Reduced specificity of autobiographical memory in Cluster C personality disorders and the role of depression, worry, and experiential avoidance.

The study objective was to investigate whether, compared with nonclinical controls, participants with an avoidant, dependent, or obsessive–compulsive Cluster C personality disorder (PD) manifested reduced levels of memory specificity and whether the association of Cluster C PDs with memory specificity is mediated by repetitive negative thoughts and experiential avoidance. The Autobiographical Memory Test (R. J. McNally, N. B. Lasko, M. L. Macklin, & R. K. Pitman, 1995) was administered along with self-report measures (translated into Dutch) for repetitive, uncontrollable, and negative thinking in the form of worry (Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990) and experiential avoidance (Acceptance and Action Questionnaire; S. C. Hayes et al., 2004) to 294 clinical participants diagnosed with Axis I disorders (assessed with the Structured Clinical Interview for DSM–IV Axis I Disorders [SCID-I]; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1994) and Axis II disorders (assessed with the SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1997)—202 with avoidant, 49 with dependent, and 120 with obsessive–compulsive PD—and to 108 matched nonclinical controls. Participants with a Cluster C PD showed lower levels of memory specificity than did nonclinical controls. Depression and worry mediated the effect of Cluster C PDs on memory specificity. Besides depression severity, repetitive, uncontrollable, and negative thinking may constitute a general mechanism mediating the association of various Axis I and II disorders with memory specificity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autobiographical memory in the euthymic phase of recurrent depression.

The authors investigated autobiographical memory specificity in subjects who formerly had depression. In 122 euthymic patients with at least two previous major depressive episodes, memory specificity was significantly impaired compared to matched control participants but not related to residual symptoms and illness characteristics, was not differentially affected by cognitive therapy, and was also not predictive of relapse/recurrence during the 2-year follow-up. However, memory specificity was associated with age, education, and immediate and delayed memory recall. The results suggest that memory specificity may reflect a global cognitive impairment that remains in patients who (formerly) had depression but does not constitute a trait marker for vulnerability for relapse/recurrence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of outcome and early vs. late improvement in OCD patients treated with cognitive behaviour therapy and pharmacotherapy

Several factors must be taken into account when deciding which specimen preparation technique(s) to use. These factors include the amount of material available, ease of preparing this material due to its properties and familiarity, location and size of the region of interest, amount of information sought, facilities accessible, and time available by the researcher to devote to the preparation of the specimen. The more popular specimen preparations for thin films, namely, electropolishing, cleaving, crushing, mechanical thinning followed by ion milling, and ultramicrotomy are discussed and the more unusual techniques such as extraction/replication, photochemical etching, lithography and reactive ion etching (RIE), chemically assisted ion beam etching (CAIBE), and precision polishing-based techniques are described. Their advantages and disadvantages in the context of the above factors are discussed. Suggestions for increasing one's success rate in preparing specimens are given. The role of transmission electron microscopy (TEM) analysis is considered since it rarely stands in isolation from other physical analytical techniques, nor is it often used as a quick diagnostic tool. Conservation of material by the minimization of the amount of material used (or destroyed) by TEM specimen preparation, and conservation of one's time by performing TEM analysis only on "worthy" samples should be given maximum consideration.     

Cognitive change through hypnosis: The interface between cognitive therapy and hypnotherapy.

Cognitive changes are characteristic for the hypnotic state. Two models of experimental hypnosis are discussed from the point of view of their cognitive aspects: E. R. Hilgard's (1977) neo-dissociation model and the cognitive-behavioral model. Some neuropsychological data are described which support the notion that high and low hypnotizable Ss differ in cognitive style. Three hypnotherapeutic strategies (symptom reduction, ego strengthening, and exploration) are discussed, and hypnosis is concluded to be a suitable method for achieving coping and integration in a step-by-step manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Degree of somatoform and psychological dissociation in dissociative disorder is correlated with reported trauma

In this study, the prevalence and severity of traumatic experiences as reported by patients with dissociative disorders and with other DSM-IV psychiatric diagnoses were compared. Furthermore, the predictive value of emotional, physical, and sexual trauma with respect to somatoform and psychological dissociation was analyzed. In contrast with comparison patients, dissociative disorder patients reported severe and multifaceted traumatization. Physical and sexual trauma predicted somatoform dissociation, sexual trauma predicted psychological dissociation as well. According to the memories of the dissociative disorder patients, this abuse occurred in an emotionally neglectful and abusive social context. Pathological dissociation was best predicted by early onset of reported intense, chronic and multiple traumatization. Methodological limitations restricting causal inferences between reported trauma and dissociation are discussed.     

Cognitive and behavioral therapies alone versus in combination with fluvoxamine in the treatment of obsessive compulsive disorder

The purpose of this treatment package design study was to investigate the differential efficacy of cognitive therapy or exposure in vivo with response prevention for obsessive compulsive disorder (OCD) versus the sequential combination with fluvoxamine. Patients with OCD (N = 117) were randomized to one of the following five conditions: a) cognitive therapy for weeks 1 to 16, b) exposure in vivo with response prevention for weeks 1 to 16, c) fluvoxamine for weeks 1 to 16 plus cognitive therapy in weeks 9 to 16, d) fluvoxamine for weeks 1 to 16 plus exposure in vivo with response prevention in weeks 9 to 16, or e) waiting list control condition for weeks 1 to 8 only. Assessments took place before treatment (pretest) and after 8 (midtest), and 16 weeks (posttest). In the first 8 weeks, six treatment sessions were delivered. During weeks 9 to 16, another 10 sessions were given. Thirty-one patients dropped out. Outcome was assessed by patient-, therapist- and assessor-ratings of the Anxiety Discomfort Scale, the Yale-Brown Obsessive Compulsive Scale, and the Padua Inventory-Revised. In contrast with the four treatments, after 8 weeks the waiting list control condition did not result in a significant decrease of symptoms. After 16 weeks of treatment, all four treatment packages were effective on these OCD ratings, but they did not differ among each other in effectiveness. In OCD, the sequential combination of fluvoxamine with cognitive therapy or exposure in vivo with response prevention is not superior to either cognitive therapy or exposure in vivo alone.     

Long-term outcomes of memory retrieval under stress.

Previous studies have found impairing effects of stress hormones on memory retrieval. So far, it is unknown whether these impairments are temporary, persistent throughout time, or whether the strength of the memory trace changes after retrieval because of the effects of stress hormones on memory processes during retrieval. In the present study, delayed cued recall (6 months after initial learning) was compared between male participants who had retrieved previously learned word pairs during stress or a control condition. Retrieval (with or without stress) had taken place either 1 day or 5 weeks after initial encoding. The group that had retrieved words under stress 5 weeks after encoding performed worse on long-term recall than the comparable control group. However, when words were retrieved under stress 1 day after encoding, no long-term effect was found, although performance at 6 months in relation to performance under stress was slightly increased compared to the control group. These results support previous findings in animals that stress may affect memory during reactivation. It further suggests that time intervals between encoding and reactivation may play an important role. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Somatoform dissociative symptoms as related to animal defensive reactions to predatory imminence and injury.

The authors hypothesized that there would be a similarity between animal defensive responses to variable predatory imminence and injury and certain somatoform dissociative symptoms of trauma-reporting patients who have dissociative disorder. As a first test of this hypothesis, 12 somatoform symptom clusters consisting of clinically observed somatoform dissociative phenomena were constructed. All clusters discriminated between patients with dissociative disorders (n?=?50) and patients with other psychiatric diagnoses (n?=?50). Those expressive of the hypothesized similarity—freezing, anesthesia-analgesia, and disturbed eating—belonged to the 5 most characteristic symptoms of dissociative disorder patients. Anesthesia-analgesia, urogenital pain, and freezing symptom clusters independently contributed to predicted presence of dissociative disorder. Using an independent sample, it appeared that anesthesia-analgesia best predicted presence of dissociative disorder after controlling for symptom severity. The results were largely consistent with the hypothesized similarity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Automatic Negative Evaluation of Suffocation Sensations in Individuals With Suffocation Fear.

The current study tested whether "suffocation sensations" (respiratory loads) are automatically evaluated in a negative way by people fearing these sensations. It was found that, after having been primed with a slight respiratory load, participants with high suffocation fear (n = 15) reacted more quickly to suffocation words and more slowly to positive words than participants with low suffocation fear (n = 21). However, the effect was present only in participants who had noticed the primes. The findings are relevant to the cognitive model of panic disorder because automatic negative appraisal of sensations may play a role in initiating a panic attack. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

BACKGROUND: Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence of depression in different patient groups has been questioned. METHODS: Psychometric properties of the HADS were assessed in six different groups of Dutch subjects (N = 6165): (1) a random sample of younger adults (age 18-65 years) (N = 199); (2) a random sample of elderly subjects of 57 to 65 years of age (N = 1901); (3) a random sample of elderly subjects of 66 years or older (N = 3293); (4) a sample of consecutive general practice patients (N = 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms (N = 169); and (6) a sample of consecutive psychiatric out-patients (N = 491). RESULTS: Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test-retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. CONCLUSIONS: The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a 'case-identifier' for psychiatric disorder or depression.