Philip Tata

Attentional bias in obsessional compulsive disorder

To date, studies of information processing in anxiety disorders have suggested that the latter are characterised by vigilance for threatening stimuli, possibly specific to personally relevant threat content. The present study represents an attempt to establish whether patients suffering from Obsessional Compulsive Disorder (OCD), generally classified as an anxiety disorder, show a similar cognitive bias. Thus, a replication of MacLeod, Mathews and Tatas (1986) study [Journal of Abnormal Psychology, 95, 15-20] is reported, employing modified materials of direct concern to the OCD subjects i.e. Contamination-related words. The results did indeed reveal content specific vigilance, whereby the OCD group were more vigilant for contamination content than mood-matched High Trait Anxious (HTA) controls, but the reverse was true for Social Anxiety words. Additionally, while a general threat interference effect was identified for both OCD and HTA subjects this was not content specific. A second experiment employing Low Trait Anxious subjects revealed no vigilance for threat nor any threat interference in this sample. The clinical implications and possible mechanism underlying these results are discussed.

Lack of cognitive recovery following withdrawal from long-term benzodiazepine use

Twenty-one patients with significant long-term therapeutic benzodiazepine (BZ) use, who remained abstinent at 6 months follow-up after successfully completing a standardized inpatient BZ withdrawal regime, and 21 normal controls matched for age and IQ but not for anxiety, were repeatedly tested on a simple battery of routine psychometric tests of cognitive function, pre- and post-withdrawal and at 6 months follow-up. The results demonstrated significant impairment in patients in verbal learning and memory, psychomotor, visuo-motor and visuo-conceptual abilities, compared with controls, at all three time points. Despite practice effects, no evidence of immediate recovery of cognitive function following BZ withdrawal was found. Modest recovery of certain deficits emerged at 6 months follow-up in the BZ group, but this remained significantly below the equivalent control performance. The implications of persisting cognitive deficits after withdrawal from long-term BZ use are discussed.

Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial

BACKGROUND Little information exists on treatment effectiveness in antisocial personality disorder (ASPD). We investigated the feasibility and effectiveness of carrying out a randomized controlled trial of cognitive behaviour therapy (CBT) in men with ASPD who were aggressive. METHOD This was an exploratory two-centre, randomized controlled trial in a community setting. Fifty-two adult men with a diagnosis of ASPD, with acts of aggression in the 6 months prior to the study, were randomized to either treatment as usual (TAU) plus CBT, or usual treatment alone. Change over 12 months of follow-up was assessed in the occurrence of any act of aggression and also in terms of alcohol misuse, mental state, beliefs and social functioning. RESULTS The follow-up rate was 79%. At 12 months, both groups reported a decrease in the occurrence of any acts of verbal or physical aggression. Trends in the data, in favour of CBT, were noted for problematic drinking, social functioning and beliefs about others. CONCLUSIONS CBT did not improve outcomes more than usual treatment for men with ASPD who are aggressive and living in the community in this exploratory study. However, the data suggest that a larger study is required to fully assess the effectiveness of CBT in reducing aggression, alcohol misuse and improving social functioning and view of others. It is feasible to carry out a rigorous randomized controlled trial in this group.

The effects of mood and verbal feedback on interrogative suggestibility

Abstract This study investigated the influence of two situational factors on interrogative suggestibility among 40 adult volunteers who had completed the Gudionsson Suggestibility Scale. The two situational influences were: (i) a non-verbal stress induction (white noise vs relaxation) immediately prior to the administration of the GSS, (ii) non-contingent positive or negative verbal feedback between interrogations. Despite some success of the stress manipulation, this factor failed to affect either recall or suggestibility. Negative feedback, on the other hand, proved to have significant effects both on mood and suggestibility within the testing situation, with evidence of suggestible and confabulated responding persisting at 1 week retest, and significant correlations with the degree of initial mood disturbance. The theoretical and forensic implications of the findings are discussed.