This study was conducted to assess the predictive value of different variables including the resp... more This study was conducted to assess the predictive value of different variables including the response to dexamethasone suppression test (DST), in 105 patients with resistant depression after the addition of lithium (600 to 800 mg/day) for 4 weeks to antidepressant medication. Clinical remission was observed in 57 patients and no improvement in 48. A dramatic and rapid relief of depression occurred in 12 patients. Variables with significant or marginally significant differences between responders and non-responders were included in a stepwise logistic regression model. Weight loss (P = 0.0013) and depressive psychomotor activity (P = 0.045) in the Newcastle diagnostic index (NDI) scale, and overall score of the Hamilton Rating Scale for Depression (HRSD) before adding the lithium (P = 0.0039) were significantly associated with clinical remission. The difference in post-DST cortisol plasma levels between both groups was marginally significant. The logistic equation resulted in a sensitivity of 78% and a specificity of 65% and total correct classification of the lithium-added response of 72%. The clinical profile of patients who improve with the addition of lithium may include significant weight loss, psychomotor retardation and possibly, poor control of cortisol secretion. Partial remission before adding lithium as well as endogenomorphic traits according to NDI may also be considered additional criteria for response.
Previous studies have shown that individuals with anxiety disorders exhibit deficits in fear inhi... more Previous studies have shown that individuals with anxiety disorders exhibit deficits in fear inhibition and excessive generalization of fear, but little data exist on individuals at risk from these disorders. The present study examined the role of trait anxiety in the acquisition and generalization of fear in 126 healthy participants selected on the basis of their trait-anxiety scores. Measures of conditioning included fear-potentiated startle, skin conductance response and online risk ratings for the unconditioned stimulus. Contrary to our hypotheses, trait anxiety did not have any effect either on the acquisition or the generalization of fear. Our results suggest that these fear conditioning processes are not impaired in individuals at risk from anxiety.
Previous research has shown that the startle reflex is potentiated during experimentally induced ... more Previous research has shown that the startle reflex is potentiated during experimentally induced anxiety (fear-potentiated startle). In the present study, the magnitude and time course of the startle blink reflex were examined among 35 undergraduates scoring one standard deviation above (n = 14) or below (n = 21) the mean in a self-report measure of sensitivity to punishment (SP) in a paradigm involving the anticipation of electric shocks. Contrary to our predictions, SP did not relate to differences in the magnitude or in the time course of fear-potentiated startle. Our data do not support an association between this individual differences variable and the fear-potentiated startle.
ABSTRACT Two types of flooding, unrestrained (with no response prevention) and restrained (with p... more ABSTRACT Two types of flooding, unrestrained (with no response prevention) and restrained (with prevention of avoidance responses), were compared in normal students who had acquired an active avoidance which was afterwards extinguished. Skin conductance responses (SCRs) were measured during the different phases of the experiment. SCRs were significantly greater throughout flooding treatment when the subjects (unrestrained) were allowed to make an avoidance response which did not terminate the warning stimulus, but SCRs declined at the same rate during subsequent extinction trials regardless of the type of flooding used. Avoidance responses during the extinction trials declined significantly faster after unrestrained flooding. The two types of flooding produced similarly large proportions of desynchrony (lack of covariation in the cessation of SCRs and avoidances) during the extinction test. Nevertheless, the particular sequence of extinction between SCRs and avoidances was found to be dependent on the type of flooding used. Results are in line with other animal and clinical studies and could be used to derive improvements in exposure methods to treat abnormal avoidances.
The factor structure, psychometric properties, and relationship with personality variables of a S... more The factor structure, psychometric properties, and relationship with personality variables of a Spanish version of the Savings Inventory-Revised (SI-R) are investigated in a sample of 381 undergraduate students. A maximum likelihood factor analysis suggests a three-factor structure, which is similar but not identical to that of the original English version. The three factors mirror the three hypothesized domains of compulsive hoarding: acquisition, difficulty discarding, and clutter. The Spanish SI-R demonstrates acceptable high internal consistency and test-retest reliability, but its divergent validity is weaker than expected because of a significant overlap with depressive symptoms. Different SI-R factors are associated with different personality traits: Whereas the difficulty discarding dimension is predominantly associated with susceptibility to punishment, the acquisition dimension is predominantly associated with susceptibility to reward. The authors conclude that the Spanish SI-R is a promising instrument to measure hoarding symptoms.
This study was conducted to assess the predictive value of different variables including the resp... more This study was conducted to assess the predictive value of different variables including the response to dexamethasone suppression test (DST), in 105 patients with resistant depression after the addition of lithium (600 to 800 mg/day) for 4 weeks to antidepressant medication. Clinical remission was observed in 57 patients and no improvement in 48. A dramatic and rapid relief of depression occurred in 12 patients. Variables with significant or marginally significant differences between responders and non-responders were included in a stepwise logistic regression model. Weight loss (P = 0.0013) and depressive psychomotor activity (P = 0.045) in the Newcastle diagnostic index (NDI) scale, and overall score of the Hamilton Rating Scale for Depression (HRSD) before adding the lithium (P = 0.0039) were significantly associated with clinical remission. The difference in post-DST cortisol plasma levels between both groups was marginally significant. The logistic equation resulted in a sensitivity of 78% and a specificity of 65% and total correct classification of the lithium-added response of 72%. The clinical profile of patients who improve with the addition of lithium may include significant weight loss, psychomotor retardation and possibly, poor control of cortisol secretion. Partial remission before adding lithium as well as endogenomorphic traits according to NDI may also be considered additional criteria for response.
Previous studies have shown that individuals with anxiety disorders exhibit deficits in fear inhi... more Previous studies have shown that individuals with anxiety disorders exhibit deficits in fear inhibition and excessive generalization of fear, but little data exist on individuals at risk from these disorders. The present study examined the role of trait anxiety in the acquisition and generalization of fear in 126 healthy participants selected on the basis of their trait-anxiety scores. Measures of conditioning included fear-potentiated startle, skin conductance response and online risk ratings for the unconditioned stimulus. Contrary to our hypotheses, trait anxiety did not have any effect either on the acquisition or the generalization of fear. Our results suggest that these fear conditioning processes are not impaired in individuals at risk from anxiety.
Previous research has shown that the startle reflex is potentiated during experimentally induced ... more Previous research has shown that the startle reflex is potentiated during experimentally induced anxiety (fear-potentiated startle). In the present study, the magnitude and time course of the startle blink reflex were examined among 35 undergraduates scoring one standard deviation above (n = 14) or below (n = 21) the mean in a self-report measure of sensitivity to punishment (SP) in a paradigm involving the anticipation of electric shocks. Contrary to our predictions, SP did not relate to differences in the magnitude or in the time course of fear-potentiated startle. Our data do not support an association between this individual differences variable and the fear-potentiated startle.
ABSTRACT Two types of flooding, unrestrained (with no response prevention) and restrained (with p... more ABSTRACT Two types of flooding, unrestrained (with no response prevention) and restrained (with prevention of avoidance responses), were compared in normal students who had acquired an active avoidance which was afterwards extinguished. Skin conductance responses (SCRs) were measured during the different phases of the experiment. SCRs were significantly greater throughout flooding treatment when the subjects (unrestrained) were allowed to make an avoidance response which did not terminate the warning stimulus, but SCRs declined at the same rate during subsequent extinction trials regardless of the type of flooding used. Avoidance responses during the extinction trials declined significantly faster after unrestrained flooding. The two types of flooding produced similarly large proportions of desynchrony (lack of covariation in the cessation of SCRs and avoidances) during the extinction test. Nevertheless, the particular sequence of extinction between SCRs and avoidances was found to be dependent on the type of flooding used. Results are in line with other animal and clinical studies and could be used to derive improvements in exposure methods to treat abnormal avoidances.
The factor structure, psychometric properties, and relationship with personality variables of a S... more The factor structure, psychometric properties, and relationship with personality variables of a Spanish version of the Savings Inventory-Revised (SI-R) are investigated in a sample of 381 undergraduate students. A maximum likelihood factor analysis suggests a three-factor structure, which is similar but not identical to that of the original English version. The three factors mirror the three hypothesized domains of compulsive hoarding: acquisition, difficulty discarding, and clutter. The Spanish SI-R demonstrates acceptable high internal consistency and test-retest reliability, but its divergent validity is weaker than expected because of a significant overlap with depressive symptoms. Different SI-R factors are associated with different personality traits: Whereas the difficulty discarding dimension is predominantly associated with susceptibility to punishment, the acquisition dimension is predominantly associated with susceptibility to reward. The authors conclude that the Spanish SI-R is a promising instrument to measure hoarding symptoms.
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Papers by Rafael Torrubia