Wednesday, December 3, 2008

Symmetrical effects of amphetamine and alpha-flupenthixol on conditioned punishment and conditioned reinforcement: contrasts with midazolam

Killcross, A.S., Everitt, B.J., & Robbins, T.W. (1997). Symmetrical effects of amphetamine and alpha-flupenthixol on conditioned punishment and conditioned reinforcement: contrasts with midazolam. Psychopharmacology, 129, 141-152.

There is evidence to suggest that forebrain dopaminergic systems are likely to be involved in both appetitive and aversive motivation. These authors studied the effects of dopamine (DA) agents on conditioned punishment (aversive learning) and conditioned reinforcement (appetitive learning) paradigms using DA agonists and antagonists injected systemically. In conditioned punishment, a Pavlovian CS predicting punishment is added to an instrumental bar-pressing paradigm, but only on one of the bars. Normal animals will adjust their bar-pressing away from this lever. (Note: These authors, however, implemented a punishment procedure by presenting a CS and shock upon bar-press, rather than a conditioned punishment procedure which would only present the CS upon bar-press). In conditioned reinforcement, a CS predicting reward is added to the instrumental bar-pressing paradigm on one of the bars. Animals will naturally come to favor this bar paired with the appetitive CS.

DA agonists increased the effect of a punishing CS, causing the animals to further decrease their bar pressing. DA agonists also enhanced the effect of an appetitive CS, increasing bar pressing. DA antagonists, on the other hand, decreased the effect of a punishing CS. They also reduced the effect of an appetitive CS. Thus, it appears dopaminergic agents modulate the behavioral impact of both appetitively and aversively motivated conditioned stimuli on instrumental performance. Systemic benzodiazepene administration was also explored with results showing a selective impact on aversively-motivated stimuli (i.e. no effect on the appetitive CS).

Saturday, November 29, 2008

The Value of Believing in Free Will

Vohs, K.D. & Schooler, J.W. (2008). The Value of Believing in Free Will. Psychological Science, 19, 1, 49-54.

This study found that weakening people's belief in free-will increased ignoble behaviors, specifically cheating. In the first experiment, a passive cheating paradigm was explored in which a computer "glitch" allowed the correct answer to a question to be flashed onto the screen unless the participant explicitly suppressed it. The experimental group was read a statement encouraging a belief in determinism, while the control condition was read an unrelated statement. Those in the experimental group showed weaker free will beliefs and more frequent cheating.

In the second experiment, an active cheating paradigm was explored. After reading either a pro-free-will statement or an anti-free-will statement, participants were left in the room on the "honor system" and told to reward themselves for their number of correct responses. In this experiment, as in the previous one, participants were under the impression that their anonymity was preserved. Results were similar with the determinism condition showing weaker free will beliefs and higher than average cheating. Thus, people's beliefs regarding their sense of control and self-agency may have social implications.

Saturday, November 22, 2008

Different lateral amygdala outputs mediate reactions and actions elicited by a fear-arousing stimulus

Amorapanth, P., LeDoux, J.E., & Nader, K. (2000). Different lateral amygdala outputs mediate reactions and actions elicited by a fear-arousing stimulus. Nature Neuroscience, 3, 1, 74-79.

One common reaction to threat is elicitation of unlearned species-typical defense reactions. Another is the ability to take novel actions in threatening situations, which may also prove advantageous. In escape-from-fear (EFF) tasks, animals come to learn that an arbitrary response (e.g. stepping into the adjoining chamber) terminates a CS which predicts shock. Authors placed lesions throughout the fear circuit to see try to elucidate function. Lateral amygdala (LA) is believed to be the sensory interface where CS information enters the amygdala; lesions here block acquisition of both conditioned freezing responses, as expected, but also block acquisition of the CS's reinforcement of a new response in the EFF task. Central nucleus (CE) lesions block expression of hard-wired motoric output (i.e. freezing itself), but not the EFF. Basal nucleus (B) lesions had no effect on conditioned freezing, but did block the EFF. By way of interactions between the B and striatal circuits, reinforcement in the amygdala may come to reinforce novel motor responses. Thus, it may be that activation of LA by a CS triggers a reactive response output system via the CE and an active output system via the B.

Thursday, October 23, 2008

Nonconscious mimicry as an automatic behavioral response to social exclusion

Lakin, J.L., Chartrand, T.L., & Arkin, R.M. (2008). I am too just like you: Nonconscious mimicry as an automatic behavioral response to social exclusion. Psychological Science, 19, 8, 816-822.

First, this study showed that following exclusion by a group, participants increased their nonconscious behavioral mimicry of a brand-new interaction partner, reinforcing the expectation that people should be motivated to engage in affiliative behaviors after exclusion. Second, the study attempted to see if this automatic behavior is carried out bluntly, or whether it is sensitive to other factors. Researchers found that individuals excluded by an in-group mimicked the behaviors of a subsequent interaction partner only if the partner was an in-group member (as opposed to an out-group member). Therefore, it appears that people are selective with their use of automatic mimicry, increasing employment of it with people who can potentially restore their status with the in-group. In this way, belongingness was seen as related to mimicry. (Other factors, such as mood, self-esteem, meaningful existence, and control did not appear to be as related.)

Thursday, October 9, 2008

Ethanol-conditioned flavor preferences compared with sugar- and fat-conditioned preferences in rats

Ackroff, K., Rozental, D., Scalfani, A. (2004). Ethanol-conditioned flavor preferences compared with sugar- and fat-conditioned preferences in rats. Physiology & Behavior, 81, 699-713.

Past studies in rats have suggested that the postingestive effects of various nutrients can condition strong flavor preferences. Research has been conducted on ethanol using oral conditioning (where the ethanol is mixed in with the flavoring, thus adding its own flavor to the mixture) and intragastic conditioning (where the ethanol is injected into the rat’s stomach after it ingests the flavoring, thus eliminating the ethanol’s flavor as a conditioning factor). However, the findings of these studies have been somewhat contradictory. Mehiel and Bolles (1988) found that rats equally preferred a flavor paired with ethanol and a flavor paired with sucrose, while Sherman et al. (1983) found that rats preferred a flavor paired with glucose to a flavor paired with ethanol. These studies different in terms of design, route of administration, and sugar used, but it is unclear which of these factors are responsible for the confliction. The present study examined this question in a series of four related experiments.

In the first experiment, sucrose and ethanol were compared to each other as well as to a control of water. These nutrients were each paired with a different flavor and administered through intragastric infusion. Unlimited access to alternating flavor/nutrient combinations was provided during a training period and then the amount of each combination consumed was measuring during a test in which the rats could choose between different combinations. The results were that (1) the rats preferred both sucrose- and ethanol-paired flavors to the water-paired flavor, (2) the rats strongly preferred the sucrose-paired flavor to the ethanol-paired flavor, and (3) the rats ingested more sucrose mixture than ethanol mixture during the training period.

The second experiment attempts to control for finding (3) in experiment one by adding the additional constraint that sucrose mixture consumption was limited to the previous day’s ethanol mixture consumption. Findings (1) and (2) did not change as a result.

In the third experiment, the oral conditioning method was used in place of intragastric infusion for nutrient administration. Once again, the findings did not change.

Finally, in the fourth experiment, ethanol was compared to fructose and corn oil using the intragastic infusions. Similar to the sucrose findings, the rats preferred these new sugars to ethanol, while still preferring ethanol to water.

This study supports the findings of Sherman et al. (1983) and eliminates training intakes, route of administration, and specific sugar/fat as explanations of Mehiel and Bolles’ (1988) contradictory findings. Something other than energy concentration affects the efficacy of ethanol as a reinforcer, making it less powerful than other sugars/fats.

Monday, October 6, 2008

Evidence for episodic memory in a Pavlovian conditioning procedure in rats

O'Brien, Jamus; Sutherland, Robert J. Evidence for episodic memory in a Pavlovian conditioning procedure in rats. Hippocampus. Vol 17(12) 2007, 1149-1152.

Several requirements have been proposed for establishing episodic memory in nonlinguistic species. Clayton et al. (2003) suggest that episodic memory competence requires integrated representations of “what", "where", and "when” content that can be flexibly updated as more information is gathered. Tests of episodic memory should be novel and unexpected, exceed the capacity of short-term memory (Dere et al., 2006), be unsolvable by familiarity judgments (Gallistel, 1990), and involve memories formed in unique one-trial learning episodes (Morris, 2001). In this article, O’Brien and Sutherland design and run an experiment that attempts to meet these requirements while testing for the flexible and integrated representations required for episodic memory.

In this experiment, twenty-two male Long-Evans rats were run through three experimental phases. In Phase 1, rats were given time to explore two different “contexts” (boxes A and B). These boxes were Plexiglas modular test chambers with steel grid floors. Box A had black colored walls and was scented with Quatzyl-D-Plus, while box B was white and scented with Clinicide. Each rat visited Box A on three successive mornings and Box B on three successive evenings. In Phase 2, rats were exposed to a single immediate shock in a “chimerical” box that was half black, half white, and unscented. For half the rats, this occurred in the morning and for the other half, it occurred in the evening; this is the study’s independent variable. In Phase 3, during mid-day, rats were placed in one of the contexts from Phase 1 (either Box A or Box B). Fear responses (this study’s dependent variable) were then measured by timing conditioned “freezing” behavior.

A repeated measure ANOVA was conducted on the percent of time spent freezing during Phase 3, and it was predicted that rats placed in the context congruent to the time of day of their shock would exhibit more freezing than rats placed in the incongruent context. (For example, if a rat was in Box A in the morning and Box B in the evening during Phase 1 and received its shock in the morning during Phase 2, then the congruent context would be Box A and the incongruent context would be Box B.) The results were a significant relationship in the direction predicted (F(1,20) = 45.0, P < 0.001).

These findings support the idea that rats acquire memories laden with temporal context (or “when” content), such as the time of day, which is an important requirement of establishing episodic memory competence. Further studies could continue this line of research by establishing evidence for rats generating “what” and “where” content, and by exploring the nature of rats’ temporal cues – possibly endogenous circadian oscillators (Gallistel, 1990) or the age of granule cells in the dentate gyrus of the hippocampus (Aimone et al., 2006).

Friday, September 19, 2008

Modifying shyness-related behavior through symptom misattribution

Brodt, S.E. & Zimbardo, P.G. (1981). Modifying shyness-related behavior through symptom misattribution. Journal of Personality and Social Psychology, 41, 437-449.

In response to anxiety-evoking stimuli, people develop a complex constellation of reactions. Over time, a general categorical label may come to link these components together and serve as a central explanation. For some people, this label may undergo further transformation from its original situational attribution to a broader usage that includes the person's disposition (personal causality). For example, a person may immediately invoke the label "I am afraid of men" which in turn may kick off a response chain and impose constraints upon it, creating self-fulfilling prophecies. The authors of this study wanted to weaken the 3-part link between perceived symptoms of arousal, the corresponding dispositional label, and resultant behaviors by intervening with symptom misattribution.

In this experiment with 46 college women, the dispositional label studied was shyness -- an excessive self-focus in which potential rejection by other people and social anxiety are salient cognitions. Seeking to redirect the arousal from an anxiety-laden source (being alone with a member of the opposite sex) to a nonpsychological source, the researchers exposed all the groups to intense noise and led the "shy misattribution" group to believe that common side effects of noise bombardment was heart-pounding and increased pulse, symptoms normally associated with their social anxiety. Another group, the "shy comparison" group were led to believe the noise only caused dry mouth. Another "non-shy" group, unlike the other groups did not score high on shyness ratings, were given the same story as the "shy misattribution group". Results showed that shy women, when given an alternative explanation for their social anxiety, were able to overcome normal limitations of their shyness, talking significantly more, acting more assertive, and showing a stronger affiliative preference than the comparison group. Thus, misattribution demonstrates the power of social cognitions in controlling behavior.

Monday, September 15, 2008

Hippocampal involvement in contextual modulaton of fear extinction

Ji, J. & Maren, S. (2007). Hippocampal involvement in contextual modulaton of fear extinction. Hippocampus, 17, 749-758.

Responding to an extinguished CS is susceptible to many recovery effects. The first is renewal, in which changing the context favors recall of extinguished fear memory. Examination of its several forms (ABA, AAB, ABC) led researchers to postulate that following extinction the meaning of the CS becomes ambiguous and requires context to disambiguate; inhibitory association is "gated" so that its activation requires the simultaneous presence of the CS and the extinction context. The second is spontaneous recovery, or the return of conditional responding with the passage of time. Studies suggest that renewal and spontaneous recovery appear to result from a similar control mechanism, rather than simply erasure of the original fear memory. Therefore, some see SR as another renewal effect that occurs outside of the "temporal extinction context". Third is reinstatement, in which the extinguished response returns after extinction if the animal is merely exposed to the US alone in a distinct context. This, likewise, appears to be a context-dependent process.

These all suggest that extinction involves new learning, and that this learning is especially sensitive to context. The hippocampus, mPFC, and amygdala have been implicated in this learning. One model holds that when the animal is tested within the extinction context, hippocampus drives mPFC inhibition of LA. When animals are presented with an extinguished CS outside of the extinction context, the hippocampus may inhibit mPFC activation and thus promote excitation in the LA to renew extinguished fear under these conditions. Another model posits direct projection from hippocampus to LA subserving contextual modulation of extinction.

Tuesday, September 9, 2008

Switching on and off fear by distinct neuronal circuits

Herry, C. et al. (2008). Switching on and off fear by distinct neuronal circuits. Nature, 454, 600-605.

Whereas firing of amygdala neurons is necessary for retrieval of conditioned fear memories, extinction of these fear memories is thought to be controlled by constraining this neural activity by local inhibitory circuitry (under the influence of mPFC). However, fear extinction is known to be a fragile behavioral state, readily influenced by context, i.e. changing context can result in spontaneous recovery. This raises the question of whether there are specialized circuits driving behavioral transitions in opposite directions, namely fear-on and fear-off. This paper showed that neurons in the BA could be divided into distinct functional classes: those exhibiting selective increases in CS+ evoked spike firing during and after fear conditioning (fear neurons) and those exhibiting selective increases in CS+ evoked spike firing during extinction (extinction neurons). Further, close analysis revealed that these two groups were not only functionally different but also differentially connected, with (1) fear neurons selectively receiving input from the hippocampus, and (2) extinction neurons being reciprocally connected to the mPFC while fear neurons only projected unidirectionally to the mPFC. This would indicate that co-localized within the same nucleus, two discrete neuronal circuits exist, intermingled in a salt-and-pepper-like manner. Their close anatomical proximity may serve to facilitate local interactions, although these mechanisms remain unexplored. Taken together with evidence showing emotional perseveration (persistent lack of state change) concomitant with inactivation of the BA, results suggest that the BA is unlikely to be associated with the storage, retrieval, or expression of conditioned fear and extinction memories, but is more likely to mediate context-dependent behavioral transitions between low and high fear states.

Monday, September 8, 2008

mPFC neurons signal memory for fear extinction

Milad, M.R. & Quirk, G.J. (7 November 2002). Neurons in the medial prefrontal cortex signal memory for fear extinction. Nature, 420, 70-74.

Extinction is a process thought to form a new memory that inhibits the once-learned conditioned response. This paper suggests that consolidation of extinction learning potentiates activity in the infralimbic cortex (IL) of the mPFC which inhibits fear during subsequent encounters with fear stimuli. Electrophysiological recording showed that IL activity remained unresponsive during the conditioning phase and also during extinction training on Day 1. However, by Day 2, activity in the IL in response to tone was present from the start of the extinction phase. Further, stimulation of the IL paired with tone presentation resulted in less freezing behavior and also accelerated extinction learning. Therefore, enhanced extinction learning could be mediated directly by the stimulation or indirectly by the behavioral feedback of decrease freezing. Since the BLA sends excitatory projections to IL, it is possible that these inputs serve to potentiate IL neurons during the consolidation of extinction. The IL is then likely to inhibit expression of fear behavior via its projections to intercalated (ITC) cells in the CE, dampening the output of the amygdala. Pairing reminder stimuli with activation of the ventral mPFC through transcranial magnetic stimulation (TMS) might help strengthen extinction of fear in clinical settings.

Neural mechanisms of extinction

Quirk, G.J. & Mueller, D. (2007). Neural mechanisms of extinction learning and retrieval. Neuropsychopharmacology Reviews, 1-17.

The simplest form of emotional regulation is extinction, is which conditioned responding to a stimulus decreases when the reinforcer is omitted. Exinction, like any learning process, occurs in 3 phases: acquisition, consolidation, and retrieval. Cannabinoid and opioid receptors appear to be implicated in the acquisition of extinction since anandamide and opioid antagonists impair within-session extinction of fear. Consolidation appears to depend on protein synthesis within the BLA, frequency bursting of the infralimbic region (IL) of the vmPFC shortly after extinction, and general involvement of the hippocampus, especially in tasks such as inhibitory avoidance and contextual fear. Retrieval of extinction memories involves the expression of inhibitory circuitry and is highly context-specific. Inhibition circuitry within the amygdala includes local inhibitory neurons within the BLA and CE, as well as islands of GABAergic neurons between these two sites known as the intercalated (ITC) cells. ITC cells could serve as a site of extinction memory since they inhibit CE output neurons and BLA neurons, acting as an off-switch for the amygdala. ITC cells receive strong projection from the IL mPFC, and IL activity is correlated with the extent of extinction retrieval. In fact, electrical stimulation of IL reduces conditioned fear and strengthens extinction memory. The prelimbic (PL) mPFC, on the other hand, excites fear expression and can augment fear expression via projections to the basal nucleus of the amygdala. Thus, the PFC can fully control overall fear expression. Individuals with PTSD show reduced vmPFC and hippocampal volume and activity, as well as increased amygdala activity. Stress may also impair extinction, since chronic stress is shown to decrease dendritic branching and spine count in hippocampus and mPFC, but increase it in BLA, which could be expected to increase conditioning and impair extinction. Pharmacological adjuncts to current extinction-based exposure therapies may accelerate and strengthen extinction. Among them D-cycloserine, yohimbine, sulpiride, and methylene blue show promise. Administration of glucocorticoids such as cortisol before exposure therapy may also help.

Sunday, September 7, 2008

Dopamine gates LTP in lateral amygdala

Bissiere, S., Humeau, Y., & Luthi, A. (June 2003). Dopamine gates LTP induction in lateral amygdala by suppressing feedforward inhibition. Nature Neuroscience, 6, 6, 587-591.

It has been known that both long-term potentiation (LTP) and concomitant activation of dopaminergic nerves to the amygdala underlie the acquisition of fear conditioning. In fact, dopamine is known to be released in the amygdala during stress and intra-amygdala injection of dopamine receptor antagonists prevents fear conditioning. This study investigated the mechanisms supporting this and showed how dopamine could modulate fear conditioning by modulating inhibitory synaptic transmission within the amygdala. Specifically, D2 dopamine receptors could enable the induction of LTP by suppressing feedforward inhibition from local inhibitory interneurons.

Friday, September 5, 2008

Neuronal Signalling of Fear Memory

Maren, S. & Quirk, G.J. (November 2004). Neuronal Signalling of Fear Memory. Nature Reviews Neuroscience, 5, 844-850.

Plasticity within the CNS is necessary for the representation of new information, and can range from synthesis and insertion of synaptic proteins to whole-brain synchronization of neuronal activity. Pavlovian fear conditioning is an especially interesting phenomenon since such fear memories are acquired rapidly and are long-lasting. Research first noticed conditioning-induced changes in the midbrain, thalamus, and cortex; however, it was unclear whether or not these were primary sites of plasticity or were simply downstream from other plastic sites. Eventually the lateral nucleus of the amygdala (LA), receiving direct projections from the auditory thalamus, was posited to be vital for auditory fear conditioning. The dorsal subdivision of the nucleus (LAd) seems to be the first site in the auditory pathway to show associative plasticity that is not fed forward passively from upstream sites, is not dependent on downstream sites, and is crucial for conditioned behavior. And LA neurons appear to drive plasticity at both thalamic and cortical levels.

Fear memories are useful to anticipate and respond to dangers within the environment. However, when signals for aversive events no longer predict those events, fear to those signals subsides. This is an inhibitory learning process known as extinction. It appears that although fear subsides after extinction, the fear memory is not erased. Extinction seems to be highly context dependent and sometimes short-lived. Fear responses can be spontaneously recovered over time. It seems biology has deemed it better to fear than not to fear. It is more likely that additional memories which interfere with pre-existing excitatory responses are learned in the extinction process. Again the amygdala seems to be essentially involved here. Further, the mPFC, which has an inhibitory influence on both the LA and the CE (the main output regions of the amygdala) through a rich network of inhibitory interneurons embedded in the amygdala, appears to be a major participant, and is perhaps modulated by context via hippocampus.

Emotion Circuits in the Brain

LeDoux, J.E. (2000). Emotion Circuits in the Brain. Annual Reviews in Neuroscience, 23, 155-184.

Emotion research was largely lost for some time in the wake of the cognitive revolution. However, people soon realized a purely cognitive view of the brain -- leaving out emotions, motivations, and the like -- is likely to paint an unrealistic view of real minds. Unfortunately, attempts to dig into emotions once again were hamstrung by the limbic system concept, a flawed and inadequate theory of the emotional brain: cognition does not only reside in the neocortex and emotions do not only reside within the limbic system (a moving target itself).

Emotion research began its official resurgence with a bottoms-up examination of fear conditioning, with a bulk of the work focused on the auditory modality. Research soon named amygdala as centrally important, a site where transmission of information about the CS and US converged and output projections controlled fear reactions. On the input side, CS sensory inputs terminate in the lateral amygdala (LA), coming from both the auditory thalamus and the auditory cortex, although plasticity seems to occur initially through the thalamic pathway. US information also seems to converge in the amygdala, receiving inputs from the spino-thalamic tract, cortical areas that process somatosensory stimuli including nociceptive stimuli, the parabrachial area, and the spinal cord. On the outbound side, the central nucleus of the amygdala (CE) projects to autonomic (hypothalamus) and defensive motoric (periaqueductal gray) centers. Methodologies used have largely been single unit recordings, long-term potentiation (LTP) studies, and pharmacological experiments which block LTP. Studies have focused on two types of fear learning: simple fear conditioning (a benign tone comes to evoke a fear response) and contextual fear conditioning (fear responsivity to environmental cues). Research agrees that the amygdala seems to be required for Pavlovian fear conditioning to occur, although the site of long-term fear memory storage is still unknown: it may very well exist in the amygdala, but it may also be distributed across multiple structures or transferred off to cortical areas over time. However, plasticity within the amygdala is probably not required for learning cognitive aspects of fear.

Human studies have echoed many of the results from animal literature. Additionally, they have found perceptual deficits of the emotional meaning of faces in patients with amygdalar damage. The amygdala also appears activated more strongly in the presence of fearful and angry faces than of happy ones. Further, when the activity of the amygdala during fear conditioning is cross-correlated with other regions of the brain, the strongest relations are seen in subcortical areas, emphasizing the importance of the direct thalamo-amygdala pathway in the human brain. Although a fear conditioning approach cannot account for all aspects of human fear and anxiety disorders, it may be especially elucidating for PTSD, panic disorders, and phobias. Difficulty in extinguishing fear memories witnessed in human disorders may also involve the medial prefrontal cortex circuitry.

Future research needs to integrate both cognition and emotion. How fear processing in the amygdala can influence perceptual, attentional, and memory functions of the cortex, and vice versa, is begging for additional research, although it is known that the amygdala does receive input from cortical sensory processing regions and projects back to these both directly and indirectly. How conscious emotional feelings are manifest is also relatively unexplored, although the models posit that feelings may arise from interactions between the amygdala and prefrontal working memory areas, sensory processing areas in cortex, long-term memory systems in the temportal lobe, and arousal systems which maintain global projections.

Tuesday, August 19, 2008

Our 100th Post!

Congratulations to all those who posted, i.e. Jeff and I. Maybe we can recruit some more people to join in! Stay tuned.

Wednesday, August 13, 2008

An Illustration of DBT

Linehan, M.M. (1998). An Illustration of Dialectical Behavior Therapy. In Session: Psychotherapy in Practice, 4, 2, 21-44.

In addition to providing illustrative transcripts from dialectical behavior therapy (DBT) sessions, the bulk of the read, this paper also summarizes DBT's theoretical perspective, its various treatment stages and targets, as well as treatment strategies. DBT was developed to treat clients meeting criteria for borderline personality disorder (BPD) whose behavioral patterns are commonly problematic and stressful for clients and therapists alike, not the least of which is suicidality. DBT theorizes that BPD individuals lack interpersonal, self-regulation, and distress-tolerance skills, and what skills they do possess are often undermined by behaviors which block the use of the capabilities the client does have. As such, outcomes are typically unpredictable, even for patients who resist the tempting urge to quit and remain in treatment.

DBT recommends splitting up therapy into different stages, each with unique goals. In Stage I, treatment tries to achieve self-control, with control over one's suicidal behaviors being most important. In Stage II, clients try to experience emotions without resistance and to form and maintain connections to people, places, and activities, even if they are somehow associated with past trauma. Stage III focuses on reducing residual problematic patterns that interfere with clients achieving other important goals. When successful, Stage IV achieves a lasting sense of completeness and the capacity for sustained joy.

DBT's treatment strategies include: (1) dialectical strategies which combine acceptance with change, synthesize opposites, and move the client from "either-or" thinking to "both-and" thinking; (2) core strategies of client validation and problem-solving; (3) communication strategies which balance warm responsiveness to the client's wishes with irreverence; and (4) case management strategies which help the therapist tackle the difficult problems of suicidality with team support and aim to ultimately teach the client how to effectively interact with their world, rather than teaching the environment how to interact with them.

Tuesday, August 12, 2008

Functional analytic psychotherapy

Kohlenberg, R.J. & Tsai, Mavis. Functional analytic psychotherapy. Journal of Psychotherapy Integration, 4, 175-201.

Functional analytic psychotherapy (FAP) is a radical behaviorist approach to psychotherapy. As such, it views everything we do as behavior and believes these behaviors are the result of contingencies of reinforcement we have experienced in past relationships. The therapy emphasizes the importance of the client-therapist relationship since it creates a functionally similar environment [to the "real world"] which can evoke problematic behavior (deemed CRB1's) that can then be observed and responded to with reinforcement, shaping, and interpretations. Improvements witnessed in-session (deemed CRB2's) can be praised and reinforced immediately, and the clinician's reinforcement can be assessed for effectiveness. Further, its emphasis on contextualism leads therapists to develop a comprehensive understanding of the meaning of a client's behaviors and forces practitioners to remain open-minded about an intervention's potential effectiveness given the context. As such, FAP commonly embraces and enhances concepts and techniques from different therapies, such as psychoanalysis and cognitive therapy. Practitioners of FAP are encouraged to tailor their use of therapeutic techniques depending on: what will evoke the client's problems in the session, whether the client's problems are rule-governed or contingency-shaped, and what will be naturally reinforcing of the client's target behaviors.

Tuesday, July 29, 2008

Acceptance and commitment therapy

Harris, R. (August 2006). Embracing your demons: an overview of acceptance and commitment therapy. Psychotherapy in Australia, 12, 4, 2-8.

Acceptance and Commitment Therapy (ACT) is one of the "third-wave" behavioral therapies which emphasizes mindfulness and is intended to be used with a broad range of clinical conditions. The goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it. Western psychology has typically operated under the "healthy normality" assumption which states that by their nature, humans are psychologically healthy. That is, they will naturally be happy and content, and suffering is seen as abnormal. However, research shows that psychiatric disorders are exceedingly commonplace, as is nonclinical psyshological suffering, despite our high standards of living. ACT assumes, rather, that psychological processes of a normal human mind are often destructive. They posit that there is a dark side of language and cognition which sits at the root of this suffering. We often struggle with our thoughts and feelings, hoping to change them, avoid them, ameliorate them, and get rid of suffering. In doing so, ACT points at that some of these tactics often create extra suffering for ourselves. These "emotional control strategies" commonly become costly, life-distorting, or harmful. In ACT, there is no attempt to reduce, change, avoid, suppress, or control these private experiences. Instead, mindfulness is encouraged.

ACT commonly employs six techniques: (1) Cognitive Defusion: Learning to perceive thoughts, images, emotions, and memories as what they are, not what they appear to be. (2) Acceptance: Allowing them to come and go without struggling with them. (3) Contact with the present moment: Awareness to the here and now experience with openness, interest, and receptiveness. (4) Observing the self: Accessing a transcendent sense of self, a continuity of consciousness which is changing. (5) Values: Discovering what is most important to one's true self. (6) Committed Action: Setting goals according to values and carrying them out responsibly.

Sunday, July 27, 2008

Relapse Prevention for Alcohol and Drug Problems

Witkiewitz, K. & Marlatt, G.A. (2004). Relapse Prevention for Alcohol and Drug Problems. American Psychologist, 59, 4, 224-235.

Relapse prevention (RP) is a cognitive-behavioral approach with the goal of identifying and preventing high-risk situations such as substance abuse, obsessive-compulsive behavior, sexual offending, obesity, and depression. Relapse is seen as both an outcome and as a transgression in the process of behavior change. An initial setback (lapse) may either translate into a return to the previous problematic behavior (relapse) or into the individual turning again towards positive change (prolapse). That individuals commonly experience lapses, and even relapses, is not contested. However, an understanding of this phenomenon continues to evolve.

Relapse is thought to be multi-determined, especially by self-efficacy, outcome expectancies, craving, motivation, coping, emotional states, and interpersonal factors. High self-efficacy, negative outcome expectancies, potent availability of coping skills following treatment, positive affect, and functional social support are expected to predict positive outcome. Craving has not historically been shown to serve as a strong predictor.

The article proposes a new reconceptualization of relapse as a multidimensional, complex system. Such a nonlinear dynamical system is believed to be able to best predict the data witnessed, which commonly includes cases where small changes introduced into the equation seem to have large effects. The model also introduces concepts of self-organization, feedback loops, timing/context effects, and interplay between tonic and phasic processes. The effectiveness and efficacy of RP for various goals is also discussed in the article.

(I, Doug Girard, am the author of this article, Relapse Prevention, and I release its content under the terms of the GNU Free Documentation License, Version 1.2 and later.)

Thursday, July 10, 2008

Theory-based research for understanding dynamic psychotherapy

Luborsky, L., Barber, J.P., & Crits-Christoph, P. (1990). Theory-based research for understanding the process of dynamic psychotherapy. Journal of Consulting and Clinical Psychology, 58, 3, 281-287.

This article reviews empirical support for 6 basic theoretical assumptions central to psychodynamic psychotherapy. (1) A therapeutic alliance must develop. The strength of therapeutic alliance (the collaborative and affective bond between therapist and client) is shown to predictive of positive outcomes. (2) Patients display transference. Trends from existing studies show central relationship patterns exist which are largely consistent over time and may be projected onto the therapist. (3) Accurate interpretations of transference by the clinician lead to increased benefits for the client. Findings are inconsistent on this point, specifically on the relation between increased number of transference interpretations and outcomes. Mediators may exist, such as how the patient responds to the interpretation. (4) The patient will benefit more from more accurate interpretations. Accurate interpretations correlate with "better" sessions. Accuracy of interpersonal aspects of interpretation predicted outcomes best. (5) Increased insight about themselves and their relationships with others leads to better outcomes. Gaining an understanding about the therapist and others is associated with outcomes. An understanding of self and parents does not seem to be as well correlated. (6) Improved patients show greater change in their transference patterns. Results are consistent with the theory that transference still exists but is under better control and mastery. Patients' expectations of how others will respond becomes less negative and their mental health improves.

Prolonged Exposure Treatment for PTSD following 9/11

Kazi, A., Freund, B., & Ironson, G. (2008). Prolonged Exposure Treatment for Posttraumatic Stress Disorder following the 9/11 attack with a person who escaped from the Twin Towers. Clinical Case Studies, 7, 100-116.

This article chronicles the progress of one 9/11 survivor through the cognitive-behavioral therapy intervention of prolonged exposure (PE) therapy to address her PTSD and depressive symptomatology. This treatment consists of (1) imaginal exposure, and (2) in vivo exposure. It is designed to elicit emotional processing until the detrimental traumatic memories and avoidances have habituated (desensitized). After 15 sessions this client improved 75% as measured by a composite index. However, there was residual symptomatology 6 months after therapy ended but measures remained sub-clinical. Progress through treatment can be seen as waxing and waning, but trending towards improvement. Still, in this type of therapy clients must be stressed before they are to feel better. With the prevalence of PTSD at 8% in the US population, clinicians are calling more and more for effective treatment regimes. PE may be a promising candidate.

Wednesday, June 18, 2008

Statistical Functions

Zimmerman, D. W., & Zumbo, B. D. (1992). Parametric alternatives to the student t test under violation of normality and homogeneity of variance. Perceptual and Motor Skills, 74, 835-844.
*Rank order tests are effective only under violations of normality; modified t-tests are far better under conditions of violated homogeneity of variance

Clinch, J. J. & Keselman, H. J. (1982). Parametric alternatives to the analysis of variance. Journal of Educational Statistics, 7, 215-231.
*Different tests were compared under various assumption violations via Monte Carlo methods; the ANOVA F test did worst, while the Brown/Forsyth method did best overall

Tomarken, A. J. & Serlin, R. C. (1986). Comparison of ANOVA alternatives under variance heterogeneity and specific noncentrality structures. Psychological Bulletin, 99, 90-99.
*ANOVA F test alternatives were compared on Type I error rates and power under variance heterogeneity; the Welch test did best in all cases except when extreme means were paired with high variances, where the Brown/Forsyth method did better

Wilcox, R. R. (1998). How many discoveries have been lost by ignoring modern statistical methods? American Psychologist, 53, 300-314.
*Many nonsignificant research results could have been significant if modern statistical methods had been used; new methods also create more accurate confidence intervals

Alternatives to Null Hypothesis Significance Testing

Abelson, R. P. (1985). A Variance Explanation Paradox: When a Little Is a Lot. Psychological Bulletin. 97 (1), 129-34.
*Using percent variance to explain the influence of situational factors is misleading

Prentice, D. A., & Miller, D. T. (1992). When small effects are impressive. Psychological Bulletin, 112, 160-164.
*Interpretation of effect size requires careful consideration of the topic being researched

Bem, D. J., & Honorton, C. (1994). Does Psi Exist? Replicable Evidence for an Anomalous Process of Information Transfer. PSYCHOLOGICAL BULLETIN. 115 (1), 4.
*An example of meta-analysis in action, arguing that psi exists (and is replicable)

Kirsch, I. & Sapirstein, G. (1998). Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention & Treatment, 1
*An example of meta-analysis in action, arguing that SSRI’s work through placebo effect

Krueger, J. (2001). Null Hypothesis Significance Testing: On the Survival of a Flawed Method. AMERICAN PSYCHOLOGIST. 56, 16-26.
*Critics and defenders of NHST use Bayesian ideas; the real issue at stake is replicability

Seaman, M. A., & Serlin, R. C. (1998). Equivalence Confidence Intervals for Two-Group Comparisons of Means. PSYCHOLOGICAL METHODS. 3 (4), 403-411.
*Equivalence confidence intervals can and should replace NHST for determining if two group means are practically equivalent

Duckworth, W.M. and Stephenson, W.R. Resampling methods: Not just for statisticians anymore. Invited paper presented at JSM 2003, San Francisco, CA.
*Explores how to teach resampling methods (jackknife and bootstrap) to psychologists

Controversy in Null Hypothesis Significance Testing

Macdonald, R. R. (1997). On statistical testing in psychology. BRITISH JOURNAL OF PSYCHOLOGY. 88 (2), 333-348.
*Criticisms of NHST apply to Neyman-Pearson approach, but not the Fisherian approach

Huberty, C. J. (1993). Historical Origins of Statistical Testing Practices. Journal of Experimental Education. 61 (4), 317-33.
*Textbooks in psychology confuse the use and interpretation of p-values and alpha-levels

Gigerenzer, G. (1993). The superego, the ego, and the id in statistical reasoning. In G. Keren & C. Lewis (Eds.), A handbook for data analysis in the behavioral sciences: Methodological issues (pp. 311-339). Hillsdale, NJ: Lawrence Erlbaum Associates.
*Textbooks present an incoherent “hybrid logic,” mixing Neyman-Pearson and Fisher

Kaiser, H. (1960). Directional statistical decisions. Psychological Review. 67, 160-167.
*When using two-sided tests, it makes no sense to use a non-directional test

Greenwald, A. G. (1975). Consequences of prejudice against the null hypothesis. Psychological Bulletin, 82, 1-20.
*The false ideas that null results are useless or more likely to be due to incompetence prevents (or at least slows) scientific progress

Rosenthal, R. (1979). The “File Drawer Problem” and tolerance for null results. Psychological Bulletin, 86, 638-641.
*Research that results in null results are rarely published, making a field of research look more “significant” than it might actually be

Rozeboom, W. W. (1960). The fallacy of the null-hypothesis significance test. Psychological Bulletin. 57, 416-28.
*Using statistical tests to make “decisions” is na├»ve and rejection criteria are arbitrary, calling for a use of confidence intervals and (if possible) Bayesian statistics

Bakan D. (1966). The test of significance in psychological research. Psychological Bulletin. 66 (6), 423-37.
*Statistical results are often misinterpreted, calling for Bayesian methods

Hunter, J. E. (1997). Needed: A Ban on the Significance Test. PSYCHOLOGICAL SCIENCE -CAMBRIDGE-. 8 (1), 3-7.
*NHST breaks down when H0 is false and most studies purposely use H0's they know to be false, causing the error rate (Type I and II) of NHST to be around 60%

Cohen, J. (1994). The Earth Is Round (p <.05). AMERICAN PSYCHOLOGIST. 49 (12), 997.
*The logic of NHST is flawed and backwards; we need to better understand our data

Cohen, J. (1990). Things I Have Learned (So Far). American Psychologist. 45 (12), 1304-12.
*Informed judgment from the researcher is indispensable; power analysis can help

Loftus, G. R. (1996). Psychology Will Be a Much Better Science When We Change the Way We Analyze Data. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE. 5 (6), 161-170.
*Null hypotheses are rarely possible, making “significance” useless; power is under-attended and the dichotomy of effects/non-effects is artificial

Harris, R. J. (1997). Reforming significance testing via three-valued logic. In Harlow, L.L., Mulaik, S.A., & Steiger, J.H. (Eds.) What if there were no significance tests? Hillsdale, NJ: Erlbaum.
*Three-valued logic can establish directionality and address Type III error

Wilkinson, L. (1999). Statistical Methods in Psychology Journals: Guidelines and Explanations. AMERICAN PSYCHOLOGIST. 54 (8), 594-604.
*APA decided not to ban NHST, instead urging researchers to distinguish between statistical and theoretical significance, and also use modern statistical graphics

Abelson, R. P. (1997). On the Surprising Longevity of Flogged Horses: Why There Is a Case for the Significance Test. PSYCHOLOGICAL SCIENCE -CAMBRIDGE-. 8 (1), 12-15.
*NHST can be used effectively in combination with other methods; enforcing a complete ban on it would be throwing away a tool that can be useful in a number of situations

Greenwald, A. G., Gonzalez, R., Harris, R. J., & Guthrie, D. (1996). Effect Sizes and p Values: What Should Be Reported and What Should Be Replicated? PSYCHOPHYSIOLOGY. 33 (2), 175-183.
*The interpretation of p-values in terms of replicability is widely mistaken

Harris, R. J. (1997). Significance Tests Have Their Place. PSYCHOLOGICAL SCIENCE -CAMBRIDGE-. 8 (1), 8-11.
*Three-valued logic can help NHST; using confidence intervals as an alternative runs into the same problems as NHST, while providing less information than a p-value would

Jones, L. V., & Tukey, J. W. (2000). A Sensible Formulation of the Significance Test. PSYCHOLOGICAL METHODS. 5, 411-414.
*Yet another iteration of the virtues of three-valued logic applied to NHST

Thursday, June 5, 2008

Balancing work and family

Pleck, J.H. (1999). Balancing work and family. Scientific American Presents: Men's Health.

With women's move into the workplace over the last few decades, men's roles have changed as well. Men spend much less of their lives working than they did in the past. Father's are not only becoming more available, but more engaged in the family as well. However, these effects are countered by an increase in divorce rates and an increase in the number of unmarried fathers. The family is far more psychologically central to men than work, as is the case for women. Fathers tend to carry their emotions home with them from work, whereas mothers keep their family experiences insulated from the workplace. There also still exist gross gender differences in the nature of behavioral interaction with children. However, despite changing roles, companies have not caught up in their sympathy for their male employees' work-family problems, so social change is still lagging.

Sunday, May 25, 2008

Child care quality matters

Love et al. (August 2003). Child care quality matters: how conclusions may vary with context. Child Development, 74, 4, 1021-1033.

A report from the NICHD concluded that more time spent in a variety of nonmaternal care arrangements leads to more externalizing behavior problems, regardless of child care quality. Authors were skeptical and tested the generalizability of these findings with 3 other studies. These new findings suggest that quality of child care is an important factor influencing children's development, and that quality may be an important moderator of the amount of time in care.

Friday, May 9, 2008

Cultural variation in infant's sleeping arrangements

Morelli, G.A., Rogoff, B., Oppenheim, D., & Goldsmith, D. (1992). Cultural variation in infant's sleeping arrangements: Questions of Independence. Developmental Psychology, Vol. 28, No. 4, 604-613.

Cultural practices differentiate infant sleep arrangements. In the middle-class US population, a common goal is to have infants sleep in their own rooms as soon as possible, consonant with the culture's importance on independence. In the Mayan population, it is not uncommon for children to sleep with their parents or other siblings well on into childhood, reflecting their culture's value on interpersonal relations. Changes are not prescribed by the authors; instead, broader cultural perspective is offered for American readers.

Wednesday, May 7, 2008

Seasonal changes of hippocampus volume in parasitic cowbirds

Clayton, N.S., Reboreda, J.C., & Kacelnik, A. (1997). Seasonal changes of hippocampus volume in parasitic cowbirds. Behavioral Processes, 41, 237-243.

This study compared a set of phylogenetically closely related species with striking differences in natural behavior, offering the opportunity for seeking neural differences in association with these behavioral changes. Notable differences exist in these South American cowbirds of the genus Molothrus related to parasitic nesting. In one species, the birds are especially active during the breeding season, searching and locating potential hosts' nests. In another two species, only females are active during the breeding season in locating potential hosts' nests (sexual dimorphism). A fourth species is non-parasitic and no sexual differences are known with respect to spatial memory use in either season. Results show that the first species shows significantly larger relative hippocampal volume in the breeding season. The sexual dimorphic species show significantly larger relative hippocampal volume in the breeding season, but only in females. The evidence suggests seasonal variation in neuroanatomy associated with specific changes in behavior, namely spatial memory demands, as opposed to purely seasonal fluctuations per se.

Continuous flash suppression reduces negative afterimages

Tsuchiya, N. & Koch, C. (August 2005). Continuous flash suppression reduces negative afterimages. Nature Neuroscience, Vol. 8, No. 8, 1096-1101.

Continuous flash suppression (CFS) is a tool that can be used to reliably suppress vivid images from conscious awareness for long periods of time. Here, different patterned images ("Mondrians") are flashed rapidly into one eye while input to the corresponding location in the other eye remains fixed, the latter typically remaining unseen often for durations greater than ten times what can be achieved with binocular rivalry or other masking methods, even though the image remains present on the retina for several minutes. Interestingly, researchers discovered that negative afterimages or "photogenes", effects lingering in view after termination of the visual stimulus, also seem to be diminished with exposure to CFS. Though it is widely believed that afterimages originate among retinal neurons, this evidence supports the conclusion that the weakened afterimage must be due to interference from sites at or beyond binocular convergence, such as the lateral geniculate nucleus (LGN) or cortex. Specifically, it must be an area which receives input from both eyes but does not correspond directly to the neuronal correlates of perceptual awareness. The results hint at differences between concepts of attention and awareness.

Tuesday, May 6, 2008

Sign Language in the Brain

Hickok, G., Bellugi, U. & Klima, E.S. (June 2001). Sign Language in the Brain. Scientific American.

Because sign language relies heavily upon visual-spatial contrast, one might expect sign language to be supported by systems in the right hemisphere rather than the traditional left hemisphere language systems. However, this does not appear to be the case. A deaf signer with damage to Wernicke's area is likely to have comprehension difficulties and one with damage to Broca's area may have difficulty producing signs, just like normal speakers. And signers with right hemisphere damage continued to be fluent and accurate in their production of signs, used normal grammar, and comprehended signs with ease. One exception of the left hemisphere's monopoly on language production is creation of a coherent discourse, where right hemisphere damage may lead to rambling as it tends to be involved in more global-level processes. Generally speaking, sign language abilities of lifelong signers appear to be independent of their nonlinguistic spatial skills. Thus, it is likely that signers maintain unique early stages of processing compared to regular speakers, but thereafter neural organization is quite similar, being translated into a format optimized for linguistic processing and being routed to central linguistic systems.

Monday, May 5, 2008

Marijuana use as a coping response

Preston, P. (2006). Marijuana use as a coping response to psychological strain: racial, ethnic, and gender differences among young adults. Deviant Behavior, 27, 397-420.

Besides tobacco and alcohol, marijuana is the most frequently used and abused substance. This study used data taken from the National Household Survey of Drug Abuse (from all 50 states), and examined 4601 subjects between the ages of 18-25 who used marijuana within the past year. Their dependent variable was marijuana use frequency, defined as either recreational or chronic, with chronic being greater than 12 times per month. Independent variables measured included strain, economic strain, norms favorable to drug use, number of friends who use drugs, and attitudes towards risky behavior. Results were also examined through the lenses of gender, ethnicity, marital status, employment status, and education.

Results indicate that social learning factors have the strongest effect on chronic marijuana use, operationalized as the number of friends who use drugs and a personal approval of drug use. Strain (operationalized as social nervousness) had the next strongest effect. Self control had a weak effect overall. High school dropouts and the unmarried were found to be particularly at risk for becoming chronic users. Strain appeared to have a stronger effect on minority groups, possibly suggesting fewer alternative coping strategies in this population. Minority women experience a "double-whammy", more likely than their nonminority counterparts to be chronic users and also more likely to be affected by social learning and self control variables.

Love in Infant Monkeys

Harlow, H.F. (June 1959). "Love in Infant Monkeys", Scientific American.

Harlow used baby rhesus monkeys to yield insights into the origin of the infant's love for its mother and concluded that bodily contact comfort is a decisive variable in this relationship. For example, newborn monkeys preferred a surrogate "cloth" mother to a "wire" mother, and sought out the cloth mother in times of emotional stress. Other variables were also explored. A mother's rocking motion appeared to enhance affection, but less so than simple contact. Heat of the mother did not appear to be an important variable. Other visual, auditory, and olfactory stimulation may also play a role. Additionally, a critical period to attachment formation seems to be evident.

Friday, April 25, 2008

Neuronal activity related to faces and matching

Ojemann, J.G., Ojemann, G.A., & Lettich, E. (1992). Neuronal activity related to faces and matching in human right nondominant temporal cortex. Brain, 115, 1-13.

Using microelectrode recording, this group set out to look at changes in neuronal activity in response to faces, previously described in monkey cortex but not well established in humans. Recording was restricted to areas of right anterior temporal cortex that would be later resected in an epileptic lobectomy, areas that showed the least epileptic activity on electrocorticography. Seven neuronal populations related to face perception were identified. In addition, three other populations, only in middle temporal gyrus, increased activity with the labelling of the emotional expression of a face. The ease with which a given task can elicit specific, temporally-coupled changes in neuronal activity suggest that human association cortex is compartmentalized into behaviorally specific systems.

Friday, April 18, 2008

Addressing Psychosocial Problems at Work

Probst, T.M. et al. (2008). A preliminary evaluation of SOLVE: Addressing Psychosocial Problems at Work. Journal of Occupational Health Psychology, Vol. 13, No. 1, 32-42.

SOLVE is a workplace intervention program implemented by many companies worldwide which aims to address the interrelated issues of job stress, workplace violence, tobacco use, drug and alcohol abuse, and HIV/AIDS. Psychosocial issues tend to coexist, e.g. stress leads to workplace hostility which spills over into home life and often results in poor coping strategies. SOLVE is based on cognitive behavioral therapy (CBT) models, which believe that behavior is influenced by cognitions, knowledge is necessary for behavioral change, and both are broadly influenced by dynamic interactions between numerous forces. Therefore, SOLVE attempts to make individuals aware of threats and their consequences, make them aware of benefits of the touted strategies, and provide specific information for tackling the health-related issues, while being both person- and organization-directed. Although SOLVE is used widely, its efficacy has not been evaluated. Current studies demonstrate improvements in knowledge among participants across locale which is encouraging. However, they do not assess attitudinal or behavioral changes, or bottom-line benefits to the organization.

Thursday, April 17, 2008

The Visual Cliff

Gibson, E.J. & Walk, R.D. (April 1960). The "Visual Cliff". Scientific American.

To investigate depth perception in human and animal species, these authors created the "visual cliff" which allowed them to experimentally adjust the optical and tactical stimuli associated with a simulated cliff while protecting the subjects from injury. They discovered that all species can perceive and avoid a sharp drop by the time they take up independent locomotion, be it at Day 1 in chicks, 4 weeks in rats, or 6 months in humans. Most rely on visual cues for depth perception. The rat, however, relies predominantly on tactual cues (being nocturnal) but will fall back on sound vision when needed. Next, the experimenters wanted to find out which visual cues played the decisive role in depth perception. Using dark-reared animals, they concluded motion parallax is an innate cue for depth discrimination, whereas responses to differential pattern-density may be learned later.

(I, Doug G, am the author of this article, The Visual Cliff, and I release its content under the terms of the GNU Free Documentation License, Version 1.2 and later.)

Web-based Methods in Terrorism and Disaster Research

Schlenger, W.E. & Silver, R.C. (April 2006). Web-based Methods in Terrorism and Disaster Research. Journal of Traumatic Stress, Vol. 26, No. 2, 185-193.

Gaining access to a traumatized population in the aftermath of a disaster can be challenging. The need for rapid response and appropriate probability sampling along with the observational nature of the studies (i.e. no random assignment) and post-only design can be problematic for the generalizability of the results. Recently, web-based methods have helped to address some of these age-old issues. (1) The literature indicates that people respond more honestly to sensitive questions in self-report than in interview-based assessments. (2) The use of e-mail also assists greatly with retention rates in longitudinal studies. (3) Respondents can answer surveys within the privacy of their home at a time that is convenient to them. (4) Question delivery can be standardized. (5) Time-consuming and error-prone steps of data coding and entry are eliminated. (6) And most importantly, recent companies such as Knowledge Networks Inc. have recruited nationally representative probability samples for just such uses. Panels can even be created in advance of disasters, enabling premeasure to be linked to postevent responses. However, these new technologies are not without their issues, e.g. populations may suffer infrastructure disruptions due to disaster that render data collection impossible such as in Hurricane Katrina.

The Early Origins of Autism

Rodier, P.M. (February 2000). The Early Origins of Autism. Scientific American.

Miller and Stromland made a surprising observation that 5% of thalidomide victims had autism, a rate about 30 times higher than the rate among the general population. This suggested that autism originates in the early weeks of pregnancy when the nervous system is just beginning to develop. Examining these victims' specific malformations indicated that their development had been impacted about 20-24 days into gestation, before many pregnant women even know they are pregnant. This was way earlier than investigators would have guessed, since very few neurons are even formed by the 4th week. However, most are the motor nerves of the cranial nerves in the brain stem. And indeed, many subjects with autism exhibit abnormalities of eye movement and lack of facial expression, consistent with this observation.

However, it is more likely that these early brain injuries affect more than just the function of the cranial nerve, and may interfere with proper development or wiring of other brain regions in turn. People with autism consistently show a reduction in the number of neurons in the cerebellum of the brainstem, a structure typically thought to involved in fine motor control but also seen activated during certain tasks requiring high-level cognitive processing. Some people with autism also display marked decreases in the facial nucleus (controls muscles of facial expression) and superior olive (a relay station for auditory information). Interestingly, "knock-out" mice engineered to lack the expression of the gene known as Hoxa1 (active when brainstem neurons are forming), show all of these symptoms. While variant alleles of Hoxa1 have been identified, these are only one of many genes involved in the spectrum of autism disorder. Other genes must be found which also increase the risk (or decrease the risk) of developing the disorder.

Wednesday, April 16, 2008

Coping with stress in different phases of romantic development

Nieder, T. & Seiffge-Krenke, I. (2001). Coping with stress in different phases of romantic development. Journal of Adolescence, 24, 297-311.

This study followed adolescents longitudinally between ages 14 and 17, annually measuring their quality of relationships, their stress levels, and their coping styles. The results taken together provide support for a developmental sequence in romantic development. The percent of participants in a relationship increased over this time period, and the durations of these relationships increased with time. With this came increases in depth -- intimacy, affection, and extent of sexual activity. Romantic stress was highest in earlier years stemming from diverse sources, later decreasing and stabilizing with age. And active coping with romantic stress was lowest initially and significantly increased at 15, remaining high. As romantic relationships develop, stress is more and more related to conflicts between the romantic partners; yet such conflicts are increasingly resolved by dyadic communication as a coping strategy. Surprisingly, the development of a more active coping style over time was not associated with the decrease in amount of romantic stress. Instead, intimacy and affection is consistently associated with reduced stress, suggesting that as the relationship matures over time romantic stress decreases.

Monday, April 7, 2008

HPA Axis, neuroendocrine factors, and stress

Tsigos, C. & Chrousos, G.P. (2002). Hypothalamic-pituitary-adrenal axis, neuroendocrine factors, and stress. Journal of Psychosomatic Research, 53, 865-871.

Psychology is concerned with the transactions and interactions we have with the world. Stress research examines how we respond to transactions that are stressful. This paper does a great job to illustrate the complexity of our physiological responses to stressors.

CRH/AVP. The paper begins with our physiological response following detection of a stressor. CRH and AVP are secreted into a special portal system and activate neurons of the paraventricular nuclei (PVN) of the hypothalamus, which primarily kicks off activation of the greater hypothalamic-pituitary-adrenal (HPA) axis.

LC/NE system. The locus ceruleus and other noradrenergic cell groups of the medulla and pons, collectively known as the LC/NE system, serve as a global alarm system, using brain epinephrine to execute autonomic and neuroendocrine responses.

The autonomic axis. The ANS provides rapid response to stress, engaging the SNS and withdrawing the PSNS, and enacting cardiovascular, respiratory, gastrointestinal, renal, and endocrine changes.

The HPA Axis. CRH and AVP normally follow certain circadian rhythms, with increasing pulses seen in the early morning hours and decreasing throughout the day. During acute stress, pulsations in this portal system markedly increase, resulting in release of ACTH from the pituitary into the general bloodstream, which finally results in secretion of cortisol and other glucocorticoids from the adrenal cortex. These corticoids involve the whole body in the organism's response to stress and ultimately contribute to the termination of the response via inhibitory feedback.

Other changes. Concomitant with the aforementioned changes, the sympathetic-adrenomedullary system (SAM) influences the body organs, and vagal and sacral parasympathetic responses are also instantiated mediating our gut responses to stress.

The paper also goes into advanced topics including interactions that exist between the HPA axis and the immune system, interactions between the HPA and the gonadal and growth axes, and interactions between the HPA and metabolism. It also discusses pathologies related to the HPA axis. A spectrum of conditions may be associated with increased and prolonged activation of the HPA axis, including melancholic depression, anorexia nervosa, OCD, panic anxiety, excessive exercising, and childhood sexual abuse. Another group of conditions may be associated with hypoactivation of the stress system, including atypical depression, seasonal depression, and chronic fatigue syndrome. Antalarmin, a CRH-R1 antagonist, was also mentioned as being a potentially important drug to combat HPA axis disorders characterized by HPA and LC/NE hyperactivity in the future.

Friday, April 4, 2008

Language Interpretation and the Immediacy Assumption

Hagoort, P. & von Berkum, J. (April 3, 2007). Beyond the sentence given. Philosophical Transactions of the Royal Society, 362, 801-811.

The view that language interpretation takes place in a two-step process has predominated, with the meaning of the sentence being computed first and the sentence meaning then being integrated with other sources of information (e.g. context, world knowledge). However, event-related brain potentials (ERPs) appear to be inconsistent with this model, finding strong empirical evidence that linguistic and extra-linguistic information are integrated in the same time-frame during sentence interpretation. Similar latencies and amplitudes of the N400 effect witnessed for all types of semantic mismatches support the immediacy assumption, that disparate information is brought to bear on language interpretation as soon as it becomes available. Neuroimaging studies suggest that the left inferior frontal cortex, including Broca's area, is an important node in the semantic unification network, and that this area is not language specific but acts as a single integration space.

Monday, March 31, 2008

Depression and cortisol responses to psychological stress

Burke, H.M., Davis, M.C., Otte, C., & Mohr, D.C. (2005). Depression and cortisol responses to psychological stress: a meta-analysis. Psychoneuroendocrinology, 30, 846-856.

This meta-analysis pulled data from seven studies (196 participants with an average age of 40), each of which examined responses to psychological (non-pharmacological) stressors. Specifically, it examined the relationship between major depressive disorder (MDD) and levels of the stress hormone cortisol during three stages of experimentally-induced stress: (1) unstimulated 'baseline', (2) 'stress reactivity' in which cortisol increases from baseline, and (3) 'stress recovery' in which cortisol returns to baseline levels.

They concluded that at baseline MDD patients have lower cortisol levels than their non-depressed (ND) counterparts in morning studies and higher baseline cortisol levels than control groups in afternoon studies. This reveals somewhat opposite patterns of normal daily cortisol fluctuation (although some have described this as simply flattened diurnal activity). Therefore, it was critical to control for these baseline effects seen in the MDD group. After adjusting for these baseline effects, MDD individuals showed blunted stress reactivity and impaired stress recovery by comparison to controls.

Put simply, normal subjects show specific baseline patterns of cortisol release throughout the day and exhibit boosted cortisol levels and rapid recovery to baseline in response to stressors. These healthy cortisol activity curves are dynamic and responsive. MDD subjects, in contrast, show abnormal baseline patterns during the day and exhibit relatively flat and unresponsive patterns of cortisol secretion during and following stress. These effects were found to be most pronounced in older and more severely depressed patients. This altered hypothalamic-pituitary-adrenal (HPA) axis functioning appears somehow linked to depression.

Aversive learning enhances perceptual and cortical discrimination

Li, W, Howard, J.D., Parrish, T.B., & Gottfried, J.A. (March 28, 2008). Aversive learning enhances perceptual and cortical discrimination of indiscriminable odor cues. Science, Vol. 319, 1842-1844.

With this study, the authors explored the impact of aversive conditioning on olfactory discrimination. While most conditioning studies examine the acquisition of new behavioral responses (CR) to formerly benign stimuli presentations, this examined how associative learning can actually alter the perceptual processing of the conditioned stimulus (CS) itself. Following a conditioning regimen, behavioral accuracy for distinguishing by smell between a previously indistinguishable pair of molecules (CS+) rose by more than a factor of 2, exceeding both chance and preconditioning performance. Interestingly, following conditioning, no improvement in distinguishing between the unconditioned control pair (CS-) was witnessed, indicating that these effects are specific to the CS+. After conditioning, reorganization of neural coding was also observed in the posterior piriform cortex, where neural representations of odor identity are maintained. This may shed new light on anxiety disorders which are characterized by exaggerated sensory sensitivity and hypervigilance, potentially self-reinforcing patterns.

Tuesday, March 18, 2008

Prolongation of brainstem auditory-evoked responses in Autistic probands and their unaffected relatives

Maziade, M. et al. (2000). Prolongation of brainstem auditory-evoked responses in Autistic probands and their unaffected relatives. Arch Gen Psychiatry, 57, 1077-1083.

Genetic factors play a major role in autism, with heritability greater than 90%. As the search for biological markers of autism continues, electrophysiological markers have been considered more and more. Early EEG studies comparing autistic subjects to control subjects revealed differences in early brain auditory-evoked responses (BAER). Prolonged BAERs indicate a slowing in nerve conduction within the early auditory system. This study confirmed slow latencies between consecutive sequential waves in autistic individuals, and went further to show that first degree relatives also show significantly longer interpeak latencies (IPLs) than matched controls. Although no significant prolongation was found in second and third degree relatives, resemblance of the IPL trait was found within families. While autism is a complex disorder, perhaps a combination of many neurophysiological deficits, IPL prolongation could be a marker of one of these deficits.

Tuesday, March 11, 2008

Anterior prefrontal function

Koechlin, E. & Hyafil, A. (October 26, 2007). Anterior prefrontal function and the limits of human decision making. Science, Vol. 318, 594-598.

Based on recent empirical findings and predictions from a neurocomputational model, the authors of this review propose a role for the not-yet-well-understood frontopolar cortex (FPC), also known as the anterior prefrontal cortex or Brodmann's area 10. They argue that processing of 'cognitive branching' is the core function of the FPC. Cognitive branching enables a previously running task to be maintained in a pending state for subsequent retrieval and execution upon completion of the ongoing one. Many of our complex behaviors and mental activities require simultaneous engagement of multiple tasks, and the FPC may perform a domain-general function in these scheduling operations.

Empowering Techniques of Play Therapy

Griffith, M. (1997). Empowering Techniques of Play Therapy: A Method for Working with Sexually Abused Children. Journal of Mental Health Counseling. 19 (2), 130-42.

This article, like many others, begins with a brief survey of play therapy theory. It is remarked that play is the natural medium of expression for children and that sexual abuse seems to block many basic developmental needs. Treatment goals are outlined and plotted along a pattern which the process of therapy follows. A case study is provided to articulate these points and exemplify the "five stages" of play therapy. These stages are the establishment of the therapeutic relationship, the later exploratory stage (in which regressive and repetitive behaviors often appear), the limit-setting stage (in which the child tests the boundaries and safety of the therapeutic setting), the growth stage (see below), and the termination stage. Treatment goals in the growth stage involve confronting the "four characteristics of sexual trauma" which are sexual traumatization, stigmatization, betrayal, and powerlessness. Sexual traumatization can lead to confusion between sexuality and affection, confusion about sexual norms, age-inappropriate sexual knowledge, and sexual behavior. It is believed that through the use of empowering techniques of play therapy (expressive/imaginative play and non-direction), the emotional distress of sexual abuse can be relieved and normal psychological development can resume.

The gateway hypothesis of rostral prefrontal cortex function

Burgess, P.W., Dumontheil, I., & Gilbert, S.J. (2007). The gateway hypothesis of rostral prefrontal cortex (area 10) function. Trends in Cognitive Science, Vol. 11, No. 7.

The rostral prefrontal cortex, area 10, is a particularly large brain region in humans, but its function is still poorly understood, to which this paper provides a nascent hypothesis. Their 'gateway hypothesis' suggests that the rostral PFC serves as a gateway between the internal mental life that exists in the absence of sensory influence (i.e. pure, imaginative cognition) and stimulus-oriented cognition. They maintain that lateral and medial subregions are differentially sensitive to changes in demands for stimulus-oriented or stimulus-independent attending, and together their coordination enables us to attend to either environmental stimuli or to self-generated representations. They highlight initial supporting evidence and discuss goals for future experimentation.

(A more general role is proffered by Koechlin & Hyafil.)

Neural substrates of musical creativity

Limb, C.J. & Braun, A.R. (February 2008). Neural substrates of spontaneous musical performance: an fMRI study of jazz improvisation. Public Library of Science ONE, 3, 2, e1679.

This study imaged jazz musicians with fMRI during low and high complexity improvisational sessions to look for correlations in brain activation/deactivation patterns. They found widespread deactivation in the dorsolateral prefrontal cortex (dlPFC), where goal-directed behaviors are thought to be consciously monitored, evaluated, and corrected. Deactivation was also observed in limbic structures. They also found consistent activation in sensorimotor areas, as expected, as well as focal activation in the medial prefrontal cortex (MPFC), a currently poorly understood structure. An emerging view sees this region, Brodmann Area 10, as playing an important role in "the neural instantiation of the self, organizing internally motivated, self-generated, and stimulus-independent behaviors".

Monday, March 10, 2008

Play therapy with sexually abused children

Hill, A. (2006). Play therapy with sexually abused children: Including parents in therapeutic play. CHILD AND FAMILY SOCIAL WORK. 11 (4), 316-324.

According to this article, situations in which sexual abuse has increased a child's separation anxiety can often be improved by including parents in play therapy. This allows the child to feel more secure in his/her primary attachment relationships, while presenting the often confused and uncomfortable parents with a positive model of interaction to emulate. It may also be beneficial for the therapist to witness and interact in the parent-child relationship which, if strained, can often exacerbate the trauma. It is noted that parents benefit from participating in the therapy by eliminating feelings of exclusion and jealousy they may have developed in response to the new therapist-child relationship, by countering feelings of guilt and failure in the role of parent/protector common to situations of child abuse, and by rebuilding confidence in their parenting abilities.

Possible complications of introducing parents into child therapy are discussed. Issues of the child's privacy and confidentiality are naturally raised, as well as the possibility that some parents might be unwilling to participate or counter-productive in the process. Suggestions or interventions by the therapist may be viewed as criticism by the parent.

Two case studies are provided to exemplify these points and to illustrate the situation of a child expressing anger towards his/her parents in response to sexual abuse (by someone else). While this is a common occurrence in play therapy, it becomes complicated when that parent is present. Lastly, it is noted that including parents in play therapy can counteract the "dynamic of secrecy" often imposed on the sexually abused child by the abuser.

Plasticity underlying fear conditioning occurs in the BLA

Fanselow, M.S. & LeDoux, J.E. (June 1999). Why we think plasticity underlying Pavlovian fear conditioning occurs in the basolateral amygdala. Neuron, Vol. 23, 229-232.

A debate over the role of the neural plasticity in the amygdala has been ongoing. The 'encoding view' believes that neural plasticity in the basolateral complex of the amygdala (BLA) encodes the emotional component of memories formed during fear conditioning. The 'modulatory view' sees the amygdala as modulating memories stored in other brain regions, not unlike current theories of the hippocampus. This paper believes that the two views are not mutually exclusive, and argues for a synthesized model in which the amygdala is both the site of fear memory encoding and storage and a modulator of memory functions in other structures.

Friday, March 7, 2008

Play Therapy with Sexually Traumatized Children

Kelly, M. M. (1995). Play Therapy with Sexually Traumatized Children: Factors That Promote Healing. Journal of Child Sexual Abuse. 4 (3), 1-11.

This article begins with a survey of play therapy theory, with special attention given to various writer's takes on the merits of directive vs. non-directive approaches. It is argued that the treatment of sexually abused children often involves a series of "resolution cycles" characterized by the alternation of active work and periods of respite. Each of these cycles comprises three phases: testing the therapeutic relationship, readdressing the trauma, and protective distancing and denial. Another cycle will then be initiated only if there is trust and respect between the child and the therapist. Cycles can take as long as four or more sessions to complete, or may play out in the course of a single session (as is common in the beginning stages of therapy).

Two case studies (one with a 7 year old girl and another with an 8 year old boy) are provided to illustrate the progression of such cycles and to show that the denial phase usually occurs when the child's personal resources are exhausted. It is argued that a clear understanding of these cycles can furnish a therapist with more realistic expectations when working with sexually abused children.

A case study using child-centered play therapy approach to treat enuresis and encopresis

Cuddy-Casey, M. (1997). A case study using child-centered play therapy approach to treat enuresis and encopresis. ELEMENTARY SCHOOL GUIDANCE AND COUNSELLING. 31 (3), 220-225.

Enuresis (bedwetting) and encopresis (bed-defecation) may come from one or more of the following causes: medical-genetic disorders, emotional disturbances, and failure to learn. Depending on the main cause, different treatments are used. Physicians are usually called to deal with the organic problems underlying medical-genetic disorders, while behavioral techniques are used to treat problems stemming from a failure to learn. However, problems rooted in emotional disturbances are commonly lumped into the "failure to learn" category and treated thusly. This article argues for an alternative treatment (i.e. non-directive play therapy) to be used in response enuresis and encopresis rooted in emotional disturbances.

A case example is provided in which an 8-year old male with enuresis and encopresis is treated with play therapy after medical-genetic disorders and failure-to-learn are ruled out. In these sessions, the child began to exhibit aggressive behavior and admitted to wanting to destroy the playroom's pictures and wall clock, which he believed to have cameras hidden behind them. After this admission was received with the permissiveness and acceptance that are the hallmarks of non-directive therapy, the child also admitted that he did not use public restrooms because of this fear of hidden cameras. He spent the next few sessions searching the playroom for cameras and, upon not finding any, began to have less and less problems with enuresis/encopresis.

Thursday, March 6, 2008

Parallel incentive processing: an integrated view of amygdala function

Balleine, B.W. & Killcross, S. (May 2006). Parallel incentive processing: an integrated view of amygdala function. Trends in Neuroscience, Vol. 29, 272-279.

Although the amygdala has been long studied for its involvement in emotional learning and memory, the exact nature of its involvement is still disputed. Historically, a serial model has predominated, with the lateral nucleus detecting threatening stimuli and the central nucleus initiating expression of defensive behaviors and other bodily responses associated with fear reactivity. However, in this paper Balleine and Killcross opine perhaps it's time to consider alternative models, and propose a model which, based on appetitive conditioning studies, has the basolateral and central nuclei operating independently and in parallel to mediate incentive processes in both appetitive and aversive situations. They suggest the basolateral nucleus encodes emotional events with reference to their particular sensory features, while the central nucleus provides affective significance to processing, motivating or inciting responses and actions.

Wednesday, March 5, 2008

Jungian Play Therapy in Elementary Schools

Allan, J., & Brown, K. (1993). Jungian Play Therapy in Elementary Schools. Elementary School Guidance and Counseling. 28 (1), 30-41.

This article discusses the Jungian approach to play therapy and provides a case study to exemplify its methods. As a (or perhaps the) proto-humanistic psychologist, Jung believed that growth and transformation are the main drives in the psyche. Thus, counseling involves mainly providing a safe and protective setting in which these internal processes can propel a child into change. This so-called self-healing archetype requires a healthy connection between the child's conscious and unconscious worlds. Therapy is thus also aimed at creating such a connection.

Jungian play therapy identifies three major themes or stages through which a child's play evolves: chaos, struggle, and resolution. It is through the progression of this resolution that the ego develops a sense of control and mastery as it learns to mediate the "struggle of opposites." Towards the end of therapy, common themes become construction, reparation, and healing.

Jungian play therapy is directive in its counseling style and makes use of interpretation interventions to "deepen affective expression." This is received much more positively by the child if it is initiated after a strong therapeutic relationship of rapport is established. This point and others are illustrated in the case study of a third grader with aggressive behavior problems. His sand play had a recurrent theme of "good guys" struggling against "bad guys." When, later in therapy, this theme was interpreted as analogous to his own feelings of isolation and confliction, he accepted it and showed remarkable change in the next session. In the next sand world he made, there was a fenced off area where kids could go and nothing could happen to them. It is argued that this opportunity to release his feelings allowed the child's positive, integrating mechanisms to guide him to growth, and that the direct interpretations expedited this process.

The Masterson Approach with Play Therapy

Mulherin, M. A. (2001). The Masterson Approach with Play Therapy: A Parallel Process between Mother and Child. AMERICAN JOURNAL OF PSYCHOTHERAPY. 55, 251-272.

This article illustrates the principles of the Masterson Approach with a long-term case study involving a child and his mother in adjunct therapy. The Masterson Approach (with which I am not very familiar) is a psychodynamic developmental self and object relations approach. It involves providing opportunities for diagnostic assessment, developing a working relationship within therapy, assisting in the breakdown of defenses, facilitating verbalization, providing cathartic release, and preparing the child for future life events. As will be seen, the diagnosis has a large effect on which treatment strategies are deemed appropriate.

The initial diagnosis for both the mother and son was distancing borderline disorder. As a result, the technique of confrontation was used as intervention. However, as confrontation led to increased anxiety in both patients, the diagnosis was changed to schizoid disorder of the self and interpretation of the schizoid dilemma became the primary therapeutic technique. This seemed to have drastic effect, as both patients responded positively. The new diagnosis was thus confirmed.

An interesting aspect of this case study was the enmeshment, or parallel progression of the mother and son. Often the son would act out (in his sand trays) the very same conflicts his mother struggled with in her verbal therapy. They both exhibited signs of the splitting defense mechanism, with the son accepting his mother while rejecting his father, and the mother having panic attacks as she fantasized about reuniting with her separated husband.

Two interesting events in the play therapy are also worth noting. First was when the son explicitly acknowledged the symbolic nature of his play by remarking (after destroying one of his sand worlds) that he was glad those "bad feelings [were] gone". And second was when the creation of a loss/death-themed sand world in his fifth year of treatment seemed to usher in a much more integrated child. After this cathartic experience, his regressive defenses completely disappeared.

Tuesday, March 4, 2008

Play therapy; the troubled child's self-encounter

Hyde ND. (1971). Play therapy; the troubled child's self-encounter. The American Journal of Nursing. 71 (7), 1366-70.

A general overview with anecdotal examples of non-directive play therapy from a psychiatric nurse. The article quotes largely and effectively from the major players (Axline, Moustakas, etc.). There is not much here that you can't get from the primary texts themselves, but it is not bad either. It outlines the theoretical framework of non-direction, permissiveness, and attentiveness on the part of the therapist. It also acknowledges the projection, darkness, and struggle for integration evident in children's play.

An experiment with play therapy

Smith LF. (1977). An experiment with play therapy. The American Journal of Nursing. 77 (12), 1963-5.

A summarized and anecdotal account of an amateur play therapist (nursing student) working with a withdrawn child. Only very limited dialogue is provided, more often utilizing descriptions of what actions and conversations took place. This article is another case study to read, but without dialogue and given the inexperience of the therapist, it leaves much to be desired as a learning tool. The child in this case study expressed his anxiety in an obsession with cleanliness, spending much of the time cleaning the windows and walls of the playroom. He also played extensively with a customizable doll house, deconstructing and reconstructing it, and had the therapist act out his own daily routines.

Using play therapy in outpatient settings

Meer PA. (1985). Using play therapy in outpatient settings. MCN. The American Journal of Maternal Child Nursing. 10 (6).

This article demonstrates the ambiguity existing in terms such as "play therapy" in research contemporary to it. What is described here is toys being used by nurses in calming children and preparing them for medical procedures, which is very different from the play therapies used by professional therapists in building permissive and accepting relationships with "troubled" children.

Aside from this rather frustrating catachresis, the article describes the interesting application of play-related concepts to children in health care settings. Specifically, puppets and dolls can be used to familiarize children with the equipment and procedures they will later be exposed to. Allowing children to participate in this play-acting can make them feel more control over the situation, assuaging some of their anxiety and leading to an overall feeling of independence.

Play Therapy With Abused Children: A Review of the Literature

White, J., & Allers, C. T. (1994). Play Therapy With Abused Children: A Review of the Literature. JOURNAL OF COUNSELING AND DEVELOPMENT. 72 (4), 390.

This article gives an overview of play therapy, identifies and explores seven characteristic behaviors exhibited by abused children, identifies and explores two general themes of play in abused children, and critiques play therapy research. The characteristic behaviors are developmental immaturity, opposition and aggression, withdrawal and passivity, self-deprecating and self-destructive behavior, hypervigilance, sexual behavior, and dissociation. The recurrent themes of play behavior are unimaginative/literal play and repetition/compulsion. Each of these behaviors and themes are elaborated on and special attention is paid to the differences between the behaviors exhibited by sexually abused, physically abused, and neglected children. Lastly, contemporary research is critiqued for its inconsistent definitions, nonstandardized methodologies, and flawed statistical designs.

Use of the telephone in child play therapy

Spero MH. (1980). Use of the telephone in child play therapy. Social Work. 25 (1), 57-60.

A brief exposition of the use and benefits of supplying a toy telephone in child play therapy settings. Spero begins by remarking that a toy is only as useful in a therapeutic context as the child's willingness to play with it. Thus, despite the potential goldmine of communication in a toy telephone, this is wasted unless the child decides to use it. Having said this, he continues on to highlight the potential uses the toy telephone might be to. A child may hold a conversation with an imaginary party, fantasize a connection with the deceased or unavailable, or even exercise projection by assuming the role of both parties. Four brief case studies are provided to illustrate these potential uses. It is remarked that children will often pretend to phone their therapist (early in therapy) in an attempt to form a connection with them, and that the act of forcibly hanging-up can be a powerful way for reserved children to learn to express their desires and frustrations.

Play therapy: the children's views

Carroll, J. (2002). Play therapy: the children's views. CHILD AND FAMILY SOCIAL WORK. 7, 177-188.

A qualitative study on children's reactions to non-directive play therapy. Interview questions pertained to how the children felt about their introduction to play therapy, their relationship with the therapist, the therapeutic processes, their likes and dislikes in therapy, and the termination of their therapy. Children's responses varied greatly, but several basic themes emerged. Notably, while children universally enjoyed their relationship with the therapist greatly, they were largely unable to pinpoint what aspects of the therapist's behavior were most helpful. The children appreciated the provisions of food at the beginning of therapy and described their sessions as being importantly "fun". Many seemed to dislike explicit "talking about their feelings". This is a truly fascinating project, but unfortunately only a small sample size was acquired. More research on this is needed.

Classical fear conditioning in functional neuroimaging

Buchel, C. & Dolan, R.J. (2000). Classical fear conditioning in functional neuroimaging. Current Opinion in Neurobiology, 10, 219-223.

A brief overview of the brief history of the examination of classical conditioning with functional neuroimaging. Early PET studies showed a striking absence of expected amygdala activation, but later demonstrated the expected amygdala involvement. More recently, 'backward masking' designs indicate a hemispheric difference when the CS+ was presented out of awareness, with greater activation observed in the right amygdala. fMRI studies showed amygdala participation during initial acquisition and early phases of extinction, and also demonstrated the characteristic decreases in amygdala activation over time. Interestingly, blocked fMRI designs revealed that social phobics do not show the 'physiological' decrease of amygdala activation over time. Finally, the paper points out the controversy about the role of the amygdala. One camp regards the amygdala as a rapid subcortical information processing unit that is continuously involved in the processing of CSs in aversive classical conditioning, producing deliberately high "false alarm" rates and being kept under the supervision of cortical controllers. The other camp sees the amygdala as enabling or permitting associative plasticity that encodes acquired sensory contingencies which are later expressed at a cortical level; once the association has been learned, the systems mediating the modulation of plasticity disengage and hence we see the decline in amygdala activation. More on this debate here.