Peter F. Lovibond

The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.

The Role of Awareness in Pavlovian Conditioning: Empirical Evidence and Theoretical Implications

This article reviews research over the past decade concerning the relationship between Pavlovian conditioning and conscious awareness. The review covers autonomic conditioning, conditioning with subliminal stimuli, eyeblink conditioning, conditioning in amnesia, evaluative conditioning, and conditioning under anesthesia. The bulk of the evidence is consistent with the position that awareness is necessary but not sufficient for conditioned performance, although studies suggestive of conditioning without awareness are identified as worthy of further investigation. Many studies have used inadequate measures of awareness, and strategies for increasing validity and sensitivity are discussed. It is concluded that conditioning may depend on the operation of a propositional system associated with consciousness rather than a separate, lower level system.

The propositional nature of human associative learning

The past 50 years have seen an accumulation of evidence suggesting that associative learning depends on high-level cognitive processes that give rise to propositional knowledge. Yet, many learning theorists maintain a belief in a learning mechanism in which links between mental representations are formed automatically. We characterize and highlight the differences between the propositional and link approaches, and review the relevant empirical evidence. We conclude that learning is the consequence of propositional reasoning processes that cooperate with the unconscious processes involved in memory retrieval and perception. We argue that this new conceptual framework allows many of the important recent advances in associative learning research to be retained, but recast in a model that provides a firmer foundation for both immediate application and future research.

A Randomized Controlled Trial of D-Cycloserine Enhancement of Exposure Therapy for Social Anxiety Disorder

BACKGROUND Pilot research has suggested that D-cycloserine (DCS) enhances treatment outcomes for anxiety disorders when employed as an adjunct to exposure therapy (ET). The aim of this study was to determine whether 50 mg of DCS enhances ET for social anxiety disorder (SAD) according to a comprehensive set of symptom and life impairment measures. METHODS In a randomized double-blind placebo-controlled trial, we administered 50 mg of DCS or placebo in combination with ET to 56 participants who met primary diagnosis for SAD. RESULTS Participants administered DCS reported greater improvement on measures of symptom severity, dysfunctional cognitions, and life-impairment from SAD in comparison with placebo-treated participants. Effect sizes were mostly in the medium range. Results also indicated that the amount of adaptive learning about ones ability to give speeches in front of an audience interacted with DCS to enhance treatment outcome. CONCLUSIONS This study shows that the administration of DCS before ET enhances treatment outcomes for SAD. Results also provide the first preliminary evidence to suggest that DCS moderates the relationship between a reduction in negative appraisals about ones speech performance and improvement in overall SAD symptoms.

Extinction in Human Fear Conditioning

Although most extinction research is conducted in animal laboratories, the study of extinction learning in human fear conditioning has gained increasing attention over the last decade. The most important findings from human fear extinction are reviewed in this article. Specifically, we review experimental investigations of the impact of conditioned inhibitors, conditioned exciters, context renewal, and reinstatement on fear extinction in human samples. We discuss data from laboratory studies of the extinction of aversively conditioned stimuli, as well as results from experimental clinical work with fearful or anxious individuals. We present directions for future research, in particular the need for further investigation of differences between animal and human conditioning outcomes, and research examining the role of both automatic and higher-order cognitive processes in human conditioning and extinction.

Facilitation of instrumental behavior by a Pavlovian appetitive conditioned stimulus.

Three experiments examined appetitive Pavlovian-instrumental interactions by presenting separately trained conditioned stimuli (CSs) during reinforced instrumental responding in rabbits. Intra-oral reinforcement was used to minimize interference from peripheral responses such as magazine approach. In experiment 1, the rabbits were first trained to perform an instrumental head-raising response for sucrose reward. A conditioned jaw movement response was then established to a 2-sec CS by pairing it with sucrose; a control stimulus was unpaired with sucrose. Instrumental responding maintained by a variable-interval 40-sec schedule was enhanced during 10-sec presentations of the paired, but not the unpaired, CS. Responding on a variable-ratio 15 schedule was unaffected except on trials on which the pre-CS baseline response rate was low; in such cases the paired CS caused a long-lasting acceleration of responding. Noncontingent presentation of the sucrose reinforcer itself briefly suppressed responding but had no long-term effect. In Experiment 2, a CS that had been conditioned at a 10-sec duration produced the same pattern of effects as in the first study, indicating that facilitation resulted from CS presentation rather than from the frustrative effects of non-reinforcement of the CS. In Experiment 3 an inhibitory CS blocked facilitation by the excitatory CS but did not itself affect instrumental responding. These results support the view that Pavlovian processes play a positive role in instrumental performance and suggest that previous findings of suppression by a short-duration CS reflect peripheral interference. The dependence of facilitation on the baseline level of responding is discussed in terms of associative and motivational theories of Pavlovian mediation.

Causal beliefs and conditioned responses: retrospective revaluation induced by experience and by instruction.

The author tested causal beliefs and conditioned responses in a task involving retrospective revaluation of the causal status of a target cue with respect to electric shock. Successful revaluation was observed on both self-report shock expectancy and skin conductance, whether the training trials were directly experienced, described, or partly experienced and partly described. The results contradict models that link anticipatory conditioned responses to a separate or earlier process from that underlying explicit causal knowledge. They suggest instead that a single learning process gives rise to propositional knowledge that (a) drives anticipatory responding, (b) forms the basis for self-reported causal beliefs, and (c) can be combined with other knowledge, provided either by experience or symbolically, to generate inferences such as retrospective revaluation.

Protection from extinction in human fear conditioning.

Two experiments examined the ability of an added stimulus to interfere with extinction of a target excitatory fear stimulus (a predictor of shock) in human autonomic conditioning. Both experiments demonstrated disruption of extinction when the added stimulus was inhibitory (a predictor of no shock, or safety signal). Subjects showed a return of fear when the target stimulus was tested alone, on both self-reported shock expectancy and skin conductance measures. The second experiment also demonstrated disruption of extinction when the added stimulus was excitatory. This results suggests that protection from extinction may occur even when the added stimulus is not inhibitory. Additional factors that may contribute to protection from extinction include context-specificity, occasion-setting and external inhibition. The results highlight the role that concurrent stimuli play in extinction, and emphasise the need to keep concurrent stimuli as similar as possible to the desired transfer context in practical applications of extinction such as exposure therapy for anxiety.

The utility of somatic items in the assessment of depression in patients with chronic pain: a comparison of the Zung Self-Rating Depression Scale and the Depression Anxiety Stress Scales in chronic pain and clinical and community samples.

Objective: To investigate the role of somatic items in the assessment of depression in chronic pain. Methods: The Self-Rating Depression Scale was administered to 398 individuals with chronic pain, 313 psychology clinic patients with similar overall levels of depression, and a general population sample of 491. All three samples were also administered the Depression Anxiety Stress Scales. Results: Confirmatory factor analysis of pooled Self-Rating Depression Scale and Depression Anxiety Stress Scales items revealed that Self-Rating Depression Scale items denoting diurnal variation, decreased appetite, weight loss and constipation failed to contribute to depression in all 3 samples. Items denoting tachycardia and irritability also failed to discriminate between depression and a combined anxiety/stress factor in all 3 samples. The chronic pain sample endorsed somatic items, in particular psychomotor retardation, sleep disturbance, constipation, and fatigue, more strongly than the other samples relative to their endorsement of nonsomatic depression items. Conclusions: It was concluded that depression measures that give emphasis to somatic symptoms provide poor measures of depression severity in any individuals and in patients with chronic pain may lead to an overestimation of the severity of depression. More recently developed instruments avoid these limitations and are also better able to discriminate depression from related states such as anxiety and tension/stress.

Forward and backward blocking of causal judgment is enhanced by additivity of effect magnitude

When two causes for a given effect are simultaneously presented, it is natural to expect an effect of greater magnitude. However many laboratory tasks preclude such an additivity rule by imposing a ceiling on effect magnitude—for example, by using a binary outcome. Under these conditions, a compound of two causal cues cannot be distinguished from a compound of one causal cue and one noncausal cue. Two experiments tested the effect of additivity on cue competition. Significant but weak forward blocking and no backward blocking were observed in a conventional “allergy” causal judgment task. Explicit pretraining of magnitude additivity produced strong and significant forward and backward blocking. Additivity pretraining was found to be unnecessary for another cue competition effect, release from overshadowing, which does not logically depend on additivity. The results confirm that blocking is constrained when effect magnitude is constrained and provide support for an inferential account of cue competition.