Browsing by Author "Rosenthal, Mark Zachary"

In the present study, we examined the predictions of an attentional-associative model (Schmajuk, Lam, & Gray Journal of Experimental Psychology: Animal Behavior Processes, 22, 321-349, 1996) regarding the effect of attentional manipulations on both discrete and contextual conditioned inhibitors.

The SLG model assumes that non-reinforced presentations of an inhibitory conditioned stimulus (CS) do not decrease its inhibitory associations. However, the model predicts that extended presentations will decrease attention to the inhibitor, thereby, decreasing both the expression of its inhibitory power in a summation test and the rate of acquisition in a retardation test. The model also predicts that subsequent presentations of the inhibitory CS with a novel CS will increase both its inhibitory power in a summation test and the rate of acquisition in a retardation test. Using a predictive learning design in humans, Experiment 1 examined the predictions involving the summation tests, whereas Experiments 2 and 3 examined the predictions involving the retardation tests. Experimental results were in agreement with the predictions of the model.

The SLG model also predicts that a salient extinction context (CX) becomes inhibitory and prevents extinction of the excitatory CS-unconditioned stimulus (US) association. Although some data seem to contradict that prediction (e.g., Bouton and King, 1983, Bouton and Swartzentruber, 1986, 1989), Larrauri and Schmajuk (2008) indicated that the CX might not appear inhibitory in a summation test because attention to the CX decreases with many but not few extinction trials. In a human predictive learning experiment, we confirmed the model's predictions that the inhibitory power of the extinction CX can be detected after a few extinction trials when attention to the CX is still high, but not after many extinction trials once attention to the CX has decreased (Experiment 4), and even after many extinction trials by presenting novel CSs to increase attention to the unattended CX (Experiment 5). Furthermore, using an eye-tracker, we confirmed the model's explanation of Experiment 4 results by showing decreased overt attention to the CX after many but not after few extinction trials (Experiment 6).

Importantly, the view that the extinction CX becomes inhibitory allows the model to explain spontaneous recovery (because attention to the excitatory CS increases before attention to the inhibitory CX), renewal (because the inhibition provided by the extinction CX disappears), and reinstatement (the inhibitory CX becomes neutral or excitatory), as well as a very large number of other experimental results related to extinction. Based on the prediction of the SLG, model the implications of our results for the treatments of anxiety disorders were discussed.

Substance use disorders are one of the most common psychiatric diagnoses among adolescents; marijuana is the illicit drug used most frequently by youth. Treatment dropout and relapse following treatment are common; innovative strategies are needed to improve treatment outcomes for youth substance abusers. The aim of this study was to develop and evaluate the feasibility of a virtual reality (VR) cue reactivity paradigm for adolescent cannabis abusers and to compare it to a video cue reactivity paradigm. Forty-two treatment-seeking youth with a cannabis use disorder completed the study, which incorporated three parts. During Part 1, drug and neutral video clips were shown to 11 youth and five substance-abuse experts who provided craving/usefulness ratings for each video clip. During Part 2, five youth met in a focus group and then individually to provide input on the development of the VR paradigm. During Part 3, 26 youth completed a laboratory procedure involving neutral and drug-related video clips and VR presentations. Heart rate, skin conductance, and skin temperature were measured as well as craving. Higher levels of craving and skin conductance were observed during drug-related presentations. The presentations did not significantly differ in their ability to elicit craving and arousal. Results suggest that youth can experience subjective and physiological reactivity to VR drug cues warranting further study with a larger, more diverse sample. Implications are discussed.

The current study tested the effects of a brief, behavioral intervention for problems with emotion perception, the ability to perceive other people’s emotions, across a range of psychiatric disorders. The intervention was delivered through an in-person training session in which participants learned a mindful breathing skill, followed by a testing phase in which participants received phone-based reminders to practice the skill for one week. A sample of 80 adults with self-reported emotion regulation difficulties was recruited for this study and was randomized to either the Mindful Breathing condition, a Habituation condition, or a Control condition. Findings from this study suggested that, in the training session, participants in the Mindful Breathing condition had higher accuracy for perception of positive emotions and lower accuracy for perception of negative emotions than the control condition at the second and third timepoints. After the week of receiving phone reminders, participants in the mindful breathing condition had lower accuracy for perception of negative emotions than the control condition. Findings also suggest that the mindful breathing intervention reduces distress, which was associated with emotion perception performance. Therefore, this study’s findings provide preliminary evidence for a method of targeting emotion perception deficits that are associated with many psychiatric disorders. By combining both in-person and digital treatment components, this intervention also provides a feasible and effective complement to mainstream mental health services.

Emerging changes in health care reform have further accelerated the need for brief and cost-effective interventions. As such, the current study tested the efficacy of two brief, phone-administered, behavioral interventions derived from behavioral activation (BA) in reducing burnout among graduate students. 66 adults currently enrolled in a doctoral program in the state of North Carolina and demonstrating current burnout were randomly assigned to one of three intervention conditions: 1) Reward: a brief intervention to help participants increase pleasant, rewarding behaviors, 2) Approach: a brief intervention to help participants approach important goals that they have been avoiding due to emotion (fear, stress, sadness) or 3) Control: a condition that involves monitoring only. All participants completed three days of daily monitoring, conducted through an online survey platform, in order to attain baseline indices of mood and activities. They then received a brief intervention over the phone and completed 7 days of additional online self-monitoring while completing the intervention. Participants completed a self-report packet assessing burnout, perceived stress, behavioral activation, experiential avoidance, mastery, anxiety and depression symptoms, quality of life, and functional impairment at baseline, post-intervention, and a 1-week follow-up assessment.

The study found that individuals in the Approach condition showed significant reductions in burnout post-intervention and at a one-week follow-up assessment, compared to individuals in the Control condition. In addition, individuals in the Approach condition showed significant improvements in well-being and significant increases in behavioral activation, compared to individuals in the Control condition. These findings suggest that a one-time intervention designed to help individuals approach challenging, avoided tasks may significantly improve indices of distress and dysfunction among doctoral-level graduate students.

Traditional in-person psychotherapies are proving incapable of addressing mental health needs globally. Computer-based interventions are one promising solution to closing the large gap between mental health treatment need and actual treatment received. The overarching aim of this study is to contribute to the body of literature focused on providing new insights into effective ways of leveraging technology to implement large-scale mental health initiatives that are financially feasible, easily transportable and quickly scalable in low-resource setting. Although many meta-analyses have provided evidence to support the efficacy of self-guided, computer-based interventions, most report low rates of treatment engagement (high attrition, low adherence). Accordingly, this dissertation investigates the efficacy of an adjunctive treatment component that uses task-sharing, where mental health care is provided by non-specialist providers (NSP; e.g., nurses, clergy, community members), to enhance engagement in a self-directed, web-based mindfulness intervention for stress and depression among Chinese students.

Fifty-four students from 36 universities across China reporting at least mild stress, anxiety and/or depression were randomly assigned to a brief (4-week online mindfulness intervention (MIND) or to the intervention plus NSP support (MIND+). Fifty-six volunteer NSP candidates without formal training in the delivery of mental health services were screened, ten were invited to participate in a 1-day training, and four were selected. NSPs were instructed to provide six brief (15-20 minute) weekly meetings, with the intention of supporting and encouraging participants in their completion of the online intervention. NSPs received weekly online group supervision. Participants completed daily monitoring of mindfulness practice and mood, as well as baseline and post-treatment self-report packet assessing depression, anxiety and stress symptoms and trait mindfulness.

The study found that participants assigned to the MIND+ (vs. MIND) condition showed significantly less attrition and more adherence, as indicated by a greater likelihood of completing post-treatment assessments and a greater percentage of course completion, respectively. There were no significant between-group differences in daily self-reports of frequency and duration of mindfulness practice across the trial. However, results indicated that participation in the online intervention was associated with significant improvements in pre- to post-treatment mindfulness and mental health outcomes. In addition, individuals in the MIND+ condition reported significant improvements in daily ratings of stress and depression across the trial, compared to individuals in the MIND condition. These findings suggest that volunteer NSPs receiving brief training and weekly supervision may significantly improve participants’ indices of treatment engagement and mental health outcomes in an online mindfulness intervention among college and graduate students in China.