Can cognitive analytic therapy treat hoarding disorder? An adjudicated hermeneutic single-case efficacy design evaluation.

This paper sought to assess whether cognitive analytic therapy (CAT) was effective with a male patient meeting diagnostic criteria for hoarding disorder (HD) who had been nonresponsive to two previous courses of cognitive behaviour therapy. An adjudicated hermeneutic single-case efficacy design (HSCED) evaluation was undertaken. A rich case record (i.e., a summary document containing the case details, formulations, and detailed qualitative and quantitative outcomes) was created. The rich case record was then debated by affirmative (N = 3) and sceptic (N = 3) research teams. Expert judges (N = 3) reviewed the debate and then delivered a final verdict as to whether treatment had worked. Judges unanimously returned a verdict in favour of the sceptic position, concluding that CAT had not enabled change. Lack of change on the primary nomothetic hoarding outcome measure was particularly influential in the final judgement. In this case of HD, CAT was therefore not effective as an intervention. More research is needed before any definitive conclusions can be drawn however as to the wider utility of CAT with HD. Methodological limitations are outlined, alongside considerations for future research.

Testing the Effectiveness of Cognitive Analytic Therapy for Hypersexuality Disorder: An Intensive Time-Series Evaluation.

The evidence base for treatment of hypersexuality disorder (HD) has few studies with appropriate methodological rigor. This study therefore conducted a single case experiment of cognitive analytic therapy (CAT) for HD using an A/B design with extended follow-up. Cruising, pornography usage, masturbation frequency and associated cognitions and emotions were measured daily in a 231-day time series. Following a three-week assessment baseline (A: 21 days), treatment was delivered via outpatient sessions (B: 147 days), with the follow-up period lasting 63 days. Results show that cruising and pornography usage extinguished. The total sexual outlet score no longer met caseness, and the primary nomothetic hypersexuality outcome measure met recovery criteria. Reduced pornography consumption was mediated by reduced obsessionality and greater interpersonal connectivity. The utility of the CAT model for intimacy problems shows promise. Directions for future HD outcome research are also provided.

Helping the heart grow fonder during absence: Daydreaming about significant others replenishes connectedness after induced loneliness.

People are known to engage in behaviours aimed at replenishing social connectedness after their sense of belonging is threatened. We explored whether the mental strategy of daydreaming about significant others could have similar effects by acting as an imaginary substitute when loved ones are unavailable. Following a loneliness induction, participants (N = 126) were asked to either daydream about a significant other, daydream about a non-social scenario or complete a control task. Social daydreamers showed significantly increased feelings of connection, love and belonging compared to non-social daydreamers and control participants. Consistent with the proposition that social daydreaming replenished connectedness, social daydreamers also behaved more pro-socially and expressed less of a desire to interact with others after daydreaming. These findings demonstrate that through imagination, social daydreaming can replenish connectedness providing a potential strategy for enhancing socio-emotional well-being.

Love is the triumph of the imagination: Daydreams about significant others are associated with increased happiness, love and connection.

Social relationships and interactions contribute to daily emotional well-being. The emotional benefits that come from engaging with others are known to arise from real events, but do they also come from the imagination during daydreaming activity? Using experience sampling methodology with 101 participants, we obtained 371 reports of naturally occurring daydreams with social and non-social content and self-reported feelings before and after daydreaming. Social, but not non-social, daydreams were associated with increased happiness, love and connection and this effect was not solely attributable to the emotional content of the daydreams. These effects were only present when participants were lacking in these feelings before daydreaming and when the daydream involved imagining others with whom the daydreamer had a high quality relationship. Findings are consistent with the idea that social daydreams may function to regulate emotion: imagining close others may serve the current emotional needs of daydreamers by increasing positive feelings towards themselves and others.

Investigating goal conflict as a source of mixed emotions.

This research investigated whether (1) the experience of mixed emotions is a consequence of activating conflicting goals and (2) mixed emotions are distinct from emotional conflict. A preliminary experiment (Study 1, N = 35) showed that an elicited goal conflict predicted more mixed emotions than a condition where the same goals were not in conflict. The second experiment was based on naturally occurring goal activation (Study 2, N = 57). This illustrated that mixed emotions were experienced more following conflicting goals compared with a facilitating goals condition-on both a direct self-report measure of mixed emotions and a minimum index measure. The results also showed that mixed emotions were different to emotional conflict. Overall, goal conflict was found to be a source of mixed emotions, and it is feasible that such states have a role in resolving personal dilemmas.

An intensive time-series evaluation of the effectiveness of cognitive behaviour therapy for hoarding disorder: a 2-year prospective study.

OBJECTIVE: To intensively evaluate the effectiveness of cognitive-behavioural therapy (CBT) for Hoarding Disorder. METHOD: An ABC with extended follow-up N=1 single-case experimental design (SCED) measured discard incidence/frequency/volume and associated cognitions, behaviours and emotions in a 644-day time series. Following a 4-week baseline (A), CBT was initially delivered via out-patient sessions (B) and then out-patient sessions plus domiciliary visits (C). Total treatment duration was 45 sessions (65 weeks) and follow-up was 4 sessions over 23 weeks. RESULTS: There was a significant increase in frequency and volume of discard, with a reliable and clinically significant reduction in hoarding. The addition of domiciliary visits did not significantly improve discard ability. DISCUSSION: The clinical utility of domiciliary visits whilst treating of hoarding is discussed and study limitations noted.

Mind-wandering and negative mood: does one thing really lead to another?

Mind-wandering is closely connected with negative mood. Whether negative mood is a cause or consequence of mind-wandering remains an important, unresolved, issue. We sought to clarify the direction of this relationship by measuring mood before and after mind-wandering. We also measured the affective content, time-orientation and relevance of mind-wandering to current concerns to explore whether the link between mind-wandering and negative mood might be explained by these characteristics. A novel experience-sampling technique with smartphone application prompted participants to answer questions about mind-wandering and mood across 7 days. While sadness tended to precede mind-wandering, mind-wandering itself was not associated with later mood and only predicted feeling worse if its content was negative. We also found prior sadness predicted retrospective mind-wandering, and prior negative mood predicted mind-wandering to current concerns. Our findings provide new insight into how mood and mind-wandering relate but suggest mind-wandering is not inherently detrimental to well-being.

Achieving the same for less: improving mood depletes blood glucose for people with poor (but not good) emotion control.

Previous studies have found that acts of self-control like emotion regulation deplete blood glucose levels. The present experiment investigated the hypothesis that the extent to which people's blood glucose levels decline during emotion regulation attempts is influenced by whether they believe themselves to be good or poor at emotion control. We found that although good and poor emotion regulators were equally able to achieve positive and negative moods, the blood glucose of poor emotion regulators was reduced after performing an affect-improving task, whereas the blood glucose of good emotion regulators remained unchanged. As evidence suggests that glucose is a limited energy resource upon which self-control relies, the implication is that good emotion regulators are able to achieve the same positive mood with less cost to their self-regulatory resource. Thus, depletion may not be an inevitable consequence of engaging in emotion regulation.

Cognitive behavioural therapy for cyclothymia: cognitive regulatory control as a mediator of mood change.

BACKGROUND: Regulatory control of cognition is implicated in the amplification of mood variability in cyclothymia. AIMS: This study examined whether cognitive behavioural therapy (CBT) directed at enhanced awareness and mood change could change global functioning, mood variability and regulatory control. METHOD: Using a prospective single case experimental design, mood and cognitive control ratings were recorded every 4 hours for 51 weeks by a patient diagnosed with cyclothymia, including a 5-week baseline, a 35-week (19 session) CBT intervention period and an 11-week follow-up period. RESULTS: Findings indicated that the patient experienced reduced mood variability and greater regulatory control, became happier and less anxious but felt less energetic. Following CBT, high energy became negatively associated with positive mood, and this change was mediated by an increase in control over thoughts. CONCLUSIONS: The results suggest that CBT directed at cognitive control and mindfulness skills may help in the treatment of cyclothymia.

Does regulating others' feelings influence people's own affective well-being?

Individuals in a variety of social contexts try to regulate other people's feelings, but how does this process affect the regulators themselves? This research aimed to establish a relationship between people's use of interpersonal affect regulation and their own affective well-being. In a field study, self- and other-reported data were collected from prisoners and staff members in a therapeutic prison using two surveys separated in time. In a laboratory study, a student sample reported their affect before and after attempting to influence the feelings of talent show contestants in a role-play task. The results of both studies indicated congruent associations between the use of affect-improving and affect-worsening interpersonal affect regulation and strategy agents' affective well-being. Our findings highlight that, when performing interpersonal affect regulation, people may not be immune from the effects of their own actions.

An investigation of the impact of encounters with artistic imagination on well-being.

Evidence about the impact of art on well-being is confined to studies of participatory arts and receptive arts that involve attending cultural events. This investigation examined the impact of art on well-being by framing people's engagement with art as encounters with artistic imagination. These encounters include traditional forms of cultural activity, such as a gallery or theater visit, but also encompass everyday activities, such as watching a screen drama or reading fiction. Three studies examined how such encounters affect emotional well-being, life satisfaction, meaning in life, and mental well-being. A survey study (N = 544) found that participants on average spent over 4 hr engaged with art the previous day. This study and an experience-sampling study (N = 50), in which participants completed a questionnaire via their smartphones twice daily for 10 days (854 responses), revealed that individuals' variety of encounters with art and accompanying elevating emotional experiences were associated with well-being. Live arts engagement was positively associated with all aspects of well-being, and visual and literary arts with greater meaning in life, whereas screen arts, audio arts, and sports spectating (for comparison) were not positively associated. A third study using (live) arts attendance and well-being data (n = 27,918) from 2 waves (3-year interval) of a large longitudinal panel survey showed that frequency of attendance predicted subsequent well-being, whereas arts participation did not. Overall, the evidence indicates that encounters with artistic imagination contribute to people's well-being, with effects varying according to the art form and the type of well-being assessed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A classification of controlled interpersonal affect regulation strategies.

Controlled interpersonal affect regulation refers to the deliberate regulation of someone else's affect. Building on existing research concerning this everyday process, the authors describe the development of a theoretical classification scheme that distinguishes between the types of strategy used to achieve interpersonal affect regulation. To test the theoretical classification, the authors generated a corpus of 378 distinct strategies using self-report questionnaires and diaries completed by student and working samples. Twenty participants then performed a card-sort of the strategies. Hierarchical cluster analysis was used to determine how well the theoretical classification represented spontaneous understandings of controlled interpersonal affect regulation. The final classification primarily distinguished between strategies used to improve versus those used to worsen others' affect, and between strategies that engaged the target in a situation or affective state versus relationship-oriented strategies. The classification provides a meaningful basis for organizing existing research and making future conceptual and empirical distinctions.

The source of display rules and their effects on primary health care professionals' well-being.

Employees' perceptions of the emotional requirements of their work role are considered a necessary antecedent of emotion work. The impact of these requirements on the emotions employees display, their well-being, and their clients' satisfaction has been explored in previous research. Emotional requirements have been characterized as organizationally-based expectations (e.g., Brotheridge & Lee, 2003), formal and informal organizational rules (e.g., Cropanzano, Weiss & Elias, 2004), occupational norms (e.g., Rafaeli & Sutton, 1987; Smith & Kleinman, 1989) and job-based demands (Brotheridge & Lee, 2002). Although all these definitions assume some kind of shared source for perceptions of emotional requirements, it remains unclear to what extent these different sources contribute and to what extent the requirements are shared by different units, teams and individuals in the organization. The present study analyses the perception of emotional requirements from a survey of ninety-seven Primary Health Care teams composed of general practitioners, nurses and administrative staff (N = 1057). The relative contribution of different sources of variance (team, organizational, and occupational) to perceived emotional requirements and the effects on employees' job satisfaction and well being are examined. Results confirm the relevance of the source and show the contribution of emotional demands to prediction of emotional exhaustion and job satisfaction levels.

Corrigendum: Using interpersonal affect regulation in simulated healthcare consultations: an experimental investigation of self-control resource depletion.

[This corrects the article DOI: 10.3389/fpsyg.2015.01485.].

Treatment of obsessive morbid jealousy with cognitive analytic therapy: An adjudicated hermeneutic single-case efficacy design evaluation.

OBJECTIVE: The evidence base for the treatment of morbid jealousy with integrative therapies is thin. This study explored the efficacy of cognitive analytic therapy (CAT). DESIGN: An adjudicated hermeneutic single-case efficacy design evaluated the cognitive analytic treatment of a patient meeting diagnostic criteria for obsessive morbid jealousy. METHOD: A rich case record was developed using a matrix of nomothetic and ideographic quantitative and qualitative outcomes. This record was then debated by sceptic and affirmative research teams. Experienced psychotherapy researchers acted as judges, assessed the original case record, and heard the affirmative-versus-sceptic debate. Judges pronounced an opinion regarding the efficacy of the therapy. RESULTS: The efficacy of CAT was supported by all three judges. Each ruled that change had occurred due to the action of the therapy, beyond any level of reasonable doubt. CONCLUSIONS: This research demonstrates the potential usefulness of CAT in treating morbid jealousy and suggests that CAT is conceptually well suited. Suggestions for future clinical and research directions are provided. PRACTITIONER POINTS: The relational approach of CAT makes it a suitable therapy for morbid jealousy. The narrative reformulation component of CAT appears to facilitate early change in chronic jealousy patterns. It is helpful for therapists during sessions to use CAT theory to diagrammatically spell out the patterns maintaining jealousy.

The role of temperature in the detection and diagnosis of neutropenic sepsis in adult solid tumour cancer patients receiving chemotherapy.

PURPOSE: The primary aim of this study was to examine the value of temperature as a diagnostic and prognostic indicator of infection and sepsis in neutropenic patients. A secondary aim was to gain insight into the presenting symptoms reported by these patients at home or on their initial admission assessment. METHODS: A cohort study was carried out using a case note review of 220 emergency admissions to a regional cancer centre. All participants were neutropenic and were diagnosed with infection on admission. The main outcome measures were relationships between Early Warning Scores and temperature values at home, on admission and during the hospital stay. RESULTS: 22% of patients who became acutely unwell did not have a fever. Pearson correlations showed only small associations between highest temperature value at any time point and highest early warning scores (r(202) = 0.176, P = .012). Temperature at home (B = 0.156, P = .336) and temperature on admission (B = 0.200, P = .052) did not predict highest Early Warning Scores. CONCLUSIONS: Body temperature is not a consistently reliable diagnostic or prognostic indicator for outcomes in patients with neutropenia and symptoms of infection. It can assist with early presentation and recognition of infection in many neutropenic patients. However, over-reliance on temperature risks missing the opportunity for early detection and treatment.

A Test and Extension of Lane and Terry's (2000) Conceptual Model of Mood-Performance Relationships Using a Large Internet Sample.

The present study tested and extended Lane and Terry (2000) conceptual model of mood-performance relationships using a large dataset from an online experiment. Methodological and theoretical advances included testing a more balanced model of pleasant and unpleasant emotions, and evaluating relationships among emotion regulation traits, states and beliefs, psychological skills use, perceptions of performance, mental preparation, and effort exerted during competition. Participants (N = 73,588) completed measures of trait emotion regulation, emotion regulation beliefs, regulation efficacy, use of psychological skills, and rated their anger, anxiety, dejection, excitement, energy, and happiness before completing a competitive concentration task. Post-competition, participants completed measures of effort exerted, beliefs about the quality of mental preparation, and subjective performance. Results showed that dejection associated with worse performance with the no-dejection group performing 3.2% better. Dejection associated with higher anxiety and anger scores and lower energy, excitement, and happiness scores. The proposed moderating effect of dejection was supported for the anxiety-performance relationship but not the anger-performance relationship. In the no-dejection group, participants who reported moderate or high anxiety outperformed those reporting low anxiety by about 1.6%. Overall, results showed partial support for Lane and Terry's model. In terms of extending the model, results showed dejection associated with greater use of suppression, less frequent use of re-appraisal and psychological skills, lower emotion regulation beliefs, and lower emotion regulation efficacy. Further, dejection associated with greater effort during performance, beliefs that pre-competition emotions did not assist goal achievement, and low subjective performance. Future research is required to investigate the role of intense emotions in emotion regulation and performance.

Does leader-affective presence influence communication of creative ideas within work teams?

Affective presence is a novel, emotion-related personality trait, supported in experimental studies, concerning the extent to which a person makes his or her interaction partners feel the same way (Eisenkraft & Elfenbein, 2010). Applying this concept to an applied teamwork context, we proposed that team-leader-affective presence would influence team members' communication of creative ideas. Multilevel modeling analysis of data from a survey study conducted with teams from a consultancy firm confirmed that team-leader-affective presence interacted with team-member creative idea generation to predict inhibition of voicing their ideas. Specifically, withholding of ideas was less likely when team members generated creative ideas and their team leader had higher positive affective presence or lower negative affective presence. These findings contribute to emotion research by showing affective presence as a trait with interpersonal meaning, which can shape how cognition is translated into social behavior in applied performance contexts, such as teamwork in organizations. (PsycINFO Database Record

Leader affective presence and innovation in teams.

Affective presence is a novel personality construct that describes the tendency of individuals to make their interaction partners feel similarly positive or negative. We adopt this construct, together with the input-process-output model of teamwork, to understand how team leaders influence team interaction and innovation performance. In 2 multisource studies, based on 350 individuals working in 87 teams of 2 public organizations and 734 individuals working in 69 teams of a private organization, we tested and supported hypotheses that team leader positive affective presence was positively related to team information sharing, whereas team leader negative affective presence was negatively related to the same team process. In turn, team information sharing was positively related to team innovation, mediating the effects of leader affective presence on this team output. The results indicate the value of adopting an interpersonal individual differences approach to understanding how affect-related characteristics of leaders influence interaction processes and complex performance in teams. (PsycINFO Database Record

Tracking Potentiating States of Dissociation: An Intensive Clinical Case Study of Sleep, Daydreaming, Mood, and Depersonalization/Derealization.

This study examined in real time the role of sleep and daydreaming as potentiating states for subsequent dissociation in depersonalization/derealization disorder (DDD). Research and theory suggests that dissociation may be exacerbated and maintained by a labile sleep-wake cycle in which "dream-like" mentation intrudes into waking life and fuels dissociative symptoms. We explore and extend this idea by examining the state of daydreaming in dissociation. Daydreaming is a state of consciousness between dreaming and waking cognition that involves stimulus-independent and task-unrelated mentation. We report the results of a unique intensive N = 1 study with an individual meeting diagnostic criteria for DDD. Using experience-sampling methodology, the participant rated (six times daily for 40 days) current daydreaming, mood, and dissociative symptoms. At the start of each day sleep quality and duration was also rated. Daydreaming was reported on 45% of occasions and significantly predicted greater dissociation, in particular when daydreams were repetitive and negative (but not fanciful) in content. These relationships were mediated by feelings of depression and anxiety. Sleep quality but not duration was a negative predictor of daily dissociation and also negatively predicted depression but not anxiety. Findings offer initial evidence that the occurrence and content of daydreams may act as potentiating states for heightened, in the moment, dissociation. The treatment implications of targeting sleep and daydreaming for dissociative disorders are discussed.