Cognitive Restructuring Before Versus After Exposure: Effect on Expectancy and Outcome in Individuals With Claustrophobia.

Maximizing the discrepancy between expected and actual outcomes during exposure (i.e., expectancy violation) is thought to optimize inhibitory learning. The current study examined Craske et al.'s suggestion that engaging in cognitive restructuring (CR) before exposure prematurely reduces expectancy and mitigates outcomes. Participants (N = 93) with claustrophobia were randomly assigned to either 15 minutes of CR before exposure (CR Before) or 15 minutes of CR after exposure (CR After). Although the CR Before condition experienced greater expectancy reduction before exposure than the CR After condition, both groups experienced similar overall expectancy reduction by the end of the intervention. Groups experienced similar gains, with large significant improvement at posttreatment and follow-up. Results suggest that both cognitive therapy and exposure therapy lead to expectancy reduction, but that the order of these interventions does not impact outcome. Clinicaltrials.org registration #NCT03628105.

Clinical Perfectionism, Dissatisfaction With Standards, and Raising the Bar: Validation of the Response to Goal Achievement Scale.

OBJECTIVES: To examine the factor structure and psychometrics of a new self-report scale measuring cognitive and behavioral reactions to goal achievement (Reactions to Goal Achievement Scale; RGAS), and to examine its relationship to other measures of clinical perfectionism in two samples. Self-reported reasons for setting higher standards following successful goal achievement were also examined. METHODS: The RGAS, Clinical Perfectionism Questionnaire (CPQ) and Frost Multidimensional Perfectionism Scale (FMPS) were administered to a sample on Amazon Mechanical Turk (N = 264) and to a sample of overweight individuals (N = 65). RESULTS: Exploratory and confirmatory factor analyses suggested two factors, entitled dissatisfaction with success (DS) and increase in standards (IS). The RGAS was associated with subscales of the CPQ and FMPS. In addition, participants indicated many reasons for setting higher standards following success. CONCLUSION: The RGAS is a new instrument for measuring both cognitive and behavioral responses to success in clinical perfectionism. Setting higher standards may not be an indication of perfectionism, as there appear to be many reasons people set higher standards.