Tragedy of the commons
Media’s role in broadcasting acute stress following the Boston Marathon bombings
Alison Holman, Dana Rose Garfin & Roxane Cohen Silver
Proceedings of the National Academy of Sciences, 7 January 2014, Pages 93–98
Abstract:
We compared the impact of media vs. direct exposure on acute stress response to collective trauma. We conducted an Internet-based survey following the Boston Marathon bombings between April 29 and May 13, 2013, with representative samples of residents from Boston (n = 846), New York City (n = 941), and the remainder of the United States (n = 2,888). Acute stress symptom scores were comparable in Boston and New York [regression coefficient (b) = 0.43; SE = 1.42; 95% confidence interval (CI), −2.36, 3.23], but lower nationwide when compared with Boston (b = −2.21; SE = 1.07; 95% CI, −4.31, −0.12). Adjusting for prebombing mental health (collected prospectively), demographics, and prior collective stress exposure, six or more daily hours of bombing-related media exposure in the week after the bombings was associated with higher acute stress than direct exposure to the bombings (continuous acute stress symptom total: media exposure b = 15.61 vs. direct exposure b = 5.69). Controlling for prospectively collected prebombing television-watching habits did not change the findings. In adjusted models, direct exposure to the 9/11 terrorist attacks and the Sandy Hook School shootings were both significantly associated with bombing-related acute stress; Superstorm Sandy exposure wasn't. Prior exposure to similar and/or violent events may render some individuals vulnerable to the negative effects of collective traumas. Repeatedly engaging with trauma-related media content for several hours daily shortly after collective trauma may prolong acute stress experiences and promote substantial stress-related symptomatology. Mass media may become a conduit that spreads negative consequences of community trauma beyond directly affected communities.
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The Benefits of Retail Therapy: Making Purchase Decisions Reduces Residual Sadness
Scott Rick, Beatriz Pereira & Katherine Alicia Burson
Journal of Consumer Psychology, October 2013
Abstract:
People often shop when feeling sad, but whether and why shopping reduces residual (lingering) sadness remains an open question. Sadness is strongly associated with a sense that situational forces control the outcomes in one’s life, and thus we theorized that the choices inherent in shopping may restore personal control over one’s environment and reduce residual sadness. Three experiments provided support for our hypothesis. Making shopping choices helped to alleviate sadness whether they were hypothetical (Experiment 1) or real (Experiment 2). In addition, all experiments found support for the underlying mechanism of personal control restoration. Notably, the benefits of restored personal control over one’s environment do not generalize to anger (Experiments 2 and 3), because anger is associated with a sense that other people (rather than situational forces) are likely to cause negative outcomes, and these appraisals are not ameliorated by restoring personal control over one’s environment.
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Expertise in Psychotherapy: An Elusive Goal?
Terence Tracey et al.
American Psychologist, forthcoming
Abstract:
It has been argued that psychotherapy is a profession without any expertise (Shanteau, 1992). We examine the validity of this claim, reviewing the literature on expertise, clinical decision making, and psychotherapeutic outcome assessment, and find it a reasonable assessment. There is no demonstration of accuracy and skill that is associated with experience as a therapist. We posit that this absence of an expertise–experience relation is attributable to therapists’ lack of access to quality outcome information regarding their interventions and an overreliance on fallible information-processing strategies even when such outcome information is available. The research on providing outcome feedback is reviewed, and although it does relate to client improvement, it has not been shown to be associated with any gains in therapist skill or expertise. We propose a model of outcome information usage and specific a priori hypothesis testing as a means of developing expertise.
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Edna Foa et al.
Journal of the American Medical Association, 25 December 2013, Pages 2650-2657
Objective: To examine the effects of counselor-delivered prolonged exposure therapy compared with supportive counseling for adolescents with PTSD.
Design, Setting, and Participants: A single-blind, randomized clinical trial of 61 adolescent girls with PTSD using a permuted block design. Counselors previously naive to prolonged exposure therapy provided the treatments in a community mental health clinic. Data collection lasted from February 2006 through March 2012.
Interventions: Participants received fourteen 60- to 90-minute sessions of prolonged exposure therapy (n = 31) or supportive counseling (n = 30).
Main Outcomes and Measures: All outcomes were assessed before treatment, at mid-treatment, and after treatment and at 3-, 6-, and 12-month follow-up. The primary outcome, PTSD symptom severity, was assessed by the Child PTSD Symptom Scale–Interview (range, 0-51; higher scores indicate greater severity). Secondary outcomes were presence or absence of PTSD diagnosis assessed by the DSM-IV Schedule for Affective Disorders and Schizophrenia for School-Age Children and functioning assessed by the Children’s Global Assessment Scale (range, 1-100; higher scores indicate better functioning). Additional secondary measures, PTSD severity assessed by the Child PTSD Symptom Scale–Self-Report (range, 0-51; higher scores indicate greater severity) and depression severity assessed by the Children’s Depression Inventory (range, 0-54; higher scores indicate greater severity), were also assessed weekly during treatment.
Results: Data were analyzed as intent to treat. During treatment, participants receiving prolonged exposure demonstrated greater improvement on the PTSD symptom severity scale (difference between treatments in improvement, 7.5; 95% CI, 2.5-12.5; P < .001) and on all secondary outcomes (loss of PTSD diagnosis: difference, 29.3%, 95% CI, 20.2%-41.2%; P = .01; self-reported PTSD severity: difference, 6.2; 95% CI, 1.2-11.2; P = .02; depression: difference, 4.9; 95% CI, 1.6-8.2; P = .008; global functioning: difference, 10.1; 95% CI, 3.4-16.8; P = .008). These treatment differences were maintained through the 12-month follow-up: for interviewer-assessed PTSD (difference, 6.0; 95% CI, 1.6-10.4; P = .02), loss of PTSD diagnosis (difference, 31.1; 95% CI, 14.7-34.8; P = .01), self-reported PTSD (difference, 9.3; 95% CI, 1.2-16.5; P = .02), depression (difference, 7.2; 95% CI, 1.4-13.0; P = .02), and global functioning (difference, 11.2; 95% CI, 4.5-17.9; P = .01).
Conclusion and Relevance: Adolescents girls with sexual abuse–related PTSD experienced greater benefit from prolonged exposure therapy than from supportive counseling even when delivered by counselors who typically provide supportive counseling.
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An electroconvulsive therapy procedure impairs reconsolidation of episodic memories in humans
Marijn Kroes et al.
Nature Neuroscience, forthcoming
Abstract:
Despite accumulating evidence for a reconsolidation process in animals, support in humans, especially for episodic memory, is limited. Using a within-subjects manipulation, we found that a single application of electroconvulsive therapy following memory reactivation in patients with unipolar depression disrupted reactivated, but not non-reactivated, memories for an emotional episode in a time-dependent manner. Our results provide evidence for reconsolidation of emotional episodic memories in humans.
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Preferring familiar emotions: As you want (and like) it?
Brett Ford & Maya Tamir
Cognition & Emotion, Winter 2014, Pages 311-324
Abstract:
Do people want to feel emotions that are familiar to them? In two studies, participants rated how much they typically felt various emotions (i.e., familiarity of the emotion) and how much they generally wanted to experience these emotions. We found that, in general, people wanted to feel pleasant emotions more than unpleasant emotions. However, for both pleasant and unpleasant emotions, people more (vs. less) familiar with an emotion also wanted to experience it more. Links between the familiarity of an emotion and wanting to experience that emotion were not explained by the concurrent experience of familiar emotions. Also, we show that although familiar emotions were also liked more, liking did not fully account for wanting familiar emotions. Finally, the familiarity of emotions mediated the links between trait affect and the emotions people wanted to feel. We propose that people are motivated to feel familiar emotions, in part, because of their instrumental value.
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Impact of retirement worry on information processing
Helen Gutierrez & Douglas Hershey
Journal of Neuroscience, Psychology, and Economics, December 2013, Pages 264-277
Abstract:
Clinically anxious individuals have been shown to process psychologically threatening words (e.g., worry) more slowly than words that are unrelated to their disorder (e.g., hammer). In the present investigation, working adults (N = 87) with different levels of financially linked retirement anxiety were investigated using the Emotional Stroop Task (EST). The EST involves presenting financially relevant retirement threat words (e.g., poverty) on a computer screen in addition to nonretirement neutral words (e.g., sailboat). Words were presented individually in 1 of 4 different colors of ink. Respondents’ task was to identify the ink color for each word as rapidly as possible. It was hypothesized that individuals with high levels of retirement anxiety would generate slower response latencies when naming the color of retirement threat words relative to neutral words. No such processing delay was predicted for nonanxious participants. ANOVA findings revealed a 2-way interaction that was consistent with a priori predictions. The data suggest working adults with retirement anxiety experienced information processing disruptions that stem from the negative emotional content linked to retirement concepts in long-term memory. From an applied perspective, these processing disruptions may represent a significant obstacle that needs to be surmounted when encouraging individuals with retirement anxiety to plan and save for the future.
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Laura Saslow et al.
Psychophysiology, forthcoming
Abstract:
What can a speech reveal about someone's state? We tested the idea that greater stress reactivity would relate to lower linguistic cognitive complexity while speaking. In Study 1, we tested whether heart rate and emotional stress reactivity to a stressful discussion would relate to lower linguistic complexity. In Studies 2 and 3, we tested whether a greater cortisol response to a standardized stressful task including a speech (Trier Social Stress Test) would be linked to speaking with less linguistic complexity during the task. We found evidence that measures of stress responsivity (emotional and physiological) and chronic stress are tied to variability in the cognitive complexity of speech. Taken together, these results provide evidence that our individual experiences of stress or “stress signatures” — how our body and mind react to stress both in the moment and over the longer term — are linked to how complex our speech under stress.
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Enhanced sensitivity and response bias for male anger in women with borderline personality disorder
Heather Barnett Veague & Jill Hooley
Psychiatry Research, forthcoming
Abstract:
Interpersonal difficulties, which are characteristic of BPD, may be related to problems with social cognition. We explored facial emotion recognition in 44 women (15 with BPD, 15 healthy controls, and 14 with a history of childhood trauma but no BPD) examining the role of BPD and abuse history in the ability to detect fearful, angry and happy cues in emotional faces. In Task 1, participants viewed pictures of morphed faces containing different percentages of specific emotions and reported the emotion they saw. In Task 2, participants were asked to increase the intensity of a specific emotion on an initially neutral face until they could detect that emotion in the face. Across both tasks, BPD predicted the earlier detection of anger in male faces. BPD symptoms also predicted the misidentification of anger in male faces containing no anger cues. Although participants with BPD were slower to recognize happiness in male faces, their overall ability to recognize happiness was unimpaired, although abuse history did predict problems with happiness recognition. Finally, recognition of fear was unrelated to abuse history and BPD. Findings suggest that BPD is associated with a bias toward seeing anger in males and that this is independent of abuse history.
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Yoichiro Takayanagi et al.
JAMA Psychiatry, forthcoming
Objective: To examine the lifetime prevalence estimates of mental and physical disorders during midlife to late life using both retrospective and cumulative evaluations.
Design, Setting, and Participants: Prospective population-based survey (Baltimore Epidemiologic Catchment Area Survey) with 4 waves of interviews of 1071 community residents in Baltimore, Maryland, between 1981 and 2005.
Main Outcomes and Measures: Lifetime prevalence of selected mental and physical disorders at wave 4 (2004-2005), according to both retrospective data and cumulative evaluations based on 4 interviews from wave 1 to wave 4.
Results: Retrospective evaluations substantially underestimated the lifetime prevalence of mental disorders as compared with cumulative evaluations. The respective lifetime prevalence estimates ascertained by retrospective and cumulative evaluations were 4.5% vs 13.1% for major depressive disorder, 0.6% vs 7.1% for obsessive-compulsive disorder, 2.5% vs 6.7% for panic disorder, 12.6% vs 25.3% for social phobia, 9.1% vs 25.9% for alcohol abuse or dependence, and 6.7% vs 17.6% for drug abuse or dependence. In contrast, retrospective lifetime prevalence estimates of physical disorders ascertained at wave 4 were much closer to those based on cumulative data from all 4 waves. The respective prevalence estimates ascertained by the 2 methods were 18.2% vs 20.2% for diabetes, 48.4% vs 55.4% for hypertension, 45.8% vs 54.0% for arthritis, 5.5% vs 7.2% for stroke, and 8.4% vs 10.5% for cancer.
Conclusions and Relevance: One-time, cross-sectional population surveys may consistently underestimate the lifetime prevalence of mental disorders. The population burden of mental disorders may therefore be substantially higher than previously appreciated.
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Brendan Saloner, Nicholas Carson & Benjamin Lê Cook
Medical Care Research and Review, forthcoming
Abstract:
Despite renewed national interest in mental health care reform, little is known about treatment patterns among youth in the general population. Using longitudinal data from the Medical Expenditure Panel Survey, we examined both initiation and continuity of mental health treatment among 2,576 youth aged 5 to 17 with possible mental health treatment need (defined as a high score on a parent-assessed psychological impairment scale, fair/poor mental health status, or perceived need for counseling). Over a 2-year period, fewer than half of sampled youth initiated new mental health treatment. Minority, female, uninsured, and lower-income youth were significantly less likely to initiate care. Only one third of treatment episodes met criteria for minimal adequacy (≥4 provider visits with psychotropic medication treatment or ≥8 visits without medication). Episodes were significantly shorter for Latino youth. Efforts to strengthen mental health treatment for youth should be broadly focused, emphasizing not only screening and access but also treatment continuity.
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Childhood abuse and vulnerability to depression: Cognitive scars in otherwise healthy young adults
Tony Wells et al.
Cognition & Emotion, forthcoming
Abstract:
Models of depression vulnerability posit that negative early experiences, such as exposure to childhood abuse (CA), increase vulnerability to depression later in life. Though most victims of CA do not go on to develop depression, the question remains as to whether these individuals retain cognitive ‘scars’ that may contribute to depression vulnerability. The present study examined the relationship between self-reported, retrospective CA and cognitive vulnerability to depression in a carefully selected sample of young adults without current or past psychopathology. We measured cognitive vulnerability with both a self-report questionnaire, the Dysfunctional Attitudes Scale (DAS), and a measure of information processing bias, the Scrambled Sentences Test (SST). Self-reported severity of CA was associated with increased cognitive vulnerability to depression on both the DAS and SST. Vulnerability to depression as measured by the SST, but not by the DAS, prospectively predicted increases in depressive symptoms over a 6-month period. Scores on the SST also interacted with CA to predict increases in depressive symptoms. These findings demonstrate the pernicious effects of CA even in those without current or past psychopathology.
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Vagal regulation and internalizing psychopathology among adolescents exposed to childhood adversity
Katie McLaughlin, Sonia Alves & Margaret Sheridan
Developmental Psychobiology, forthcoming
Abstract:
Childhood adversity (CA) is strongly associated with youth psychopathology. Identifying factors that reduce vulnerability following CA is critical for developing preventive interventions. Vagal tone and vagal reactivity following psychosocial stressors might influence psychopathology among youths exposed to CA. We acquired heart period and impedance cardiography data to calculate respiratory sinus arrhythmia (RSA) and preejection period (PEP) from 157 adolescents aged 13–17 years at rest and during the Trier Social Stress Test (TSST). Internalizing and externalizing symptoms and multiple forms of CA were assessed. Resting RSA and RSA reactivity interacted with CA in predicting internalizing but not externalizing psychopathology; CA was unassociated with internalizing problems in adolescents with high resting RSA and RSA reactivity. No interactions were observed with PEP. High resting RSA predicted greater vagal rebound and accelerated heart rate recovery following the TSST, highlighting one potential mechanism underlying low internalizing symptoms following CA among youths with high vagal tone.
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Mark Relyea & Sarah Ullman
Psychology of Women Quarterly, forthcoming
Abstract:
Social reactions to disclosures of sexual assault have significant effects on women’s postassault outcomes. The Social Reactions Questionnaire measures these reactions (as reported by survivors) and aggregates them into positive and negative scales. However, studies indicate that only some “negative” reactions have a negative valence for survivors, whereas others produce a mixed (positive and negative) valence. The current study compares a one-primary-factor model of negative reactions to a model with two primary factors that we have labeled “turning against” (TA) and “unsupportive acknowledgment” (UA). Results showed that although one primary factor was plausible, two primary factors provided a better fit to the data. To assess the discriminant validity of the two factors, we performed regressions predicting social support, psychological adjustment, and coping behaviors. Analyses supported the hypotheses that reactions of being turned against were related to social withdrawal, increased self-blame, and decreased sexual assertiveness, whereas reactions of UA were related to both adaptive and maladaptive coping. Against predictions, depression and posttraumatic stress disorder were more related to receiving UA than to receiving TA reactions. Implications for interventions and research are discussed. Importantly, almost all women (94%) in our sample received reactions that acknowledged that an assault occurred but failed to provide support, and this lack of support was associated with worse coping than even more hostile reactions such as being blamed or stigmatized. Therefore, there seems a great need for effective programs to train community members to respond to survivors with the kind of emotional and tangible support that promotes better outcomes.
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Hannah Snyder et al.
Cognition & Emotion, forthcoming
Abstract:
People constantly face the need to choose one option from among many, such as when selecting words to express a thought. Selecting between many options can be difficult for anyone, and can feel overwhelming for individuals with elevated anxiety. The current study demonstrates that anxiety is associated with impaired selection across three different verbal tasks, and tests the specificity of this finding to anxiety. Anxiety and depression frequently co-occur; thus, it might be assumed that they would demonstrate similar associations with selection, although they also have distinct profiles of symptoms, neuroanatomy and neurochemistry. Here, we report for the first time that anxiety and depressive symptoms counter-intuitively have opposite effects on selection among competing options. Specifically, whereas anxiety symptoms are associated with impairments in verbal selection, depressive symptoms are associated with better selection performance. Implications for understanding the mechanisms of anxiety, depression and selection are discussed.