A Comparison of Cognitive Restructuring and Thought Listing for Excessive Acquiring in Hoarding Disorder Abstract Excessive acquiring is a common symptom of hoarding disorder (HD). Little is known about subjective distress associated with acquiring in HD. The present study examined acquiring-related distress and reactions to cognitive restructuring (CR) in 92 individuals with HD and 66 community control (CC) participants. All participants identified an item of interest at a high-risk acquiring location and then decided whether or not to acquire the item. HD participants completed the acquiring task while receiving a CR-based intervention or a thought-listing (TL) control condition. Results showed that HD participants reported more severe distress and greater urges to acquire the item of interest than did CC participants. Nevertheless, subjective distress decreased in both groups following the acquiring task. There were no differences in acquiring-related distress between the CR and TL conditions. The findings indicate that subjective distress may decrease after relatively short periods of time in individuals with HD, but that a single session of CR may not alleviate acquiring-related distress in HD participants.

Doubting the Diagnosis but Seeking a Talking Cure: An Experimental Investigation of Causal Explanations for Depression and Willingness to Accept Treatment Abstract In the current literature there is a general lack of research examining the impact of causal explanations on beliefs about psychotherapy, willingness to accept treatment, and treatment expectancies. The present study was aimed at experimentally investigating effects of causal explanations for depression on treatment-seeking behavior and beliefs. Participants at a large Southern university (N = 139; 78% female; average age 19.77) received bogus screening results indicating high depression risk, then viewed an explanation of depression etiology (fixed biological vs. malleable biopsychosocial) before receiving a treatment referral (antidepressant vs. psychotherapy). Participants accepted the cover story at face value, but some expressed doubts about the screening task’s ability to properly assess their individual depression. Within the skeptics, those given a fixed biological explanation for depression were relatively unwilling to accept either treatment, but those given a malleable biopsychosocial explanation were much more willing to accept psychotherapy. Importantly, differences in skepticism were not due to levels of actual depressive symptoms. Information about the malleability of depression may have a protective effect for persons who otherwise would not accept treatment.

Training Rejection Interpretation in Eating disordeRs (TRIER): Preliminary Findings of a Feasibility Study in Adolescents with Anorexia Nervosa Abstract This study investigated expectations of social rejection in adolescents with anorexia nervosa. Female adolescents (N = 24) admitted for hospital treatment completed both a positive interpretation bias training (experimental training) and a 50% positive and 50% negative interpretation bias training (control training), in a counterbalanced order, in two different testing sessions using a within-subjects design. The primary outcome for the training was the frequency of negative interpretations produced in the sentence completion task. At baseline, participants produced more negative than benign interpretations of ambiguous social scenarios (medium/large effect size). Following experimental training, participants produced fewer negative and more benign interpretations compared to control training (medium/large effect sizes). A trend for higher levels of self-esteem following virtual ostracism was found in the experimental condition compared to the control condition (small/medium effect size). Interpretation bias modification has the potential to improve resilience to rejection in adolescents with anorexia nervosa.

GAD-Specific Cognitive Behavioral Treatment for Children and Adolescents: A Pilot Randomized Controlled Trial Abstract Cognitive behavioral therapy (CBT) designed to target generalized anxiety disorder (GAD) in youth was examined in a pilot feasibility trial. Participants (aged 10–18 years) were randomized to either 10 weeks of individual CBT (n = 20) or supported wait-list (n = 20). Diagnostic status (primary outcome) was assessed blindly at post-treatment for both groups, and at a 3-month follow-up for treated participants. Two participants failed to complete CBT and retained their GAD during the trial. Intention-to-treat analyses revealed large between-group differences in favor of CBT at post-treatment for remission from GAD (80% vs 0%) and comorbid disorders (83% vs 0%), and for all secondary outcomes (child and parent-reported). All gains were maintained at 3-month follow-up in the CBT group. Consistent with the treatment model, significant pre- to post-treatment reductions in several cognitive processes were found for CBT but not wait-listed participants, with these gains maintained at follow-up. Further investigations are warranted. Trial registry: ISRCTN.com Identifier ISRCTN50951795

Should I Keep It? Thoughts Verbalized During a Discarding Task Abstract An essential criterion for hoarding disorder (HD) is difficulty parting with possessions, but relatively little research has been conducted on responses by people with HD during actual efforts to discard objects. Frost et al. (Behav Res Therapy 85:13–22, 2016) reported quantitative findings from a discarding task comparing those with HD to community control participants without significant hoarding symptoms (CC) on discarding behavior. The present study used qualitative data analysis of the verbal statements made by HD and CC participants while talking aloud about whether to discard or keep a personal object of low monetary value. Data were coded and analyzed using Atlas.ti software via an iterative process in order to examine thoughts reported during decision-making. Findings indicated that participants made more comments about reasons for saving than discarding and that HD participants reported more reasons to save and fewer reasons to discard than did CC participants. They also voiced more thoughts about emotions, both negative and positive, than did controls, especially for anxiety, anger and guilt and general distress. HD participants expressed more ambivalence about discarding compared to controls. Findings are discussed in relation to the cognitive and behavioural model for hoarding, previous findings regarding reasons for saving, and treatment implications.

Cognitive Bias Modification of Expectancies (CBM-E): Effects on Interpretation Bias and Autobiographical Memory, and Relations with Social and Attachment Anxiety Abstract Social anxiety is characterised by a bias to recall negative social autobiographical memories as well as anxious expectations about future social interactions. Neuroscientific research shows that a shared neural network underlies both temporal directions of autobiographical recall and future self-projections. Inspired by these findings, the current study tested the effectiveness of a Cognitive Bias Modification training to induce expectancies about the outcome of possible future social interactions (CBM-E). Its effects on interpretation bias, autobiographical recall and personal future projections were tested additionally. Participants read short social scenarios that could possibly happen to them in the future. Each scenario ended in word-fragment which, when completed, disambiguated the meaning of the scenario in either an optimistic or pessimistic way contingent on experimental condition. The CBM-E training was tested in 120 student participants and appeared effective in changing expectancies. The effect generalized to social interpretation bias (scrambled sentences). No direct effects of the training were found on autobiographical recall or future projections. However, participants trained to have pessimistic expectancies who had higher attachment anxiety showed a less positive interpretation bias related to the future. Furthermore, participants with high social anxiety reported less positive personal future projections when trained to have optimistic social expectancies.

Training to Inhibit Negative Content Affects Memory and Rumination Abstract Depressive rumination, the tendency to engage in repetitive self-focus in response to distress, seems to be affected by a variety of cognitive biases that in turn maintain negative emotional states. The current study examined whether the difficulty in inhibiting attention to negative information contributes to rumination and to rumination-related biases in memory. Seventy-nine ruminators underwent a 3-week computer-based training, designed to increase either inhibition of negative words or attention to them. On immediate post-training trials, as well as on 2-week follow-up tests, we found evidence for transfer of inhibition training. Training effects also occurred on session-by-session and post-training measures of state rumination, but not on a measure of trait rumination, assessed 2 weeks later. Finally, participants who were trained to inhibit negative material subsequently showed less negative bias on a memory test. These findings further establish the causal role of biased inhibition in rumination, and substantiate the view of rumination as a habit that encourages people to perceive, interpret, and remember events in a repetitive self-focused manner.

The Voice of Depression: Prevalence and Stability Across Time of Perception-Laden Intrusive Thoughts in Depression Abstract Intrusive depressive thoughts are typically defined in terms of their content, frequency, and pervasiveness. The extent to which they carry sensory properties is largely unexplored. In a pilot study, 56.5% of individuals with mild to moderate depressive symptoms experienced depressive thoughts with sensory features. The present study explored the prevalence of sensory thoughts in patients with severe depression and examined the stability of the sensory phenomena across time. A total of 163 participants with severe depression completed an online assessment at baseline and 3 months later. Diagnostic status was established at baseline over the telephone. The primary outcome was the Sensory Properties of Depressive Thoughts Questionnaire (SPD). The frequency of sensory properties of negative thoughts was similar (60.7% reported at least one sensory irritation; thus, 39.3% of the sample reported not a single, even mild sensory irritation) to the pilot study. The highest prevalence was observed for bodily sensations (41.1%; pilot: 39.6%) followed by auditory (37.4%; pilot: 30.6%) and visual (31.3%; pilot: 27.2%) perceptions. Prevalence remained essentially unchanged over time, but test–retest reliability was weak to moderate (r = .56). Unlike in the pilot study, no association emerged with quality of life and suicidality. Yet, those reporting sensory phenomena were prescribed more medication, had a similar number of prior hospitalizations despite their younger age, were more frequently in psychotherapy (statistical trend), and had more pain symptoms, which tentatively suggests a more complicated course of illness. Replication in independent samples is needed. Our findings support the notion that depressive thoughts are not “silent” but are commonly accompanied by sensory experiences.

Are Socially Anxious Children Really Less Liked, or Do They Only Think So? Abstract The purpose of this study was to examine the relation of social anxiety with self-perceived and peer-reported likability, while controlling for the possible influence of depression. In total, 586 children (7 to 13 years) completed questionnaires to measure social anxiety, self-assessed likability, and depression. Peer-reported likability was derived from sociometric data on likability. As expected, children with higher self-reported social anxiety perceived themselves as less liked by classroom peers than children with lower self-reported social anxiety. In reality, children with higher levels of social anxiety were more liked by peers than children with lower levels of social anxiety. Multilinear regression analyses indicated no confounding effect of depression: Social anxiety, but not depression, was a significant predictor of biased perceived likability. Correcting the discrepancy between objective versus subjective likability may be a crucial target in the prevention and treatment of social anxiety disorders in children.

Imagery Rescripting of Aversive Autobiographical Memories: Effects on Memory Distress, Emotions, and Feelings of Mastery Abstract Imagery rescripting (ImRs) has been shown to be a promising intervention for aversive emotional memories, but research on underlying mechanisms is only in its beginnings. Previous analogue studies on ImRs were mainly based on the trauma film paradigm, but the personal relevance of film-induced memories is limited. Therefore, the present study aimed to investigate the effects of ImRs on personally relevant autobiographical memories. Sixty-five participants who had experienced a distressing life-event were randomly assigned to ImRs or no-intervention control (NIC). ImRs led to less intrusive memories than NIC during the 1-week follow-up period, but was not superior in reducing overall event-related stress symptoms. When retrieving the memory after 1 week, ImRs participants reported greater reductions in sadness and distress, and higher feelings of mastery. Findings underline the potential of the paradigm used in this study to test memory processes involved in ImRs. Limitations and modifications of the paradigm are discussed.