Integrating neurobiology and psychopathology into evidence-based treatment of social anxiety disorder

Social anxiety disorder (SAD) is a common, chronic psychiatric disorder characterized by a persistent fear of social or performance situations in which embarrassment can occur. This disorder typically appears during the mid-adolescent years and is unremitting throughout life if not properly treated. SAD presents as two subtypes: the more common and debilitating generalized form, and the nongeneralized form, which consists predominantly of performance anxiety. The majority of patients with SAD have comorbid mental disorders, including mood, anxiety, and substance abuse. No single development theory has been proposed to account for the origins of SAD, although current understanding of the etiology of SAD posits an interaction between psychological and biological factors. Risk factors include environmental and parenting influences and dysfunctional cognitive and conditioning events in early childhood. The neurobiology of SAD appears to involve neurochemical dysfunction, as evidenced by studies of neuroreceptor imaging, neuroendocrine function, and profiles of response to specific medications. Clinical trials have demonstrated that benzodiazepines and antidepressants are effective in the treatment of SAD. The selective serotonin reuptake inhibitors are emerging as the first-line treatment for SAD, based on their proven safety, tolerability, and efficacy. Goals for ongoing future research include development of approaches to achieve remission, to convert nonresponders and partial responders to full responders, and to prevent relapse and maintain long-term efficacy. This monograph explores the epidemiology, clinical presentation, and differential diagnosis of SAD, with a focus on neural circuitry of social relationships and neurochemical dysfunction. The prevalence, rates of recognition and treatment, patterns of comorbidity, quality-of-life issues, and natural history of SAD are discussed as well as pharmacologic and psychosocial treatment strategies for SAD.     

Sociodemographic, clinical and outcome differences among anxiety disorders

The aims of this paper are to analyze differences in sociodemographic and clinical characteristics among the various anxiety disorders treated in a Psychology Clinic, and the results of treatment in each anxiety disorder. Data from 282 patients of University Psychology Clinic at the Complutense University of Madrid, who had at least one diagnosis of anxiety according to DMS-IV-TR criteria, were analyzed. The most frequent anxiety disorders were nonspecific anxiety disorder (19.1%) and social phobia (18.8%). Significant differences were observed according to sex (in all disorders, the percentage of women was significantly higher than that of men, except for obsessive-compulsive disorder). Unspecific anxiety disorder required a smaller number of assessment and treatment sessions, whereas obsessive-compulsive disorder required a greater number of sessions. There were no significant differences between the percentage of patients who completed treatment and dropout rates in specific phobia, general anxiety disorder and obsessive-compulsive disorder. Differences between epidemiological and clinical data are discussed.     

Building phrases in language production: An MEG study of simple composition

Although research on language production has developed detailed maps of the brain basis of single word production in both time and space, little is known about the spatiotemporal dynamics of the processes that combine individual words into larger representations during production. Studying composition in production is challenging due to difficulties both in controlling produced utterances and in measuring the associated brain responses. Here, we circumvent both problems using a minimal composition paradigm combined with the high temporal resolution of magnetoencephalography (MEG). With MEG, we measured the planning stages of simple adjective–noun phrases (‘red tree’), matched list controls (‘red, blue’), and individual nouns (‘tree’) and adjectives (‘red’), with results indicating combinatorial processing in the ventro-medial prefrontal cortex (vmPFC) and left anterior temporal lobe (LATL), two regions previously implicated for the comprehension of similar phrases. These effects began relatively quickly (∼180 ms) after the presentation of a production prompt, suggesting that combination commences with initial lexical access. Further, while in comprehension, vmPFC effects have followed LATL effects, in this production paradigm vmPFC effects occurred mostly in parallel with LATL effects, suggesting that a late process in comprehension is an early process in production. Thus, our results provide a novel neural bridge between psycholinguistic models of comprehension and production that posit functionally similar combinatorial mechanisms operating in reversed order.     

Longitudinal trajectories of bicultural identity integration in recently immigrated Hispanic adolescents: Links with mental health and family functioning

This study examined, in a sample of recently immigrated Hispanic adolescents in Miami and Los Angeles, the extent to which bicultural identity integration (BII; involving the ability to synthesise one's heritage and receiving cultural streams and to identify as a member of both cultures) is best understood as a developmental construct that changes over time or as an individual‐difference construct that is largely stable over time. We were also interested in the extent to which these trajectories predicted mental health and family functioning. Recent‐immigrant 9th graders (N = 302) were assessed 6 times from 9th to 12th grade. Latent class growth analyses using the first 5 timepoints identified 2 trajectory classes—one with lower BII scores over time and another with higher BII scores over time. Higher heritage and US identity at baseline predicted membership in the higher BII class. At the 6th study timepoint, lower BII adolescents reported significantly poorer self‐esteem, optimism, prosocial behaviour and family relationships compared with their higher BII counterparts. These findings are discussed in terms of further research on the over‐time trajectory of biculturalism, and on the need to develop interventions to promote BII as a way of facilitating well‐being and positive family functioning.     

Esfuerzo y decremento de vigilancia en tareas de discriminación sucesiva y simultánea

Resumen

El objetivo del experimento presentado en este artículo fue probar la hipótesis de que el decremento de sensibilidad en tareas de atención sostenida, ocurre porque los recursos atencionales o esfuerzo que demanda la tarea no pueden matenerse durante un tiempo prolongado. Comparamos dos tareas que diferían en carga de memoria y registramos tres grupos de índices de esfuerzo o gasto atencional: rendimiento en una tarea secundaria concurrente, esfuerzo subjetivo y actividad cardiovascular (IBI medio y amplitud espectral del componente 0.10 Hz). En ambas tareas observamos un declive significativo a lo largo del tiempo en eficiencia o ritmo de procesamiento, indicado por la razón entre la precisión y la velocidad. Los datos acerca del esfuerzo subjetivo y el rendimiento en la tarea secundaria no parecen apoyar la hipótesis original. El principal hallazgo fue que la actividad cardiovascular al comienzo de la tarea, medida por la amplitud del componente 0.1 Hz, era un predictor significativo del decremento de eficiencia en ambas tareas de vigilancia. Si esta amplitud es un índice fisiológico fiable de atención, nuestro resultado sugiere que un procesamiento controlado, con esfuerzo, al comienzo de la tarea previene el decremento de vigilancia.     

Entrevista a Urie Bronfenbrenner

RESUMEN

Urie Bronfenbrenner comienza repasando su biografía y explicando la influencia de figuras como Kurt Lewin, Tolman o sus propios padres en su formación científica. A continuación se ocupa de los problemas metodológicos de la investigación en Psicología, sus estudios incorporando el modelo “persona-proceso-contexto” o los trabajos de laboratorio, centrándose en diversas reflexiones en torno a la perspectiva ecológica y la consideración del ambiente. Además el autor adelanta algunos conceptos de su último trabajo todavía inédito, como el factor tiempo o la relevancia del sistema de creencias para comprender el desarrollo. Finalmente aborda su vinculación a programas de intervención social y comunitarios y aporta algunas ideas acerca del futuro de la psicología europea y española.     

Does category labeling lead to forgetting?

What effect does labeling an object as a member of a familiar category have on memory for that object? Recent studies suggest that recognition memory can be negatively impacted by categorizing objects during encoding. This paper examines the “representational shift hypothesis” which argues that categorizing an object impairs recognition memory by altering the trace of the encoded memory to be more similar to the category prototype. Previous evidence for this idea comes from experiments in which a basic-level category labeling task was compared to a non-category labeling incidental encoding task, usually a preference judgment (e.g., “Do you like this item?”). In two experiments, we examine alternative tasks that attempt to control for processing demands and the degree to which category information is explicitly recruited at the time of study. Contrary to the predictions of the representational shift hypothesis, we find no evidence that memory is selectively impaired by category labeling. Overall, the pattern of results across both studies appears consistent with well-established variables known to influence memory such as encoding specificity and distinctiveness effects.     

Incivility at work,upset at home? Testing the cross‐level moderation effect of emotional dysregulation among female nurses from primary health care

Workplace incivility is a growing problem in nursing. However, most studies that explore this psychosocial risk and its consequences do so considering a single level and a between‐person perspective. The aims of the study were to explore whether the effects of experiencing incivility during work‐time could explain the daily levels of well‐being of nurses at home; and to analyze if that relationship could be moderated by their levels of emotional dysregulation as a trait. This is a multilevel study with diary methodology. The study was carried out in 18 primary health‐care centers belonging to Madrid and the Basque Country, in Spain. Ninety‐four nurses completed a general questionnaire and 54 of them a diary booklet over five consecutive working days in two different moments, immediately after work and at bedtime. The results showed that nurses’ emotional dysregulation moderated the relationship between daily workplace incivility and daily fatigue, and positive affect at night at home. However, there were no direct effects of daily incivility on these outcome variables. In conclusion, the presence of difficulties in emotional regulation among nurses can increase the negative effects of daily workplace incivility on their health and well‐being.     

Long Term Child-Centered Play Therapy Effects on Academic Achievement with Normal Functioning Children

This follow up study with 23 normal functioning 1st graders examined the long-term effectiveness of Child-Centered Play Therapy (CCPT) on academic achievement. Through the use of a one-way repeated measures analysis of variance, researchers examined the use of CCPT from pre-intervention to mid-intervention (16 sessions) to post-intervention (26 sessions). Results indicated that children who participated in 26 sessions of CCPT demonstrated statistically significant improvement on the Early Achievement Composite as measured on the Young Children’s Achievement Test (YCAT), along with increases in the Reading, Mathematics, and Spoken Language subscales. Participants showed statistically consistent improvement in academic scores of the full duration of the study. Overall, the findings imply that CCPT as a long term method can support academic achievement in the school system with normal functioning 1st grade students. The outcome suggests long term CCPT is an intervention for elementary/primary school counselors to use with children who have emotional or academic needs. The findings open the door for school counselors or outside professionals to use play therapy with children in the school system as a way of providing academic support and thereby promoting the field of play therapy in the school system.