Self-report questionnaires, behavioral assessment tasks, and an implicit behavior measure: do they predict social anxiety in everyday life?

Social anxiety is commonly assessed with self-report measures. This study aimed to investigate whether maximum anxiety levels during in vivo and virtual reality behavioral assessment tasks (BATs), and implicit approach-avoidance tendencies during the approach-avoidance task (AAT) explain more variation as predictors of daily social anxiety than self-report measures. A total of 62 university students (Mage = 20.79; SD = 4.91) with high levels of social anxiety completed self-report measures on fear of negative evaluation (FNE-B) as well as fear and avoidance in social situations (Liebowitz social anxiety scale-self report), in vivo and virtual reality BATs, and the AAT (independent variables) in the laboratory. On seven consecutive days, social anxiety, experiential avoidance, and negative social events (dependent variables) were assessed. The results revealed that fear of negative evaluation predicted everyday social anxiety and experiential avoidance. Fear and avoidance in social situations only predicted experiential avoidance. Neither implicit approach-avoidance tendencies during the AAT nor maximum anxiety levels during the in vivo and virtual reality BATs predicted any outcome variable. Our results support the use of self-report questionnaires in the assessment of social anxiety

Effectiveness of different modalities of psychotherapeutic treatment for patients with cluster C personality disorders: results of a large prospective multicentre study.

Abstract BACKGROUND: No previous studies have compared the effectiveness of different modalities of psychotherapeutic treatment, as defined by different settings and durations, for patients with cluster C personality disorders. The aim of this multicentre study wa

Virtual Reflexes

Virtual Reality is used successfully to treat people for regular phobias. A new challenge is to develop Virtual Reality Exposure Training for social skills. Virtual actors in such systems have to show appropriate social behavior including emotions, gaze, and keeping distance. The behavior must be realistic and real-time. Current approaches consist of four steps: 1) trainee social signal detection, 2) cognitive-affective interpretation, 3) determination of the appropriate bodily responses, and 4) actuation. The "cognitive" detour of such approaches does not match the directness of human bodily reflexes and causes unrealistic responses and delay. Instead, we propose virtual reflexes as concurrent sensory-motor processes to control virtual actors. Here we present a virtual reflexes architecture, explain how emotion and cognitive modulation are embedded, detail its workings, and give an example description of an aggression training application

Irrational Beliefs in Employees with an Adjustment, a Depressive, or an Anxiety Disorder: a Prospective Cohort Study

It remains unclear if patients with different types of common mental disorders, such as adjustment, anxiety and depressive disorders, have the same irrational ideas. The aim of this prospective cohort study (n = 190) is to investigate differences in level and type of irrational beliefs among these groups and to examine whether a change in irrational beliefs is related to symptom recovery. Irrational beliefs (IBI) and symptoms were measured at four points in time: at baseline, after 3, 6 and 12 months. Results showed that diagnostic groups differed in their level of irrational beliefs and this effect remained over time. Highest levels of irrationality were observed in the double diagnosis group, followed by the anxiety disorder group and the depression group. Participants with adjustment disorders showed the lowest levels of irrationality, comparable to a community sample. We did not find differences in the type of irrational beliefs between diagnostic groups. The level of irrationality declined over time for all diagnostic groups. No differences in decrease were observed between diagnostic groups. The magnitude and direction of change in irrational beliefs were related to the magnitude of recovery of depressive, anxiety and stress symptoms over time. These results support the application of general cognitive interventions, especially for patients with a depressive or an anxiety disorder

Absence of evidence or evidence of absence: Reflecting on therapeutic implementations of attentional bias modification

Attentional bias modification (ABM) represents one of a number of cognitive bias modification techniques which are beginning to show promise as therapeutic interventions for emotional pathology. Numerous studies with both clinical and non-clinical populations have now demonstrated that ABM can reduce emotional vulnerability. However, some recent studies have failed to achieve change in either selective attention or emotional vulnerability using ABM methodologies, including a recent randomised controlled trial by Carlbring et al. Some have sought to represent such absence of evidence as a sound basis not to further pursue ABM as an online intervention. While these findings obviously raise questions about the specific conditions under which ABM procedures will produce therapeutic benefits, we suggest that the failure of some studies to modify selective attention does not challenge the theoretical and empirical basis of ABM. The present paper seeks to put these ABM failure s in perspective within the broader context of attentional bias modification research. In doing so it is apparent that the current findings and future prospects of ABM are in fact very promising, suggesting that more research in this area is warranted, not less

Evidenzbasierte Psychotherapie der Panikstörung mit und ohne Agoraphobie : ein Überblick zur S1-Leitlinie der Deutschen Gesellschaft für Psychologie

Alpers GW, Gerlach AL, Heinrichs N. Evidence-based psychotherapy of panic disorder with or without agoraphobia. Psychotherapeut. 2011;56(6):535-548.From the evidence reported in the recent guidelines [Heinrichs et al. (2009) Evidenzbasierte Leitlinie zur Psychotherapie der Panikstorung mit und ohne Agoraphobie. Hogrefe, Gottingen] the following conclusions can be drawn with respect to the treatment of panic disorder with or without agoraphobia, as well as for agoraphobia without panic disorder: Every psychotherapy should be preceded by suitable diagnostics and a case formulation. The effectiveness of every psychotherapy should be evaluated with well established measures. For the treatment of panic disorder without agoraphobia, cognitive behavioral treatment (CBT) and applied relaxation have been shown to be effective (evidence grade 1). For panic disorder with agoraphobia, CBT, combination treatment (CBT plus medication), as well as panic-focused psychodynamic psychotherapy in the outpatient setting have shown short-term effectiveness (evidence grade 1). Longer lasting effects have been documented for CBT (evidence grade 1). For agoraphobia without panic disorder, CBT with a focus on situational exposure can be recommended (evidence grade 1)

Initiating antiretrovirals during tuberculosis treatment: a drug safety review

Introduction: Integrating HIV and tuberculosis (TB) treatment can reduce mortality substantially. Practical barriers to treatment integration still exist and include safety concerns related to concomitant drug use because of drug interactions and additive toxicities. Altered therapeutic concentrations may influence the chances of treatment success or toxicity. Areas covered: The available data on drug-drug interactions between the rifamycin class of anti-mycobacterials and the non-nucleoside reverse transcriptase inhibitor and the protease inhibitor classes of antiretrovirals are discussed with recommendations for integrated use. Additive drug toxicities, the impact of immune reconstitution inflammatory syndrome (IRIS) and the latest data on survival benefits of integrating treatment are elucidated. Expert opinion: Deferring treatment of HIV to avoid drug interactions with TB treatment or the occurrence of IRIS is not necessary. In the integrated management of TB-HIV co-infection, rational drug combinations aimed at reducing toxicities while effecting TB cure and suppressing HIV viral load are possible