Ces travaux de thèse portent sur la reconnaissance automatique du stress chez des humains en interaction dans des situations anxiogènes: prise de parole en public, entretiens et jeux sérieux à partir d'indices audio et visuels.Afin de concevoir des modèles de reconnaissance automatique du stress, nous utilisons : des indices audio calculés à partir de la voix des sujets, capturée par un micro cravate; et des indices visuels calculés soit à partir de l'expression faciale des sujets capturés par une webcam, soit à partir de la posture des sujets capturée par une Kinect. Une partie des travaux portent sur la fusion des informations apportées par les différentes modalités.L'expression et la gestion du stress sont influencées à la fois par des différences interpersonnelles (traits de personnalité, expériences passées, milieu culturel) et contextuelles (type de stresseur, enjeux de la situation). Nous évaluons le stress sur différents publics à travers des corpus de données collectés pendant la thèse: un public sociophobe en situation anxiogène, face à une machine et face à des humains; un public non pathologique en simulation d'entretien d'embauche; et un public non pathologique en interaction face à un ordinateur ou face au robot humanoïde Nao. Les comparaisons inter- individus, et inter-corpus révèlent la diversité de l'expression du stress.Une application de ces travaux pourrait être la conception d'outils thérapeutiques pour la maitrise du stress, notamment à destination des populations phobiques.Mots clé : stress, phobie sociale, détection multimodale du stress , indices audio du stress, indices faciaux du stress, indices posturaux du stress, fusion multimodale / This thesis focuses on the automatic recognition of human stress during stress-inducing interactions (public speaking, job interview and serious games), using audio and visual cues.In order to build automatic stress recognition models, we used audio cues computed from subjects' voice captured via a lapel microphone, and visual cues computed either form subjects' facial expressions captured via a webcam, or subjects' posture captured via a Kinect. Part of this work is dedicated to the study of information fusion form those various modalities.Stress expression and coping are influenced both by interpersonal differences (personality traits, past experiences, cultural background) and contextual differences (type of stressor, situation's stakes). We evaluated stress in various populations in data corpora collected during this thesis: social phobics in anxiety-inducing situations in interaction with a machine and with humans; apathologic subjects in a mock job interview; and apathologic subjects interaction with a computer and with the humanoid robot Nao. Inter-individual and inter-corpora comparisons highlight the variability of stress expression.A possible application of this work could be the elaboration of therapeutic software to learn stress coping strategies, particularly for social phobics.Key words: stress, social phobia, multimodal stress detection, stress audio cues, stress facial cues, stress postural cues, multimodal fusion

CARVALHO , Evelyn Benevides. O papel do pai na fobia e na neurose obsessiva: o Pequeno Hans e o Homem dos ratos em Freud e em Lacan. 2006. 151f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2006. / Submitted by moises gomes (celtinha_malvado@hotmail.com) on 2012-01-06T12:20:39Z No. of bitstreams: 1 2006_dis_EBCarvalho.PDF: 814361 bytes, checksum: 6f41d2cdad2649e2a1c4668261af9ca7 (MD5) / Approved for entry into archive by Maria Josineide Góis(josineide@ufc.br) on 2012-03-08T15:03:08Z (GMT) No. of bitstreams: 1 2006_dis_EBCarvalho.PDF: 814361 bytes, checksum: 6f41d2cdad2649e2a1c4668261af9ca7 (MD5) / Made available in DSpace on 2012-03-08T15:03:08Z (GMT). No. of bitstreams: 1 2006_dis_EBCarvalho.PDF: 814361 bytes, checksum: 6f41d2cdad2649e2a1c4668261af9ca7 (MD5) Previous issue date: 2006-11-24 / This work aims at thinking upon the actions of the father (here understood as father in reality) in his possible contribution in leading the son to an obsessive neurosis or phobia from the relationships that happen in the context of the Oedipal triangulation. As neurosis is a defense strategy in face of castration, which particularities in the desiring relationships could lead to one typical form of defense or another? If the obsessive conflict unfolds eminently in the level of thought and the phobic in the level of reality (in the relationship with the phobic object), what could generate this difference? Aiming at clarifying some aspects of the role of the real father in structuring the child’s neurosis, it is necessary to observe the very development of the paternal function in its real, symbolic and imaginary levels; the relationship of the father with several other elements of the family’s dynamics: the desiring dynamics in the parental couple, the way that each of them relates to the law, the elements that interfere in those relationships, how the circulation of the phallus takes place in each case, among others. We have decided to carry out a bibliographical research and selected the clinical cases ‘Little Hans’ and ‘Rat Man’ as the fundamental basis of our discussion, as we believe that the analysis of what is most particular can unveil universal aspects of each structure. Furthermore, we start from the principle that the Freudian text is not exhausted in its possibilities of surprising us and offering new questions. We utilize the Lacanian contribution (in an initial moment of his teachings) and another reading of those clinical cases. Authors such as Jerusalinsk, Julien, Dor, Ambertín, Gazzola, Melman, among others, are also summoned to enrich our discussion. We investigate the similarities and the differences in the way that the father, in each case, has performed his function, which is dual: restrainer and model of identification, as well as his possible consequences on the subject, the subject’s way of dealing with desire and castration. In phobia, to delimitate and allay the anguish, the subject needs to resort to the phobic object as a supplement to the paternal function that appears in an insufficient form in the relationship mother-son. This object comes to provide limits to the subject’s world, to demarcate points of danger and to serve as support to a series of symbolic-imaginary elaborations which can render possible a meaningful change, as in Hans’ case, in which there was an analytical intervention. In the obsessive neurosis, there is a subject tormented by recurring thoughts and driven to rituals as attempts of protection in face of danger, permanently in conflict with the phallic instance, oscillating between the wish of transgressing it and the devoted submission. A law that, for the obsessive has become difficult to elaborate, perhaps because it has been put in excessive or ambiguous way in the desiring context of the child. In the obsessive, the passage from the ‘being’ to the ‘having’ becomes more problematic due to the message of maternal dissatisfaction in relation to the husband. That makes it difficult to the subject to give up on his imaginary phallic identification, while at the same time he recognizes the existence and fears the instance of the law. As to the phobic, it can be that he has been more at the mercy of maternal desire, without a third instance to protect him of the risk of annihilation. ‘Killing (the father) or dying’ is the obsessive’s impasse. ‘Escaping (the maternal pleasure) is the phobic’s effort. This way, we attempt to bring our contributions, to recognize paradox and leave unanswered some questions that arise along the process and that can serve as a starting point to future research. / Este trabalho tem como objetivo pensar a atuação do pai (entendido, aqui, como pai da realidade), em sua possível contribuição ao encaminhamento do filho para uma neurose obsessiva ou fobia, a partir da relações que acontecem no contexto da triangulação edipiana. Sendo a neurose uma estratégia de defesa frente à castração, que particularidades nas relações desejantes poderiam conduzir a uma ou outra forma típica de defesa? Se a conflitiva obsessiva desenrola-se eminentemente no plano do pensamento; e a fóbica, no plano da realidade (na relação com o objeto fóbico), o que poderia gerar esta diferença? Visando esclarecer alguns aspectos acerca do papel do pai real na estruturação da neurose da criança, é necessário observar o próprio desdobramento da função paterna em seus níveis real, simbólico e imaginário; a relação do pai com diversos outros elementos da dinâmica familiar: a dinâmica desejante no casal parental, a forma como cada um de relaciona com a lei, os elementos que interferem nestas relações, como se dá a circulação do falo em cada caso, dentre outros. Optamos por uma pesquisa bibliográfica e elegemos os casos clínicos ‘Pequeno Hans’ e ‘Homem dos Ratos’ como base primordial de nossa discussão, pois acreditamos que a análise do que é mais particular pode revelar aspectos universais de cada estrutura. Além disso, partimos do princípio de que o texto freudiano não está esgotado em suas possibilidades de nos surpreender e oferecer novos questionamentos. Utilizamos a contribuição lacaniana (em um momento inicial de seu ensino) e sua releitura destes casos clínicos. Autores como Jerusalinsk, Julien, Dor, Ambertín, Gazzola, Melman, dentre outros, também são convocados a enriquecer nossa discussão. Investigamos as semelhanças e diferenças na forma como o pai, em cada caso, cumpriu sua função que é dupla: interditor e modelo de identificação, assim como suas possíveis conseqüências sobre o sujeito, a forma deste lidar com o desejo e a castração. Na fobia, para delimitar e apaziguar a angústia, o sujeito precisa lançar mão do objeto fóbico como suplência para a função paterna que comparece de forma insuficiente na relação mãe-filho. Este objeto vem fornecer limites ao mundo do sujeito, demarcar pontos de perigo e servir de suporte a uma série de elaborações simbólico-imaginárias que podem possibilitar um remanejamento significante, como no caso de Hans em que houve uma intervenção analítica. Na neurose obsessiva, observa-se um sujeito atormentado por pensamentos recorrentes e impelido a rituais como tentativas de proteção frente ao perigo, eternamente em conflito com a instância fálica, oscilando entre o desejo de transgredi-la e a submissão fervorosa. Lei que, para o obsessivo ficou difícil de elaborar, talvez por ter sido colocada de forma excessiva ou ambígua no contexto desejante da criança. No obsessivo, a passagem do ‘ser’ ao ‘ter’ torna-se mais problemática pela mensagem de insatisfação materna em relação ao marido. Isto dificulta o sujeito abrir mão de sua identificação fálica imaginária, ao mesmo tempo em que reconhece a existência e teme a instância da lei. Já o fóbico, pode ter ficado mais a mercê do desejo materno, sem uma instância terceira que o proteja do risco de aniquilamento. ‘Matar (o pai) ou morrer’ é o impasse do obsessivo. ‘Escapar (do gozo materno)’ é o esforço do fóbico. Desta forma, buscamos trazer nossas contribuições, reconhecer paradoxos e deixar em aberto algumas perguntas que se abrem ao longo do processo e que podem servir como ponto de partida para futuras pesquisas.

As interações entre o sistema nervoso central e os sistemas imune e endócrino são o objeto de estudo da psiconeuroimunologia. Protocolos de indução de estresse têm sido amplamente utilizados como métodos confiáveis de investigação da relação entre transtornos psiquiátricos, aspectos psicológicos, traços de personalidade, ansiedade e a resposta imune. O procedimento de simulação de falar em público (SFP) é um protocolo experimental validado que reconhecidamente é capaz de ativar o eixo hipotálamo-hipófise-adrenal (HPA) e produzir respostas de estresse em sujeitos humanos. Esse método foi utilizado para: 1) Comparar a reatividade imunológica de indivíduos com diagnóstico de fobia social com a de indivíduos sem qualquer diagnóstico psiquiátrico; 2) Investigar se ocorrem alterações imunes subseqüentes à exposição a um estressor agudo induzido em laboratório e 3) identificar e correlacionar parâmetros imunológicos com traços de personalidade, humor, níveis de ansiedade e medidas fisiológicas. Os traços de personalidade foram investigados por meio dos seguintes instrumentos: Inventário de Temperamento e Caráter (TCI), Escala de Afeto Positivo e Negativo (PANAS), Inventário de Ansiedade Traço (IDATE-T), Inventário de Depressão de Beck (BDI), Inventário de Estratégias de ?Coping? de Folkman e Lazarus e Adaptação da Escala de Percepção de Estresse (PSS). Os sintomas de ansiedade foram avaliados por meio da Escala Analógica Visual de Humor (VAMS), da Escala de Sintomas Somáticos (ESS) e do IDATE-Estado. As variáveis psicofisiológicas avaliadas foram pressão arterial sistólica (PAS), diastólica (PAD), batimentos cardíacos (BPM), resposta galvânica da pele (GSR) e temperatura. Os níveis plasmáticos de catecolaminas (adrenalina, noradrenalina e dopamina) e hormônios do eixo HPA (cortisol e ACTH) também foram dosados. Realizou-se a contagem de células imunes polimorfonucleares e mononucleares no sangue periférico e mediu-se a atividade citotóxica de células NK e neutrófilos. Dosou-se proteínas de fase aguda e imunoglobulinas (A, D, G, M e E) a produção de citocinas no sangue por ELISA e RT-PCR. Os dados foram submetidos a análises de variância para dados com medidas repetidas testando efeitos de grupo, sexo, momento experimental e interações. As correlações entre as variáveis foram testadas por regressões múltiplas e coeficientes de correlação de Pearson. Os resultados apontam que o SFP foi eficiente para induzir estresse e produzir alterações detectáveis em diversos dos parâmetros investigados. As diferenças entre fóbicos sociais e controles são significativas para traços de personalidade e atuam ao longo do tempo para as medidas psicofisiológicas. Alterações imunes e hormonais estiveram mais frequentemente associadas ao gênero do que ao grupo experimental, e afetaram mais homens. Além disso, as alterações imunes foram de pequena magnitude afetando componentes inespecíficos da resposta imune. Conjuntamente, os resultados apontam uma relativa ativação do eixo HPA em fóbicos mas que não corresponde a alterações imunes de mesma magnitude. Mais estudos com uma amostra maior e a investigação de outros parâmetros são necessários para compreender melhor como a fobia social afeta o sistema imune de homens e mulheres e investigar se as alterações podem aumentar a susceptibilidade a doenças nesse grupo de sujeitos. Uma vez que essa interação seja melhor compreendida poderá subsidiar estratégias mais adequadas para abordar e elaborar estratégias de prevenção e intervenção capazes de promover comportamentos saudáveis. / Interactions among the nervous, immune and endocrine systems are the object of study of Psychoneuroimmunology. Stress protocols have been broadly used as reliable means to investigate the relationship among psychiatric disorders, psychological aspects, personality traits, anxiety and immune response has been studied using these interactions. The Simulated Public Speaking (SPS) is a validated experimental procedure known to activate the Hypothalamus-Pituitary-Adrenal (HPA) axis and produce stress responses in human subjects. This method was used to: 1) compare the immune reactions of individuals with a diagnosis of social phobia to that of individuals without any psychiatric diagnosis; 2) investigate if immune alterations occur subsequent to the exposure to an acute laboratory induced stressor; 3) identify and correlate immune parameters with personality traits, mood, anxiety levels and physiologic measures. Personality traits were investigated with Cloninger?s Temperament and Character?s Inventory (TCI), Positive and Negative Affects Scale (PANAS), State-Trait Anxiety Scale (STAI?T), Beck?s Depression Inventory (BDI), Lazarus?s Coping Strategies Inventory, Perceived Stress Scale (PSS). Anxiety symptoms were investigated along the procedure with the Bodily Symptoms Scale (ESS), STAI-E and the Visual Analogue Mood Scale (VAMS). Psychophysiologic variables assessed were Systolic (PAS) and Diastolic (PAD) Blood Pressure, Heart Rate (BPM), Galvanic Skin Response (GSR) and temperature. Plasmatic circulating levels of cathecolamines (Adrenaline, Noradrenaline and Dopamine) and HPA axis hormones (Cortisol, ACTH) were assessed. Peripheral blood cell population counts were obtained for polymorphonuclear (PMN) and mononuclear cells. Cytotoxic activity of neutrophils and NK cells was assessed, as well as cytokine production by ELISA and RT-PCR. Acute phase proteins and immunoglobulins (A, D, G, M, and E) were dosed on peripheral blood. Data was submitted to variance analysis for data with repeated measures testing effects of group, sex, experimental moment and interactions on variables. Correlations among variables were tested by multiple regressions and Pearson?s correlation deltas. The results show SPS was efficient in inducing stress and produce detectable alterations in several of the parameters investigated. Differences between social phobics and controls are significant for personality traits and, along time for psychophysiologic measures. Hormonal and immune alterations were more often associated to gender rather than to the group subjects belonged to, with men being more susceptible to the procedure. Also, immune changes were of small magnitude, usually affecting inespecific components of the response. Together, the results point to a relatively higher activation of the HPA-axis in social phobics, but one that does not correspond to immune responses of the same magnitude. Further studies with a larger sample and investigation of other parameters are necessary to better understand how social phobia affects the immune system of men and women and to investigate if the alterations can increase susceptibility to diseases in this group of individuals. Once this interaction is better understood it may provide the basis for an improved design to approach and elaborate prevention/intervention strategies and promote healthy behaviours.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work has dealt with the clinical Little Hans case - statement by Freud in 1909 - and aims to bring the dialogue between this theoretical and Jacques Lacan, with prints and case analysis. Specifically, the study aims to provide for the issue of child psychoanalysis and addressing the problem of phobia while symptomatic output. Considering the clinic with children as contemporary practice of psychoanalysis, there was a theoretical study, whose methodological dynamics was the literature, using mainly from Freud´s texts and Lacan. Therefore, the work is divided into three sections. The first brings the issue of child psychoanalysis, highlighting as it reaches the place of subject of desire and law, making it therefore possible to be analyzed. In addition, support for the next chapter in this first are brought some positions and functions assumed by the child in the family dynamics. The second chapter develops the dialogue between Freud and Lacan about Hans case, presenting the facts following the case, the chronology, the directions of Freud and Lacan considerations. Are treated some issues such as the relationship between Hans and his mother, the question of the paternal function, as well as the complex of Oedipus and castration in Hans. Finally, the third chapter is the phobia as symptomatic output, serving Hans as the means possible so that it is positioned in the world and enter in the symbolic order. Thus, issues are worked that concern the phobia, such as anxiety, anguish, symptomatic formation and its prospects and the specific clinical case, the focus on substitutive function assumed by the phobic symptom on the limping paternal function. We conclude the work by pointing out some directions for the relationship between the current children´s clinic and the symptom. / Este trabalho tem por tema o caso clínico do pequeno Hans comunicado por Freud em 1909 e almeja trazer o diálogo entre esse teórico e Jacques Lacan, com as impressões e análises do caso. Especificamente, o estudo objetiva dispor sobre a questão da criança para psicanálise e abordar a problemática da fobia enquanto saída sintomática. Considerando a clínica com criança como prática contemporânea à psicanálise, realizou-se um estudo teórico, cuja dinâmica metodológica foi a pesquisa bibliográfica, utilizando-se, sobretudo, de textos de Freud e de Lacan. Por conseguinte, o trabalho se encontra estruturado em três capítulos. O primeiro traz a questão da criança para psicanálise, destacando como ela alcança o lugar de sujeito de desejo e de direito, tornando-se, portanto possível de ser analisada. Além disso, por fundamentar o capítulo seguinte, neste primeiro são trazidas algumas posições e funções assumidas pela criança na dinâmica familiar. No segundo capítulo, é desenvolvido o diálogo entre Freud e Lacan acerca do caso Hans, apresentando os fatos que acompanham o caso, a cronologia, os direcionamentos de Freud e as considerações de Lacan. São tratados alguns assuntos como a relação entre Hans e sua mãe, a questão da função paterna, assim como os complexos de Édipo e de castração em Hans. Por fim, o terceiro capítulo traz a fobia como saída sintomática, servindo a Hans como o meio possível para que ele se posicione no mundo e insira-se na ordem simbólica. Assim, são trabalhados temas que tangem à fobia, como a ansiedade, a angústia, a formação sintomática e suas perspectivas e no caso clínico específico, a aposta na função de suplência assumida pelo sintoma fóbico, diante da função paterna claudicante. Concluímos o trabalho apontando alguns direcionamentos para a relação existente entre a clínica infantil atual e o sintoma.

What are the school experiences of HIV-positive secondary school learners on ARV treatment? Although the provision of life-saving antiretroviral (ARV) treatment is central in the medical and policy response to the HIV pandemic, relatively little research (in the SADC region and in Namibia particularly) attends to people’s experiences and the social effects of taking ARV treatment. This study probed the experiences of high school learners on ARV treatment in Khomas Region, Namibia. As researcher I used a qualitative case study design based mainly on interviews with a purposive, select sample of eight learners at the school where I am a teacher-counsellor. Methods used also included: observations; focus group interviews with eight teachers at the site school; a questionnaire survey with Life Skills teachers from 25 schools in the Khomas Region; and document analysis. Using a theory of health-related stigma and discrimination as well as perspectives on resilience and agency as conceptual and analytical lenses, this study found that only a handful of these learners were living openly with HIV and AIDS. Being both HIV-positive and on ARV medication was a double bind for learners facing pervasive stigma and discrimination in and out of school. Discourses associated with HIV and AIDS, sex, and sexuality shaped people’s response to them and they feared being ‘caught out’. Here the study explores the complex reciprocal relationship between cause and effect in stigma, showing some consequences for these learners: isolation (both voluntary and imposed), mental anguish, depression and suicidal leanings; also (at school) absenteeism, grade repetition and dropout. Distinguishing stigma from discrimination in this study enabled insight into actual practices that constrain learner participation and inclusion in and out of school. Trust between learners on ARVs and teachers proved to be low. Teacher respondents not only felt unequipped to deal with the psychosocial needs of learners on ARVs but also indicated that confronting these needs animated their personal vulnerability (around HIV-related experiences in their own families). However, hopeful patterns also emerged. Some mediatory factors out of school shaped these learners’ experiences and identities positively, with implications for in-school experiences and participation. Some learner journeys reflected shifts from deep despair towards the emergence of voice, positive self-concepts and resilient dispositions. Here, also, this study enters a neglected area of research, showing how the complex interplay of learners’ own agency with social support brought these positive outcomes. Most learners had experienced rejection from immediate family, receiving support rather from community members who became ‘family’. The study thus also raises pressing questions on the nature of support structures (both in and out of school) in contexts shaped by HIV and AIDS, where stigma and discrimination are pervasive and where stable family structures, parental oversight and ‘normal’ progression through school cannot be assumed. It recommends that schools gain better insight into how learners’ circumstances shape their experiences, and develop internal policies, procedures and networks to reduce stigma and discrimination against HIV-positive learners on ARV treatment, as well as. ensuring material, medical, emotional, and psychological support for them.

While previous studies successfully identified the core neural substrates of the animal subtype of specific phobia, only few and inconsistent research is available for dental phobia. These findings might partly relate to the fact that, typically, visual stimuli were employed. The current study aimed to investigate the influence of stimulus modality on neural fear processing in dental phobia. Thirteen dental phobics (DP) and thirteen healthy controls (HC) attended a block-design functional magnetic resonance imaging (fMRI) symptom provocation paradigm encompassing both visual and auditory stimuli. Drill sounds and matched neutral sinus tones served as auditory stimuli and dentist scenes and matched neutral videos as visual stimuli. Group comparisons showed increased activation in the insula, anterior cingulate cortex, orbitofrontal cortex, and thalamus in DP compared to HC during auditory but not visual stimulation. On the contrary, no differential autonomic reactions were observed in DP. Present results are largely comparable to brain areas identified in animal phobia, but also point towards a potential downregulation of autonomic outflow by neural fear circuits in this disorder. Findings enlarge our knowledge about neural correlates of dental phobia and may help to understand the neural underpinnings of the clinical and physiological characteristics of the disorder.

This paper presents the Social Phobia Psychotherapy Research Network. The research program encompasses a coordinated group of studies adopting a standard protocol and an agreed-on set of standardized measures for the assessment and treatment of social phobia (SP). In the central project (study A), a multicenter randomized controlled trial, refined models of manualized cognitive-behavioral therapy and manualized short-term psychodynamic psychotherapy are compared in the treatment of SP. A sample of 512 outpatients will be randomized to either cognitive-behavioral therapy, short-term psychodynamic psychotherapy or waiting list. Assessments will be made at baseline, at the end of treatment and 6 and 12 months after the end of treatment. For quality assurance and treatment integrity, a specific project using highly elaborated measures has been established (project Q). Study A is complemented by 4 interrelated add-on projects focusing on attachment style (study B1), on cost-effectiveness (study B2), on variation in the serotonin transporter gene in SP (study C1) and on structural and functional deviations of the hippocampus and amygdala (study C2). Thus, the Social Phobia Psychotherapy Research Network program enables a highly interdisciplinary research into SP. The unique sample size achieved by the multicenter approach allows for studies of subgroups (e.g. comorbid disorders, isolated vs. generalized SP), of responders and nonresponders of each treatment approach, for generalization of results and for a sufficient power to detect differences between treatments. Psychological and biological parameters will be related to treatment outcome, and variables for differential treatment indication will be gained. Thus, the results provided by the network may have an important impact on the treatment of SP and on the development of treatment guidelines for SP. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

BACKGROUND.One group of theories aiming at providing a framework explaining the etiology, maintenance and phenomenology of anxiety disorders is classified as cognitive models of anxiety. These approaches assume that distortions in specific levels of information processing are relevant for the onset and maintenance of the disorder. A detailed knowledge about the nature of these distortions would have important implications for the therapy of anxiety, as the implementation of confrontative or cognitive elements precisely fitting the distortions might enhance efficacy. Still, these models and related empirical evidence provide conflicting assumptions about the nature of disorder-linked processing distortions. Many cognitive models of anxiety (e.g., Fox, Russo, & Dutton, 2002; Mathews & Mackintosh, 1998; Williams, Watts, MacLeod, & Mathews, 1997) postulate that anxiety-linked biases of attention imply hypervigilance to threat and distractibility from other stimuli in the presence of feared materials. This is convincingly confirmed by various experimentalclinical studies assessing attention for threat in anxious participants compared to non-anxious controls (for a review, seeMathews &MacLeod, 2005). In contrast, assumptions concerning anxiety-linked biased memory for threat are less convincing; based on the shared tendency for avoidance of deeper elaboration in anxiety disorders, some models predict memory biases only for implicit memory tasks (Williams et al., 1997) or even disclaim the relevance of memory in anxiety at all (e.g., Mogg, Bradley, Miles, & Dixon, 2004). Other theories restrict the possibility of measuring disorder-specific memory biases to tasks that require merely perceptual encoding of the materials instead of verbal-conceptual memory (e.g., Fox et al., 2002; Mathews &Mackintosh, 1998). On the one hand, none of these models has integrated all the inconsistencies in empirical data on the topic. On the other hand, the numerous empirical studies on memory in anxiety that have been conducted with varying materials, anxiety disorders, encoding and retrieval conditions do not allow final conclusions about the prerequisites for finding memory biases (for a review, see MacLeod & Mathews, 2004). A more detailed investigation of the complete spectrum of memory for threat utilizing carefully controlled variations of depth of encoding and materials is needed. In view of these inconsistencies, it is all the more surprising that one important part of this spectrum has so far remained completely uninvestigated: visual working memory (VWM). No study has ever differentially addressed VWM for threat in anxious vs. nonanxious participants and none of the cognitive models of anxiety provides any predictions concerning this stage of information processing. Research on cognitive biases in anxiety has thus far only addressed the two extremes of the processing continuum: attention and longer-term memory. In between, a gap remains, the bridging of which might bring us closer to defining the prerequisites of memory biases in anxiety. As empirical research has provided substantial and coherent knowledge concerning attention in anxiety, and as attention and VWM are so closely linked (see, for instance, Cowan, 1995), the thorough investigation of VWM may provide important clues for models of anxiety. Is anxiety related to VWM biases favoring the processing of threatening information, or does the avoidance presumed by cognitive models of anxiety already begin at this stage? RESEARCH AIMS. To investigate the relevance of biased VWM in anxiety, the present research focused in eight experiments on the following main research questions: (1) Is threat preferably stored in VWM in anxious individuals? (2) Does threat preference occur at the cost of the storage of other items, or is extra storage capacity provided? (3) Would the appearance of threat interrupt ongoing encoding of non-threatening items? (4) Does prioritized encoding of threat in anxiety occur strategically or automatically? (5) Are disorder-specific VWM biases also materials-specific? (6) Are VWM biases in anxiety modifiable through cognitive-behavioral therapy? METHODS. In Experiments 1-4, a spatial-sequential cueing paradigm was used. A subset of real-object display items was successively cued on each trial by a sudden change of the picture background for 150 ms each. After the cueing, one of the display pictures was hidden and probed for a memory test. On most trials, a cued item was tested, and memory accuracy was determined depending on the item’s position within the cue string and depending on its valence. In some cases, memory for an uncued item was tested. Experiment 1 and 2 were directed at discovering whether spider fearfuls and non-anxious controls would differ with respect to the accuracy in memorizing cued spiders and uncued spiders and, thus, reveal disorder-specific biases of VWM. In addition, the question whether the presence of a spider image is related to costs for the memorization of other images was tested. Experiment 3 addressed whether any disorder-specific VWM biases found earlier were specific to the feared spiders. Therefore, the critical stimuli here were a snake and a spider. Participants were spider fearfuls and non-anxious controls, both without snake anxiety. In Experiment 4, it was tested whether disorder-specific biases found in Experiment 1 and 2 were modifiable through cognitive-behavioral treatment. The critical stimulus was a spider image. Spider fearfuls were tested three times. Half of them received a cognitive-behavioral intervention after the first test, the other half only after the second test. In two additional experiments, VWM was assessed with a change-detection paradigm. The main aim was to clarify whether disorder-specific effects found in the previous experiments were associated with automatic or with strategic selective encoding of threatening materials, and whether any group differences in spider change detection were materials-specific to spiders, but not to snakes. In Experiment 5, several images were presented simultaneously in a study display for either 100 or 500 milliseconds. After a short interruption, a test display was presented including either the same items as the first one or one changed item. Participants’ accuracy in determining whether displays were the same or different was measured depending on the valence of the changed item, set size, and presentation time of the display. There were trials with and without spiders. If a change was made, it could involve either a non-spider or a spider item. Of specific interest was the condition in which a spider image was presented initially, but not in the test phase, as noticing this specific change would require storage of that image in VWM. Would group differences be particularly pronounced in the shorter encoding condition suggesting automatic encoding of threat, or would they occur in the longer encoding condition, suggesting strategic encoding of spiders? In Experiment 6, change detection accuracy for spiders vs. snakes was tested. The participants in both experiments were spider fearfuls vs. controls, but those of Experiment 6 were additionally required to lack snake anxiety. Moreover, a temporal VWM paradigm - an attentional blink task - was applied to assess whether a biased encoding of spider images in spider fearfuls would occur at the expense of non-threatening items undergoing concurrent processing, and whether this effect was specific to spiders, but not to snakes. Series of real-object pictures were presented at rates of 80 ms at the display center. The observer’s task was to identify and report the two target pictures indicated by a brighter background. In Experiment 7, the first target always depicted a neutral item. The valence of the second target was varied - either negative depicting a spider, positive, or neutral. Participants varied with respect to their spider anxiety. In Experiment 8, spider fearfuls and non-anxious controls, both without snake anxiety, were tested. The experiment was nearly the same as the previous one, but two negative target types were tested: disorder-relevant spiders and negative but not feared snakes. Of specific interest was whether the appearance of a threatening target would reduce the report probability of the earlier attended target, indicating the interruption of its VWM encoding in favor of the threat item. RESULTS. (1) Both anxious and non-anxious controls, showed VWM advantages for negative materials such as spider or snake images. (2) In addition, there were disorderspecific VWM biases: some effects were larger in spider fearfuls than in non-anxious controls and some effects occurred exclusively in spider fearfuls. (3) Group differences and, thus, disorder-specificity were particularly pronounced under competitive circumstances, that is, under the condition of numerous stimuli competing for processing resources: when only little orientation time was allowed, when only little time was provided for selecting and encoding items from a crowd, and when VWMfor the critical item required reflexive instead of voluntary attention. (4) Pronounced memory for task-relevant, voluntarily attended spiders was related to difficulties in disengaging attention from these items in the fearful group, reflected in reduced memory accuracy for the item following it. (5) Disorder-specific VWM biases seem to be based on attentional biases to threatening materials resulting in a very quick, automatic memory consolidation. However, this preferential encoding was not at the cost of neutral materials currently undergoing encoding processes. (6) All disorder-specific VWM biases occured only with fear-related materials, not with other negative materials. (7) Automatic and highly disorder-specific fear-related VWM biases – but not strategic VWM biases occuring in both groups - were modifiable through cognitive-behavioral intervention. CONCLUSIONS. This work provides additional information about informationprocessing distortions related to specific anxiety. With the experimental investigation of biased VWM, this work has been performed to fill a gap within research on cognitive biases in anxiety. Moreover, this dissertation contributes to cognitive theories of anxiety by proposing several recommendations for refinements of current theoretical approaches. Most important, it was suggested to extend existing models by a more detailed consideration of attention and memory. In view of numerous previous empirical studies on the topic and the conclusions of this dissertation, a differentiation of the attentional engagement and disengagement component appears inevitable. Even more important, in view of the data presented here predictions concerning VWM for threatening materials need to be taken into account. In addition, suggestions are provided for the differential consideration of biases occuring from prepotent threat value of negative stimuli vs. individual threat value. A proposal for a cognitive model of anxiety extended by all these aspects is provided to serve as an invitation of further research in the investigation of the nature of memory biases in anxiety disorders. REFERENCES: Cowan, N. (1995). Attention and Memory. An integrated framework.New York: Oxford University Press. Fox, E., Russo, R., & Dutton, K. (2002). Attentional bias for threat: Evidence for delayed disengagement from emotional faces. Cognition and Emotion, 16, 355-379. MacLeod, C., & Mathews, A. (2004). Selective memory effects in anxiety disorders: An overview of research findings and their implications. In D. Reisberg & P. Hertel (eds.), Memory and Emotion. Oxford: Oxford University Press. Mathews, A., & Mackintosh, B. (1998). A cognitive model of selective processing in anxiety. Cognitive Therapy and Research, 22 (6), 539-560. Mathews, A., & MacLeod, C. (2005). Cognitive vulnerability to emotional disorders. Annual Review of Clinical Psychology, 1, 167-195.Mathews, Mogg, May, & Eysenck (1989). Mogg, K., Bradley, B.P., Miles, F., & Dixon, R. (2004). Time course of attentional bias for threat scenes: Testing the vigilance avoidance hypothesis. Cognition and Emotion, 18(5), 689-700. Williams, J.M.G., Watts, F.N., MacLeod, C., & Mathews, A. (1997). Cognitive psychology and emotional disorders. Chichester: John Wiley.

Denna studie tar sin grund i fyra förskollärares erfarenheter av selektiv mutism i förskolan. Studiens syfte är att bidra med kunskap kring förskollärares metoder i arbetet med selektiv mutism i förskolan. Föreliggande studies metod tar sin grund i ett kvalitativt tillvägagångssätt med en fenomenologisk inriktning. Empiriinsamlingen grundas i semistrukturerade intervjuer med de fyra utvalda förskollärarna. Resultatet av studien påvisar att förskollärarnas upplevelser i arbetet med selektiv mutism är ytterst likvärdigt, både när det kommer till fördelaktiga arbetsmetoder samt den bristfälliga samverkan som bedrivs i detta arbete. Resultatet påvisar även att intervjuade förskollärare upplever att det finns en utbredd okunskap om selektiv mutism inom både förskolan och hälso- och sjukvården, förskollärarna förtydligar att det krävs utveckling inom detta område.

Elevated social anxiety (SA) is linked to issues with emotional distress, substance use, and social anxiety disorder (SAD). Notwithstanding concerns of how sexuality has been defined in the extant literature, emerging evidence suggests that the prevalence of SA and related challenges may be disproportionately present among sexual minorities, including lesbians, gay men, and bisexuals (LGBs). This trend may be especially relevant within the developmental context of emerging adulthood, an important period for development of sexual identity, and a time when individuals are already predisposed to heightened feelings of SA. The present study examined the relationship between sexual orientation (measured using sexual identity, sexual attraction, and past romantic and sexual behavior) and social anxiety (related to social interaction and social performance) among emerging adults. minority sexual identities [Welch's F(5,48.08) = 5.56, p = .002, ηp2 = .02.], same-sex attraction [Welch's F(4,108.06) = 11.27, p < .001, ηp2 = .04], and same-sex romantic [Welch's F(5,85.91) = 6.88, p < .001, ηp2 = .03] and sexual experiences[F(5,61.95) = 8.88, p < .001, ηp2 = .04], particularly among those who indicated attraction to multiple sexes. Findings support research that indicates that sexual minority adults experience higher levels of SA than majority (i.e., heterosexual, opposite-sex oriented) adults, and that assessment of sexuality may reflect number of sexual minorities identified. Future directions including intersections of race/ethnicity and gender are discussed.