asked them to judge its orientation with regard to gravitational vertical, both when the stimulated body part was upright (or, in the case of the lips, aligned), and when it was tilted (lips, distorted). We found that when the head or hand was tilted forward 30°, or when the lower lip was distorted approximately 38° to the left or right, the tactile vertical shifted in the same direction by only a fraction (8.7, 8.6, and 36.3% for the cheek, lips, and hand, respectively) of the change in orientation of the stimulated region. The results indicated considerable, but usually incomplete, orientation constancy. In Experiment 2, we measured tactile vertical on the hand for forward tilts from 0° to 45°. We found that as the hand was tilted, the tactile vertical increasingly shifted in the same direction as the hand (i.e., a tactile Aubert effect). In Experiment 3, the effect of attentional focus on tactile vertical was examined by comparing the tactile vertical of participants who attended to body‐centered coordinates, and others who attended to gravitation‐centered coordinates. We found that focusing on body‐centered coordinates caused a decrease in orientation constancy. We sought to examine the role of attention further in Experiment 4, measuring tactile vertical on the cheek of persons with temporomandibular disorders. Compared with normal participants, these participants displayed significantly lower constancy. The results were accounted for by a narrowing of attention to painful signals, so that proprioceptive information was attended to less. In conclusion, the degree of tactile orientation constancy that participants demonstrate varies as a function of body site and attentional focus.     

Can we fight stigma with science? The effect of aetiological framing on attitudes towards anorexia nervosa and the impact on volitional stigma

The present study experimentally investigated the way in which exposure to various aetiological explanations of anorexia nervosa (AN) differentially affected stigmatisation and behavioural intention outcomes. University students (N = 161) were randomly assigned to read one of four aetiological vignettes presenting the causes of AN as biological/genetic, socio‐cultural, environmental, or multifactorial. Results indicate that those who received a socio‐cultural explanation made stronger socio‐cultural causal attributions, fewer biological/genetic causal attributions, and were significantly less willing to sign a health insurance petition for AN. Unexpectedly, the multifactorial group considered individuals with AN as more responsible and blameworthy for their condition. Overall, findings were comparative with previous research and partially support the propositions of attribution theory. Results also suggest that by conceptualising the aetiology of AN as biological or genetic, or at least increasing one's knowledge of these contributing factors, it may be possible to decrease the level of blame‐based stigma associated with AN.     

Structural models of psychotherapy groups and their effect on inpatients with borderline personality disorders: Patients' perceptions

This research compares the way in which various group structural models affect self-understanding, interpersonal relationships and catharsis in hospitalized patients with borderline personality disorders. Each of the models is characterized by a different combination of group focus and leadership style. Three psychotherapy groups were chosen as paradigms: the dynamic psychotherapy group; the therapeutic games group, and psychodrama group. Sixty three inpatients with borderline personality disorders participated in the study. The one-way ANOVA yielded significant differences between the group models. Results of the post-hoc t-test showed that the dynamic and the games groups were perceived by the patients as more beneficial than psychodrama.     

The Use of the Devereux Scales of Mental Disorders in the Assessment of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder

The present study was designed to gather validity data on the Devereux Scales of Mental Disorders (DSMD) for distinguishing among children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 32), Conduct Disorder (CD; N = 34), or no clinical diagnosis (NC; N = 65). Three types of indicators were compared: (a) DSMD scale, composite, and total scores, (b) the number of ADHD or CD-related items endorsed, and (c) diagnostic efficiency statistics (e.g., sensitivity, positive and negative predictive power). The clinical groups did not differ significantly from each other, but both were significantly higher than the NC group on all DSMD scales. Moreover, there were significant differences between the ADHD and the CD groups on the number of respective ADHD and CD-related items endorsed. A cut-off of seven to eight items yielded the best discrimination between the two diagnostic groups. Diagnostic efficiency statistics indicate that the DSMD may be effective at differentiating between similar disruptive behavior disorders.     

Comorbidity in schizophrenia: A prognostic study of personality disorders in recovered and non-recovered schizophrenia patients

Symptoms and outcome in schizophrenia are heterogeneous. Part of the variation in outcome might be due to the coexistence of other forms of psychopathology. In the present study the prevalence of personality disorders in a group of recovered and non-recovered schizophrenia patients was focused to examine the prognostic implications of comorbidity for the outcome of the disorder. The results showed no significant differences in prevalence of personality disorders in the two groups at first admission to the hospital, but the difference at the time of interview was close to significance. Emotional and conduct difficulties in adolescence were significantly more prevalent in the non-recovered group. Schizoid features and emotional and conduct disorders in childhood were also more often reported among the non-recovered subjects. The results confirm that comorbidity contributes to the variation in outcome for schizophrenia patients, but does not confirm its prognostic significance.     

Enhancing exposure-based therapy from a translational research perspective

Combining an effective psychological treatment with conventional anxiolytic medication is typically not more effective than unimodal therapy for treating anxiety disorders. However, recent advances in the neuroscience of fear reduction have led to novel approaches for combining psychological therapy and pharmacological agents. Exposure-based treatments in humans partly rely on extinction to reduce the fear response in anxiety disorders. Animal studies have shown that D-cycloserine (DCS), a partial agonist at the glycine recognition site of the glutamatergic N-methyl-D-aspartate receptor facilitates extinction learning. Similarly, recent human trials have shown that DCS enhances fear reduction during exposure therapy of some anxiety disorders. This article discusses the biological and psychological mechanisms of extinction learning and the therapeutic value of DCS as an augmentation strategy for exposure therapy. Areas of future research will be identified.     

Prevalence of the extinction burst and its attenuation during treatment

Although extinction has been an effective treatment for a variety of behavior disorders, its use may be associated with several adverse side effects, the most common being an initial increase in the frequency of the target response, called an "extinction burst." We attempted to determine the prevalence of the extinction burst in applied research and its possible attenuation with other operant procedures. An analysis of 113 sets of extinction data indicated that bursting may not be as common as previously assumed (it occurred in 24% of the cases) and may be less likely when extinction is implemented with alternative procedures rather than as the sole intervention (bursting was evident in 12% of the former cases and 36% of the latter).     

Personality Disorders and Spinal Cord Injury: A Pilot Study

A substantial body of research has found that spinal cord injury (SCI) patients have relatively high degrees of energy, impulsivity, and risk-taking (W. Fordyce, 1964; G. P. Taylor, 1970; B. Woodbury, 1978). The present study endeavors to extend our knowledge to the personality disorder (PD) domain. Forty SCI participants and 40 matched controls were given a semistructured diagnostic interview and a self-report personality disorder instrument. Findings indicated that 27.5% of SCI patients, and a similar number of controls, have PDs. Unexpectedly, impulsive/externalizing disorders (histrionic, narcissistic, antisocial, and borderline) were not unusually high in SCI patients, and were not higher than controls. Avoidant and depressive disorders were unexpectedly high.     

Emotional avoidance: an experimental test of individual differences and response suppression using biological challenge

The present study examined the affective consequences of response inhibition during a state of anxiety-related physical stress. Forty-eight non-clinical participants were selected on the basis of pre-experimental differences in emotional avoidance (high versus low) and subjected to four inhalations of 20% carbon dioxide-enriched air. Half of the participants were instructed to inhibit the challenge-induced aversive emotional state, whereas the other half was instructed to simply observe their emotional response. Participants high in emotional avoidance compared to those low in emotional avoidance responded with greater levels of anxiety and affective distress but not physiological arousal. Individuals high in emotional avoidance also reported greater levels of anxiety relative to the low emotional avoidance group when suppressing compared to observing bodily sensations. These findings are discussed in terms of the significance of emotional avoidance processes during physical stress, with implications for better understanding the nature of panic disorder.     

Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.