The validity of individual frontal alpha asymmetry EEG neurofeedback.

Frontal asymmetry in alpha oscillations is assumed to be associated with psychopathology and individual differences in emotional responding. Brain-activity-based feedback is a promising tool for the modulation of cortical activity. Here, we validated a neurofeedback protocol designed to change relative frontal asymmetry based on individual alpha peak frequencies, including real-time average referencing and eye-correction. Participants (N = 60) were randomly assigned to a right, left or placebo neurofeedback group. Results show a difference in trainability between groups, with a linear change in frontal alpha asymmetry over time for the right neurofeedback group during rest. Moreover, the asymmetry changes in the right group were frequency and location specific, even though trainability did not persist at 1 week and 1 month follow-ups. On the behavioral level, subjective stress on the second test day was reduced in the left and placebo neurofeedback groups, but not in the right neurofeedback group. We found individual differences in trainability that were dependent on training group, with participants in the right neurofeedback group being more likely to change their frontal asymmetry in the desired direction. Individual differences in trainability were also reflected in the ability to change frontal asymmetry during the feedback.

[The causal relationship between dissociation and trauma. A critical review]. / Uber die kausale Beziehung zwischen Dissoziation und Trauma. Ein kritischer Uberblick.

This article discusses the accepted view that trauma causes dissociation. We critically evaluate studies that explored this relationship and discuss their shortcomings. In addition, individual differences related to dissociative experiences are discussed. In doing so, we focus on their potential to create pseudo-correlations between dissociative symptoms and self-reports of childhood trauma. After concluding that the causal link between trauma and dissociation is far from self-evident or empirically substantiated, we suggest some avenues for further research.

The causal link between self-reported trauma and dissociation: a critical review.

The idea that traumatic experiences cause dissociative symptoms is a recurrent theme in clinical literature. The present article summarizes evidence that cast doubts on the commonly voiced view that the connection between self-reported trauma and dissociation is a simple and robust one. It is argued that: (1) the correlations between self-reported traumatic experiences and dissociative symptoms reported in the literature are, at best, modest; (2) other factors may act as a third variable in the relationship between trauma and dissociation; and (3) high scores on the Dissociative Experiences Scale are accompanied by fantasy proneness, heightened suggestibility, and susceptibility to pseudomemories. These correlates of dissociation may promote a positive response bias to retrospective self-report instruments of traumatic experiences. Thus, the possibility that dissociation encourages self-reported traumatic experiences rather than vice versa merits investigation. While attractive, simple models in which trauma directly causes dissociation are unlikely to be true.

Another White Christmas: fantasy proneness and reports of 'hallucinatory experiences' in undergraduate students.

In the current experiment, 44 undergraduate students were asked to listen to white noise and instructed to press a button when they believed hearing a recording of Bing Crosby's White Christmas without this record actually being presented. Fourteen participants (32%) pressed the button at least once. These participants had higher scores on fantasy proneness and the Launay-Slade Hallucination Scale (LSHS) compared to participants without hallucinatory reports. Both groups did not differ in terms of imagery vividness or sensitivity to social demands. Logistic regression suggested that fantasy proneness is a better predictor of hallucinatory reports than are LSHS scores. This might imply that hallucinatory reports obtained during the White Christmas test reflect a non-specific preference for odd items rather than schizophrenia-like, internal experiences.

Unconscious processes, subliminal stimulation, and anxiety.

Ever since Poetzl's studies, subliminal stimulation has been used as a paradigm to explore the connection between unconscious processes and psychopathology. Inspired by the psychodynamic tradition, folk psychology attributes a dramatic power to subliminal stimulation. In contrast, most modern researchers argue that effects of subliminal stimulation are rather limited. Does that mean that the unconscious is irrelevant to psychopathology? Not necessarily. Ohman and Soares' hypothesis about the preattentive origins of phobic reactions represents a good example of a model in which a "quick and dirty" unconscious may produce pathogenic effects. Although the empirical basis of this model is still meagre, its attractiveness hinges on the assumption that "quick and dirty" processes that make up the first second of human information processing are essential for higher level analysis and performance. In line with this, recent studies have indicated that the attentional bias that accompanies pathological anxiety, might be an unconscious phenomenon. Theories that focus on unconscious cognitive processes involved in pathological anxiety are certainly interesting, but it should be emphasized that there are other aspects of automaticity (i.e., involuntariness) that may be as relevant to psychopathology as absence of awareness.

Suppression and ritualistic behaviour in normal participants.

OBJECTIVE: Previous research has shown that normal and abnormal ritualistic behaviours do not differ in content. Rather, the differences between both categories of rituals pertain to characteristics such as frequency, intensity, discomfort and resistance. This study sought to investigate whether thought suppression is linked to these characteristics. DESIGN: Cross-sectional; questionnaires on thought suppression and rituals were administered to a sample of undergraduate students (N = 166). METHOD: Habitual suppressors (N = 20) and non-suppressors (N = 20), as measured by the White Bear Suppression Inventory, were selected and compared with regard to the characteristics of their rituals. RESULTS: Suppressors experienced their rituals as more intense, discomforting and resistance-provoking than did non-suppressors. There were no group differences in the content, frequency, and perceived senselessness of rituals. CONCLUSION: Although the cross-sectional nature of the present study precludes causal inferences, its findings are consistent with the view that chronic thought suppression may promote ritualistic behaviour. Clearly, the details of the link between thought suppression and rituals require further examination.

The potential conflict between clinical and judicial decision making heuristics.

The Gudjonsson Suggestibility Scale (GSS; Gudjonsson, 1984) was introduced as a tool for identifying suspects who are at risk of making false confessions. High GSS-scores indicate a greater risk of making false confessions. Recently, some authors have claimed that low GSS-scores can be used to support the credibility of recovered memories. This new application broadens the use of the GSS in two ways. First, low GSS-scores are considered to possess diagnostic value. Second, the GSS is advocated as a practical tool in clinical settings. This article critically evaluates such a clinical application of the GSS. Our main argument has to do with the incompatibility of basic clinical and judicial decision making heuristics. Psychotherapists, and other medical professionals, should base their decisions on different parameters than judicial professionals. Compared to judicial heuristics, clinical heuristics can be characterized as more empathetic, less critical, and less conservative. Given these differences, clinical conclusions (including those about the accuracy of recovered memories) cannot be easily translated into judicial decisions. If they do enter the judicial domain, these conclusions may lead to dubious forensic decisions.

Traumatic memories, eye movements, phobia, and panic: a critical note on the proliferation of EMDR.

In the past years, Eye Movement Desensitization and Reprocessing (EMDR) has become increasingly popular as a treatment method for Posttraumatic Stress Disorder (PTSD). The current article critically evaluates three recurring assumptions in EMDR literature: (a) the notion that traumatic memories are fixed and stable and that flashbacks are accurate reproductions of the traumatic incident; (b) the idea that eye movements, or other lateralized rhythmic behaviors have an inhibitory effect on emotional memories; and (c) the assumption that EMDR is not only effective in treating PTSD, but can also be successfully applied to other psychopathological conditions. There is little support for any of these three assumptions. Meanwhile, the expansion of the theoretical underpinnings of EMDR in the absence of a sound empirical basis casts doubts on the massive proliferation of this treatment method.

Assumptions of students and psychotherapists about memory.

The present study explored assumptions about memory in a Dutch sample consisting of 27 psychotherapists and 50 undergraduate students. Participants completed a questionnaire about memory and repression. Analysis indicated that a substantial proportion of the participants held assumptions about memory that are unrealistic in the sense that they do not meet a generally accepted standard among memory scientists. Although most respondents said that memory is not an accurate reflection of reality, metaphors provided by students and psychotherapists suggest that the reconstructive nature of memory was less well acknowledged.

Treating phobic children: effects of EMDR versus exposure.

This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia.

Eye movement desensitisation and reprocessing versus exposure in vivo. A single-session crossover study of spider-phobic children.

BACKGROUND: Eye movement desensitisation and reprocessing (EMDR) is a relatively new therapeutic technique that has been proposed as a treatment for post-traumatic stress disorder and other anxiety complaints. METHOD: We compared the efficacy of EMDR with that of exposure in vivo in the treatment of a specific phobia. Twenty-two spider-phobic children who met the DSM-III-R criteria for specific phobia participated in the study. Children were treated with one session of exposure in vivo and one session of EMDR in a crossover design. Treatment outcome was evaluated by self-report measures, a behavioural avoidance test and a physiological index (skin conductance level). RESULTS: Results showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioural measure was less pronounced, and exposure in vivo was found to be superior in reducing avoidance behaviour. With regard to skin conductance level, EMDR and exposure in vivo did not differ. CONCLUSIONS: EMDR has no additional value in treatment of this type of animal phobia, for which exposure in vivo is the treatment of choice.

UCS inflation and human aversive autonomic conditioning.

Fifty students participated in a differential conditioning paradigm. In the first part of the experiment, one neutral slide (CS+) was paired with a tone (UCS) and another neutral slide (CS-) was never followed by a tone. During the subsequent inflation phase, unsignalled UCSs gradually increased in strength for the inflation group while they were kept constant for the control group. During extinction trials, the inflation group initially showed relatively stronger UCS expectancies on the CS+ trials than the control group. In contrast to what was predicted, the UCS inflation procedure did not result in stronger conditioning effects of the skin conductance response compared to the control procedure. The effectiveness of the UCS inflation procedure was not related to trait anxiety.

Startle responses of spider phobics to masked stimuli: a pilot study.

The present study tested the hypothesis that briefly flashed and backwardly masked phobic stimuli potentiate startle reflexes in phobic subjects. Spider phobic (n = 17) and normal control (n = 12) subjects were exposed to short (30 ms) and backwardly masked presentations of phobic slides (i.e., spiders) and neutral slides (i.e., flowers, mushrooms, snakes). On half the trials, eyeblink startle reflexes were elicited with auditory probes following presentation of the slides. In spite of the degraded stimulus conditions, there were some indications that phobics exhibited a startle pattern different from control subjects. More specifically, phobic subjects tended to react with larger startles during the second block of spider trials than control subjects. No such group differences were found for the neutral trials. As the eyeblink startle reflex is closely linked to the thalamo-amygdala pathway, the present findings provide some preliminary support for the idea that the preattentive processing of phobic cues is located at the subcortical level.

Effects of endorphin blocking on conditioned SCR in humans.

In order to test the hypothesis that low levels of endogenous opioids (endorphins) predispose to strong conditioning effects, female Ss (N = 36) were assigned to a placebo group, a low-dose naltrexone group, or a high-dose naltrexone group and then underwent a classical conditioning procedure. This procedure consisted of an acquisition phase in which all Ss received 5 pairings of a CS+ (neutral picture) and a UCS (100 dB white noise). The CS- (neutral picture) was never followed by a UCS. During extinction, Ss received 4 unreinforced presentations of CS+ and CS-. Throughout the experiment, skin conductance responses (SCRs) to the CSs and UCSs were recorded. Acquisition was successful in that CS+ slides elicited stronger SCRs than CS- slides. However, during acquisition, there was no interaction between drug and differential response (CS+ vs CS-). During extinction, there was no overall remaining effect of conditioning. Again, no evidence was found to suggest that (remaining) effects of conditioning were stronger in the naltrexone treated Ss than in the placebo Ss. If anything, the opposite seemed to be true with especially high-dose naltrexone Ss showing relatively weak conditioning effects.

Imagery ability and exposure in vivo in spider phobia.

The present study deals with the effect of imagery ability on treatment outcome in spider phobias. Thirty-eight spider phobics completed the Questionnaire on Mental Imagery (QMI) and the Spider Questionnaire (SPQ). Subjects also went through a behavioral approach task (BAT) during which heart rate and avoidance behavior were measured. Each subject was then given one-session treatment as described by Ost. Immediately after treatment, SPQ and BAT data were again obtained. On the basis of their QMI scores, subjects were assigned to a 'good', 'moderate', or 'poor' imagers group. Neither pre-treatment nor post-treatment measures were found to vary as a function of imagery ability. Thus it appears that, at least for specific phobias such as spider fear, imagery ability is not a relevant variable for predicting the effects of in vivo exposure.

Covariation bias and electrodermal responding in spider phobics before and after behavioural treatment.

The present study investigated whether a covariation bias is present in severe spider phobics and whether such bias is modified by successful treatment. In addition, this study sought to examine whether a covariation bias is linked to differential autonomic responding. Subjects were 20 untreated phobics, 19 treated phobics, and 18 no-fear controls. Subjects were exposed to a series of 72 slides comprising three categories: spiders (fear-relevant), mushrooms, and flowers. At slide offset one of three possible outcomes occurred: a shock, a tone, or nothing at all. All slide-outcome combinations occurred equally frequent. The results show that an equally strong covariation bias is present in severe spider phobics, in successfully treated phobics, and in no-fear controls. Thus, the present data only partially sustain earlier findings of Tomarken, A. J., Mineka, S. & Cook, M. (1989) (Journal of Abnormal Psychology, 98, 381-394). The covariation bias appeared to be mimicked by differentially heightened autonomic responding. The current data suggest that both the covariation bias and the heightened physiological responding reflect a "beloningness" between spider slides and aversive outcome.