State Mindful Attention Awareness as a Dyadic Protective Factor During COVID-19: a Daily Diary Study.

Objectives: Accumulating evidence suggests that mindfulness, as a trait, can be a form of personal resilience to stress. However, mindfulness is considered a present-moment state which makes it important to focus on its state-level (vs. trait-level) effects. Modern theories of stress suggest that coping with stress often involves interpersonal processes, and it is therefore valuable to clarify mindfulness interpersonal (vs. intrapersonal) stress-buffering effects. The current study examined mindful attention awareness as a dyadic protective factor at the start of the COVID-19 pandemic. Methods: A convenience sample of 72 cohabiting romantic couples participated in a 21-day daily diary study. The background (pre-diary) questionnaire assessed their experience of COVID-related stressors (e.g., financial and health-related burdens). The diary assessed state mindful attention awareness, mood, COVID-related stress, relationship satisfaction, and perceived partner responsiveness (PPR). Results: A series of Actor-Partner Interdependence Multilevel Models were used to analyze the dyadic data. Actor state mindful awareness was associated with better daily personal (mood and stress) and relational (PPR and satisfaction) outcomes. Partner state mindful awareness was associated with higher PPR. Actor state mindful awareness also attenuated the association between pre-diary COVID-related stressors and daily COVID-related stress. Conclusion: State mindfulness may serve as a dyadic protective factor when couples face stressful circumstances. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-02025-z.

Physiological activation and co-activation in an imagery-based treatment for test anxiety.

Objective: The effectiveness of Imagery Rescripting (IR) has been demonstrated in the treatment of various psychological disorders, but the mechanisms underlying it remain unclear. While current investigations predominantly refer to memory processes, physiological processes have received less attention. The main aim of this study is to test whether client physiological activation (i.e., arousal) and client-therapist physiological activation (i.e., synchrony) during IR segments predicted improvement on next-session outcomes and overall treatment response, and to compare these to the role of physiological (co)-activation during traditional cognitive-behavioral (CB) segments. Methods: The results are based on 177 therapy sessions from an imagery-based treatment for test anxiety with 60 clients. Client and therapist electrodermal activity was continuously monitored, next-session outcome was assessed with the Outcome Rating Scale and treatment outcome was assessed using the Test Anxiety Inventory. Results: Hierarchical linear models demonstrated that average physiological synchrony during IR segments (but not during CB ones) was significantly associated with higher well-being at both the session and the overall treatment levels. Clients' physiological arousal in either IR or CB segments was not predictive of either outcome. Conclusion: These results provide initial evidence for the idea that physiological synchrony might be an important underlying mechanism in IR.

Physiological synchrony and therapeutic alliance in an imagery-based treatment.

Client-therapist synchrony in various channels (e.g., self-reported affect or physical movement) has been shown as a key process in the construction and development of therapeutic alliance. However, psychophysiological synchrony between clients and therapists has been understudied, with the few extant studies typically relying on single-session data, and no studies examining it within the context of emotion-focused techniques. The main aim of the current paper is to examine the role of client-therapist physiological synchrony during segments of one emotion-focused technique-namely, imagery (IM) work-in predicting therapeutic alliance, and to compare it to the role of synchrony during segments of more traditional cognitive-behavioral (CB) techniques. We conducted an open-trial study in which 31 clients with test anxiety received a 6-session protocol-based treatment. Both clients' and therapists' electrodermal activity (EDA) were continuously assessed during sessions. The physiological measures for 5 sessions each (N = 128) were used to compute client-therapist synchrony in IM and CB segments. Therapeutic alliance was assessed using the Session Alliance Inventory. Client-therapist dyads' synchrony during IM and CB segments was, on average, greater than chance. Synchrony varied mostly at the session (vs. the dyad) level. Multilevel analyses revealed that the synchrony within IM segments (but not within CB segments) was significantly associated with the therapeutic bond aspect (but not the task/goal aspects) of alliance. Physiological synchrony during emotion-focused IM is tied to the bond component of the therapeutic alliance at the session level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Imagery-based treatment for test anxiety: A multiple-baseline open trial.

BACKGROUND: Many students are affected by test anxiety (TA), which involves considerable distress and can lead to reduced performance. Despite its prevalence, TA has been under-studied; specifically, few effective and brief interventions have been identified to date. In our work, we explore the adaptation of imagery, an emotion-focused treatment technique used widely in the treatment of other anxiety disorders, for addressing TA. METHODS: In a two-site concurrent multiple-baseline pilot study (n = 31), we examined the effectiveness of a targeted six-session protocol developed for the treatment of TA, which integrates traditional cognitive behavioral techniques with imagery work. RESULTS: The protocol was well-accepted by clients. We found that students' test anxiety levels did not drop between the recruitment and pre-intervention assessments, but did drop significantly from recruitment or baseline to the delayed follow-up (Cohen's d = 0.75 and 0.84, respectively). We also found evidence for session-level processes tying the quality of the imagery work with session efficacy. LIMITATIONS: The study involved a relatively small sample size, leading to weaker power to detect treatment effects. Moreover, some clients did not have any exams scheduled before the delayed follow-up assessment. Due to the scheduling intensity of the sessions, some clients had insufficient time to implement or practice skills and to complete tasks discussed in the sessions. CONCLUSIONS: This study provides preliminary evidence for the utility of integrating imagery work with traditional cognitive-behavioral techniques for treating test anxiety.

[Imagery Rescripting and Psychophysical Relations Based on the ImRs-Therapy Concept Used for Test Anxiety: Review and First Experience]. / Imagery Rescripting und psychophysiologische Zusammenhänge anhand eines ImRs-Behandlungskonzepts für Prüfungsangst: Überblick und erste Erfahrungen.

Imagery Rescripting (ImRs) is an emotion-focused treatment technique, which was developed for persons suffering from traumatic experiences. ImRs includes imaginary exposure and rescripting alongside cognitive re-structuring. The principle of ImRs is based on the activation of emotions and the structuring of dysfunctional affective-cognitive schemata. ImRs is an effective treatment for PTSD and could be adapted to suit other psychological disorders. The current state of research focuses primarily on the wide range of uses. To date, physiological processes during the imagery rescripting have not been explored. Because of this, together with the cooperation of colleagues at Bar-Ilan University in Israel, we have conducted a pilot study to investigate psychophysiological patterns during ImRS sessions. Specifically, we examine the effectiveness of a targeted 6-session protocol developed for the treatment of test anxiety on a student sample, during which we monitor the sympathetic response of both clients and therapists. First feedback from the participants supports the power of imagery.