Keep calm and carry on:The relations between narrative coherence, trauma, social support, psychological well-being, and cortisol responses

In order to explain trauma resilience, previous research has been investigating possible risk and protective factors, both on an individual and a contextual level. In this experimental study, we examined narrative coherence and social support in relation to trauma resilience. Participants were asked to write about a turning point memory, after which they did the Maastricht Acute Stress Test, our lab analog of a traumatic event. Following, half of the participants received social support, whereas the other half did not. Afterwards, all participants wrote a narrative on the traumatic event. Moment-to-moment fluctuations in psychological and physiological well-being throughout the experiment were investigated with state anxiety questionnaires and cortisol measures. Results showed that narratives of traumatic experiences were less coherent than narratives of turning point memories. However, contrary to our predictions, coherence, and, in particular, thematic coherence, related positively to anxiety levels. Possibly, particular types of thematic coherence are a non-adaptive form of coping, which reflect unfinished attempts at meaning-making and are more similar to continuous rumination than to arriving at a resolution. Furthermore, coherence at baseline could not buffer against the impact of trauma on anxiety levels in this study. Contrary to our hypotheses, social support did not have the intended beneficial effects on coherence, neither on well-being. Multiple explanations as to why our support manipulation remained ineffective are suggested. Remarkably, lower cortisol levels at baseline and after writing about the turning point memory predicted higher coherence in the trauma narratives. This may suggest that the ability to remain calm in difficult situations does relate to the ability to cope adaptively with future difficult experiences. Clinical and social implications of the present findings are discussed, and future research recommendations on the relations between narrative coherence, social support, and trauma resilience are addressed

Ruining the surprise:The effect of safety information on return of fear

Background and objectives: In psychoeducation before exposure treatment patients are sometimes provided with information about the (low) probability that the feared outcome would occur. Since it has been proposed in the literature that this might have adverse effects, the current study investigated the effect of providing participants with this type of safety information on return of fear. Method: In an ABA-renewal paradigm, participants in the experimental group were instructed between acquisition and extinction that the probability of US-occurrence would be extremely small in the remainder of the experiment. Participants in the control group did not receive this information. Results: Less return of fear in US-expectancy ratings was observed in participants who received the safety information. Limitations: We failed to find successful acquisition in the skin-conductance data, which prevented us from interpreting the results of this outcome measure. Conclusions: These results suggest that providing safety information is not deleterious for the effects of exposure and can even be beneficial for its effects. However, further clinical research is needed

Virtually Unexpected:No Role for Expectancy Violation in Virtual Reality Exposure for Public Speaking Anxiety

In the current study, we examined the role of expectancy violation and retrospective reasoning about the absence of feared outcomes in virtual reality exposure therapy (VRET). Participants fearful of public speaking were asked to give speeches in virtual reality. We asked each participant individually to report their expectancies about feared outcomes in public speaking situations and which of these could be tested in VRET. Each of the expectancies was categorized as being related to: (1) participants' own reactions, (2) (overt) reactions of the audience, or (3) (covert) negative evaluation. We examined whether the proportion of testable expectancies could predict treatment outcome and which type of expectancies were evaluated as being more testable in VRET. Additionally, we experimentally manipulated retrospective reasoning about whether or not expectancies related to the overt reactions of the audience could be violated by providing verbal information after VRET about whether or not the virtual audience was interactive. A reduction in public speaking anxiety was observed from pre- to post-VRET. Treatment effects were, however, not predicted by the individually reported proportions of testable expectancies. Participants evaluated expectancies about their own reactions as being more testable in VRET compared to expectancies about reactions of the audience or about being negatively evaluated. In addition, we did not find evidence that the experimental manipulation regarding whether or not the audience was interactive influenced treatment effects. In conclusion, the results of the current study suggest that the effects of VRET are not univocally explained by the mechanism of expectancy violation

Effect of Pycnogenol® on attention-deficit hyperactivity disorder (ADHD) : study protocol for a randomised controlled trial

Background: Methylphenidate (MPH), the first choice medication for attention-deficit hyperactivity disorder (ADHD), is associated with serious adverse effects like arrhythmia. Evidence on the association of ADHD with immune and oxidant-antioxidant imbalances offers potential for antioxidant and/or immunomodulatory nutritional supplements as ADHD therapy. One small randomised trial in ADHD suggests, despite various limitations, therapeutic benefit from Pycnogenol (R), a herbal, polyphenol-rich extract. Methods: This phase III trial is a 10-week, randomised, double-blind, placebo and active treatment controlled multicentre trial with three parallel treatment arms to compare the effect of Pycnogenol r to MPH and placebo on the behaviour of 144 paediatric ADHD and attention-deficit disorder (ADD) patients. Evaluations of behaviour (measured by the ADHDRating Scale (primary endpoint) and the Social-emotional Questionnaire (SEQ)), immunity (plasma cytokine and antibody levels, white blood cell counts and faecal microbial composition), oxidative stress (erythrocyte glutathione, plasma lipid-soluble vitamins and malondialdehyde and urinary 8-OHdG levels, as well as antioxidant enzyme activity and gene expression), serum zinc and neuropeptide Y level, urinary catecholamines and physical complaints (Physical Complaints Questionnaire) will be performed in week 10 and compared to baseline. Acceptability evaluations will be based on adherence, dropouts and reports of adverse events. Dietary habits will be taken into account. Discussion: This trial takes into account comorbid behavioural and physical symptoms, as well as a broad range of innovative immune and oxidative biomarkers, expected to provide fundamental knowledge on ADHD aetiology and therapy. Research on microbiota in ADHD is novel. Moreover, the active control arm is rather unseen in research on nutritional supplements, but of great importance, as patients and parents are often concerned with the side effects of MPH

Narrative Coherence and Identity: Associations With Psychological Well-Being and Internalizing Symptoms

There are considerable differences in the ways in which individuals remember and try to make meaning out of past personal experiences. One autobiographical memory characteristic that has been receiving growing attention is narrative coherence, or the extent to which an individual is able to construct coherent accounts of their autobiographical memories. Previously, differences in narrative coherence have been found to be related to well-being, with more coherent individuals displaying higher levels of well-being. This study aimed to extend previous findings by examining the associations between narrative coherence, identity functioning, psychological well-being, and internalizing symptoms in a sample of 395 American young adults (ages 18–30). We examined whether these associations differed within individuals as a function of the identity-relevance of the memory. In line with our prediction, narrative coherence was positively related to healthy identity functioning. However, the hypothesis that narrative coherence would be positively related to psychological well-being and negatively related to internalizing symptoms was only partially confirmed (i.e. only for personal growth and anxiety symptoms). These findings indicate that the relation between coherence and well-being might be more complex than originally assumed. Contrary to our predictions, it was not significantly more beneficial for an individual to narrate about a memory with high identity-relevance compared to a memory with low identity-relevance. Thus, it might be the individual’s general ability to include identity content within their narratives of personal experiences that moderates the association between coherence and well-being, rather than the identity-relevance of the specific memory. In the current study, we also found a significant gender effect, with women being more coherent than men. Furthermore, exploratory analyses indicated that being more coherence was associated with fewer internalizing symptoms and fewer identity-related struggles in men, but not in women. Possible explanations for the observed gender differences are discussed. Future longitudinal and experimental studies are needed to further clarify the link between narrative coherence, identity, and well-being

Transitions from avoidance: Reinforcing competing behaviours reduces generalised avoidance in new contexts.

Generalised avoidance behaviours are a common diagnostic feature of anxiety-related disorders and a barrier to affecting changes in anxiety during therapy. However, strategies to mitigate generalised avoidance are under-investigated. Even less attention is given to reducing the category-based generalisation of avoidance. We therefore investigated the potential of an operant-based approach. Specifically, it was examined whether reinforcing competing (non-avoidance) behaviours to threat-predictive cues would interfere with the expression of generalised avoidance. Using a matching-to-sample task, artificial stimulus categories were established using physically dissimilar nonsense shapes. A member of one category (conditioned stimulus; CS1) was then associated with an aversive outcome in an Acquisition context, unless an avoidance response was made. Next, competing behaviours were reinforced in response to the CS1 in new contexts. Finally, we tested for the generalisation of avoidance to another member of the stimulus category (generalisation stimulus; GS1) in both a Novel context and the Acquisition context. The selective generalisation of avoidance to GS1 was observed, but only in the Acquisition context. In the Novel context, the generalisation of avoidance to GSs was significantly reduced. A comparison group (Experiment 2), which did not learn any competing behaviours, avoided GS1 in both contexts. These findings suggest that reinforcing competing behavioural responses to threat-predictive cues can lead to reductions in generalised avoidance. This study is among the first study to demonstrate sustained reductions in generalised avoidance resulting from operant-based protocols, and the clinical and research implications are discussed

Annual Reports of the Board of Selectmen Treasurer, and Supervisor of Schools of the Town of Greene, for the Year Ending March 6, 1896

An in situ method for sealing an array of pre-filled micro-cavities, such as encountered in electrophoretic displays, is presented. The technique, which is based on photoembossing, forms a hermetic seal between the cover and the cavity walls. The seal locations are defined by ultraviolet exposure through a photolithographic mask, forming a latent image overlapping with the locations of the cavity walls. During a thermal development step, while the cover is mounted on top of the micro-cavities, the seal evolves and makes firm contact with the cavity walls. This technology is demonstrated to be insensitive to small deviations in cavity height, flatness of the cover and thin fluid films remaining between the cover and the top of the cavity walls. In the past, these aspects made it difficult to effectively seal large-area devices