Cognitive behavioral therapy (CBT) is an evidence-based, structured, goal-oriented, time-limited intervention for psychological disorders. CBT integrates behavioral and cognitive principles and therapeutic strategies; practitioners and clients work collaboratively to identify patterns of behaving and thinking that contribute to the persistence of symptoms, with the goal of replacing them with more adaptive alternatives. In the treatment of anxiety problems, the primary focus of CBT is on reducing avoidance of feared stimuli (e.g., spiders) or situations (e.g., public speaking) and modifying biases in thinking (e.g., the tendency to interpret benign situations as threatening). At its broadest, CBT is an umbrella term; it describes a range of interventions targeting cognitive and behavioral processes—ranging from early, traditional CBT protocols to more recently developed approaches (e.g., mindfulness-based cognitive therapy). CBT protocols have been developed for the full range of anxiety disorders, and a strong evidence base supports their efficacy.
Michelle L. Moulds, Jessica R. Grisham, and Bronwyn M. Graham
Christopher J. Plack and Hannah H. Guest
The psychology of hearing loss brings together many different subdisciplines of psychology, including neurophysiology, perception, cognition, and mental health. Hearing loss is defined clinically in terms of pure-tone audiometric thresholds: the lowest sound pressure levels that an individual can detect when listening for pure tones at various frequencies. Audiometric thresholds can be elevated by damage to the sensitive hair cells of the cochlea (the hearing part of the inner ear) caused by aging, ototoxic drugs, noise exposure, or disease. This damage can also cause reductions in frequency selectivity (the ability of the ear to separate out the different frequency components of sounds) and abnormally rapid growth of loudness with sound level. However, hearing loss is a heterogeneous condition and audiometric thresholds are relatively insensitive to many of the disorders that affect real-world listening ability. Hair cell loss and damage to the auditory nerve can occur before audiometric thresholds are affected. Dysfunction of neurons in the auditory brainstem as a consequence of aging is associated with deficits in processing the rapid temporal fluctuations in sounds, causing difficulties in sound localization and in speech and music perception. The impact of hearing loss on an individual can be profound and includes problems in communication (particularly in noisy environments), social isolation, and depression. Hearing loss may also be an important contributor to age-related cognitive decline and dementia.
Jonathan S. Abramowitz
Obsessive-compulsive disorder (OCD) is one of the most destructive psychological disorders. Its symptoms often interfere with work or school, interpersonal relationships, and with activities of daily living (e.g., driving, using the bathroom). Moreover, the psychopathology of OCD is seemingly complex: sufferers battle ubiquitous unwanted thoughts, doubts, and images that, while senseless on the one hand, are perceived as signs of danger on the other hand. The thematic variation and elaborate relations between behavioral and cognitive signs and symptoms can be perplexing to even the most experienced of observers. Cognitive-behavioral models of OCD explain these phenomena and account for their heterogeneity. These models also have implications for how OCD is treated using exposure and response prevention, which research indicates are effective short- and long-term interventions.