Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

Evaluation of a group cue-exposure treatment for opiate addicts

Twenty-four detoxified opiate addicts were randomized to an experimental group and a control group to evaluate efficacy of a group cue-exposure treatment to reduce or extinguish classically conditioned responses to drug-related stimuli. Assessment included psychophysiological responses (skin temperature, skin conductance level--SCL--, and heart rate) to a videotape and subjective measures (subjective craving, positive and negative affect) before and after the videotape. The experimental group received a group cue-exposure program to drug-related stimuli that comprised twelve treatment sessions administered three times weekly. The treatment program significantly reduced conditioned responses to drug-related stimuli, as measured by SCL and positive affect.     

Clinicians’ Attitudes Toward Therapeutic Alliance in E-Therapy

Although therapeutic alliance is a crucial factor in face-to-face therapies, no data exist on clinicians’ attitudes towards alliance in E-therapy. The study explored clinicians’ perceived importance of alliance in E-therapy, clinicians’ confidence in their skills to develop alliance in E-therapy, and whether attitudes towards alliance in E-therapy are associated with intended E-therapy practice. Clinicians (n = 106) responded to an online survey. The majority of clinicians considered alliance to be extremely important in both face-to-face therapy and E-therapy. However, clinicians’ ratings of the importance of alliance in face-to-face therapies were significantly higher than their ratings of the importance of alliance in E-therapy. Clinicians reported less confidence in their skills to develop alliance in E-therapy than in face-to-face therapy. Intended E-therapy practice correlated with confidence in one's ability to develop alliance in E-therapy and with previous E-therapy practice.     

La percepción de la conducta agresiva: Un estudio taxonómico de las diferencias inter e intraculturales

Resumen

El presente artículo tiene corno principal objetivo ser una alternativa a las tradicionales clasificaciones teóricas de la agresión e, incluso, a los estudios taxonómicos empíricos más recientes. Usar estímulos no representativos, ofrecer indicios sobre las dimensiones de juicios preseleccionados, etc. son algunos de los inconvenientes que no permiten considerar a estas dimensiones perceptuales de la agresión como fiables. En este trabajo se pretenden superar estas y otras críticas con el fin de proporcionar las verdaderas dimensiones que subyacen a la percepción social de los episodios agresivos cotidianos. El Escalamiento Multidimensional (Modelo IÑDSCAL) fue seleccionado como el análisis más apropiado para proponer una taxonomía empírica adecuada y comprobar hasta qué punto una misma taxonomía es compartida por diferentes subculturas (Universitaria y Reclusa). El análisis de los datos nos permitió concluir acerca de la existencia de un dominio psicológico en 4 dimensiones para percibir un conjunto de estímulos agresivos, de la existencia de ciertas diferencias entre ambas submuestras y, por último, de la homogeneidad existente dentro de una misma muestra, independientemente de algunas variables de personalidad previamente seleccionadas.     

Word recognition in Alzheimer's disease: Effects of semantic degeneration

Impairments of word recognition in Alzheimer's disease (AD) have been less widely investigated than impairments affecting word retrieval and production. In particular, we know little about what makes individual words easier or harder for patients with AD to recognize. We used a lexical selection task in which participants were shown sets of four items, each set consisting of one word and three non‐words. The task was simply to point to the word on each trial. Forty patients with mild‐to‐moderate AD were significantly impaired on this task relative to matched controls who made very few errors. The number of patients with AD able to recognize each word correctly was predicted by the frequency, age of acquisition, and imageability of the words, but not by their length or number of orthographic neighbours. Patient Mini‐Mental State Examination and phonological fluency scores also predicted the number of words recognized. We propose that progressive degradation of central semantic representations in AD differentially affects the ability to recognize low‐imageability, low‐frequency, late‐acquired words, with the same factors affecting word recognition as affecting word retrieval.     

How impulsiveness, trait anger, and extracurricular activities might affect aggression in school children

Individual differences in personality traits such as impulsivity and trait anger as well as environmental variables have an impact on aggressiveness. We tested a model incorporating the related variables of impulsiveness, trait anger, and aggression and incorporated the possible mediating influences of leisure-time activities. Regression analyses of data from 1129 pre-adolescents and 1093 adolescents (55.4% females) from a study evaluating the Spanish version of the Buss and Perry aggression questionnaire (AQ; Santisteban, Alvarado, & Recio, 2007) showed a relation between impulsiveness (Barratt Impulsiveness Scale) and aggression (AQ). Trait anger (Spielberger’s State-Trait Anger Expression Inventory), the time spent watching TV and playing video games, and the time spent doing homework (all related to impulsiveness) also are related to physical, as well as verbal aggression (with low to moderate coefficients). Multiple mediation analyses confirm that media violence exposure and homework, respectively, can have aggravating and attenuating effects on self-reported aggression. These results provide key variables for longitudinal studies which could reveal the causal nature of the results found with our cross-sectional design.     

Acute stress or systemic insulin injection increases flunitrazepam sensitive-GABAA receptor density in synaptosomes of chick forebrain: Modulation by systemic epinephrine

Interactions between acute stress and systemic insulin and epinephrine on GABAA receptor density in the forebrain were studied. Here, 10 day-old chicks were intraperitoneally injected with insulin, epinephrine or vehicle and then immediately stressed by partial water immersion for 15 min and killed by decapitation. Non-stressed controls were similarly injected, then returned to their rearing boxes for 15 min and then killed. Forebrains were dissected and GABAA receptor density was measured ex vivo in synaptosomes by 3[H]-flunitrazepam binding assay. In non-stressed chicks, insulin at 1.25, 2.50 and 5.00 IU/kg of body weight (non-hypoglycemic doses) increased Bmax by 33, 53 and 44% compared to saline, respectively. A similar increase of 41% was observed in receptor density after stress. However, the insulin effect was not additive to the stress-induced increase suggesting that both effects occur through similar mechanisms. In contrast, epinephrine, at 0.25 and 0.5 mg/kg did not induce any changes in Bmax in non-stressed chicks. Nevertheless, after stress these doses increased the receptor density by about 13 and 27%, respectively. Similarly, the same epinephrine doses co-administered with insulin (2.50 IU/kg), increased the receptor density by about 20% compared to insulin alone. These results suggest that systemic epinephrine, perhaps by evoking central norepinephrine release, modulates the increase in forebrain GABAA receptor binding induced by both insulin and stress.     

Psychometric properties of the Spanish version of the Revised Competitive State Anxiety Inventory-2 with athletes

The aim of this work was to develop a Spanish adaptation of the Revised Competitive State Anxiety Inventory-2. The scale was translated and its psychometric properties were analyzed with data from a sample of 149 athletes. Exploratory and confirmatory factor analyses were performed which supported a 16-item CSAI-2R assessing the three hypothesised dimensions of anxiety: Somatic anxiety, Cognitive anxiety, and Self-confidence. Overall fit of the model was good with a value of .97 for Comparative and Non-Normed Fit Indexes, and .045 for Root Mean Square Error of Approximation. Cronbach alpha coefficients for the factors ranged from .79 to .83. It is concluded that this version shows adequate properties, in terms of its dimensionality and internal consistency. Guidelines are also provided for future research on its validity as a measure of state anxiety in competitive situations.