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Fong ZH, Sündermann O. Modulating disgust in mental contamination: Experimental evidence for the role of disgust. J Behav Ther Exp Psychiatry 2020; 68:101567. [PMID: 32197134 DOI: 10.1016/j.jbtep.2020.101567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/14/2020] [Accepted: 03/01/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Disgust has been associated with mental contamination (MC), although the evidence has hitherto been nonexperimental. Furthermore, strategies that can target both disgust and MC have not been well explored. We investigated the role of disgust in MC by inducing disgust via olfaction within the "dirty kiss" paradigm and conversely, to see if pairing pleasant olfactory stimulus during re-exposure, based on counterconditioning, can reduce MC. We also examined whether disgust constructs (propensity and sensitivity) and trait MC are associated with state MC arising from the "dirty kiss". METHODS MC was first evoked using the "dirty kiss" paradigm, in which participants (N = 90) visualized receiving a non-consensual kiss from a physically dirty man (time 1). After a break, participants repeated the "dirty kiss" task in a room that was scented to smell either disgusting, pleasant or neutral (time 2). Participants completed measures of disgust and trait MC after the experiment. RESULTS Participants in the disgust condition reported increased feelings of dirtiness at time 2. Disgust propensity predicted feelings of dirtiness at time 1. Disgust sensitivity and trait MC were not associated with state MC indices. LIMITATIONS The use of a non-clinical female sample, extraneous factors during the break and contextual factors arising from room change at time 2 are some potential limitations. CONCLUSIONS Induced disgust within a MC paradigm resulted in increased feelings of dirtiness, suggestive of disgust-based emotional reasoning. Pairing pleasant olfactory stimulus was not effective at attenuating MC or disgust.
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Affiliation(s)
- Zhi Hui Fong
- Department of Psychology, National University of Singapore, Singapore
| | - Oliver Sündermann
- Department of Psychology, National University of Singapore, Singapore.
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Rozenman M, Gonzalez A, Logan C, Goger P. Cognitive bias modification for threat interpretations: Impact on anxiety symptoms and stress reactivity. Depress Anxiety 2020; 37:438-448. [PMID: 32301579 PMCID: PMC7299169 DOI: 10.1002/da.23018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/15/2019] [Accepted: 06/15/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Cognitive bias modification for interpretations (CBM-I) is a computerized intervention that has received increasing attention in the last decade as a potential experimental intervention for anxiety. Initial CBM-I trials with clinical populations suggest the potential utility of this approach. However, most CBM-I experiments have been conducted with unaffected samples, few (one or two) training sessions, and have not examined transfer effects to anxiety-related constructs such as stress reactivity. METHOD This study compared a 12-session CBM-I intervention (n = 12) to an interpretation control condition (ICC; n = 12) in individuals (N = 24) with elevated trait anxiety on interpretation bias, anxiety symptom, and stress reactivity outcomes (electrodermal activity, heart rate, and respiratory sinus arrhythmia). RESULTS Compared to the ICC group, participants assigned to CBM-I experienced significantly greater improvements in interpretation bias and anxiety symptoms by post-intervention 4 weeks later, with impact on anxiety maintained at 1-month follow-up. While CBM-I and ICC groups did not differ in stress reactivity during an acute stressor at pre-intervention, the CBM-I group evidenced improved stress reactivity at post-intervention compared to ICC on two psychophysiological indices, electrodermal activity and heart rate. CONCLUSIONS The results of this pilot study suggest that CBM-I may hold promise for reducing anxiety symptoms, as well as impact psychophysiological arousal during an acute stressor.
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Affiliation(s)
- Michelle Rozenman
- University of Denver Department of Psychology / UCLA Division of Child & Adolescent Psychiatry
| | | | - Christina Logan
- California State University Long Beach Department of Psychology
| | - Pauline Goger
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology
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Mason EB, Burkhart K, Lazebnik R. Adolescent Stress Management in a Primary Care Clinic. J Pediatr Health Care 2019; 33:178-185. [PMID: 30190185 DOI: 10.1016/j.pedhc.2018.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/31/2018] [Accepted: 08/03/2018] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The American Academy of Pediatrics recommends that adolescents be screened for mental health concerns and receive anticipatory guidance on stress management strategies. METHODS Eighty-six participants (50 participants in the intervention group; 36 participants in the control group) participated in the study. Intervention group participants received training in diaphragmatic breathing, progressive muscle relaxation, and use of no-cost/low-cost exercise options. Biofeedback was used to guide relaxation. Subjective distress and heart rate variability was measured before and after the intervention. RESULTS After the intervention, decreased levels of perceived stress and increased heart rate variability were reported compared with the control group. DISCUSSION This study show that an integrated care model in a primary care setting is feasible and effective at improving stress management.
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Burkhart K, Mason E, Lazebnik R. Stress Management Intervention: A Pilot Evaluation in an Urban Adolescent Medicine Clinic. Clin Pediatr (Phila) 2018; 57:700-705. [PMID: 28969459 DOI: 10.1177/0009922817733704] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Thirty patients aged 11 to 21 years presenting in an adolescent medicine clinic received a one-time stress management intervention. The intervention included psychoeducation on the effect stress has on the body and the positive benefits of exercise, diaphragmatic breathing, and progressive muscle relaxation. The intervention also included use of a biofeedback game to aid in relaxation. Analyses revealed an association between higher levels of internalizing symptoms and perceived stress. A clinically significant decrease in subjective distress was endorsed at post-intervention. Ninety-three percent of participants reported that the intervention was helpful and that they had the requisite knowledge to practice stress management strategies outside of the clinic. At a one-week follow-up, of the 23 participants who were able to be reached, 22 wanted to participate in additional training. Findings suggest that a one-time stress management intervention can be beneficial for patients and easily incorporated within a primary care setting.
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Affiliation(s)
- Kimberly Burkhart
- 1 Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Elizabeth Mason
- 1 Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Rina Lazebnik
- 1 Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
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Rozenman M, Vreeland A, Iglesias M, Mendez M, Piacentini J. The tell-tale heart: physiological reactivity during resolution of ambiguity in youth anxiety. Cogn Emot 2017; 32:389-396. [PMID: 28278737 DOI: 10.1080/02699931.2017.1289152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In the past decade, cognitive biases and physiological arousal have each been proposed as mechanisms through which paediatric anxiety develops and is maintained over time. Preliminary studies have found associations between anxious interpretations of ambiguity, physiological arousal, and avoidance, supporting theories that link cognition, psychophysiology, and behaviour. However, little is known about the relationship between youths' resolutions of ambiguity and physiological arousal during acute stress. Such information may have important clinical implications for use of verbal self-regulation strategies and cognitive restructuring during treatments for paediatric anxiety. In this brief report, we present findings suggesting that anxious, but not typically developing, youth select avoidant goals via non-threatening resolution of ambiguity during a stressor, and that this resolution of ambiguity is accompanied by physiological reactivity (heart rate, heart rate variability, and respiratory sinus arrhythmia). We propose future empirical research on the interplay between interpretation bias, psychophysiology, and child anxiety, as well as clinical implications.
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Affiliation(s)
- Michelle Rozenman
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - Allison Vreeland
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - Marisela Iglesias
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - Melissa Mendez
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - John Piacentini
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
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No Significant Evidence of Cognitive Biases for Emotional Stimuli in Children At-Risk of Developing Anxiety Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 44:1243-52. [PMID: 26747448 PMCID: PMC5007265 DOI: 10.1007/s10802-015-0122-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper explores whether the increased vulnerability of children of anxious parents to develop anxiety disorders may be partially explained by these children having increased cognitive biases towards threat compared with children of non-anxious parents. Parents completed questionnaires about their child’s anxiety symptoms. Children aged 5–9 (n = 85) participated in two cognitive bias tasks: 1) an emotion recognition task, and 2) an ambiguous situations questionnaire. For the emotion recognition task, there were no significant differences between at-risk children and children of non-anxious parents in their cognitive bias scores for reaction times or for accuracy in identifying angry or happy facial expressions. In addition, there were no significant differences between at-risk children and children of non-anxious parents in the number of threat interpretations made for the ambiguous situations questionnaire. It is possible that these cognitive biases only become present subsequent to the development of an anxiety disorder, or only in older at-risk children.
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Rozenman M, Peris T, Bergman RL, Chang S, O'Neill J, McCracken JT, Piacentini J. Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD. Child Psychiatry Hum Dev 2017; 48:63-72. [PMID: 27225633 PMCID: PMC5860879 DOI: 10.1007/s10578-016-0653-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prior research has identified OCD subtypes or "clusters" of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7-17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment.
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Affiliation(s)
- Michelle Rozenman
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA.
| | - Tara Peris
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA
| | - R Lindsey Bergman
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA
| | - Susanna Chang
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA
| | - Joseph O'Neill
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA
| | - James T McCracken
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA
| | - John Piacentini
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA
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Emotional reasoning processes and dysphoric mood: cross-sectional and prospective relationships. PLoS One 2013; 8:e67359. [PMID: 23826276 PMCID: PMC3691160 DOI: 10.1371/journal.pone.0067359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 05/16/2013] [Indexed: 11/19/2022] Open
Abstract
Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world [1]. Emotional reasoning appears to characterise anxiety disorders. We aimed to determine whether elevated levels of emotional reasoning also characterise dysphoria. In Study 1, low dysphoric (BDI-II≤4; n = 28) and high dysphoric (BDI-II ≥14; n = 42) university students were administered an emotional reasoning task relevant for dysphoria. In Study 2, a larger university sample were administered the same task, with additional self-referent ratings, and were followed up 8 weeks later. In Study 1, both the low and high dysphoric participants demonstrated emotional reasoning and there were no significant differences in scores on the emotional reasoning task between the low and high dysphoric groups. In Study 2, self-referent emotional reasoning interpretations showed small-sized positive correlations with depression symptoms. Emotional reasoning tendencies were stable across an 8-week interval although not predictive of subsequent depressive symptoms. Further, anxiety symptoms were independently associated with emotional reasoning and emotional reasoning was not associated with anxiety sensitivity, alexithymia, or deductive reasoning tendencies. The implications of these findings are discussed, including the possibility that while all individuals may engage in emotional reasoning, self-referent emotional reasoning may be associated with increased levels of depressive symptoms.
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