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.     

Manipulation of focus of attention and its effects on anxiety in high-anxious individuals and repressors

Abstract

There were four groups of participants: low-anxious (low anxiety-low defensiveness), repressors (low anxiety-high defensiveness), high-anxious (high anxiety-low defensiveness), and defensive high-anxious (high anxiety-high defensiveness). They were exposed to self-focus and other-focus conditions, and self-report, physiological, and behavioural measures of anxiety were recorded. The focus manipulation (self vs. other) was effective, with all four groups having higher self-reported anxiety in the self-focus condition. It was found that self-focused attention accounted for a significant amount of variation in self-reported anxiety. The findings were discussed within the theoretical framework proposed by Eysenck (1997).     

Two‐year‐olds are vigilant of others’ non‐verbal cues to credibility

Data from three experiments provide the first evidence that children, at least as young as age two, are vigilant of others’ non‐verbal cues to credibility, and flexibly use these cues to facilitate learning. Experiment 1 revealed that 2‐ and 3‐year‐olds prefer to learn about objects from someone who appears, through non‐verbal cues, to be confident in performing actions on those objects than from someone who appears uncertain when performing actions on those objects. Experiment 2 revealed that when 2‐year‐olds observe only one model perform a single action, either confidently or unconfidently, they do not use the model’s level of confidence in this single instance to influence their learning. Experiment 3 revealed that 2‐year‐olds will use a single model’s level of confidence to guide their learning if they have observed that the model has a history of being either consistently confident or consistently uncertain. These findings reveal that young children selectively alter their learning based on others’ non‐verbal cues of credibility, and underscore the importance of an early sensitivity to socio‐cognitive cues for human learning and development.     

An event-related potential study of the revelation effect

Event-related potentials (ERPs) were recorded during a verbal recognition memory task in order to investigate whether changes in familiarity are part of the explanation for the revelation effect. For half of the test words, participants solved an anagram prior to making the old/new recognition judgment. A revelation effect was obtained: When test words were preceded by the anagram task, a higher probability of an old response was associated with the items than was otherwise the case. The ERPs recorded time-locked to the onset of the test words were separated according to old/new status andthe presence/absence of the anagram task. The ERP index of familiarity was of lower amplitude for both old and new items that were preceded by the anagram task. These findings are consistent with the view that part of the explanation for the revelation effect is a reduction in the familiarity of the critical test items.     

Effects of focus of attention on physiological,behavioural, and reported state anxiety in repressors,low-anxious,high-anxious,and defensive high-anxious individuals

Abstract

Discrepancies between physiological activity, behavioural anxiety, and self-reported anxiety were examined when focus of attention was manipulated in a public speech task for four groups of individuals: repressors, low-anxious, high-anxious, and the defensive high-anxious. They were exposed to self-focus (when their behaviour was socially evaluated) and other-focus (when their behaviour was not socially evaluated) conditions. Repressors had consistently the lowest level of self-reported anxiety, but had consistently greater physiological activity in all conditions and greater behavioural anxiety in the self-focus condition. The high-anxious showed the opposite pattern, i.e. their self-reported anxiety was greater than their physiological and behavioural anxiety, and this finding was significant in the self-focus condition. No significant pattern of discrepancy was found for the low-anxious or defensive high-anxious groups. The findings are discussed and interpreted within the framework of recent cognitive models of anxiety.     

Recall and response time norms for English–Swahili word pairs and facts about Kenya

In the vast literature exploring learning, many studies have used paired-associate stimuli, despite the fact that real-world learning involves many different types of information. One of the most popular materials used in studies of learning has been a set of Swahili–English word pairs for which Nelson and Dunlosky (Memory 2; 325–335, 1994) published recall norms two decades ago. These norms involved use of the Swahili words as cues to facilitate recall of the English translation. It is unclear whether cueing in the opposite direction (from English to Swahili) would lead to symmetric recall performance. Bilingual research has suggested that translation in these two different directions involves asymmetric links that may differentially impact recall performance, depending on which language is used as the cue (Kroll & Stewart, Journal of Memory and Language 33; 149–174,1994). Moreover, the norms for these and many other learning stimuli have typically been gathered from college students. In the present study, we report recall accuracy and response time norms for Swahili words when they are cued by their English translations. We also report norms for a companion set of fact stimuli that may be used along with the Swahili–English word pairs to assess learning on a broader scale across different stimulus materials. Data were collected using Amazon’s Mechanical Turk to establish a sample that was diverse in both age and ethnicity. These different, but related, stimulus sets will be applicable to studies of learning, metacognition, and memory in diverse samples.     

Conception of Adulthood Among Iranian Emerging Adults

Using a questionnaire adapted from Arnett and Padilla‐Walker (2015), the authors examined the concept of adulthood among 366 Iranian emerging adults ages 17 to 29. Results suggested that the concept and criteria of adulthood are influenced by the cultural context. Implications for practice and recommendations for future research are discussed.     

Attentional bias to pictures of fear-relevant animals in a dot probe task

Attentional bias to fear-relevant animals was assessed in 69 participants not preselected on self-reported anxiety with the use of a dot probe task showing pictures of snakes, spiders, mushrooms, and flowers. Probes that replaced the fear-relevant stimuli (snakes and spiders) were found faster than probes that replaced the non-fear-relevant stimuli, indicating an attentional bias in the entire sample. The bias was not correlated with self-reported state or trait anxiety or with general fearfulness. Participants reporting higher levels of spider fear showed an enhanced bias to spiders, but the bias remained significant in low scorers. The bias to snake pictures was not related to snake fear and was significant in high and low scorers. These results indicate preferential processing of fear-relevant stimuli in an unselected sample.     

Response inhibition and attentional control in anxiety

Traditionally, anxiety has been associated with a selective attentional bias for threat and a decreased capacity in attentional control. In two different experiments, we investigated whether individuals with different levels of self-reported state anxiety (Experiment 1) and induced anxiety (Experiment 2) had impaired response inhibition processes (attentional control deficit) as characterized by a different response style in the presence of negative stimuli under low and high perceptual load conditions. A go/no-go paradigm with emotional distractors (angry, happy, and neutral faces) was used to provide measures of perceptual sensitivity, inhibition, and response style. Our findings showed that perceptual sensitivity, as assessed by the d' parameter of signal detection theory, was reduced in all participants for angry faces under low perceptual load, where enough perceptual resources were available to be attracted by distractors. Importantly, despite similar perceptual sensitivity, the beta parameter indicated that high state anxiety individuals in both experiments were less flexible at adjusting to task demands in the presence of angry face distractors by adopting a stricter criterion. Implications of findings are discussed within current models of attentional control in anxiety.