Tom J. Barry

Maternal postnatal depression predicts altered offspring biological stress reactivity in adulthood.

Highlights • Postnatally depressed (PND) mothers’ offspring showed increased cortisol stress reactivity.• This response at age 22-years was relative to control offspring.• There was also evidence of stable alterations in cortisol secretion in the PND group.• Offspring or subsequent maternal depression did not explain group differences.• Early maternal depression can predict offspring biological sensitivity to stress.

An integrative review of attention biases and their contribution to treatment for anxiety disorders

Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians.

Meet the fribbles: Novel stimuli for use within behavioural research

Clinical researchers make use of experimental models for mental disorders. In many cases, these models use stimuli that are relevant to the disorder under scrutiny, which allows one to experimentally investigate the factors that contribute to the development of the disorder. For example, one might use spiders or spider-like stimuli in the study of specific phobia. More broadly, researchers often make use of real-world stimuli such as images of animals, geometrical shapes or emotional words. However, these stimuli are often limited in their experimental controllability and their applicability to the disorder in question. We present a novel set of animal-like stimuli, called Fribbles, for use within behavioural research. Fribbles have desirable properties for use in research because they are similar to real-world stimuli, but due to their novelty, participants will not have had previous experience with them. They also have known properties that can be experimentally manipulated. We present an investigation into similarity between Fribbles in order to illustrate their utility in research that relies on comparisons between similar stimuli. Fribbles offer both experimental control and generalisability to the real world, although some consideration must be made concerning the properties that influence similarity between Fribbles when selecting them along a dimension of similarity.

Treatment of avoidance behavior as an adjunct to exposure therapy: Insights from modern learning theory

Pathological avoidance of benign stimuli is a hallmark of anxiety and related disorders, and exposure-based treatments have often encouraged the removal of avoidance, or safety behaviors, due to their negative effects on extinction learning. Unfortunately, empirical evidence suggests that avoidance behaviors can persist following treatment, and the mere availability of avoidance behavior can be sufficient to renew fear following successful extinction learning. The present paper critically examines the function of avoidance behavior through the lens of modern learning theory, and speculates on novel behavioral and pharmacological strategies for targeting avoidance as an adjunct to current evidence-based treatments.

The role of stimulus specificity and attention in the generalization of extinction

Exposure therapy for anxiety is effective but fear can still return afterward. This may be because the stimuli that people are exposed to are dissimilar from the stimuli to which fear was originally acquired. After pairing an animal-like image (A) with a shock stimulus (US), a perceptually similar stimulus (B) was presented without the US in extinction. Participants were then shown A (ABA), a second generalization stimulus (ABC) or B (ABB). Groups ABA and ABC evidenced a return of US expectancy relative to participants who were shown B (ABB). Participants in group ABC who self-reported high levels of attentional control evidenced greater return of expectancy relative to participants low in attentional control. Participants with a high level of attentional control also showed steeper extinction gradients. Attentional control may influence perceptions of similarity and the learning that follows. Making note of such differences may be valuable in exposure treatment for anxiety.

DEFICITS IN DISENGAGING ATTENTION FROM THREAT PREDICT IMPROVED RESPONSE TO COGNITIVE BEHAVIORAL THERAPY FOR ANXIETY

Pretreatment biases in attending toward threat have been shown to predict greater symptom reduction following cognitive behavioral therapy (CBT) for anxiety. Findings to date do not extend to clinical severity of diagnoses and they assess treatment response immediately posttreatment and not at follow‐up. Research in this area has also not examined components of vigilance (e.g., engagement, disengagement) or whether these effects are confined to external attention and not attention to internal symptoms of anxiety.

Amygdala volume and hypothalamic-pituitary-adrenal axis reactivity to social stress

Highlights • Amygdala volumes were not associated with stress-related cortisol reactivity.• However, postnatally depressed mothers’ offspring showed an association.• For these offspring, smaller volumes corresponded with heightened reactivity.• This association was relative to age-matched control offspring.

Feature specific attention and return of fear

Anxiety disorders are often treated by repeatedly presenting stimuli that are perceptually similar to original stimuli to which fear was originally acquired. Fear can return after it is extinguished because of the differences between these stimuli. It may possible to attenuate return of fear by manipulating attention to the commonalities between feared stimuli and extinction stimuli. After acquiring fear for an animal-like stimulus by pairing with an electro-cutaneous shock, fear was extinguished by repeatedly presenting a similar stimulus. During extinction participants were asked questions that instructed them to attend towards the features in common between the acquisition and extinction stimulus or towards the unique features of the extinction stimulus. Return of fear was assessed by presenting a second perceptually similar stimulus after extinction. Participants showed a return in skin conductance responding after extinction in the unique condition, and not in the common condition. Both groups showed a return in self-report ratings of US expectancy. Neither group showed a return in fear potentiated startle, but there was evidence that this may have been due to individual differences in emotional attentional control. Our conclusions are limited by the use of a self-report measure of emotional attentional control and the absence of limits on the length of time participants could take to answer the extinction questions. It may be possible to enhance extinction and prevent a return of the physiological aspects of fear by manipulating attention during extinction. However, this does not appear to influence explicit expectancy of aversive outcomes. Individual differences in attentional control may influence this process.

Meta-analysis of the association between rumination and reduced autobiographical memory specificity

ABSTRACT The CaRFAX model, proposed by Williams J. M. G. (2006. Capture and rumination, functional avoidance, and executive control (CaRFAX): Three processes that underlie overgeneral memory. Cognition and Emotion, 20, 548–568. doi:10.1080/02699930500450465; Williams, J. M. G., Barnhofer, T., Crane, C., Herman, D., Raes, F., Watkins, E., & Dalgleish, T. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133(1), 122–148. doi:10.1037/0033-2909.133.1.122) posits that reduced autobiographical memory specificity, a key factor associated with the emergence and maintenance of emotional disorders, may result from heightened rumination. We provide the first meta-analysis of the relation between autobiographical memory specificity and trait rumination. PsycINFO, PsycARTICLES and MEDLINE databases were searched and the following were extracted: the correlation between the number of specific memories recalled in the Autobiographical Memory Test and self-reported trait rumination scores, and its sub-factors – brooding and reflection. The pooled effect size for the correlation between memory specificity and trait rumination was small (d = −.05) and did not differ significantly from zero (p = .09). The effect sizes for the correlation with brooding and reflection were not significantly different from zero. There is limited support for the association between trait rumination and memory specificity suggested in CaRFAX.

Emotional attentional control predicts changes in diurnal cortisol secretion following exposure to a prolonged psychosocial stressor

Hypothalamic-pituitary-adrenal (HPA) axis irregularities have been associated with several psychological disorders. Hence, the identification of individual difference variables that predict variations in HPA-axis activity represents an important challenge for psychiatric research. We investigated whether self-reported attentional control in emotionally demanding situations prospectively predicted changes in diurnal salivary cortisol secretion following exposure to a prolonged psychosocial stressor. Low ability to voluntarily control attention has previously been associated with anxiety and depressive symptomatology. Attentional control was assessed using the Emotional Attentional Control Scale. In students who were preparing for academic examination, salivary cortisol was assessed before (time 1) and after (time 2) examination. Results showed that lower levels of self-reported emotional attentional control at time 1 (N=90) predicted higher absolute diurnal cortisol secretion and a slower decline in cortisol throughout the day at time 2 (N=71). Difficulty controlling attention during emotional experiences may lead to chronic HPA-axis hyperactivity after prolonged exposure to stress. These results indicate that screening for individual differences may foster prediction of HPA-axis disturbances, paving the way for targeted disorder prevention.