To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Since its inclusion in the DSM-III, various theories and treatment approaches have been developed for generalised anxiety disorder (GAD). Aaron T. Beck was the first to offer a cognitive conceptualisation of GAD in Anxiety Disorders and Phobias: A Cognitive Perspective. This original cognitive model of GAD was initially found to be promising in treating GAD but has not been developed further. Other theoretical models and treatments of GAD have gained more research attention, such as the Intolerance of Uncertainty model and Meta-Cognitive model. This article offers a brief overview of multiple theories and treatment approaches of GAD followed by an extensive discussion about the original cognitive model and a revised cognitive model of GAD in the Beckian tradition. Specifically, this paper describes how known key psychological maintenance factors of anxiety disorders, i.e. threat beliefs, safety-seeking behaviours and selective attention, can be used to conceptualise the experience of people with GAD and guide treatment. This is done with theoretical discussion as well as clinical examples. Finally, the paper offers suggestions for key ingredients to be included in cognitive therapy for GAD and future directions for research.
Key learning aims
(1) To understand the clinical implications of the original cognitive model and the revised model of generalised anxiety disorder presented here.
(2) To understand the role of inflated responsibility for safety, safety-seeking behaviours and elevated evidence requirements in generalised anxiety disorder.
(3) To understand and be able to implement treatment recommendations of the revised cognitive model of generalised anxiety disorder.
Previous studies have brought conflicting results regarding the effects of valence and arousal in visual word processing. Some authors have pointed to participants’ individual differences as one of the possible explanations for these inconsistencies. The main aim of the present research was to examine whether participants’ individual differences in the level of epistemically unwarranted beliefs (EUB) contribute to these conflicting results. Therefore, participants who varied in their level of paranormal, pseudoscientific and conspiracy beliefs (assessed by self-report measures) performed a lexical decision task (LDT) and a recognition memory task. Linear mixed-effects models over LDT response times revealed that the effects of words’ emotional content (both valence and arousal) were modulated by the degree of individuals’ EUB. In addition, signal detection theory analyses showed that in the recognition task (but not in the LDT) response bias became more liberal as individuals’ EUB increased. These patterns of effects were not general to all EUB instances. The obtained results highlight the need to consider participants’ individual differences in affective word processing and signal detection. In addition, this study reveals some basic psychological mechanisms that would underlie EUB, a fact that has both theoretical and applied relevance.
Data from neurocognitive assessments may not be accurate in the context of factors impacting validity, such as disengagement, unmotivated responding, or intentional underperformance. Performance validity tests (PVTs) were developed to address these phenomena and assess underperformance on neurocognitive tests. However, PVTs can be burdensome, rely on cutoff scores that reduce information, do not examine potential variations in task engagement across a battery, and are typically not well-suited to acquisition of large cognitive datasets. Here we describe the development of novel performance validity measures that could address some of these limitations by leveraging psychometric concepts using data embedded within the Penn Computerized Neurocognitive Battery (PennCNB).
Methods:
We first developed these validity measures using simulations of invalid response patterns with parameters drawn from real data. Next, we examined their application in two large, independent samples: 1) children and adolescents from the Philadelphia Neurodevelopmental Cohort (n = 9498); and 2) adult servicemembers from the Marine Resiliency Study-II (n = 1444).
Results:
Our performance validity metrics detected patterns of invalid responding in simulated data, even at subtle levels. Furthermore, a combination of these metrics significantly predicted previously established validity rules for these tests in both developmental and adult datasets. Moreover, most clinical diagnostic groups did not show reduced validity estimates.
Conclusions:
These results provide proof-of-concept evidence for multivariate, data-driven performance validity metrics. These metrics offer a novel method for determining the performance validity for individual neurocognitive tests that is scalable, applicable across different tests, less burdensome, and dimensional. However, more research is needed into their application.
This book offers a psychological account of thrills (goosebumps and tears), of the epiphanic experience of seeing ordinary things in a profoundly new way, and of the experience of the sublime. The unifying characteristic of these 'strong experiences' is that they all begin with surprise. They are important in literature: literature is about these experiences, and literature can cause these experiences. This book offers an overview of theories of these kinds of experience, and of what might cause them to happen. In the final chapter, various literary strategies are explored as possible causes. The book draws on psychological accounts of surprise, and of emotion, and cognitive approaches to what knowledge is, why it is possible to have feelings of profound knowledge, and why what we know can sometimes not be put into words.
Julia Tanney’s Meaning, Mind, and Action challenges widely held presuppositions within philosophy in its classical 'analytic', 'naturalist', and 'cognitivist' forms. Beginning with canonical views in the philosophy of language and logic, the arguments are then applied to discussions of knowledge, action, causation, the nature of the mental, consciousness, and thinking.
Responding to a tradition that harks back to Plato and was resurrected by Mill, Frege, Russell, Moore, and the early Wittgenstein, Meaning, Mind, and Action challenges today's orthodoxy on its own terms, beginning with canonical views in the philosophy of language and philosophical logic. The arguments of these early chapters are then applied to the theory of knowledge, action, and causation, followed by those on the nature of the mental, consciousness, and thinking. The final section, on the logic of the mental, widens the arguments to include the subject of animal minds, the postulation of mental representations in cultural anthropology, the author's intention in literary theory, and the philosophical problem of irrationality in psychiatry.
The alcohol-attributable disease burden is greater in low- and middle-income countries (LMICs) as compared to high-income countries. Despite the effectiveness of interventions such as health promotion and education, brief interventions, psychological treatments, family-focused interventions, and biomedical treatments, access to evidence-based care for alcohol use disorders (AUDs) in LMICs is limited. This can be explained by poor access to general health and mental health care, limited availability of relevant clinical skills among health care providers, lack of political will and/or financial resources, historical stigma and discrimination against people with AUDs, and poor planning and implementation of policies. Access to care for AUDs in LMICs could be improved through evidence-based strategies such as designing innovative, local and culturally acceptable solutions, health system strengthening by adopting a collaborative stepped care approach, horizontal integration of care into existing models of care (e.g., HIV care), task sharing to optimise limited human resources, working with families of individuals with AUD, and leveraging technology-enabled interventions. Moving ahead, research, policy and practice in LMICs need to focus on evidence-based decision-making, responsiveness to context and culture, working collaboratively with a range of stakeholders to design and implement interventions, identifying upstream social determinants of AUDs, developing and evaluating policy interventions such as increased taxation on alcohol, and developing services for special populations (e.g., adolescents) with AUDs.
The COVID-19 pandemic has had negative consequences on the mental health of the population, which has been documented. Marginalised groups that are at risk of poor mental health overall have been particularly impacted. The purpose of this review is to describe the mental health impact of the COVID-19 pandemic on marginalised group (i.e. persons who are socio-economically disadvantaged, migrants and members of ethno-racial minorities, experience homelessness) and identified interventions which could be well-suited to prevent and address mental health difficulties. We conducted a literature review of systematic reviews on mental health difficulties since the beginning of the COVID-19 epidemic and appropriate interventions among marginalised groups published from January 1, 2020 to May 2, 2022, using Google Scholar and PubMed (MEDLINE). Among 792 studies on mental health difficulties among members of marginalised groups identified by keywords, 17 studies met our eligibility criteria. Twelve systematic reviews examining mental health difficulties in one or several marginalised groups during the COVID-19 pandemic and five systematic reviews on interventions that can mitigate the mental health impact of the COVID-19 pandemic were retained in our literature review. The mental health of marginalised groups was severely affected during the COVID-19 pandemic. Most frequently reported mental health difficulties included symptoms of anxiety and depression. Additionally, there are interventions that appear effective and well-suited for marginalised populations, which should be disseminated on a large scale to mitigate the psychiatric burden in these groups and at the population level.
Few studies have explored associations between adaptive functioning and cognition in adolescents with early-onset schizophrenia spectrum disorders (EOS).
Methods:
Adaptive functioning, cognition, positive, negative, and general symptoms were characterized in adolescents with EOS and healthy controls. A modified scale of negative, respectively, general symptoms was used. Bivariate analyses identified correlates of adaptive functioning to be included in multivariate analysis.
Results:
Adolescents with EOS showed significant impairments of social- and neurocognitive functions (−0.86 < Cohen´s ds < −0.58) and adaptive functioning (Cohen´s d = −2.23). Visual memory, verbal working memory, processing speed, reaction time, social cognition, and modified negative and general symptoms correlated significantly with adaptive functioning. The multiple regression analysis revealed only verbal working memory as uniquely associated with adaptive functioning (explaining 22.7 % of its variance). Verbal working memory also associated significantly with adaptive functioning in the context of the nonsignificant modified negative and the significant modified general symptoms dimension.
Conclusions:
Adolescents with first-episode EOS had large impairments in adaptive functioning and moderate to large cognitive deficits. Verbal working memory was an important associate to concurrent adaptive functioning and may be a treatment target for trials to improve cognitive and adaptive functioning in adolescents with EOS.
COVID-19 changed the landscape of employment and financial security in the USA, contributing to multi-systemic disruptions in family life. Using dyadic, daily-diary parent–adolescent data from a nationwide American sample (18,415 daily assessments; 29 days: 4/8/2020–4/21/2020 and 5/18/2020–6/1/2020; N = 635 parent–adolescent dyads), this intensive longitudinal study investigated how COVID-19-related job loss and working-from-home (WFH) arrangements influenced parents’ and children’s daily affect indirectly through family functioning (i.e., parent–adolescent conflict, inter-adult conflict, and parental warmth) and whether these links varied by family socioeconomic status (SES). Parental employment status was linked to these family relational dynamics, which were then connected to parents’ and adolescents’ daily affect. Although SES did not moderate these links, low-income families were more likely to experience job loss, parent–adolescent conflict, and inter-adult conflict and less likely to WFH than higher-income families. As inter-relations within the family are a malleable point for intervention, clinicians working with families recovering from the fiscal impact of the COVID-19 pandemic are encouraged to use approaches that strengthen family relationships, especially between adolescents and their parents. Unemployment subsidies are discussed as a means to support families struggling with job loss, and organizations are urged to consider the benefits of WFH on employee health and work-life balance.
Family dysfunction plays an important role in cyberbullying and cybervictimization. However, little research has investigated the longitudinal relations and the mediating mechanisms between them during adolescence. This study examined the longitudinal relations between family dysfunction and cyberbullying and cybervictimization, along with whether depressive symptoms function as mediators between them at the within-person level. A total of 3,743 Chinese adolescents (46.2% females; Mage = 9.92 years; SD = 0.51) participated a five-wave longitudinal study with a 6-month time interval. The results of random intercept cross-lagged panel model found that: (1) family dysfunction directly predicted depressive symptoms and vice versa at the within-person level; (2) depressive symptoms directly predicted cyberbullying and cybervictimization at the within-person level, but not vice versa; (3) family dysfunction indirectly predicted cyberbullying and cybervictimization via depressive symptoms at the within-person level; (4) at the between-person level, there were significant associations among family dysfunction, depressive symptoms, cyberbullying and cybervictimization. The results are discussed on the basis of the mechanisms that lead to cyberbullying and cybervictimization.
This study investigated whether L1-Korean L2-English speakers could use (in)definiteness to predict unmentioned (non-)unique referents. In previous studies on the topic, methodological considerations made it difficult to separate the effects of grammar from the effects of non-linguistic knowledge. We used a visual world paradigm eye-tracking task to resolve such issues and designed stimuli that focused only on (in)definiteness. Participants’ eye movements were recorded as they heard “Click on the/a blue circle.” L1 and advanced L2 speakers used definiteness information to predict unique referents before the critical noun (circle) was heard while indefinite articles were not utilized to the same extent. Intermediate L2 speakers relied heavily on color words, not articles, to locate a referent. The results imply that predicting a referent solely based on definiteness (without real-world knowledge) requires substantial advancement in L2 development, and indefinite articles do not predict non-unique referents as clearly as definite articles predict unique referents.
Gambling marketing is frequently visible in the United Kingdom, especially around the national sport, soccer. Previous research has documented the frequency with which gambling marketing logos can be seen in domestic club soccer, and also the frequency of television advertising around international tournaments. The present research investigates the frequency and content of television advertising during the men’s 2020 Euro soccer tournament, a high-profile tournament shown since the industry’s voluntary “whistle-to-whistle ban” on gambling advertising came into effect. Overall, 113 gambling adverts were recorded (4.5 adverts per relevant match). Financial inducements were the most frequently shown category (56.6%), followed by adverts raising awareness of a given operator’s brand (19.5%), adverts featuring the odds on specific complex bets (18.6%), and adverts promoting safer gambling (5.3%). Adverts featured a range of safer gambling messages, with the “when the fun stops, stop” message featuring in 56.6% of adverts. This research indicates that gambling advertising remains a frequent part of the experience of watching live televised soccer in the UK, and shows how the content of this advertising was comparable to what has been seen in the previous literature.
Over the past decade, there have been massive developments in web-based and internet technologies, along with the introduction of smartphones. Smartphones represent a new generation of mobile technology that has fundamentally changed telecommunications (Abboudi and Amin 2011). They are equipped with immense computing capabilities that allow constant access to the internet and they enable more than just voice- and text-based communication. Smartphones are generally regarded as handheld computers rather than merely mobile telephones (Abboudi and Amin 2011). The release of Apple’s iPhone in 2007 most likely sparked a revolution in the telecommunications and information technology arena. The launch of the Apple App Store in July 2008 is also regarded as a pivotal moment in the advancement of smartphone technologies (Payne et al. 2012). The store enables users to download smartphone-based applications (apps) – computer programs that give smartphones capabilities and functions beyond accessing the internet.
This chapter examines the changes in economic inequalities in the UK and internationally along with the links between poverty and inequality. We outline the way in which health and illness are distributed in the population and the psychosocial factors that operate to create and maintain health inequalities. Poverty and economic inequality are intrinsically and instrumentally related. Both are relevant to deprivation, violate human dignity, hinder social and health goals, and fluctuate in populations in a correlated manner. Health and illness are socially patterned in the same way as we saw for the experience of poverty, and are related to social class and status. Health and ill-health are determined not only by biological mechanisms, but also by a series of upstream factors which are material, psychological, social, and political – that is, by the ‘causes of the causes’. The examination of poverty, economic inequality and health inequalities reveal psychological, social, economic, and political factors that can help us to develop a firmer understanding of the social exclusion of people with mental health conditions as well as important aspects of public mental health.
In the guide written by Harden and Crosby (2000) for the Association for Medical Education in Europe (AMEE) called The Good Teacher Is More Than a Lecturer, the shift from traditional models of learning to a more learner-led one is emphasized and reflects the altered roles and expectations of teachers. Rather than dispensing information the teacher is seen more as a facilitator of learning and providing a supportive relationship for that learning to happen.
Supportive relationships are crucial to the success of training in busy clinical environments. Yet providing support and supportive relationships is still problematic in the health service. In 2019 alone, there were three published reports all highlighting problems and making suggestions for change; one from Health Education England (HEE); one from a National Institute of Health Research (NIHR) funded study undertaken by a team based at the University of Exeter Medical School; and one from the General Medical Council (GMC). It is worth looking at these briefly in turn.
Portfolio-based learning is relatively new to medical education and, in many ways, quite far removed from the more traditional instructional pedagogy that has been associated with the education of doctors for centuries. Despite that, the use of portfolios has rapidly expanded in recent years. This increased popularity is clearly set against a background of important changes and new trends in medical education. Before considering further the use of portfolios, it is useful to understand some of these changes as the contextual factors on which the search for new and creative learning and assessment strategies (which include portfolio-based learning) is predicated. We will particularly focus on.
This chapter is an updated version of a previous article on the use of simulation in psychiatry training (Dave 2012). Professor Dave’s observation that changes in the delivery of psychiatric care, such as ward closures and the creation of specialist teams, might limit the availability of direct patient contact for trainees was prescient. What was, however, unimaginable at the time of writing the article was the effect that a global pandemic such as COVID-19 would have on the provision of clinical training by limiting access to clinical placements (Lucey and Johnston 2020). These factors have increased the urgency and pressure for those concerned with the delivery of training to create and deliver simulation-based learning (SBL), often online. Many educators may have found themselves wishing for a guide on how to produce psychiatry-orientated SBL experiences.