Hofmann,S. G. (2012). An Introduction to Modern CBT: Psychological Solutions to Mental Health Problems Malden,MA: Wiley-Blackwell

This paper reviews Hofmann’s (2012) An Introduction to Modern CBT: Psychological Solutions to Mental Health Problems. Hofmann’s book is a new tool in the struggle to disseminate CBT to the uninitiated and to train new clinicians in the basic elements of cognitive behavioral treatments. This book is an accessible introduction to basic cognitive behavioral models and techniques across a variety of conditions, with ample hypothetical case material to illustrate the approaches described. The book provides a theoretical introduction to CBT, discusses the general processes and procedures used in treatment, illustrates the approach in 10 specific problem areas, and summarizes empirical support for the approaches described. Particularly helpful are the clinical examples, learning objectives, suggested exercises, and sample dialogues that are provided. While the book tends to give less attention to the behavioral tradition in CBT, and is not intended to illustrate the use of CBT in complex cases or diverse populations, it achieves the author’s goal of providing a primer on both traditional CBT techniques and emerging CBT technologies. Students, new clinicians, allied health professionals, and patients can benefit from this important work.     

The role of avoidance of emotional material in the anxiety disorders

Many psychotherapeutic traditions have conceptualized clinical levels of anxiety as resulting from the avoidance of threatening or emotional material. In this paper, we examine behavioral models of avoidance of emotions and emotional material, integrating findings that support established behavioral theories of emotional avoidance and anxiety, and that extend these theories to further explain the intense, intrusive, and interfering nature of clinical anxiety. Research on the suppression and avoidance of emotional material suggests that emotional avoidance and thought suppression may not only hinder the learning process and maintain anxious responding, but may also (a) paradoxically heighten anxious responding to threatening cues and (b) interfere with emotion functionality, thereby further impeding adaptive responding. Findings are discussed in terms of future research and implications for clinical treatment of anxiety disorders.     

The Experience of Intrusions Scale: a preliminary examination

Intrusive thoughts (i.e., unwelcome, distressing, involuntary thoughts) are prevalent in a variety of clinical conditions and are increasingly a focus of translational research. The goal of this study was to develop and preliminarily examine a brief self-report measure designed to assess clinically relevant aspects of the experience of intrusive thoughts related to a particular target. The Experience of Intrusions Scale (EIS) is a five-item measure that assesses the frequency, unpredictability, and unwantedness of intrusive thoughts, as well as the interference and distress caused by the intrusions, each on a five-point Likert-type scale. Five times over a four-] period, female undergraduates (N=160) completed the EIS in response to intrusive thoughts regarding a film clip depicting a sexual assault. On the first and last days, participants completed the EIS five minutes after watching the clip. In between film clip viewings, participants completed the EIS once per day. The EIS demonstrated good internal consistency, good to excellent test-retest reliability using both immediate post-stimulus and 24-hour time intervals, and convergent validity with two existing measures of intrusive phenomena: the White Bear Suppression Inventory (Wegner & Zanakos, 1994) and the Post-traumatic Stress Disorder Checklist-Civilian Version (Weathers, Litz, Herman, Huska, & Keane, 1993).     

The role of fear of emotion in distress, arousal, and cognitive interference following an emotional stimulus

Diverse theories of psychopathology suggest that reactions to internal experiences, such as emotion, are important in the development and maintenance of psychological distress and symptomatology. This study examines the relationships between one type of reaction to emotion, fear of emotion, and reactivity to, recovery from, and interference of emotional material. As predicted, fear of emotion was related to greater increases in distress, negative affect, and skin conductance in reaction to an emotional film clip, and to greater interference of film-related material in a modified emotional Stroop task. These relationships remained when variance contributed by general negative affect was removed. Findings provide preliminary evidence that fear of emotion may be related to emotional distress and physiological arousal, and that this relationship may exist beyond shared variance due to self-report response style and general negative affectivity.     

Masculinity and Emotionality: An Investigation of Men's Primary and Secondary Emotional Responding

In this study, we investigated the role of masculinity in men's affect intensity and men's fear of emotions. Men's masculine ideology and self-reported masculine gender role stress were assessed as cognitive and experiential factors of adherence to traditional masculine gender norms. Masculine ideology was negatively related to men's global affect intensity. However, on a 3-factor model of affect intensity, only negative reactivity was significantly related to masculine ideology. Both masculine ideology and masculine gender role stress were positively related to men's fear of emotions. Results are discussed in the context of theories of gender differences in emotion.     

Examining the role of emotional avoidance in the relationship between posttraumatic stress disorder symptom severity and worry

A growing body of literature suggests that worry is a cognitive activity functioning to avoid unpleasant internal experiences such as negative thoughts, emotions, and somatic responses. Given the highly aversive internal events associated with posttraumatic stress disorder (PTSD), individuals experiencing PTSD symptoms following exposure to a traumatic event may be particularly motivated to engage in avoidant regulation strategies such as worry. Surprisingly, however, few studies to date have examined the relationship between PTSD and worry as well as potential factors that might explain this association. Therefore, the goal of this study was to examine the association between PTSD symptom severity and worry and the extent to which emotional avoidance explains this relationship. To this end, 207 college students with a history of traumatic exposure (meeting Criterion A for a PTSD diagnosis) completed a series of questionnaires assessing history of exposure to potentially traumatic events, PTSD symptom severity, emotional avoidance tendencies, and worry. Results demonstrated that PTSD symptom severity was positively associated with worry and emotional avoidance. Further, emotional avoidance was found to fully account for this relationship, providing support for the proposed emotionally avoidant function of worry. The implications of these findings for future research and the treatment of worry among individuals with a history of traumatic exposure are discussed.     

An experimental investigation of the effect of worry on responses to a discrimination learning task

The current study examined the impact of both the tendency to worry (trait worry) and the process of worry (state worry) on subsequent behavioral responding in a schedule discrimination learning task. High and low trait worriers were randomly assigned to a state worry or relaxation incubation condition and completed a test of executive functioning and a dual contingency learning task that utilized neutral discriminative cues over the course of 2 contingency phases. Although state and trait worry did not impact executive functioning, the state worry condition was associated with diminished sensitivity to learning task contingencies over the course of the first contingency learning trials in comparison to the relaxation condition. This relationship was unique to the state worry condition above and beyond shared variance with subjective anxiety level. Results suggest that state worry may lead to a decrement in selective behavioral responding to neutral discriminative cues in the environment. The findings suggest that the process of worry may lead to less adaptive responding to neutral cues and interfere with adaptive behaviors, which may thereby contribute to and maintain anxiety.