Social trauma and its association with posttraumatic stress disorder and social anxiety disorder.

The key characteristic of a traumatic event as defined by the Diagnostic and Mental Manual of Mental Disorders (DSM) seems to be a threat to life. However, evidence suggests that other types of threats may play a role in the development of PTSD and other disorders such as social anxiety disorder (SAD). One such threat is social trauma, which involves humiliation and rejection in social situations. In this study, we explored whether there were differences in the frequency, type and severity of social trauma endured by individuals with a primary diagnosis of SAD (n = 60) compared to a clinical control group of individuals with a primary diagnosis of obsessive compulsive disorder (OCD, n = 19) and a control group of individuals with no psychiatric disorders (n = 60). The results showed that most participants in this study had experienced social trauma. There were no clear differences in the types of experiences between the groups. However, one third of participants in the SAD group (but none in the other groups) met criteria for PTSD or suffered from clinically significant PTSD symptoms in response to their most significant social trauma. This group of SAD patients described more severe social trauma than other participants. This line of research could have implications for theoretical models of both PTSD and SAD, and for the treatment of individuals with SAD suffering from PTSD after social trauma.

Measuring Biases of Visual Attention: A Comparison of Four Tasks.

: Attention biases to stimuli with emotional content may play a role in the development and maintenance of anxiety disorders. The most commonly used tasks in measuring and treating such biases, the dot-probe and spatial cueing tasks, have yielded mixed results, however. We assessed the sensitivity of four visual attention tasks (dot-probe, spatial cueing, visual search with irrelevant distractor and attentional blink tasks) to differences in attentional processing between threatening and neutral faces in 33 outpatients with a primary diagnosis of social anxiety disorder (SAD) and 26 healthy controls. The dot-probe and cueing tasks revealed no differential processing of neutral and threatening faces between the SAD and control groups. The irrelevant distractor task showed some sensitivity to differential processing for the SAD group, but the attentional blink task was uniquely sensitive to such differences in both groups, and revealed processing differences between the SAD and control groups. The attentional blink task also revealed interesting temporal dynamics of attentional processing of emotional stimuli and may provide a uniquely nuanced picture of attentional response to emotional stimuli. Our results therefore suggest that the attentional blink task is more suitable for measuring preferential attending to emotional stimuli and treating dysfunctional attention patterns than the more commonly used dot-probe and cueing tasks.

Implementation of the Bergen 4-Day Treatment for Obsessive Compulsive Disorder in Iceland.

OBJECTIVE: The purpose of this study was to evaluate the first implementation outside of Norway of the Bergen 4-day treatment for Obsessive Compulsive Disorder (OCD), an innovative and effective treatment format with high acceptance and basically no drop-out. METHOD: Nineteen patients with OCD underwent the treatment at the Icelandic Anxiety Clinic (Kvíðameðferðarstöðin). Of these, 17 of the patients were classified pretreatment with severe to extreme symptoms and 2 were classified with moderate symptoms. 63% of the patients had previously received treatment for OCD (ERP or CBT). RESULTS: Mean pretreatment score on Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was 28.79 (SD = 4.42). One week post-treatment mean Y-BOCS score was 9.95 (SD = 3.67). 94.7% of the patients had responded to treatment and 73.7 were in remission according to the international consensus criteria. At 3-month follow-up, the Y-BOCS score was 11.09 (SD = 5.89) where 78.9% of the patients had responded to treatment and 63.2% were in remission. CONCLUSIONS: All patients expressed high satisfaction with the treatment format, and none of the patients would have preferred longer term treatment. The therapists also expressed satisfaction with the treatment format. The Bergen 4-day treatment for OCD is a very promising treatment for OCD, and can be successfully implemented outside Norway.

Barking up the wrong tree in attentional bias modification? Comparing the sensitivity of four tasks to attentional biases.

BACKGROUND AND OBJECTIVES: Attentional bias modification (ABM) is a potentially exciting new development in the treatment of anxiety disorders. However, reported therapeutic benefits have not always been replicated. To gauge the sensitivity of tasks used in ABM treatment and assessment, we used a counterbalanced within-subject design to measure their discriminant sensitivity to neutral and threatening facial expressions, comparing them with other well-known tasks that measure visual attention. METHODS: We compared two tasks often used in the assessment and treatment of attention bias (the dot-probe and the spatial cueing paradigms) with two well-known visual attention tasks (the irrelevant singleton and attentional blink paradigms), measuring their sensitivity to processing differences between threatening and neutral expressions for non-clinical observers. RESULTS: The dot-probe, spatial cueing and irrelevant singleton paradigms showed little or no sensitivity to processing differences between facial expressions while the attentional blink task proved very sensitive to such differences. Furthermore, the attentional blink task provided an intriguing picture of the temporal dynamics of attentional biases that the other paradigms cannot do. LIMITATIONS: These results need to be replicated with larger samples, including a comparison of a group of individuals diagnosed with social anxiety disorder and normal controls. CONCLUSIONS: Our results indicate that the sensitivity of putative attentional bias measures should be assessed experimentally for more powerful assessment and treatment of such biases. If the attentional blink task is indeed particularly sensitive to attentional biases, as our findings indicate, it is not unreasonable to expect that interventions based on this task may be more effective than those based on the tasks that are currently used.

Fortune and reversals of fortune in visual search: Reward contingencies for pop-out targets affect search efficiency and target repetition effects.

Rewards have long been known to modulate overt behavior. But their possible impact on attentional and perceptual processes is less well documented. Here, we study whether the (changeable) reward level associated with two different pop-out targets might affect visual search and trial-to-trial target repetition effects (see Maljkovic & Nakayama, 1994). Observers searched for a target diamond shape with a singleton color among distractor diamond shapes of another color (e.g., green among red or vice versa) and then judged whether the target had a notch at its top or bottom. Correct judgments led to reward, with symbolic feedback indicating this immediately; actual rewards accumulated for receipt at study end. One particular target color led to a higher (10:1) reward for 75% of its correct judgments, whereas the other singleton target color (counterbalanced over participants) yielded the higher reward on only 25% of the trials. We measured search performance in terms of inverse efficiency (response time/proportion correct). The reward schedules not only led to better performance overall for the more rewarding target color, but also increased trial-to-trial priming for successively repeated targets in that color. The actual level of reward received on the preceding trial affected this, as did (orthogonally) the likely level. When reward schedules were reversed within blocks, without explicit instruction, corresponding reversal of the impact on search performance emerged within around 6 trials, asymptoting at around 15 trials, apparently without the observers' explicit knowledge of the contingency. These results establish that pop-out search and target repetition effects can be influenced by target reward levels, with search performance and repetition effects dynamically tracking changes in reward contingency.