Is agoraphobia harder to treat? A comparison of agoraphobics' and simple phobics' response to treatment

Agoraphobia is reputed to be more difficult to treat than simple phobia. In a test of this supposition, 38 agoraphobics and 19 simple phobics were each given 10 sessions of graduated in vivo exposure. They were assessed before and after therapy using a behavioral avoidance test, behavioral diaries, and self-report measures. Analysis of covariance revealed unequivocal posttest differences only on self-assessed disability level; agoraphobics had changed less in their report of global disability immediately following treatment but not at follow-up. Sixty-eight percent of the simple phobics showed clinically significant improvement on avoidance of the Main Phobia, compared with 34% of the agoraphobics. On three other outcome measures, including more precise behavioral measures of phobia, agoraphobics and simple phobics responded equivalently to treatment. Given clinicians' impression about the comparative difficulty in treating agoraphobic clients, fewer differences in treatment response were obtained than were expected. Several possible explanations for this discrepancy are discussed.     

The intuitive personologist revisited: A critique of dialectical person perception

A critical examination of dialectical person perception as advanced by Lamiell, Foss, Trierweiler, and Leffel, (1983) reveals some important problems both in its empirical basis and in the underlying model of the intuitive personologist. The present article discusses these problems and suggests some alternative conceptions of the intuitive personologist.     

Overgeneral autobiographical memory in children of depressed mothers

The goal of this study was to examine overgeneral autobiographical memory in a population at-risk for depression (i.e., children of depressed mothers). We predicted that children of depressed mothers would display less-specific memories than children of non-depressed mothers and that these results would be observed among children with no prior history of depression themselves. Participants in this study were children (age 8–14; 50% girls, 83% Caucasian) of mothers with (n = 103) or without (n = 120) a history of major depressive disorder during the child's life. Mothers' and children's diagnoses were confirmed with a diagnostic interview, and children completed the Autobiographical Memory Test and a measure of depressive symptoms. We found that children of depressed mothers, compared to children of non-depressed mothers, recalled less-specific memories in response to negative cue words but not positive cue words. Importantly, these results were maintained even when we statistically controlled for the influence of children's current depressive symptom levels and excluded children with currently depressed mothers. These results suggest that overgeneral autobiographical memory for negative events may serve as a marker of depression risk among high-risk children with no prior depression history.     

Expanding Diversity: Noncategorical Inclusion and Equity

Contemporary public policy and laws give strong support to equal protection and civil rights. This article argues that a modern society and each person therein should cultivate qualities in one’s self and others that will promote inclusion and equity to continually reduce and eventually eliminate unjust bias, prejudice, and discrimination (albeit perhaps an “impossible dream”). To date, equal protection has depended primarily on governmental regulations based on categorization of human factors. It is argued that everyone, particularly those persons granted “professional” status in society, should aspire for self-concept features that will move toward adopting and expanding inclusion to eliminate the need for categorization per se. Rather than diversity per se, inclusion and equity have contemporary support for better obtaining the personal and social values that can reduce bias, discrimination, and prejudice. It is recommended that interventions be directed at the structural, institutionalized, and close-minded barriers that exist in individual and collective decision making.     

Obsessive-compulsive disorder as a disturbance of security motivation

The authors hypothesize that the symptoms of obsessive-compulsive disorder (OCD), despite their apparent nonrationality, have what might be termed an epistemic origin--that is, they stem from an inability to generate the normal "feeling of knowing" that would otherwise signal task completion and terminate the expression of a security motivational system. The authors compare their satiety-signal construct, which they term yedasentience, to various other senses of the feeling of knowing and indicate why OCD-like symptoms would stem from the abnormal absence of such a terminator emotion. In addition, they advance a tentative neuropsychological model to explain its underpinnings. The proposed model integrates many previous disparate observations and concepts about OCD and embeds it within the broader understanding of normal motivation.     

Structural equation models for interchangeable dyads: being the same makes a difference

Structural equation modeling (SEM) offers a flexible method for studying the patterns of interdependence in partners' behavior, which lie at the heart of interactions and relationships. Although SEM has been applied to the study of distinguishable dyads, in which partners are distinguishable by type, such as male and female, it has rarely been applied to the study of interchangeable dyads, such as male-male or female-female pairs. The authors integrate a wide range of dyadic interdependence models--including actor-partner interdependence models, mutual-influence models, and common-fate or dyadic personality models--into an SEM framework for use with interchangeable dyads. The authors also address the use of latent variables at both the dyadic and individual levels, whereby substantive relationships in these models can be corrected for errors of measurement. Furthermore, the authors discuss the conceptual underpinnings of dyadic models and give examples of their application.     

Automatic processing in spider phobia: implicit fear associations over the course of treatment

This study evaluates the cognitive model of anxiety by investigating treatment-related changes in automatic associations to evaluate schematic processing. Spider-phobic participants (n = 31) and healthy controls (n = 30) completed fear-based Implicit Association Tests (IATs), which are reaction-time measures that tap implicit associations without requiring conscious introspection. The specific tasks involved classifying pictures of snakes and spiders along with semantic categorizations (good vs.bad, afraid vs. unafraid, danger vs. safety, and disgusting vs. appealing). Phobic individuals were assessed before and after group-based exposure treatment and 2 months later, controls were assessed at matched time points. Results supported clinical applications for implicit fear associations, including prediction of phobic avoidance, and treatment sensitivity of the fear- and disgust-specific automatic associations.     

Book Review

Abstract

Over the past 20 years, the clinical evaluation of family systems has been spearheaded by Robert Beavers and his colleagues at the Southwest Family Institute in Dallas, Texas. Out of their research and clinical work has evolved the Beavers System Model for Family Assessment (BSM). The BSM is a collection of three instruments the first of which was the Beavers-Timberlawn Family Evaluation Scale (1972) featured in the widely popular book, No Single Thread (Lewis et al, 1976). The Centripetal/Centrifugal Family Style Scale shortly followed (1974), and more recently (1983) the Self-Report Family Instrument was added to the BSM. Although the focus of the following critique is on the Beavers-Timberlawn Family Evaluation Scale (BT), the measure is designed to be used in conjunction with the other scales to more fully identify the health/competence of a particular family.