Psych Science & Public Interest

what was an early conception of ptsd

DSM - traumatic stress reactions were classified as acute posttrauma responses under gross stress reaction, whereas longer lasting reactions were subsumed under the anxiety or depressive neuroses
DSMIII is when PTSD formally introduced

DSM-IV conception of PTSD

An anxiety disorder involving severe and persistent stress reactions following exposure to trauma. Stressed focus on disassociation bc Research indicated that dissociation immediately following trauma predicted later PTSD

criterion for PTSD

A - Exposure to actual or threatened harm to oneself or others, accompanied by intense fear, helplessness or horror.

B - Re-experiencing
C - Avoidance and emotional numbing
D - Increased arousal

ASD vs PTSD

ASD describes acute reactions lasting 2 days to 4 weeks following trauma. PTSD can be considered when symptoms persist beyond 1 month.

Why ASD in dsm

• To diagnose acute stress reactions within the first month following trauma.

• To identify individuals at high risk of developing PTSD.

• To address the diagnostic gap that could prevent early access to mental health services

Prevalence of PTSD?

70% of population exposed to trsuma but only 4-5% have trauma at any type; women 2x more likely to develop PTSD than men

Best treatment for PTSD?

TraumaFocused Cognitive Behaviour Therapy (TFCBT) (100 trials support this conclusion)

How did scientific theories inform PTSD treatments?

• Classical conditioning: Explained how stimuli acquire fearful associations, informing exposure therapy.

• Emotional processing theory (Foa & Kozak, 1986): Informed prolonged exposure therapy.

• Cognitive therapy (Beck, 1976): Informed cognitive processing therapy (CPT)

What are efficacy trials, and what are their limitations?

Highly controlled RCTs testing whether a treatment safely and effectively reduces symptoms under optimal conditions; limits: Specialist clinicians, restrictive inclusion criteria and artificial research conditions may limit generalisability

What are effectiveness trials?

Effectiveness trials test whether proven treatments work in routine clinical settings

What is Rogers's diffusion of innovations theory?

An adopter model explaining how innovations spread through four components: innovation, communication channels, time and social systems

What other theoretical approaches explain dissemination?

Roger’s diffusion; Theory of reasoned action/planned behaviour: Behavioural intentions depend on expected benefits, social norms and perceived ability; Organisational models: Emphasise organisational culture, resources and structural barriers; Social marketing models: Tailor strategies to stakeholders' needs, perceptions and readiness for change.

main barriers to disseminating EBTs?

• Treatment proponents: Poor understanding of organisational culture and unwillingness to adapt treatments.

• Practitioners: Allegiance to existing practices and resistance to change.

• Organisations: Limited funding, inadequate training and supervision, fragmented structures and staff turnover.

• Leadership: Lack of sustained commitment or support for implementation

What is prolonged exposure (PE) therapy, and how does it work?

PE is based on emotional processing theory (Foa & Kozak, 1986), which proposes that PTSD involves pathological fear structures and unrealistic beliefs about danger and one's ability to cope; Repeated exposure challenges expectations of harm, reduces avoidance and promotes emotional processing.

What evidence supports the efficacy and safety of PE?

• Numerous RCTs demonstrate effectiveness across trauma types, populations and cultures.

• PE generally outperforms supportive counselling, relaxation and treatment as usual.

• Improvements are often maintained for a year or longer.

• Adding other CBT components generally does not improve outcomes over PE alone.

• Controlled studies do not support claims that PE causes greater symptom deterioration or dropout than comparable psychological treatments

How do cognitive therapy (CT), cognitive processing therapy (CPT) and EMDR differ?

• CT: Identifies and modifies maladaptive trauma-related beliefs, including guilt and self-blame.

• CPT: Combines cognitive approaches with exposure-related procedures to challenge problematic beliefs.

• EMDR: Involves recalling traumatic memories while attending to external stimuli, typically bilateral eye movements.

Why do many clinicians resist evidence-based treatments?

• Traditional psychotherapy often values individualisation, insight and exploration of underlying life problems.

• EBTs may be perceived as overly structured, narrow or inflexible.

• Clinicians may believe RCT patients are unrepresentative of real-world patients.

• Some believe therapeutic relationships and common factors matter more than specific treatment techniques.

• Lack of training and familiarity reinforces resistance

Isaac R etc paper?

636,120 ways to have PTSD - infation of possible diagnoses with PTSD

What are the three psychological propositions examined by Brewer et al. (2018)?

• Thoughts and feelings: Risk perceptions, anticipated regret and vaccine confidence motivate vaccination.

• Social processes: Social norms, relationships, networks and strategic motivations influence vaccination.

• Direct behavioural interventions: Vaccination can be increased through reminders, defaults, incentives and requirements without first changing beliefs. (strong evidence for this)

What are the three main problems with vaccination uptake?

inadequacy (low uptake), delay (after recommended age), instability

How do risk appraisals influence vaccination behaviour?

tri-risk model (deliberative = probability of infection, experiential = intrusive vulnerability, affective = affect like worry), more risk perceived = more likely to vaccine

What is anticipated regret, and why is it important?

Anticipating regret from remaining unvaccinated is associated with greater vaccination uptake - better predictor of vaccination intentions and behaviour than perceived likelihood, severity or worry

Why are educational and fear-based interventions often ineffective at increasing vaccination?

• Fear-based messages can provoke anger and psychological reactance.

• Correlations between beliefs and vaccination do not establish that changing those beliefs will change behaviour (knowledge doesnt = action)

What four social processes influence vaccination behaviour?

• Social dyads: Relationships between providers and patients or parents and children.

• Social networks: Influence from family, friends and connected individuals.

• Social norms: Perceptions of what others do and expect.

• Strategic behaviour: Altruism and free riding in response to herd immunity

How do healthcare providers influence vaccination decisions?

trust alone does not adequately explain the influence of provider recommendations. - Presumptive recommendations present vaccination as the normal course of care vs participatory recommendations

How do social norms and social networks influence vaccination?

Social norms (descriptive, injunctive, social contagion, homophily) are associated with vaccination, but there is limited experimental evidence that changing norms increases actual uptake

What are altruism and free riding in vaccination decisions?

• Altruism: Getting vaccinated partly to protect other people from infection.

• Free riding: Avoiding vaccination while benefiting from the protection provided by vaccinated people through herd immunity

What is the intention–behaviour gap, and how can it be addressed?

individuals intend to get vaccinated but fail to follow through. reminders, prompts, primes (keep vaccination salient), reduce barrier, default

interventions have the strongest evidence for increasing vaccination uptake

• Reminders and recalls.

• Healthy defaults and convenient vaccination services.

• Incentives and sanctions.

• Vaccination requirements

How should vaccination interventions be matched to different public-health problems

The authors emphasise identifying the underlying cause of low uptake before choosing an intervention. For example, sanctions may be inappropriate where affordability or access is the main barrier.

What is misinformation, and how does it differ from ignorance?

misinformation: false but accepted as true; ignorance: lack of correct info

What are the four main societal sources of misinformation?

rumours; govt/ politics; vested interests; media

How do media fragmentation and echo chambers contribute to misinformation?

• Selective exposure: People prefer information sources consistent with their existing beliefs.

• Echo chambers: Networks repeatedly circulate similar viewpoints with limited exposure to alternatives.

• Media fragmentation: Audiences become divided across different information sources.

• Repetition: False information becomes familiar and appears widely accepted

What four questions do people use to evaluate whether information is true?

1. Is it compatible with what I already believe?

2. Does it form a coherent and plausible story?

3. Does it come from a credible source?

4. Do other people believe it?

What is processing fluency, and how does it influence belief?

Processing fluency is the subjective ease with which information is understood or processed.

• Easily processed information feels more familiar and credible.

• Repetition, clear presentation, rhyme and familiar accents can increase fluency.

• People may mistake ease of processing for evidence of truth.

This helps explain why repeated misinformation becomes increasingly believable

What is the illusory truth effect?

repeated statements become believed to be true

What are the sleeper effect and source misattribution?

• Sleeper effect: Information from an untrustworthy source may become persuasive over time because its content is remembered while its source is forgotten.

• Source misattribution: People remember information but incorrectly attribute it to a different source or context.

What is the continued influence effect (CIE)?

continued influence effect occurs when misinformation continues to influence reasoning and judgements after it has been explicitly corrected or retracted.

People may accurately remember the correction while still relying on the original misinformation when making inferences.

SEE WAREHOUSE FIRE EXPERIMENT
Participants read a fictional report about a warehouse fire.

• Initially, the fire was attributed to negligently stored gas cylinders and oil paints.

• Some participants subsequently received a correction stating that the storage closet was empty.

• Participants were then asked questions requiring inferences about the fire.

Despite remembering the correction, participants continued to refer to the gas cylinders and paints when explaining the fire.

How does mental-model theory explain the continued influence effect?

People may continue relying on the false explanation because it preserves the coherence of their mental model. When misinformation is retracted, it can leave a gap in the causal explanation.

How does retrieval failure explain the continued influence effect?

Misinformation may be automatically retrieved from memory even after correction.

backfire effects?

familiarity backfire effect: correction can inadvertently strengthen misinformation by repeating it; corrective context may subsequently be forgotten
overkill backfire effect; correction is so complicated or contains so many counterarguments that the original misinformation becomes easier to understand and remember
worldview backfire effect: corrective information threatens deeply held beliefs or identities, potentially strengthening commitment to the original misinformation

What is psychological reactance, and how can it undermine corrections?

Psychological reactance is resistance arising when people perceive that their freedom to think or act is being threatened.

Authoritative corrections may provoke resistance, causing people to reject the information.

The paper discusses mock-jury research in which jurors sometimes relied more heavily on inadmissible evidence after being instructed to disregard it.

What are the three principal techniques for reducing the continued influence effect?

1. Pre-exposure warnings: Warn people before encountering potentially misleading information.

2. Repeated retractions: Reinforce the correction, while avoiding unnecessary repetition of the myth.

3. Alternative explanations: Replace the false causal account with a plausible explanation that fills the gap left by the correction.

What are the paper's main recommendations for designing effective corrections?

Lewandowsky et al. argue that misinformation persists because of how people construct mental models, retrieve memories, assess familiarity and defend existing beliefs. Effective debiasing therefore requires more than simply telling people that a claim is false

What are learning styles?

Learning styles refer to the idea that individuals differ in which modes of instruction or study are most effective for them.

Proponents argue that teachers should identify students' learning styles and tailor instruction accordingly.

What is the meshing hypothesis?

The meshing hypothesis proposes that learning is most effective when instructional methods match learners' preferred styles

What is the difference between study preferences and the learning-styles hypothesis?

• Study preferences: People prefer particular ways of receiving information or studying.

• Learning-styles hypothesis: Tailoring instruction according to these individual differences improves learning outcome

Why has the learning-styles approach become so popular?

• People find psychological categories and personality types appealing.

• Parents and students want education to recognise individual differences.

• Learning styles suggest that everyone can succeed if taught appropriately.

• The approach can attribute poor educational outcomes to unsuitable instruction.

• A commercial industry promotes learning-style assessments and training

What are examples of popular learning-style models?

• Dunn and Dunn: Classifies learners according to environmental, emotional, sociological, physiological and psychological preferences.

• Kolb: Classifies learners using concrete versus abstract perception and active versus reflective processing.

• Honey and Mumford: Another widely promoted learning-style questionnaire

What experimental design is required to validate learning-styles-based instruction?

1. Classify learners into groups based on their assessed learning styles.

2. Randomly assign learners within each group to different instructional methods.

3. Assess all participants using the same outcome test.

4. Demonstrate that different instructional methods produce the best outcomes for different learning-style groups.

What is a crossover interaction, and why is it essential?

A crossover interaction occurs when the instructional method producing the best outcome differs between learner groups.

What did Figure 1 in the paper demonstrate about acceptable evidence for learning styles?

Figure 1 (p. 110) compares nine hypothetical experimental outcomes.

• Figures A–C: Acceptable evidence because different instructional methods optimise performance for different groups.

• Figures D–I: Unacceptable evidence because the same method optimises performance for both groups.

Even statistically significant interactions are insufficient unless they demonstrate that different groups benefit most from different instructional methods.

How does the broader learning-styles hypothesis differ from the meshing hypothesis?

The broader learning-styles hypothesis requires evidence that different groups benefit most from different teaching methods.

The meshing hypothesis additionally predicts that the optimal method will match the learner's preferred style.

Why do differences in cognitive abilities fail to establish the learning-styles hypothesis?

People have different cognitive strengths, such as verbal comprehension, spatial visualisation and numerical ability.

However, demonstrating different abilities does not establish that different instructional methods optimise learning for different groups on the same educational outcome.

The authors also distinguish objectively measured abilities from self-reported preferences, which may be weakly related.

What did Sternberg et al. (1999) find

The study classified gifted students according to analytical, creative or practical strengths and assigned them to different instructional approaches.

Students receiving instruction matched to their strongest ability outperformed mismatched students on some assessments.

However, Pashler et al. identified several methodological problems:

• The relevant results relied on highly transformed outcome measures.

• Only a subset of the original sample was included in the key analysis.

• Outliers were excluded for unspecified reasons.

• The teaching methods did not correspond closely to widely marketed learning-style interventions.

The authors considered the findings suggestive but unconvincing

What did Massa and Mayer (2006) find about visual and verbal learners?

Participants completed computer-based electronics lessons with supplementary explanations presented through text or illustrations.

Researchers assessed visual and verbal preferences and abilities to test whether matching instruction improved performance.

No evidence for meshing hyp

What did Cook et al. (2009) find about sensing and intuitive learners?

Medical residents received instruction in which problems were presented either before or after the relevant explanatory information.

The researchers predicted that sensing and intuitive learners would benefit from different sequences.

Finding: There was no support for the predicted learning-style-by-instruction interaction

What did Constantinidou and Baker (2002) find?

no meshing hyp supprot - Participants received information visually, auditorily or through both modalities and completed a verbal recall test.

• Visual presentation generally produced better recall than purely verbal presentation.

• Self-reported visual or verbal learning preferences did not meaningfully predict performance across modalities.

What are aptitude-by-treatment interactions (ATIs)?

An aptitude-by-treatment interaction occurs when the effectiveness of an instructional method depends on a learner's aptitude or ability. distinguish this research from learning-style preferences because aptitude measures assess cognitive abilities

What does the ATI literature suggest about structured versus unstructured instruction?

Some studies say Lower-ability with explicit guidance and structured teaching,Higher-ability students performed better with less structured approaches that encouraged independent learning. However, other studies found no interaction or different patterns.

What did Callender and McDaniel (2007) find about embedded questions?

Participants read a psychology textbook chapter with or without embedded questions.

• Poor structure builders: Benefited from embedded questions on the information those questions targeted.

• Good structure builders: Did not benefit from embedded questions and performed better on some untargeted information without them.

What is locus of control, and how might it interact with instruction?

Locus of control concerns whether people perceive outcomes as primarily determined by their own actions or by external factors.

• Internal locus of control: Some evidence suggests these students benefit more from less structured instruction.

• External locus of control: Some evidence suggests these students may benefit more from structured guidance.

What was Pashler et al.'s overall conclusion about learning styles?

The authors found no adequate evidence to justify using learning-style assessments to guide general educational practice

What are the main limitations of existing interventions for perpetrators of intimate partner violence (IPV)?

• Many use short-term, standardised, one-size-fits-all treatment programmes.

• They often overlook individual differences and co-occurring conditions.

• Traditional CBT programmes target distorted cognitions, communication and emotion regulation, but may overlook substance misuse, PTSD symptoms or experiential avoidance

Why do the authors propose the I³ Model as an alternative framework for IPV treatment?

IPV arises from interacting distal and proximal risk factors that vary between individuals.

The I³ Model provides a meta-theoretical framework that:

• Integrates sociocultural, psychological and criminological explanations.

• Organises risk factors into three interacting processes.

• Guides individualised assessment, case conceptualisation and intervention.

• Allows clinicians to combine techniques from different treatment approaches

What is the I³ Model, and what are its three components?

Developed by Finkel (2007), the I³ Model proposes that IPV becomes more likely when the urge to behave aggressively exceeds the forces inhibiting aggression.

Its three components are:

• Instigation: Provoking circumstances that trigger aggressive impulses.

• Impellance: Factors that strengthen the urge to aggress following provocation.

• Inhibition: Factors that counteract aggressive impulses and prevent violent behaviour

What is Perfect Storm Theory?

Perfect Storm Theory predicts that IPV risk is greatest when:

1. Instigation is high: Strong provocation.

2. Impellance is high: Strong aggressive tendencies.

3. Inhibition is low: Limited ability to resist aggression.

What empirical evidence supports Perfect Storm Theory?

• Birkley and Eckhardt (2019): High instigation, high trait anger and ineffective emotion regulation interacted to predict IPV-related responses during imagined relationship scenarios.

• Blake et al. (2018): Cognitive reappraisal training reduced aggressive vocalisations associated with negative urgency when relationship quality was high, but this protective effect was absent when relationship quality was low.

How can the I³ Model guide individualised IPV treatment?

Clinicians assess the individual's instigating, impelling and inhibiting factors, then select interventions targeting their particular risk profile

Why is the I³ Model described as meta-theoretical?

It does not privilege a particular therapeutic orientation.

For example, feminist-centred, trauma-informed and CBT-based approaches may all contribute to I³-informed treatment if their components address empirically supported risk factors.

The framework evaluates whether an intervention adequately targets instigation, impellance, inhibition and their interactions.

What are the main challenges of implementing I³-informed IPV interventions?

• Comprehensive individual assessment requires time and resources.

• IPV treatment frequently occurs in under-resourced healthcare and criminal justice settings.

• Group therapy remains the dominant treatment format, making individualisation difficult.

• Clinicians must determine which risk factors to prioritise and how to combine interventions

How could group IPV interventions be adapted to incorporate the I³ Model?

• Conduct comprehensive assessments of individual I³ risk factors, co-occurring problems and motivation.

• Adapt group content to participants' risk profiles.

• Use smaller groups to allow greater individual attention.

• Separate high-risk and low-risk perpetrators to avoid potentially harmful group interactions.

• Supplement group treatment with individual sessions when necessar

What role does motivational interviewing (MI) play in I³-informed interventions?

MI aims to increase clients' motivation and engagement in treatment.

The authors propose:

• An initial individual MI session before group treatment.

• Personalised feedback about instigating, impelling and inhibiting factors.

• Exploration of the individual's motivation for change.

• Individual booster sessions to apply group skills to personal circumstances.

IPV paper?

Massa et al. propose that organising IPV interventions around the interacting processes of instigation, impellance and inhibition could improve treatment individualisation. The framework is theoretically and empirically promising, but its effectiveness as a treatment approach remains to be established