Cognitive defusion and self-relevant negative thoughts: examining the impact of a ninety year old technique

Cognitive defusion techniques are designed to reduce the functions of thoughts by altering the context in which they occur, rather than the attempting to alter the form, frequency, or situational sensitivity of the thoughts themselves. Applied technologies designed to produce cognitive defusion seem to lead to reductions in the believability of negative thoughts, but defusion techniques are generally only parts of complex packages and the role of defusion techniques per se is note yet known. The present study examined the impact of a cognitive defusion technique first described by Titchener nearly 90 years ago: rapidly repeating a single word. In series of eight single-case alternating treatment designs, this defusion technique was compared to a distraction task, and to a thought control task on reductions in the discomfort and believability of self-relevant negative thoughts. The cognitive defusion technique reduced both discomfort and believability more so than the comparison approaches. Control studies showed that the effect was probably not due to demand characteristics.     

Assessing psychological inflexibility: the psychometric properties of the Avoidance and Fusion Questionnaire for Youth in two adult samples

The current study examined whether the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; L. A. Greco, W. Lambert, & R. A. Baer, 2008), a self-report measure of psychological inflexibility for children and adolescents, might be useful for measuring psychological inflexibility for adults. The psychometric properties of the AFQ-Y were examined using data from a college student sample (N = 387) and a clinical sample of patients with anxiety disorders (N = 115). The AFQ-Y, but not the Acceptance and Action Questionnaire-II (AAQ-II; F. W. Bond et al., in press), demonstrated a reading level at or below the recommended 5th or 6th grade reading level. The AFQ-Y also demonstrated adequate reliability (internal consistency), factorial validity, convergent and discriminant validity, and concurrent validity predicting psychological symptoms. Moreover, the AFQ-Y showed incremental validity over the AAQ-II in predicting several psychological symptom domains. Implications for the assessment of psychological inflexibility are discussed.     

Altering Impulsive Decision Making With an Acceptance-Based Procedure

Delay discounting is one facet of impulsive decision making and involves subjectively devaluing a delayed outcome. Steeply discounting delayed rewards is correlated with substance abuse and other problematic behaviors. To the extent that steep delay discounting underlies these clinical disorders, it would be advantageous to find psychosocial avenues for reducing delay discounting. Acceptance-based interventions may prove useful as they may help to decrease the distress that arises while waiting for a delayed outcome. The current study was conducted to determine if a 60–90 minute acceptance-based training would change delay discounting rates among 30 undergraduate university students in comparison to a waitlist control. Measures given at pre- and posttraining included a hypothetical monetary delay discounting task, the Acceptance and Action Questionnaire-II (AAQ-II), and the Distress Tolerance Scale. Those assigned to the treatment group decreased their discounting of delayed money, but not distress intolerance or psychological inflexibility when compared to the waitlist control group. After the waiting period, the control group received the intervention. Combining all participants’ pre- to posttreatment data, the acceptance-based treatment significantly decreased discounting of monetary rewards and increased distress tolerance. The difference in AAQ-II approached significance. Acceptance-based treatments may be a worthwhile option for decreasing delay discounting rates and, consequently, affecting the choices that underlie addiction and other problematic behaviors.     

Using habit reversal to treat chronic vocal tic disorder in children

In the present study, a nonconcurrent multiple baseline design was used to evaluate the effectiveness of simplified habit reversal in three children diagnosed with chronic vocal tic disorder. In two children, vocal tics were substantially reduced. In a third child, tics were not reduced, and the addition of a supplemental contingency management program was ineffective. Despite these mixed results, the treatment was viewed as acceptable to the children's parents in all cases as measured by a standard index of treatment acceptability. Implications of these findings are discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

Photographic Assessment of Change in Trichotillomania: Psychometric Properties and Variables Influencing Interpretation

Although photographic assessment has been found to be reliable in assessing hair loss in Trichotillomania, the validity of this method is unclear, particularly for gauging progress in treatment. The current study evaluated the psychometric properties of photographic assessment of change in Trichotillomania. Photographs showing hair loss of adults with Trichotillomania were taken before and after participating in a clinical trial for the condition. Undergraduate college students (N?=?211) rated treatment response according to the photos, and additional archival data on hair pulling severity and psychosocial health were retrieved from the clinical trial. Photographic assessment of change was found to possess fair reliability (ICC?=?0.53), acceptable criterion validity (r?=?0.51), good concurrent validity (r?=?0.30–0.36), and excellent incremental validity (ΔR ²?=?8.67, p?<?0.01). In addition, photographic measures were significantly correlated with change in quality of life (r?=?0.42), and thus could be considered an index of the social validity of Trichotillomania treatment. Gender of the photo rater and pulling topography affected the criterion validity of photographic assessment (partial η ²?=?0.05–0.11). Recommendations for improving photographic assessment and future directions for hair pulling research are discussed.     

Body-Focused Repetitive Behaviors: The Proximal and Distal Effects of Affective Variables on Behavioral Expression

This paper reports on 2 studies designed to examine the contribution of affective variables on the expression of body-focused repetitive behaviors (BFRBs; e.g., skin picking, nail biting). The first study revealed that persons engaging in a BFRB experienced significantly higher levels of anxiety and depression than those without BFRBs. The second study was conducted to determine if repetitive behaviors were differentially affected across various emotional states and across those persons with and without BFRBs. Participants were randomly exposed to anxiety, depression, boredom, and control conditions. Results showed no differential effects on the occurrence of repetitive behaviors within the no-BFRB group; however, the BFRB group engaged in more repetitive behaviors in the Bored condition than in the Control condition. This study offers the first experimental evidence that emotional variables can have a differential impact on the expression of BFRBs.     

Examination of the Relationship Between Perfectionism and Religiosity as Mediated by Psychological Inflexibility

A relationship between perfectionism and religiosity has been suggested in the literature, and this relationship is clarified further when the adaptive and maladaptive dimensions of both constructs are compared. Literature in both areas implicates the idea of a rigid and inflexible personality style that may explain why well meaning high standards can be associated with negative outcomes such as perfectionism. This investigation examined the relationship of perfectionism and religiosity, using adaptive and maladaptive dimensions, as mediated by psychological inflexibility. Validated measures of perfectionism, religiosity, and psychological inflexibility were given to 376 undergraduate college students in an anonymous online survey. Adaptive perfectionism (high standards) was found to be significantly correlated (r = .26, p < .01, two-tailed) with adaptive religiosity (intrinsic orientation). Maladaptive perfectionism (discrepancy) was found to be significantly correlated (r = .13, p < .05, two-tailed) with maladaptive religiosity (extrinsic orientation). Psychological inflexibility was found to be significantly correlated with the maladaptive dimensions of both perfectionism and religiosity. It was also shown to mediate the relationship between maladaptive (extrinsic) religiosity and maladaptive (discrepancy) perfectionism. Implications and future directions are discussed.     

ANALYZING THE INFLUENCE OF TIC‐RELATED TALK ON VOCAL AND MOTOR TICS IN CHILDREN WITH TOURETTE'S SYNDROME

This study examined the effect of tic‐related talk on the vocal and motor tics of 2 boys with Tourette's syndrome. Using ABAB withdrawal designs, the boys were alternately exposed to conditions with and without talk of their tics. For both boys, vocal tics markedly increased when talk pertained to tics and decreased when talk did not pertain to tics, but motor tic covariance was less consistent.     

Effects of differential rates of alternative reinforcement on resurgence of human behavior

Despite the success of exposure‐based psychotherapies in anxiety treatment, relapse remains problematic. Resurgence, the return of previously eliminated behavior following the elimination of an alternative source of reinforcement, is a promising model of operant relapse. Nonhuman resurgence research has shown that higher rates of alternative reinforcement result in faster, more comprehensive suppression of target behavior, but also in greater resurgence when alternative reinforcement is eliminated. This study investigated rich and lean rates of alternative reinforcement on response suppression and resurgence in typically developing humans. In Phase 1, three groups (Rich, n = 18; Lean, n = 18; Control, n = 10) acquired the target response. In Phase 2, target responding was extinguished and alternative reinforcement delivered on RI 1 s, RI 3 s, and extinction schedules, respectively. Resurgence was assessed during Phase 3 under extinction conditions for all groups. Target responding was suppressed most thoroughly in Rich and partially in Lean. Target responding resurged in the Rich and Lean groups, but not in the Control group. Between groups, resurgence was more pronounced in the Rich group than the Lean and Control groups. Clinical implications of these findings, including care on the part of clinicians when identifying alternative sources of reinforcement, are discussed.     

Comparing Japanese International College Students' and U.S. College Students' Mental‐Health‐Related Stigmatizing Attitudes

This study examined differences between Japanese international college students and U.S. college students on stigma toward people with psychological disorders, stigma tolerance in help seeking, and self‐concealment. Japanese international students had greater stigma toward individuals with psychological disorders than did their U.S. counterparts. No interrelationships between these variables, however, were found in the Japanese international student group. Este estudio examinó las diferencias entre estudiantes universitarios internacionales japoneses y estudiantes universitarios estadounidenses en lo concerniente al estigma hacia las personas con trastornos psicológicos, la tolerancia del estigma al buscar ayuda y la auto‐ocultación. Los estudiantes internacionales japoneses mostraron un mayor estigma hacia los individuos con trastornos psicológicos que sus homólogos estadounidenses. Sin embargo, no se encontró ninguna interrelación entre estas variables en el grupo de estudiantes internacionales japoneses.