Metacognitions in patients with hallucinations and obsessive-compulsive disorder: the superstition factor

On the basis of the analogy between intrusive thoughts and auditory hallucinations established by Morrison et al. [(1995). Intrusive thoughts and auditory hallucinations: a cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 265-280], the present work compares the metacognitive beliefs and processes of five groups of patients (current hallucinators, never-hallucinated people with a diagnosis of schizophrenia, recovered hallucinators, obsessive-compulsive disorder (OCD) patients, and a clinical control group) and a non-clinical group. The results show that of the five metacognitive factors considered in this study, two were found to be different in the current hallucinators group in comparison to any other group in the design. Likewise, it is found that the metacognitive beliefs of the current hallucinators coincide with those of the OCD patients in various factors, particularly that relating to superstition, and this is interpreted as lending support to the model of Morrison et al. (1995). Furthermore, the results are discussed in the light of existing research on Thought-Action Fusion, stressing the role that may be played by superstitious beliefs and magical thinking in auditory hallucinations and OCD.     

Anxiety sensitivity and auditory perception of heartbeat

Anxiety sensitivity (AS) is the fear of sensations associated with autonomic arousal. AS has been associated with the development and maintenance of panic disorder. Given that panic patients often rate cardiac symptoms as the most fear-provoking feature of a panic attack, AS individuals may be especially responsive to cardiac stimuli. Consequently, we developed a signal-in-white-noise detection paradigm to examine the strategies that high and low AS individuals use to detect and discriminate normal and abnormal heartbeat sounds. Compared to low AS individuals, high AS individuals demonstrated a greater propensity to report the presence of normal, but not abnormal, heartbeat sounds. High and low AS individuals did not differ in their ability to perceive normal heartbeat sounds against a background of white noise; however, high AS individuals consistently demonstrated lower ability to discriminate abnormal heartbeats from background noise and between abnormal and normal heartbeats. AS was characterized by an elevated false alarm rate across all tasks. These results suggest that heartbeat sounds may be fear-relevant cues for AS individuals, and may affect their attention and perception in tasks involving threat signals.     

Repeated checking really does cause memory distrust

Memory phenomena associated with obsessive-compulsive disorder (OCD) have received increased attention in the recent literature. Some debate remains about whether OCD is characterized by deficits in memory per se, or by poor memory confidence. Following from a recent study that demonstrated memory distrust results from repeated checking of a virtual computerized stove, we asked 50 undergraduate students to repeatedly turn on, turn off and check either a real kitchen stove (relevant checking) or a real kitchen faucet (irrelevant checking) in a standardized, ritualized manner. All participants completed a final check of the stove following these 19 checking trials. Results indicated that following repeated relevant checking, participants reported significantly reduced memory confidence, vividness and detail. Repeated irrelevant checking did not produce these decreases. Results are discussed in terms of cognitive-behavioural formulations of OCD and in terms of the effects of repetition on memory and metamemory.     

Social anxiety and problematic cannabis use: evaluating the moderating role of stress reactivity and perceived coping

Despite epidemiological reports indicating an association between social anxiety disorder (SAD) and cannabis use disorders (CUD), there is a paucity of research exploring the nature of this relationship. The present investigation examined potential moderators of this relationship that are consistent with a tension-reduction model of addiction. Specifically, physiological reactivity to stress and perceived coping with stress were evaluated as moderators of the relation between symptoms of SAD and CUD. Physiological (SCR) and subjective (perceived coping) responses to unpredictable white noise bursts were collected from non-clinical participants (n=123). Lifetime symptoms of CUD and anxiety disorders were assessed using a structured diagnostic interview. CUD symptomatology was associated with symptoms of SAD but not with symptoms of any other anxiety disorder. Only perceived coping to unpredictable stimuli moderated the relationship between SAD and CUD symptoms. Findings are discussed in the context of tension-reduction models of co-occurring social anxiety and problematic cannabis use.     

Avoidance behavior in panic disorder: the moderating influence of perceived control

The relations among anxiety sensitivity, perceived control, and agoraphobia were examined in 239 patients diagnosed with panic disorder (PD). Most patients exhibited agoraphobia accompanying their PD (98% situational avoidance; 90% experiential avoidance; and 80% endorsed interoceptive fear and avoidance). Anxiety sensitivity and perceived emotional control were associated with agoraphobia, and perceived threat control was found to moderate the relationship between anxiety sensitivity and agoraphobia. Lower levels of perceived control were associated with a stronger relationship between anxiety sensitivity and agoraphobia. Results were consistent for self-reported and clinician-rated agoraphobia. Implications for the role of perceived control in agoraphobia development and treatment are discussed.     

Eating patterns and breakfast consumption in obese patients with binge eating disorder

This study examined eating patterns and breakfast consumption, and their relationships to weight and binge eating, in obese individuals with binge eating disorder (BED). One-hundred seventy-three consecutively evaluated men (n=46) and women (n=127) with BED were administered semi-structured interviews and self-report measures to assess the frequency of meals and snacks eaten, as well as binge eating and eating disorder features. Overall, those who consumed more frequent meals, particularly breakfast, and snacks, weighed less. Breakfast, which was eaten on a daily basis by less than half of participants (n=74; 43%), was the least frequently eaten meal of the day. Participants (n=56; 32%) who ate three meals per day weighed significantly less, and had significantly fewer binges, than participants (n=117; 68%) who did not regularly eat three meals per day. Thus, eating more frequently, having breakfast and consuming three meals every day, have potentially important clinical applications for the treatment of BED given that the effectiveness of specific interventions within treatments for BED are unknown, and that weight loss outcome for BED has been poor.     

Dysfunctional belief-based obsessive-compulsive disorder subgroups

An attempt was made to identify obsessive-compulsive disorder (OCD) subgroups based on differences in OCD related beliefs. OCD patients (N=367) were assessed with the Obsessional-Beliefs Questionnaire prior to treatment. Individuals' scores on measures of inflated personal responsibility and the tendency to overestimate threat, perfectionism and intolerance of uncertainty, and over-importance and over-control of thoughts were subjected to cluster analysis. Support for both a simple and complex subgroup model was found (2-subgroup and 5-subgroup taxonomies). A low-beliefs subgroup was identified in both taxonomies. The low-beliefs subgroups reported scores on belief measures equivalent to scores reported for non-OCD comparison groups in earlier studies. Additional analyses were conducted to determine relations between belief-based and symptom subgroups. Significant relationships were found (e.g., Symmetry symptom subgroup membership was associated with membership in the Perfectionism/Certainty beliefs subgroup), although the shared variance was modest. Implications for understanding OCD heterogeneity and for cognitive theory are discussed.     

Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents

Past research into the psychological consequences of traumatic events has largely focused on post-traumatic stress disorder (PTSD), although other anxiety disorders and depression are also common in the aftermath of trauma. Little is known about differential predictors of these conditions. The present study investigated the extent to which theoretically derived cognitive variables predict PTSD, phobias and depression after motor vehicle accidents. The cognitive predictors were compared to a set of established, mainly non-cognitive predictors. In addition, we tested how disorder-specific the cognitive predictors are. Participants (n=101) were interviewed within a year after having been injured in a motor vehicle accident. Diagnoses of PTSD, travel phobias and depression, symptom severities and predictor variables were assessed with self-report questionnaires and structured interviews. In multiple regression analyses, the sets of cognitive variables derived from disorder-specific models explained significantly greater proportions of the variance of the symptom severities than the established predictors (PTSD 76% vs. 45%, depression 72% vs. 46% and phobia 66% vs. 40%), and than cognitive variables derived from the models of the other disorders. In addition, the majority of individual cognitive variables showed the expected pattern of differences between diagnostic groups. The results support the hypothesis that disorder-specific sets of cognitive factors contribute to the development and maintenance of PTSD, phobias and depression following traumatic events.     

Implicit and explicit processing in deep dyslexia: Semantic blocking as a test for failure of inhibition in the phonological output lexicon

The failure of inhibition hypothesis posits a theoretical distinction between implicit and explicit access in deep dyslexia. Specifically, the effects of failure of inhibition are assumed only in conditions that have an explicit selection requirement in the context of production (i.e., aloud reading). In contrast, the failure of inhibition hypothesis proposes that implicit processing and explicit access to semantic information without production demands are intact in deep dyslexia. Evidence for intact implicit and explicit access requires that performance in deep dyslexia parallels that observed in neurologically intact participants on tasks based on implicit and explicit processes. In other words, deep dyslexics should produce normal effects in conditions with implicit task demands (i.e., lexical decision) and on tasks based on explicit access without production (i.e., forced choice semantic decisions) because failure of inhibition does not impact the availability of lexical information, only explicit retrieval in the context of production. This research examined the distinction between implicit and explicit processes in deep dyslexia using semantic blocking in lexical decision and forced choice semantic decisions as a test for the failure of inhibition hypothesis. The results of the semantic blocking paradigm support the distinction between implicit and explicit processing and provide evidence for failure of inhibition as an explanation for semantic errors in deep dyslexia.     

The other other: when the exotic other subjugates the familiar other

In this paper, the theme of the other will be examined and it will be argued that it is important to differentiate between two distinct types of other--the 'exotic' other which is distant and very different from the subject, and the 'familiar' other which is closer to the subject. The dynamic relationship between these two others will be investigated, and emphasis will be given to the process through which the exotic other tends to subjugate the familiar other. This relationship will then be discussed in its various applied forms, in the contexts of clinical practice and socio-political dimensions. In particular, a new reading of Jung's approach to the 'primitive' will be developed, based on the subjugation of the 'familiar' other by the 'exotic' other. A similar line of investigation will be followed to examine the concept of psychological trauma. In addition, Freud's 'narcissism of minor differences' and Bion's distinction between 'narcissism' and 'socialism' will be considered in the light of this differentiation between these two others.