David A. Moscovitch

The worried mind: autonomic and prefrontal activation during worrying.

To study the psychophysiological correlates of worrying, the authors recorded heart rate, respiratory sinus arrhythmia (RSA), skin conductance level, and alpha electroencephalographic asymmetry in healthy males during baseline, relaxation, worry induction, and anticipation of an impromptu speech task. Compared with baseline, relaxation, and anticipation, worrying was associated with greater heart rate and lower RSA. Worrying was further characterized by higher skin conductance levels compared with baseline but lower levels than during anticipation. Finally, worrying was associated with relatively greater left frontal activity compared with anticipation. Trait public speaking anxiety was positively correlated with left frontal activity during worrying. These results support the notion that worrying is a unique emotional state that is different from fearful anticipation.

Randomness, Attributions of Arousal, and Belief in God

Beliefs in God, or similar spiritual forces, have permeated every culture the world has seen, past or present (Atran & Norenzayan, 2004). Although there are likely many reasons why such beliefs are so strongly held (Kirkpatrick, 1998; Norenzayan & Hansen, 2006), attempts to cope with perceptions of randomness may be a key factor. Randomness is presumed to be highly aversive (Pennebaker & Stone, 2004), and people will go to considerable lengths to reaffirm order in the face of evidence to the contrary (e.g., by blaming victims of random misfortune or seeing patterns in random arrays; Jost, Banaji, & Nosek, 2004; Lerner, 1980; Whitson & Galinsky, 2008; also see Heine, Proulx, & Vohs, 2006). Affirming the existence of a controlling God, therefore, may provide an excellent means for insulating oneself from the aversive arousal associated with randomness. However, no experimental test of this hypothesis exists. Park (2005) has suggested that traumatic events can strengthen belief in God because of the threat they pose to nonrandomness, but this correlational research (also see Laurin, Kay, & Moscovitch, 2008) focused only on negative events and assumed (rather than directly assessed) the role of randomness. Some research has manipulated self-conceptions that may be related to preserving beliefs in order (e.g., Kay, Gaucher, Napier, Callan, & Laurin, 2008; McGregor, Haji, Nash, & Teper, 2008), but none has investigated randomness directly, and none, crucially, has assessed the role of arousal in generating between-condition differences in belief in God. In this study, we employed a novel paradigm to test (a) whether direct manipulations designed to prime thoughts of randomness cause increased beliefs in supernatural sources of control (even when controlling for negative valence) and (b) whether this effect is due to arousal generated by thoughts of randomness. To heighten thoughts of randomness, we supraliminally primed half the participants with randomness-related words; the other half were primed with words matched in negative valence. To assess the role of arousal, we employed a misattribution paradigm (Zanna & Cooper, 1974), which involved requiring all participants to swallow a pill ostensibly containing an herbal supplement. Half the participants were told that the pill sometimes induces arousal as a side effect, and half were told that the pill has no side effects. Previous work has shown that the side-effect condition leads participants to attribute the cause of any experienced arousal to this salient source (Proulx & Heine, 2008; Zanna & Cooper, 1974). Hypothesizing that beliefs in supernatural control function, at least in part, to down-regulate the aversive arousal associated with randomness, we expected the randomness primes to increase beliefs in God, but only for those participants not given the opportunity to attribute the cause of their arousal to the ingested pill.

Mediation of Changes in Anxiety and Depression During Treatment of Social Phobia.

To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated 91% of the improvements in depression over time. Conversely, decreases in depression only accounted for 6% of the decreases in social anxiety over time. Changes in social anxiety fully mediated changes in depression during the course of treatment. The theoretical and clinical implications of these findings for the relationship between anxiety and depression are discussed. reserved).

Changes in self-perception during treatment of social phobia.

Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed.

Sudden gains during therapy of social phobia.

The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967 session-to-session intervals met criteria for sudden gains, which most frequently occurred in Session 5. Individuals with sudden gains showed similar improvements in the 2 treatment groups. Although cognitive-behavioral therapy was associated with more cognitive changes than exposure therapy, cognitive changes did not precede sudden gains. In general, the results of this study question the clinical significance of sudden gains in social phobia treatment.

SUPER FACE-INVERSION EFFECTS FOR ISOLATED INTERNAL OR EXTERNAL FEATURES, AND FOR FRACTURED FACES

Two experiments were conducted to determine the contributions of the face and object systems to the recognition of upright and inverted faces. In Experiment 1, CK, a person with object agnosia and normal recognition of upright faces, and 12 controls attempted to identify faces when presented with upright or inverted versions of the whole face, or with only their internal or external features. CK recognised as many upright whole faces as controls and the performance of both dropped slightly in the upright, internal feature condition. CKs recognition, however, was impaired in the upright, external condition, and severely impaired in the inverted whole condition, whereas control performance was equivalent in the two, and only somewhat worse than in the upright whole condition. Recognition in the inverted internal and external condition was extremely poor for all participants, leading to a super-inversion effect. This super-inversion effect suggested that recognition depends on more than just piecemeal identification of individual features. Experiment 2 was conducted to determine whether relational information is needed even for the identification of inverted faces. Twelve controls were required to identify whole and fractured faces in the upright and inverted orientation. The fractured faces had all the parts in the canonical order (eyes above nose above mouth) but they were separated by gaps, thereby altering the spatial relation among them. Recognition of inverted fractured faces was much worse than recognition of upright fractured faces and inverted whole faces, producing yet another super-inversion effect. The deficit in the inverted fractured condition was equal to the combined drop in performance in the other two conditions, indicating that the effects of inversion and fracturing are additive. On the basis of these results, we proposed that the face system forms holistic representations of faces based on orientation-specific global configurations primarily of internal features. When this information is unavailable, as when viewing inverted or fractured faces, the object system is needed to integrate information about individual features, which themselves may be orientation-specific, with information about the local or categorical relations among them into an object-system counterpart of the face-system representation. The creation of the facial counterpart by the object system and the consequent identification by the face system involves an exchange of information between the two systems according to an interactive activation model.

Frontal EEG asymmetry and symptom response to cognitive behavioral therapy in patients with social anxiety disorder

Although previous studies have shown that socially anxious individuals exhibit greater relative right frontal electroencephalogram (EEG) activity at rest, no studies have investigated whether improvements in symptoms as a result of treatment are associated with concomitant changes in resting brain activity. Regional EEG activity was measured at rest in 23 patients with social anxiety disorder (SAD) before and after cognitive behavioral therapy (CBT). Results indicated that patients shifted significantly from greater relative right to greater relative left resting frontal brain activity from pre- to posttreatment. Greater left frontal EEG activity at pretreatment predicted greater reduction in social anxiety from pre- to posttreatment and lower posttreatment social anxiety after accounting for pretreatment symptoms. These relations were specific to the frontal alpha EEG asymmetry metric. These preliminary findings suggest that resting frontal EEG asymmetry may be a predictor of symptom change and endstate functioning in SAD patients who undergo efficacious psychological treatment.

Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure.

High (n=41) and low (n=39) socially anxious (SA) participants completed the Waterloo Images and Memories Interview (WIMI), a new assessment tool that measures the accessibility and properties of mental images and associated autobiographical memories that individuals may experience across both anxiety-provoking (negative) and non-anxiety-provoking (positive) social situations. Results indicated that both high and low SA individuals experience negative images and associated autobiographical memories in anxiety-provoking social situations, but the rates of endorsement of such images and memories among high SA participants were substantially lower than those reported in recent studies. Moreover, whereas low SA individuals were capable of accessing a relatively balanced array of both negative and positive self-representations that were rich in episodic detail, high SA individuals retrieved a higher, more unbalanced ratio of negative-to-positive images and memories, as well as impoverished positive images that were significantly degraded in episodic detail. Finally, negative images influenced the two groups differently, with high SA individuals experiencing more negative emotional and cognitive consequences associated with bringing such images to mind. These results are discussed in relation to theoretical models of learning and memory within the context of contemporary cognitive behavioral models of social anxiety.

In the absence of rose-colored glasses: Ratings of self-attributes and their differential certainty and importance across multiple dimensions in social phobia

Sixty-seven individuals with social phobia (social anxiety disorder) and 60 healthy controls rated their perceived standing relative to others on 13 self-attribute dimensions, their level of certainty concerning those standings, and the importance of each dimension. As expected, individuals with social phobia provided self-ratings that were significantly more negative than controls across all dimensions. In addition, positive self-views were equated with higher levels of certainty and importance for controls, but not for individuals with social phobia. Thus, whereas reports of control participants reflected a healthy, positive framing of self-views, the ratings of clinical participants demonstrated an orientation toward self-framing that was neither positive nor negative. Together, these novel findings shed light on the nature of self-appraisals in social anxiety. Implications of these results are discussed in terms of contemporary cognitive-behavioral models of social phobia.

Changes in EEG Cross-Frequency Coupling During Cognitive Behavioral Therapy for Social Anxiety Disorder

Coupling between EEG delta and beta oscillations is enhanced among anxious and healthy individuals during anticipatory anxiety. EEG coupling patterns associated with psychotherapy have not yet been quantified in socially anxious individuals. In this study, we used a double baseline, repeated measures design, in which 25 adults with a principal diagnosis of social anxiety disorder completed 12 weekly sessions of standardized group cognitive behavioral therapy and four EEG assessments: two at pretreatment, one at midtreatment, and one at posttreatment. Treatment was associated with reductions in symptom severity across multiple measures and informants, as well as reductions in delta-beta coupling at rest and during speech anticipation. Moreover, the clinical group exhibited greater coupling at pretreatment than did post hoc control participants with low social anxiety. The EEG cross-frequency profiles in the clinical group normalized by the posttreatment assessment. These findings provide evidence of concomitant improvement in neural and behavioral functioning among socially anxious adults undergoing psychotherapy.