Warren Mansell

SOCIAL ANXIETY AND ATTENTION AWAY FROM EMOTIONAL FACES

A substantial literature indicates that anxiety is often associated with selective attention to threat cues. Socially anxious individuals are excessively concerned about negative evaluation by others. One might therefore predict that high social anxiety would be associated with selective attention to negative facial expressions. On the other hand, some recent models have suggested that social anxiety may be associated with reduced processing of external social cues. A modified dot-probe task was used to investigate face attention. High and low socially anxious individuals were presented with pairs of pictures, consisting of a face (positive, neutral, or negative) and a household object, under conditions of social-evaluative threat or no threat. The results indicated that, compared to low socially anxious individuals, high socially anxious individuals show an attentional bias away from emotional (positive and negative) faces but this effect is only observed under conditions of social-evaluative threat. The...

Patients with generalized social phobia direct their attention away from faces

The experiment tested whether patients with social phobia direct their attention to or away from faces with a range of emotional expressions. A modified dot probe paradigm (J. Abnorm. Psychol. 95 (1986) 15) measured whether participants attended more to faces or to household objects. Twenty patients with social phobia were faster in identifying the probe when it occurred in the location of the household objects, regardless of whether the facial expressions were positive, neutral, or negative. In contrast, controls did not exhibit an attentional preference. The results are in line with recent theories of social phobia that emphasize the role of reduced processing of external social cues in maintaining social anxiety.

How do I appear to others? Social anxiety and processing of the observable self.

Two information processing biases that could maintain social anxiety were investigated. High and low socially anxious individuals encoded positive and negative trait words in one of three ways: public self-referent, private self-referent, and other-referent. Half were then told they would soon have to give a speech. As predicted, compared to low socially anxious individuals, high socially anxious individuals recalled less positive public self-referent words, but only when both groups were anticipating giving a speech. No memory biases were observed for private self-referent or other-referent words. Next all participants gave a speech. Correlational analyses suggested that high socially anxious individuals may use the somatic concomitants of anxiety to overestimate how anxious they appear and underestimate how well they come across.

Conceptual foundations of the transdiagnostic approach to CBT

This article defines and explains the transdiagnostic approach to cognitive-behavioral therapy (CBT) and elaborates on its conceptual foundations and implications for research and practice. We argue that the approach has good philosophical, historical, pragmatic, and empirical foundations. We distinguish between transdiagnostic approaches based on multiple processes that are universally applied (e.g., Harvey, Watkins, Mansell, & Shafran, 2004), multiple processes limited in the range of disorders covered (e.g., Fairburn, Cooper, & Shafran, 2003), symptom-based accounts (e.g., Persons, 1986), and universal single process accounts (e.g., experiential avoidance, self-absorption). We summarize existing evidence and identify key issues relating to the methodology of future research on the transdiagnostic approach. The article concludes by highlighting the great potential benefits of the approach and highlights significant practical, political, and scientific obstacles to putting it into practice on a large scale.

Selective attention in social phobia and the moderating effect of a concurrent depressive disorder.

Studies using the modified Stroop colour naming task have provided results consistent with the hypothesis that social phobia is associated with an attentional bias towards negative social-evaluative words. However, these results could also have arisen as a consequence of non-attentional processes. For this reason, the present study uses a modified version of MacLeod et al.s (J. Abnorm. Psychol. 95 (1986) 15) dot-probe task, which provides a more direct measure of attention. Patients with social phobia (n=28), patients with social phobia and a concurrent depressive disorder (n=33), and non-patients (n=40) were presented with word pairs each consisting of a neutral word and a threat word. The results indicated that patients with social phobia show an attentional bias towards social-threat words while non-patients tend to avoid social-threat words. Patients with social phobia and a concurrent depressive disorder behaved like non-patients, indicating that concurrent depression abolishes the attentional bias. Physical threat words were also included in the study. The main analysis indicated that social phobia is also associated with an attentional bias to physical threat. However, a post hoc analysis (which requires replication) suggested that the physical threat bias might have arisen because some social phobia patients also had another anxiety disorder in which physical concerns are likely to have been prominent. Overall, the results emphasise the importance of assessing comorbidity when investigating attentional biases.

The Interpretation of, and Responses to, Changes in Internal States: An Integrative Cognitive Model of Mood Swings and Bipolar Disorders

A cognitive approach to understanding mood swings and bipolar disorders is provided, with the interpretation of changes in internal state as a central explanatory factor. The model explains how attempts at affect regulation are disturbed through the multiple and conflicting extreme personal meanings that are given to internal states. They prompt exaggerated efforts to enhance or exert control over internal states, which paradoxically provoke further internal state changes, thereby feeding into a vicious cycle that can maintain or exacerbate symptoms. Counterproductive attempts at control are classified as either ascent behaviours (increasing activation), or descent behaviours (decreasing activation). It is suggested that appraisals of extreme personal meaning are influenced by specific sets of beliefs about affect and its regulation, and about the self and relations with others, leading to an interaction that raises vulnerability to relapse. Pertinent literature is reviewed and found to be compatible with such a model. The clinical implications are discussed and compared to existing interventions.

A survey of parents’ reactions to the diagnosis of an autistic spectrum disorder by a local service Access to information and use of services

We conducted a postal survey of parents whose child had been diagnosed with an autistic spectrum disorder by a district diagnostic service. The service was regarded as having improved signifi- cantly following recent changes, but there were still shortcomings. Parents had obtained useful information from a range of other sources, including a parents’ support group, school teachers, speech and language therapists, educational psychologists, the Internet, books and academic journals. Special units and schools were rated as the most useful source of support and treatment, but many other interventions were rated highly. Parents reported a diverse range of both negative and positive consequences of diagnosis, and many reported a change in their attitudes to diagnosis over time. Many expressed frustration with trying to get an early diagnosis, with the social, educational and health services, and with the way that autistic spectrum disorders are regarded by laypeople and other parents.

Control theory and psychopathology: An integrative approach

Perceptual control theory (PCT; Powers, 1973) is presented and adapted as a framework to understand the causes, maintenance, and treatment of psychological disorders. PCT provides dynamic, working models based on the principle that goal-directed activity arises from a hierarchy of negative feedback loops that control perception through control of the environment. The theory proposes that psychological distress arises from the unresolved conflict between goals. The present paper integrates PCT, control theory, and self-regulatory approaches to psychopathology and psychotherapy and recent empirical findings, particularly in the field of cognitive therapy. The approach aims to offer fresh insights into the role of goal conflict, automatic processes, imagery, perceptual distortion, and loss of control in psychological disorders. Implications for psychological therapy are discussed, including an integration of the existing work on the assessment of control profiles and the use of assertive versus yielding modes of control.

A preliminary study of autobiographical memory in remitted bipolar and unipolar depression and the role of imagery in the specificity of memory.

Autobiographical memory was investigated in a sample of 19 individuals with remitted bipolar affective disorder and a community sample of 16 individuals with remitted unipolar depression who had similar low levels of current symptoms. Each participant was prompted to recall one positive memory and one negative memory, to rate it on several scales, and to describe it in detail. Relative to the remitted unipolar group, the remitted bipolar group reported more general than specific negative memories and more frequent recollections of the negative memory during their everyday life. Across the sample, 95% of all specific memories involved a mental image, whereas only 56% of all general memories involved a mental image, suggesting a role of imagery in the retrieval of a specific memory. Characteristic examples of memories are provided. These results are preliminary yet they suggest that patients with bipolar disorder in remission may show memory characteristics that are often associated with symptomatic unipolar depression.

What is the mechanism of psychological change? A qualitative analysis of six individuals who experienced personal change and recovery

OBJECTIVE The mechanism of psychological change, whether this occurs as a result of psychotherapeutic intervention or during natural recovery, remains unknown. The aim of this study was to explore and understand how and why psychological change occurs. DESIGN This study presents the accounts of six individuals who experienced psychological change and recovery following a significant problem in their lives using the qualitative method of interpretative phenomenological analysis (IPA). METHOD A semi-structured interview covered several aspects of their experience which included details of the problem they faced, how the problem affected their lives, how they were able to overcome the problem, and how they felt about their problem looking back. RESULTS Four superordinate themes emerged from the analysis: hopelessness and issues of control; the change process; new self versus old self; and putting the problem into perspective. CONCLUSIONS Findings are discussed in relation to existing literature on hopelessness and locus of control, experiential avoidance, acceptance and mindfulness, insight, and adversarial growth. The findings are also discussed in relation to a theory of self-regulation known as perceptual control theory (PCT). It is proposed that this theory may provide a valid account of the mechanism of psychological change.