Death Anxiety in the COVID-19 Pandemic: Testing REBT Models of Psychopathology and Psychological Health of Death Anxiety.

Objective: This paper aimed to examine the validity of the death anxiety psychopathological and psychological health models of Rational-Emotive Behavior Therapy (REBT). We investigated whether irrational and rational beliefs were associated with death anxiety and if there are possible significant positive correlations between death anxiety and depression, anxiety, and stress. Method: A sample of 200 individuals completed online self-report measures and Structural Equation Modelling (SEM) was chosen to assess the validity of the REBT psychopathological model and the REBT psychological health model. Pearson's correlation analysis was utilized to confirm the relationships between death anxiety and depression, anxiety, and stress. Results: REBT's model of psychopathology provide acceptable fit of the data. Results suggest that LFT beliefs mediate the relationship between DEM and death anxiety, while no mediation effect was found for the psychological health model. Additionally, high correlations were obtained between death anxiety and depression, anxiety, and stress. Conclusions: Results provided empirical support for the REBT models of death anxiety and underline the critical importance of cognitive constructs in the prediction of death anxiety. Results are discussed within the framework of REBT theory, which can serve as a foundation for new research directions regarding death anxiety, both theoretical and clinical.

Emotion regulation difficulties in the relation between stress-related insomnia symptoms and brain response to emotional faces: An fMRI study.

The aim of the current study was to investigate whether the experience of insomnia symptoms per se and symptoms of insomnia due to stress are associated with an increased brain response to the presentation of emotional faces. In addition, we also examined whether the effect of these sleep difficulties on emotional reactivity at the brain level depends on the experience of emotion regulation (ER) difficulties. The current sample consisted of 37 individuals (20 females, 17 males) selected from a larger group of 120 respondents who completed a survey about sleep problems and ER difficulties. Our results indicate that the tendency to experience stress-related insomnia symptoms but not insomnia symptoms per se modulates brain responses to emotional facial expressions, especially in areas of the parietal cortex, insula, and surrounding opercular voxels. Furthermore, difficulties in ER might play an important role, as the effect of stress-related insomnia symptoms on most of these brain regions disappears when controlling for difficulties in ER. However, an effect in the insula was maintained during the presentation of angry faces, suggesting that stress-related insomnia symptoms may increase the brain response to anger in the insula relatively independent from difficulties in ER. These findings suggest that individuals affected by stress-related insomnia symptoms show an enhanced brain response when presented with emotional stimuli (either positive or negative) in brain areas associated with hyperarousal, which could represent a possible ER deficit in these individuals. Thus, interventions that focus on targeting ER difficulties might be effective in reducing the hyperarousal state in individuals affected by stress-related insomnia symptoms.

Eating Behavior-Choice or Reconstruction of Past Experience? A Randomized Clinical Trial of Changing Eating Intentions of Healthy Adults Through Hypnotic Suggestions.

Recent meta-analyses have shown that psychological interventions have a small to medium effect on weight loss. We propose here a different approach to changing eating intentions. According to the Free Will literature, people decide to act before they acknowledge it, and they decide based on the reconstruction of previous experiences. The action can thus be inhibited immediately (max 100 ms) after awareness. We wanted to test if intervention based on this model, using hypnotic suggestions, can effectively change the intentions of eating. This study aims to identify which format of hypnotic suggestion can be more effective in changing eating intentions regarding high-calorie foods. Therefore, 88 healthy adult participants randomized in four groups received one session of hypnotic induction and suggestions or placebo. We measured the eating intentions through a computer task in which participants could choose pictures of low and high caloric food before, during, and after hypnosis. For the within-subject effect, results showed that two types of hypnotic suggestions significantly impacted the intentions of eating on high-calorie foods with large-effect, namely Cognitive Rehearsal (d = 0.81, p < .001) and Memory Substitution (d = 0.82, p < .001). After controlling for pretest ratings, we found a significant between-effect: the Cognitive Rehearsal group differed significantly from the Control in terms of intentions of eating (d = 0.85, p < .05). We conclude that hypnosis with Cognitive Rehearsal suggestions can help to positively impact the intentions of eating.

The Role of Emotion Regulation Difficulties in the Relation Between Insomnia and Depressive Symptoms.

BACKGROUND: Emotion regulation (ER) difficulties have been reported to be more severe in individuals with insomnia symptoms compared with controls, which in turn might explain the experience of depressive symptoms in these individuals. To our knowledge, no study has directly tested this hypothesis; therefore, we aimed to examine the indirect association between possible insomnia disorder and depressive symptoms through ER difficulties. METHOD: One hundred and seven individuals with possible insomnia disorder and 268 controls (based on a cutoff score on the Sleep Condition Indicator) completed measures of ER difficulties and depressive symptoms. RESULTS: As expected, individuals with possible insomnia disorder showed more severe depressive symptoms and ER difficulties compared with controls. Moreover, there was a significant indirect association between possible insomnia disorder and depressive symptoms through overall ER difficulties. CONCLUSION: ER difficulties were more severe in individuals with possible insomnia disorder and were further associated with more severe depressive symptoms. We speculate that by adding interventions aimed to develop ER abilities, Cognitive Behavioral Therapy for Insomnia (CBT-I) could become a more effective intervention for individuals with insomnia symptoms and associated emotional difficulties. LIMITATIONS: We used cross-sectional measures in our models of indirect associations.

The Impact of Irrational Beliefs on Paranoid Thoughts.

BACKGROUND: Although the ABC model proposed by cognitive behavioral theory has strong empirical support for a wide range of psychological problems, little is known about the role of irrational beliefs (IBs), a central concept of the ABC model, in the aetiology of paranoid thoughts, one of the most common psychotic symptoms. AIMS: The present study aimed to investigate the impact of IBs on paranoid thoughts and people's perceptions of others. METHOD: Eighty-one non-clinical participants (m age = 21.21 years, SD = 2.72, range 18-33; 83.95% female) recruited for this study were randomly assigned to one of the two conditions: IBs or rational beliefs (RBs). In a role-play paradigm, subjects were asked to imagine holding a list of IBs or RBs, respectively, while being exposed to a neutral social context in a virtual reality environment. RESULTS: In line with the ABC model, results indicate that IBs lead to significantly higher levels of state paranoid thoughts and more negative perceptions of others than RBs, even after controlling for participants' baseline irrationality and trait paranoia [F (5,68) = 11.23, p < .001, Wilk's λ = .54, partial η2 = .45]. CONCLUSIONS: The findings of this paper suggest that IBs might play an aetiological role in the occurrence of paranoid thoughts. Practical and theoretical implications of these results are also considered.

Reversal Learning Task in Children with Autism Spectrum Disorder: A Robot-Based Approach.

Children with autism spectrum disorder (ASD) engage in highly perseverative and inflexible behaviours. Technological tools, such as robots, received increased attention as social reinforces and/or assisting tools for improving the performance of children with ASD. The aim of our study is to investigate the role of the robotic toy Keepon in a cognitive flexibility task performed by children with ASD and typically developing (TD) children. The number of participants included in this study is 81 children: 40 TD children and 41 children with ASD. Each participant had to go through two conditions: robot interaction and human interaction in which they had performed the reversal learning task. Our primary outcomes are the number of errors from acquisition phase and from reversal phase of the task; as secondary outcomes we have measured attentional engagement and positive affect. The results of this study showed that children with ASD are more engaged in the task and they seem to enjoy more the task when interacting with the robot compared with the interaction with the adult. On the other hand their cognitive flexibility performance is, in general, similar in the robot and the human conditions with the exception of the learning phase where the robot can interfere with the performance. Implication for future research and practice are discussed.

Optimal attentional focus during exposure in specific phobia: a meta-analysis.

Over the last 30 years, researchers have disagreed over the consequences of diverting attention from threat for exposure efficacy, which is an important theoretical and clinical debate. Therefore, the present meta-analysis assessed the efficacy of attentionally focused exposure against distracted and attentionally uninstructed exposure regarding distress, behavioral, and physiological outcomes. We included 15 randomized studies with specific phobia, totaling 444 participants and targeting outcomes at post-exposure and follow-up. Results indicated no difference between the efficacy of distracted exposure as opposed to focused or uninstructed exposure for distress and physiology. For behavior, at post-exposure, results were marginally significant in favor of distracted as opposed to focused exposure, while at follow-up results significantly favored distraction. However, concerning behavior, uninstructed exposure was superior to distraction. Moderation analyses revealed that, regarding distress reduction and approach behavior, distracted exposure significantly outperformed focused exposure when the distracter was interactive (g=1.010/g=1.128) and exposure was spread over the course of multiple sessions (g=1.527/g=1.606). No moderation analysis was significant for physiological measures. These findings suggest that distraction during exposure could be less counterproductive than previously considered and even beneficial under certain circumstances. Theoretical implications and future directions for research are discussed.

Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy.

OBJECTIVE: To describe the alterations in the bone metabolism of HIV-seropositive patients and evaluate the effects of antiretroviral therapies. DESIGN: Cross-sectional analytical study. METHOD AND MATERIALS: A total of 142 subjects (113 male, 29 female), aged 20-45 years were divided into four groups: group A, 33 HIV-seropositive antiretroviral-naive patients; group B1, 36 HIV-seropositive patients on antiviral therapy for over 1 year, without protease inhibitors (PI); group B2, 42 HIV-seropositive patients on combined therapy containing PI for over 1 year; and group C, 15 healthy, HIV-seronegative subjects. Bone mineral density (BMD) were determined by dual energy X-ray absorptiometry in total body, lumbar spine and proximal femur; and evaluation of serum osteocalcin, d-pyridinoline, parathyroid hormone (THP), calcium and phosphate, and urine calcium. RESULTS: BMD was significantly lower in HIV-seropositive patients in comparison with healthy controls, in all sites studied. However, no statistical differences were observed among all groups of HIV-infected patients, independently of the antiretroviral therapy. There was a significantly higher occurrence of osteopenia and osteoporosis in HIV-infected patients in comparison with controls (P < 0.0001), with no differences among treatment-naive patients and either of the treatment groups. Bone formation and resorption markers were similar among all studied groups. There was a significant correlation in all bone sites between time of infection and BMD (P < 0.02). CONCLUSIONS: BMD was significantly lower in HIV-seropositive patients in comparison with controls in lumbar spine, proximal femur and total body, without significant differences among treatment-naive patients and either of the treatment groups. Only time with HIV infection and not specific therapy was associated with BMD decreases.