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1.
Behav Ther ; 55(4): 649-679, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38937042

RESUMEN

Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despite evidence linking SOGIECEs with serious iatrogenic effects, and despite support for LGBTQ+-affirmative care alternatives, SOGIECE practices persist. In the 1970s and 1980s, Behavior Therapy published articles testing and/or endorsing SOGIECEs, thereby contributing to their overall development, acceptance, and use. The Behavior Therapy Task Force on SOGIECEs was assembled to conduct a rigorous review of the SOGIECE articles published in Behavior Therapy and to decide whether, and what, formal action(s) should be taken on these articles. This report provides a detailed review of the historic SOGIECE literature published in Behavior Therapy and outlines the Task Force's deliberative and democratic processes resulting in actions to: (1) add prominent advisory information to k = 24 SOGIECE papers in the form of digital "black box" disclaimers that caution readers that the SOGIECE practices tested or described in these papers are inconsistent with modern standards, (2) offset organizational financial benefits from the publication of these papers, and (3) promote LGBTQ+-affirmative practices. SOGIECEs are not the only concerning practices across the field's history, and the pages of today's scientific journals include practices that will be at odds with tomorrow's moral standards and ethical guidelines. This report calls for precautionary measures and editorial safeguards to minimize the future likelihood and impact of problematic published scholarship, including the need to fully include those with relevant lived experiences in all aspects of clinical science and peer review.


Asunto(s)
Terapia Conductista , Identidad de Género , Conducta Sexual , Minorías Sexuales y de Género , Humanos , Terapia Conductista/métodos , Comités Consultivos , Femenino
2.
J Anxiety Disord ; 104: 102875, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38763062

RESUMEN

Individuals with Social Anxiety Disorder (SAD) are at risk for employment problems. This multi-site trial examined the efficacy of Work-Related Cognitive Behavioral Therapy provided alongside vocational services as usual (WCBT+VSAU), a group-based treatment designed to improve mental health and employment outcomes for individuals with SAD. Vocational service-seeking participants with SAD (N = 250) were randomized to either WCBT+VSAU or VSAU-alone. Hypotheses were that participants randomized to WCBT+VSAU would report less social anxiety, less depression, and more hours worked than participants randomized to VSAU-alone. WCBT+VSAU participants had significantly greater improvements on the Liebowitz Social Anxiety Scale (LSAS; d=-.25, CI=-0.49 to -0.02, p = .03) at post-assessment compared to VSAU-alone. The conditions did not differ on any variable at later time points or on secondary outcomes. Unexpectedly, participants randomized to VSAU-alone experienced LSAS improvements, similar to WCBT+VASU at later timepoints. Baseline psychological flexibility (beta=-.098 [-0.19-0.008]) and depression (beta=-0.18 [-0.34-0.009]) moderated change in social anxiety. Participants with lower psychological flexibility and higher depression responded more strongly to WCBT+VSAU than VSAU-alone over the duration of the study, suggesting that WCBT+VSAU may particularly benefit those with greater psychopathology. Results indicate that vocational centers are promising settings for treating SAD and employment-focused refinements are likely needed to improve work outcomes.


Asunto(s)
Terapia Cognitivo-Conductual , Fobia Social , Desempleo , Humanos , Terapia Cognitivo-Conductual/métodos , Masculino , Femenino , Adulto , Fobia Social/terapia , Fobia Social/psicología , Desempleo/psicología , Desempleo/estadística & datos numéricos , Persona de Mediana Edad , Resultado del Tratamiento , Depresión/terapia , Rehabilitación Vocacional/métodos
3.
JMIR Ment Health ; 10: e46200, 2023 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-37486735

RESUMEN

BACKGROUND: The global burden of anxiety and depression has created an urgent need for scalable approaches to increase access to evidence-based mental health care. The Screening and Treatment for Anxiety and Depression (STAND) system of care was developed to meet this need through the use of internet-connected devices for assessment and provision of treatment. STAND triages to level of care (monitoring only, digital therapy with coaches, digital therapy assisted by clinicians in training, and clinical care) and then continuously monitors symptoms to adapt level of care. Triaging and adaptation are based on symptom severity and suicide risk scores obtained from computerized adaptive testing administered remotely. OBJECTIVE: This article discusses how the STAND system of care improves upon current clinical paradigms, and presents preliminary data on feasibility, acceptability, and effectiveness of STAND in a sample of US-based university students. METHODS: US-based university students were recruited and enrolled in an open trial of the STAND system of care. Participants were triaged based on initial symptom severity derived from a computerized adaptive test and monitored over 40 weeks on anxiety, depression, and suicide risk to inform treatment adaptation and evaluate preliminary effectiveness. RESULTS: Nearly 5000 students were screened and 516 received care. Depression and anxiety severity scores improved across all tiers (P<.001 in all cases). Suicide risk severity improved in the highest tier (ie, clinical care; P<.001). Acceptability and feasibility were demonstrated. CONCLUSIONS: STAND is a feasible and acceptable model of care that can reach large numbers of individuals. STAND showed preliminary effectiveness on all primary outcome measures. Current directions to improve STAND are described.

4.
Fac Rev ; 12: 8, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37077452

RESUMEN

Social anxiety disorder (SAD) is characterized by persistent anxiety or avoidance of social situations because of a fear of negative evaluation. Cognitive behavioral therapy (CBT) (typically with an exposure component) is a first-line treatment for social anxiety, but there remains room for improvement with regard to treatment efficacy. Therefore, the field continues to better understand the mechanisms underlying SAD and its common and complex comorbidities in order to develop targeted interventions to improve symptom outcomes. Additionally, efforts are under way to improve the efficacy and accessibility of CBT. This review outlines major advances in understanding and treating SAD in adults over the past roughly 3 years (2019 to early May 2022). Themes are identified and discussed, as are recommendations for future research.

5.
Cogn Behav Ther ; 52(2): 146-162, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36409226

RESUMEN

This study explored relationships among perceived interpersonal competence and demographic and work history variables in a randomized control trial for social anxiety disorder (SAD) that compared work-related group cognitive behavioral therapy plus vocational services (WCBT+VSAU) to vocational services only (VSAU-alone). Intervention effects of perceived interpersonal competence on treatment outcomes over 12 weeks were also examined. Data from 250 job seekers with SAD (59.2% Female; 40.8% Black/African American; 82.4% Non-Hispanic/non-Latino/a) were analyzed. We predicted negative relationships between perceived interpersonal competence and symptoms/impairment and that individuals with lower perceived interpersonal competence would benefit more quickly in WCBT+VSAU relative to VSAU-alone. Results indicated that perceived interpersonal competence did not vary by gender, race, ethnicity, homeless status, or employment history. There were no intervention effects of perceived interpersonal competence regarding social anxiety or overall functional impairment, but results supported negative relationships between perceived interpersonal competence and lower social anxiety and overall functional impairment in both conditions. Separately, perceived interpersonal competence moderated effects in the depression model such that there were faster declines in depression at lower perceived interpersonal competence levels in WCBT+VSAU, but not in VSAU-alone. Results indicate the value of attending to perceived interpersonal competence in interventions, which may result in mood benefits.


Asunto(s)
Empleo , Fobia Social , Humanos , Femenino , Masculino , Fobia Social/terapia , Afecto , Resultado del Tratamiento , Ansiedad/terapia , Ansiedad/psicología
6.
Psychol Trauma ; 14(6): 1040-1046, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31714101

RESUMEN

OBJECTIVE: Social capital, or the resources that an individual can draw on through his or her social networks and the value ascribed to these resources by the individual, has been hypothesized to be an important factor in the development of mental health problems following a natural disaster. Nevertheless, little research has been conducted in this area. The present study aimed to evaluate the potential buffering effect of the 2 types of social capital-bonding and bridging social capital-on the association between severity of trauma exposure and posttraumatic stress disorder (PTSD) symptoms in a large sample of earthquake survivors in Iran. METHOD: Participants were 600 adults who survived the Azarbaijan earthquake in Iran. Participants were selected using a multistage sampling method. PTSD symptoms were reported in 37% of the participants, 95% CI [34%, 41%]. RESULTS: Consistent with prior research, significant differences were found between areas that were highly affected and areas that were less affected by the disaster. Although both bonding and bridging social capitals were negatively related to PTSD symptoms, this buffering effect against PTSD symptoms was about 2 times as large for bridging capital than for bonding social capital. CONCLUSION: While bridging and bonding social capital are both significant protective factors for mental health outcomes following natural disasters, bridging social capital may be more important. Future directions for this area of research are discussed, as are policy implications for disaster preparedness and postdisaster interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Asunto(s)
Terremotos , Capital Social , Trastornos por Estrés Postraumático , Adulto , Femenino , Humanos , Irán , Masculino , Factores de Riesgo , Apoyo Social , Trastornos por Estrés Postraumático/psicología , Sobrevivientes/psicología
7.
Health (London) ; 26(6): 702-719, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-33287564

RESUMEN

As the world struggles to cope with the COVID-19 pandemic, it is critical that the psychosocial aspects related to health are attended to in addition to biological aspects. To this end, the present study aimed to explore the challenges and concerns facing people affected by COVID-19. This qualitative study was conducted using the content analysis method. A total of 25 people affected by COVID-19 were selected purposefully and administered semi-structured interviews. The sampling continued until data saturation. Coding and analysis of data were performed simultaneously using the Granheim method. After reviewing codes, checking the consistency and comparing categories, 5 categories, and 15 subcategories were explored. The most important psychosocial challenges of COVID-19 included the lack of accurate and timely dissemination of information, the intensification of economic problems, psychological instability, weakness in social prevention, and the suspension of social rituals. Identifying the psychosocial challenges and problems of people who faced by pandemic diseases such as COVID-19, and developing appropriate and timely planning for managing them can lead to designing effective strategies for prevention, treatment, and recovery of affected communities.


Asunto(s)
COVID-19 , Adaptación Psicológica , Humanos , Irán , Pandemias , Investigación Cualitativa
8.
Personal Ment Health ; 15(2): 147-156, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33393216

RESUMEN

To evaluate the usefulness of the DSM-5 maladaptive personality domains in explaining the similarities and differences among four disorders included in the obsessive-compulsive spectrum, 428 Italian community-dwelling women (mean age = 31.96 years, SD = 12.30 years) were administered the Obsessive-Compulsive Spectrum Disorder Scales and the Personality Inventory for DSM-5-Short Form as part of an ongoing online survey on women's health. Multiple Indicators Multiple Causes (MIMIC) confirmatory bifactor analysis results showed that the OCSD general factor (i.e., obsessive-compulsive spectrum factor) was positively associated with Negative Affectivity, whereas Body Dysmorphic Disorder (BDD), Hoarding Disorder (HD), and Skin-Picking Disorder (SPD) specific factors showed significant and substantial differential relationships with dysfunctional personality domains. Specifically, BDD was positively associated with Negative Affectivity, Detachment and Psychoticism domains; HD was associated with high Negative Affectivity and Psychoticism; and SPD was associated with Detachment. © 2020 John Wiley & Sons, Ltd.


Asunto(s)
Trastorno Obsesivo Compulsivo , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Italia , Trastorno Obsesivo Compulsivo/diagnóstico , Trastorno Obsesivo Compulsivo/epidemiología , Personalidad , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/epidemiología
9.
Behav Res Ther ; 124: 103499, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31751896

RESUMEN

Addressing the 'replication crisis' and questionable research practices are at the forefront of international research agendas in clinical psychological science. The aim of this paper is to consider how the quality of research practices can be improved by a specific focus on publication practices. Currently, the responsibility for documenting quality research practices is primarily placed on authors. However, barriers to improved quality publication practices cut across all levels of the research community and require a broader approach that shares the burden for ensuring the production of high quality publications. We describe a framework that is intended to be ambitious and aspirational and encourage discussion and adoption of strategies to improve quality publication practices (QPPs). The framework cuts across multiple stakeholders and is designed to enhance (a) the quality of reporting; (b) adherence to protocols and guidelines; (c) timely accessibility of study materials and data. We discuss how QPPs might be improved by (a) funding bodies considering formally supporting QPPs; (b) research institutions encouraging a research culture that espouses quality research practices, and internally supporting QPP review processes and professional development in QPPs; (c) journals expanding editorial teams to include reviewers with design and statistical expertise, considering strategies to enhance QPP adherence during the peer review process, and committing to ongoing assessment and development of QPP training for peer reviewers; and (d) authors and peer reviewers integrating QPPs during the manuscript preparation/peer review process, engaging in ongoing QPP training, and committing to openness and transparency initiatives. We discuss the current state and potential next steps within each stage of the framework and provide information and resources to enhance QPPs. We hope that the suggestions offered here inspire research institutions, leaders and faculty to discuss, reflect on, and take action towards, integrating these, or other, QPPs into their research practice and workplace.


Asunto(s)
Difusión de la Información , Publicaciones Periódicas como Asunto , Psicología , Investigación , Humanos , Reproducibilidad de los Resultados
11.
Psychol Serv ; 17(2): 227-232, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-30265070

RESUMEN

Tinnitus, or the perception of sound in the absence of an acoustic stimulus, is a highly prevalent and distressing symptom that currently lacks an effective medical treatment. Tinnitus is highly comorbid with insomnia, depression, and anxiety and is the most common service-connected disability among veterans of the U.S. military. This article evaluates Integrative Tinnitus Management (ITM), a multidisciplinary 9-week education and skills-based program aimed at reducing distress related to tinnitus. Thirty U.S. veterans completed a course of ITM at a large, urban Veteran's Administration (VA) hospital and provided pre- and posttreatment data. Veterans completed self-report measures related to tinnitus symptoms, depression symptoms, and mindfulness at pre- and posttreatment. Results demonstrated that veterans who completed the program experienced significant decreases in self-reported distress related to tinnitus symptoms, impairment because of tinnitus symptoms, and depression symptoms. Overall, this preliminary evaluation of ITM suggests it may be an efficacious treatment for tinnitus-related distress and warrants advancement to a randomized control trial (RCT). (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Depresión/rehabilitación , Distrés Psicológico , Psicoterapia , Acúfeno/rehabilitación , Veteranos , Adulto , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Plena , Evaluación de Resultado en la Atención de Salud , Educación del Paciente como Asunto , Proyectos Piloto , Acúfeno/psicología , Estados Unidos , United States Department of Veterans Affairs , Veteranos/psicología
12.
J Am Coll Health ; 68(4): 419-429, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30908123

RESUMEN

Objective: To examine the effects of universal and targeted suicide prevention programs on relevant outcomes in college campuses. Methods: College suicide prevention programs published from 2009 to 2018 were assessed on outcomes including knowledge, skills, self-efficacy, suicidal ideation, and suicidal behaviors. Effects of the interventions on outcome variables with sufficient studies to warrant meta-analysis (ie, knowledge, skills, and self-efficacy) were meta-analyzed. Studies reporting on the remaining outcomes (ie, suicidal ideation and behaviors) were systematically reviewed. Results: Significant increases in suicide prevention knowledge, skills, and self-efficacy were observed in universal prevention interventions that typically employed gatekeeper prevention strategies. Evidence of reductions in suicidal ideation and behaviors was observed across targeted suicide prevention programs for at-risk students. Conclusion: Prevention programs are beneficial for training those likely to come in contact with people endorsing suicidality, but further research is needed to show that suicide interventions can consistently have significant effects on suicidal students as well.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/estadística & datos numéricos , Servicios de Salud para Estudiantes/estadística & datos numéricos , Prevención del Suicidio , Humanos , Autoeficacia , Estudiantes , Ideación Suicida , Universidades
13.
J Rural Health ; 36(3): 371-380, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31508861

RESUMEN

PURPOSE: To explore the feasibility and utility of using a workshop, and supervision-consultation plus external facilitation to disseminate and implement cognitive-behavioral therapy in Veterans Affairs (VA) community-based outpatient clinics (CBOCs). METHODS: This study occurred in the context of a randomized controlled trial aimed at comparing 2 methods for implementing Coordinated Anxiety Learning Management (CALM) in VA CBOCs. A 3-phase (workshop, supervision-consultation, external facilitation) model was used to support 32 VA CBOC mental health providers in learning and adopting CALM in their clinical practice. Qualitative data describe training activities and the feasibility and utility of each training phase in addressing challenges to adopting CALM. FINDINGS: All 3 phases of the model were feasible to use with our sample of CBOC mental health providers. Providers reported challenges learning CALM during the workshop and concerns about not having enough training post-workshop to use CALM in practice. Providers primarily utilized supervision-consultation to tailor CALM to their practice, including learning how to prioritize a target disorder, "switch" the focus of treatment to a different disorder when comorbidities were present, and modify CALM sessions to fit shorter treatment visits. Providers primarily utilized external facilitation to further tailor CALM to their practice through implementation (eg, concrete help) and support-oriented help. Key lessons for implementing CALM in CBOCs are presented and discussed. CONCLUSIONS: Findings provide initial evidence for the feasibility and utility of using each component of a facilitation-enhanced training model to promote CBOC VA providers' implementation of a computer and manual version of CALM in their practice.


Asunto(s)
Ansiedad , Servicios Comunitarios de Salud Mental , Veteranos , Instituciones de Atención Ambulatoria , Ansiedad/diagnóstico , Ansiedad/terapia , Humanos , Estados Unidos , United States Department of Veterans Affairs
14.
Contemp Clin Trials Commun ; 16: 100464, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31701038

RESUMEN

This paper provides a methodological description of a multi-site, randomized controlled trial (RCT) of a cognitive-behavioral intervention for enhancing employment success among unemployed persons whose employment efforts have been undermined by social anxiety disorder (SAD). SAD is a common and impairing condition, with negative impacts on occupational functioning. In response to these documented employment-related impairments, in a previous project, we produced and tested an eight-session work-related group cognitive-behavioral therapy provided alongside vocational services as usual (WCBT + VSAU). WCBT is delivered by vocational service professionals and is designed in a context and style that overcomes accessibility and stigma-related obstacles with special focus on employment-related targets. Our previous project found that WCBT + VSAU significantly improved social anxiety, depression, and a range of employment-related outcomes compared to a control group of socially anxious job-seekers who received vocational services as usual without WCBT (VSAU-alone). Participants in this study were all homeless, primarily African American job-seekers with high levels of psychiatric comorbidity and limited education and employment histories. The present, two-region study addresses whether WCBT + VSAU enhances job placement, job retention and mental health outcomes in a larger sample assessed over an extended follow-up period. In addition, this trial evaluates whether the effects of WCBT + VSAU generalize to a new population of urban-based, racially diverse job-seekers with vocational and educational histories that differ from our original sample. This study also investigates the system-effects of WCBT + VSAU in a new site that will be informative for broad implementation of WCBT + VSAU. Finally, this project involves a refined, technology-assisted form of WCBT + VSAU designed to be delivered more easily by vocational services professionals.

15.
R Soc Open Sci ; 6(8): 181555, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31598218

RESUMEN

Pets have numerous, effective methods to communicate with their human hosts. Perhaps most conspicuous of these are distress vocalizations: in cats, the 'miaow' and in dogs, the 'whine' or 'whimper'. We compared a sample of young adults who owned cats and or dogs ('pet-owners' n = 264) and who did not (n = 297) on their ratings of the valence of animal distress vocalizations, taken from a standardized database of sounds. We also examined these participants' self-reported symptoms of anxiety and depression, and their scores on a measure of interpersonal relationship functioning. Pet-owners rated the animal distress vocalizations as sadder than adults who did not own a pet. Cat-owners specifically gave the most negative ratings of cat miaows compared with other participants, but were no different in their ratings of other sounds. Dog sounds were rated more negatively overall, in fact as negatively as human baby cries. Pet-owning adults (cat only, dog only, both) were not significantly different from adults with no pets on symptoms of depression, anxiety or on self-reported interpersonal relationship functioning. We suggest that pet ownership is associated with greater sensitivity to negative emotion in cat and dog distress vocalizations.

16.
Community Ment Health J ; 55(3): 542-547, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30796682

RESUMEN

Post-Traumatic Stress Disorder (PTSD) is one of the most debilitating and costly mental health problems that can develop following exposure to natural disasters. Nevertheless, much remains unknown about how to best address PTSD and other mental health needs in disaster-stricken areas, particularly in rural and under-resourced areas. The present study is a population-based cross-sectional study conducted in rural areas that were affected by a destructive earthquake in Iran. The aim of the research is to explore the prevalence and determinants of PTSD among survivors 3 years after the earthquake. A multi-stage cluster random sampling technique was used to obtain a sample of 600 respondents between the ages of 18- and 87-years-old in affected areas. In the present sample, 224 individuals (37.3%) reported some PTSD symptoms. Factors associated with an increased likelihood of developing PTSD included being in a severely-stricken (as opposed to moderately-stricken) village and being female. However, there were no significant associations between PTSD and age groups, marital status, profession, and educational status. These results underscore the need for improved psychosocial interventions following disasters.


Asunto(s)
Terremotos , Apoyo Social , Trastornos por Estrés Postraumático/epidemiología , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Vigilancia de la Población/métodos , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Trastornos por Estrés Postraumático/psicología , Sobrevivientes/estadística & datos numéricos , Adulto Joven
17.
J Affect Disord ; 242: 105-110, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30173058

RESUMEN

BACKGROUND: Although psychological treatments for social anxiety disorder (SAD) can be highly effective, many individuals do not respond to treatment. Identifying factors associated with improved outcomes can facilitate individualized treatment choices. We investigated whether patterns of neural connectivity predicted treatment responses and whether treatment type, cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT), moderated this effect. METHODS: Participants with SAD (n = 34) underwent fMRI prior to treatment and completed implicit and explicit emotion regulation tasks. Neural connectivity measures were estimates of amygdala-prefrontal cortex connectivity. Treatment responder status was defined using the 'clinically significant change index' (Loerinc et al., 2015). RESULTS: Right amygdala-right ventrolateral prefrontal cortex connectivity during implicit emotion regulation was a significant predictor of treatment response (OR = 9.01, 95% CI = 1.77, 46.0, p = .008). Stronger inverse connectivity was associated with greater likelihood of treatment response. There were no significant neural moderators of treatment response to CBT versus ACT. LIMITATIONS: The primary limitation of this work was the small sample size which restricted the power to detect significant moderation effects, and results should be interpreted as preliminary. CONCLUSIONS: Amygdala-vlPFC connectivity during affect labeling predicted treatment responder status following CBT or ACT for social anxiety disorder. This suggests that the functioning of neural circuitry supporting emotion regulation capacities may be a 'gateway' to receiving benefit from psychological treatments. Future work should aim to replicate this effect in a larger sample and consider methods for enhancing functional connectivity within this circuitry as a potential treatment adjunct.


Asunto(s)
Amígdala del Cerebelo/fisiopatología , Terapia Cognitivo-Conductual , Vías Nerviosas/fisiopatología , Fobia Social/terapia , Corteza Prefrontal/fisiopatología , Adulto , Amígdala del Cerebelo/diagnóstico por imagen , Emociones/fisiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Fobia Social/fisiopatología , Corteza Prefrontal/diagnóstico por imagen , Adulto Joven
18.
Neurosci Biobehav Rev ; 88: 117-140, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29550209

RESUMEN

Anxiety disorders are the most common mental disorders and are often chronic and disabling. Although exposure-based treatments are effective, a substantial number of individuals fail to fully remit or experience a return of symptoms after treatment. Understanding the critical processes underlying the development and treatment of anxiety disorders will help identify individuals at risk and optimize treatments. Aversive associative learning offers explanatory pathways through which fear and anxiety emerge, spread, persist, and resurge. This narrative review examines the advances made in our understanding of associative fear and avoidance learning in anxiety disorders. Overall, the extant literature supports a key role of aversive associative learning in the development and treatment of anxiety disorders. However, research targeting specific mechanisms such as extinction generalization and avoidance, the fragility of extinction, and moderating influences of individual differences pertinent to anxiety disorders (e.g., age, sex, depression) is needed. We discuss the need for more ecological valid and complex paradigms to model ambiguity and conflict as well as for clinical translation studies to optimize treatment.


Asunto(s)
Trastornos de Ansiedad/psicología , Reacción de Prevención/fisiología , Extinción Psicológica/fisiología , Miedo/psicología , Trastornos de Ansiedad/terapia , Condicionamiento Clásico/fisiología , Humanos , Investigación
19.
Cogn Emot ; 31(4): 687-698, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-26998883

RESUMEN

Violation of unconditioned stimulus (US) expectancy during extinction training may enhance associative learning and result in improved long-term extinction retention compared to within-session habituation. This experiment examines variation in US expectancy (i.e., expectancy violation) as a predictor of long-term extinction retention. It also examines within-session habituation of fear-potentiated startle (electromyography, EMG) and fear of conditioned stimuli (CS) throughout extinction training as predictors of extinction retention. Participants (n = 63) underwent fear conditioning, extinction and retention and provided continuous ratings of US expectancy and EMG, as well as CS fear ratings before and after each phase. Variation in US expectancy throughout extinction and habituation of EMG and fear was entered into a regression as predictors of retention and reinstatement of levels of expectancy and fear. Greater variation in US expectancy throughout extinction training was significantly predictive of enhanced extinction performance measured at retention test, although not after reinstatement test. Slope of EMG and CS fear during extinction did not predict retention of extinction. Within-session habituation of EMG and self-reported fear is not sufficient for long-term retention of extinction learning, and models emphasizing expectation violation may result in enhanced outcomes.


Asunto(s)
Aprendizaje por Asociación , Extinción Psicológica , Miedo , Habituación Psicofisiológica , Condicionamiento Clásico , Femenino , Humanos , Masculino , Reflejo de Sobresalto , Incertidumbre , Adulto Joven
20.
Psychol Assess ; 29(8): 967-977, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27656902

RESUMEN

Emotional expressions are an essential element of human interactions. Recent work has increasingly recognized that emotional vocalizations can color and shape interactions between individuals. Here we present data on the psychometric properties of a recently developed database of authentic nonlinguistic emotional vocalizations from human adults and infants (the Oxford Vocal 'OxVoc' Sounds Database; Parsons, Young, Craske, Stein, & Kringelbach, 2014). In a large sample (n = 562), we demonstrate that adults can reliably categorize these sounds (as 'positive,' 'negative,' or 'sounds with no emotion'), and rate valence in these sounds consistently over time. In an extended sample (n = 945, including the initial n = 562), we also investigated a number of individual difference factors in relation to valence ratings of these vocalizations. Results demonstrated small but significant effects of (a) symptoms of depression and anxiety with more negative ratings of adult neutral vocalizations (R2 = .011 and R2 = .008, respectively) and (b) gender differences in perceived valence such that female listeners rated adult neutral vocalizations more positively and infant cry vocalizations more negatively than male listeners (R2 = .021, R2 = .010, respectively). Of note, we did not find evidence of negativity bias among other affective vocalizations or gender differences in perceived valence of adult laughter, adult cries, infant laughter, or infant neutral vocalizations. Together, these findings largely converge with factors previously shown to impact processing of emotional facial expressions, suggesting a modality-independent impact of depression, anxiety, and listener gender, particularly among vocalizations with more ambiguous valence. (PsycINFO Database Record


Asunto(s)
Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Bases de Datos como Asunto , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Emociones , Relaciones Interpersonales , Caracteres Sexuales , Percepción del Habla , Calidad de la Voz , Adolescente , Femenino , Humanos , Individualidad , Lactante , Masculino , Encuestas y Cuestionarios , Adulto Joven
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