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This study was designed to assess the psychological factors influencing life satisfaction of undergraduates. The instruments used were Perceived Stress Scale (PSS), Wong and Law Emotional Intelligence Scale (WLEIS), Rosenberge Self-esteem Scale (RSS), and Satisfaction with Life Scale (SWLS). A total number of 190 participants were purposively selected across various faculties in Ekiti State University. Four hypotheses were tested using Independent t-test to find the effects of perceived stress, emotional intelligence, and self-esteem on life satisfaction. Multiple regression was used to find the joint and individual influences of these variables. The results showed that there is no significant influence of perceived stress on life satisfaction (t (75) = 1.23, p = .22, 95% CI [-1.14, 4.83). There is no significant influence of self-esteem on life satisfaction (t (51) = -1.31, p = .20, 95% CI [-5.28, 1.11), and there is no significant joint influence of perceived stress, emotional intelligence and self-esteem on life satisfaction (F (3,187) = 1.79, p = .15, R2 =.03). Additionally, perceived stress (β = .07, p = .33), emotional intelligence (β = .14, p = 054) and self-esteem (β = .02, p = .83) did not have independent influences on life satisfaction. Implications of the present findings for future research are discussed, as well as potential interventions for improving life satisfaction.

Objective: Treatment selection could improve outcomes by helping individuals select their optimal intervention. We refine the Personalized Advantage Index approach to generate individual treatment recommendations based on pre-treatment characteristics for adults with depression deciding between cognitive behavioral (CBT) versus psychodynamic therapy (PDT). Method: Data were drawn from a randomized comparison of CBT versus PDT in a sample of 167 individuals with depression. We introduce a novel method combining four different statistical techniques to identify consistent patient characteristics associated with treatment outcome. We combined these variables to generate predictions indicating the optimal treatment for each patient. We assessed retrospectively the effectiveness of our model by comparing the average treatment outcomes for the patients who received their indicated treatment versus those who did not. Results: Depression severity, anxiety sensitivity, extraversion, and psychological treatment needs were found to predict differential treatment efficacy. The average post-treatment Hamilton Depression Rating Scale scores was 1.6 points lower (95%CI=[0.5:2.8]; d=0.21) for those who received their indicated treatment compared to non-indicated. Among the 60% of patients with the strongest treatment recommendations, that advantage grew to 2.6 points (95%CI=[1.4:3.7]; d=0.37). Treatment recommendations were improved by combining different statistical techniques to identify moderators of treatment response rather than relying on one method. Conclusions: Patient characteristics could help individuals choose between CBT and PDT. The small sample and lack of a separate validation sample indicate the need for prospective tests before using this model for treatment selection. These findings contribute to a growing literature on model-guided treatment recommendations in depression.

Background. Studies investigating the link between depressive symptoms and inflammation have yielded inconsistent results, which may be due to two factors. First, studies differed regarding the specific inflammatory markers studied and covariates accounted for. Second, specific depressive symptoms may be differentially related to inflammation. We address both challenges using network psychometrics.Methods. We estimated seven regularized mixed graphical models in the NESDA data (N=2321) to explore shared variances among 1) depression severity, modeled via depression sum-score, 9 DSM-5 symptoms, or 28 individual depressive symptoms; 2) inflammatory markers C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α); 3) before and after adjusting for sex, age, body mass index (BMI), exercise, smoking, alcohol, and chronic diseases.Results. The depression sum-score was related to both IL-6 and CRP before, and only to IL-6 after covariate adjustment. When modeling the DSM-5 symptoms and CRP in a conceptual replication of Jokela et al. (2016), CRP was associated with ‘sleep problems’, ‘energy level’, and ‘weight/appetite changes’; only the first two links survived covariate adjustment. In a conservative model with all 38 variables, symptoms and markers were unrelated. Following recent psychometric work, we re-estimated the full model without regularization: the depressive symptoms ‘insomnia, ‘hypersomnia’, and ‘aches and pain’ showed unique positive relations to all inflammatory markers.Conclusions. We found evidence for differential relations between markers, depressive symptoms, and covariates. Associations between symptoms and markers were attenuated after covariate adjustment; BMI and sex consistently showed strong relations with inflammatory markers.

Our aim was to determine if deficits in intentional forgetting that are associated with depression and dysphoria (subclinical depression) could be explained, at least in part, by variations in working memory function. Sixty dysphoric and 61 non-dysphoric participants completed a modified version of the think/no-think (TNT) task and a measure of complex working memory (the operation span task). The TNT task involved participants learning a series of emotional cue–target word pairs, before being presented with a subset of the cues and asked to either recall the associated target (think) or to prevent it from coming to mind (no think) by thinking about a substitute target word. Participants were subsequently asked to recall the targets to all cues (regardless of previous recall instructions). As expected, after controlling for anxiety, we found that dysphoric individuals exhibited impaired forgetting relative to the non-dysphoric participants. Also as expected, we found that superior working memory function was associated with more successful forgetting. Critically, in the dysphoric group, we found that working memory mediated the effect of depression on intentional forgetting. That is, depression influenced forgetting indirectly via its effect on working memory. However, under conditions of repeated suppression, there was also a direct effect of depression on forgetting. These findings represent an important development in the understanding of impaired forgetting in depression and also suggest that working memory training might be a viable intervention for improving the ability of depressed individuals to prevent unwanted memories from coming to mind.

Idiographic, or individual-level, methodology has been touted for its potential clinical utility. Empirically modeling relationships between symptoms for a single individual may offer both the client and therapist information that is useful for case conceptualization and treatment planning. However, few studies have investigated the feasibility and utility of integrating idiographic models in a clinical setting. In the current pilot study, clients (n = 12) completed ecological momentary assessment regarding psychological symptoms five times per day for three weeks. The clients also generated predictions about the associative and directed relationships in their networks. Graphical vector autoregression was used to generate contemporaneous and directed networks from each client’s data, and both clients and therapists completed self-report questionnaires regarding the feasibility and utility of these methods. Results indicated that the idiographic model structures varied widely across participants and differed markedly from the client’s own predictions. Clients found the models useful; however, the therapists demonstrated a more tempered response. These results echo previous findings suggesting that clients are willing to complete intensive data collection and are interested in the output, whereas therapists may be less open to idiographic methods. We provide recommendations for future implementation of personalized models in clinical settings.

The United States (US) spent 201 billion dollars on mental health-related concerns in 2016, ranking mental illness as the leading cause of disability and the single largest source of economic burden worldwide. With mental health-related treatment costs and economic burden only projected to rise, there is an increasing need for cost-inclusive evaluations of mental health interventions in the US. This systematic review evaluated the intervention characteristics and the quality of 9 economic evaluation studies (e.g., cost-effectiveness, cost-benefit) of youth mental health services conducted in the US from 2003 to 2019. Existing evaluations suggest that certain mental health interventions for youth, among the few that have been formally evaluated, may be cost-effective and cost-beneficial. However, intervention characteristics were generally homogenous, a majority of studies did not adhere to the standard of economic evaluations of the CHEERS checklist, and outcome measures were not consistently clinically useful, limiting the utility of such youth mental health economic evaluations to policymakers. By adhering to standards of economic evaluations and diversifying the characteristics of interventions subject to economic evaluations, intervention researchers can increase confidence in conclusions about which youth mental health interventions are cost-effective or cost-beneficial and more meaningfully inform evidence-based mental health policy.

Anhedonia reflects a dysfunction in the reward system, which can be manifested in an inability to enjoy pleasurable situations (i.e., lack of positive emotions), but also by a lack of motivation to engage in pleasurable activities (i.e., lack of motivation). Little is known about the interrelations between positive emotions and motivation in daily life, and whether these associations are altered in anhedonic individuals. In the present study, we used a network approach to explore the reciprocal, lagged associations between positive emotions and motivation in anhedonic individuals (N = 66) and controls (N = 68). Participants (aged between 18 and 24 years) filled out momentary assessments of affect 3 times per day for 30 consecutive days. Our results showed that (a) anhedonic individuals and controls had similar moment-to-moment transfer of positive emotions; (b) in the anhedonic network feeling cheerful was the node with the highest outstrength, both within this group and compared with the control group; (c) feeling relaxed had the highest outstrength in the control network, and (d) anhedonic individuals had stronger pathways from positive emotions to motivation than controls. Taken together, our findings suggest that low levels of positive emotions lead to decreased motivation in the anhedonic group, which could instigate a negative spiral of low pleasure and low motivation. On a more positive note, we showed that cheerfulness had the highest outstrength in the network of anhedonic participants. Hence, interventions may focus on increasing cheerfulness in anhedonic individuals, as this will likely have the greatest impact on other positive emotions and motivations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Aim: Real-time monitoring of psychotherapeutic processes was recently described as a promising, new way of track-ing periods of change in ongoing treatments. This approach generates complex, multivariate datasets that have to be presented in an intuitive way for clinicians to aid their clinical decision-making. Using network modeling and new approaches in centrality analyses, we examine “bridge nodes” between symptom stress and aspects of the psychotherapeutic process between therapy session (intersession processes, ISP). Method: We recorded intersession processes as well as depressive and anxiety symptoms using daily questionnaires in ten cases. Regularized, thresholded intraindividual dynamic networks were estimated. We applied bridge centrality analysis to identify individual bridges between psychotherapeutic processes and symptoms in the resulting models. Casewise interpretations of bridge centrality values are offered. Results: Bridge centrality analysis revealed individual bridge nodes between intersession processes and symptom severity. Strength and direction of bridges varied substantially across individuals. Conclusion: Given current methodological challenges, idiographic network studies are feasible and offer important insights for psychotherapy process research. In this case, we demonstrated how patients deal with periods of increased symptom stress. In this case we have described how patients deal with their therapy under increased symptom load. Bridges between psychotherapeutic processes and symptom stress are a promising target for monitoring systems based on ISP. Future studies should examine the clinical utility of network-based monitoring and feedback in ongoing therapies. In the near future, process feedback systems based on idiographic models could serve clinicians to improve treatments. Keywords: depression, anxiety, intersession processes, ecological momentary assessment, network analysis

Steinley, Hoffman, Brusco, and Sher (2017) proposed a new method for evaluating the performance of psychological network models: fixed-margin sampling. The authors investigated LASSO regularized Ising models (eLasso) by generating random datasets with the same margins as the original binary dataset, and concluded that many estimated eLasso parameters are not distinguishable from those that would be expected if the data were generated by chance. We argue that fixed-margin sampling cannot be used for this purpose, as it generates data under a particular null-hypothesis: a unidimensional factor model with interchangeable indicators (i.e., the Rasch model). We show this by discussing relevant psychometric literature and by performing simulation studies. Results indicate that while eLasso correctly estimated network models and estimated almost no edges due to chance, fixed-margin sampling performed poorly in classifying true effects as “interesting” (Steinley et al. 2017, p. 1004). Further simulation studies indicate that fixed-margin sampling offers a powerful method for highlighting local misfit from the Rasch model, but performs only moderately in identifying global departures from the Rasch model. We conclude that fixed-margin sampling is not up to the task of assessing if results from estimated Ising models or other multivariate psychometric models are due to chance.

Compared to childhood and adulthood, adolescence is a time of greater risk-taking behavior, potentially resulting in serious consequences. Theories of adolescent brain development highlight the imbalance between neural circuitry for reward vs. regulation. Although this imbalance may make adolescents more vulnerable to impaired decision-making in the context of heightened arousal, not all adolescents exhibit problematic risk behavior, suggesting other factors are involved. Relatedly, parent-adolescent conflict increases in mid-adolescence, and is linked to negative outcomes like substance use related risk-taking. However, the mechanism by which parent-adolescent conflict and risk-taking are linked is still unknown. Therefore, we investigated this association using a multi-method experimental design. Parent-adolescent dyads were randomly assigned to complete a discussion task together on the topic of either the adolescent’s dream vacation or an adolescent-identified conflict topic. During the task, adolescent peripheral psychophysiology was measured for later calculation of heart rate variability (HRV), an index of self-regulation. Immediately after the discussion task, adolescents completed a performance-based measure of risk-taking propensity that indexes real-world risk behaviors. We hypothesized that parent-adolescent conflict would predict greater adolescent risk-taking propensity, and that increased behavioral arousal in the context of conflict, coupled with impaired self-regulation, would explain this link. Results indicated no direct effect of parent-adolescent conflict on adolescent risk-taking propensity. However, there was a significant conditional indirect effect: lower HRV, indexing worse regulatory ability, mediated the relation between conflict and risk-taking propensity but only for adolescents exhibiting behavioral arousal during the discussion task. We discuss implications for understanding adolescent risk-taking behavior.

Background: Suicide is one of the major public health problems in young adults. Detecting the risk factors and correlates among university students might help identify students who are under risk and who need early interventions for suicide prevention.Aims: The current study aimed to investigate the cognitive style, self-esteem, hopelessness, rumination, cognitive reactivity, and personality characteristics of Turkish university students, who previously attempted suicide and who did not.Method: A total of 355 university students (34 previous suicide attempters) were recruited for this study, and they completed the Ten-Item Personality Inventory (TIPI), the Ruminative Response Scale (RRS), the Leiden Index of Depression Sensitivity–Revised (LEIDS-R), the Beck Hopelessness Scale (BHS), the Cognitive Style Questionnaire–Short Form (CSQ), the Rosenberg Self-Esteem Scale (RSES), and the Hospital Anxiety and Depression Scale (HADS).Results: Higher RRS, BHS, CSQ scores and lower TIPI-A and RSES scores were significantly associated with a previous suicide attempt.Conclusion: Negative cognitive style, hopelessness, and rumination were significant correlates of a previous suicide attempt. These cognitive factors may be targets in psychotherapy to reduce suicide attempts in college-age individuals.

Research suggests that personality may change due to important life events, such as psychotherapy, and that personality and attitudes may predict treatment progress. Longitudinal data in a community mental health clinic showed positive changes in Emotional Stability, Hope, Gratitude, and Motivation during the course of psychotherapy. The static approach relating baseline personality and attitudes to treatment progress did not yield fruitful results. The dynamic approach was more effective, in which we treated personality and attitudes as malleable and used changes in these variables as predictors of progress. Treatment progress correlated with an increase in Emotional Stability. Positive changes in general life attitudes (Hope, Gratitude, Quality of Life) more so than therapy-specific attitudes (Motivation, Working Alliance) predicted symptom reduction.

Laboratory procedures have been used for decades as analogues for clinical processes with the goal of improving our understanding of psychological treatments and identifying strategies to make treatments more effective. The focus of this area of research has often been translation from the laboratory to the clinic. This process, however, has not been seamless; strategies that work in the laboratory do not always result in improved outcomes when applied clinically. One possible reason for this gap between experimental and clinical research is the failure to focus on translation from the clinic to the laboratory. In the current review, we will first discuss two well-established laboratory analogues (extinction and cognitive reappraisal), identify critical aspects of the related clinical procedures (exposure and cognitive restructuring) that we believe are missing from these analogues, and propose modifications to these analogues to better capture the clinical process. Second, we will further highlight the benefit of translation from the clinic to the laboratory by discussing two clinical procedures that have more recently been brought into the laboratory for examination (eye movement desensitization and reprocessing and imagery rescripting), discuss how we might improve translation from the clinic to the laboratory and future directions for this research.

Background. The demand for psychological services outpaces the number of available providers. Waitlists at mental health clinics range from weeks to months in length, and longer wait-times predict less favorable outcomes once treatment begins. There is a need for efficient, sustainable service models that provide faster access to care. Offering interim, low-intensity supports to treatment-seekers may both strengthen clinically-relevant proximal outcomes and prevent clinical deterioration while waiting for longer-term treatment. Thus, we tested the acceptability and short-term effects of a solution-focused single-session consultation (SSC), offered to individuals waiting for therapy at two outpatient mental health clinics. Method. Clients wait-listed for outpatient therapy at either clinic were offered an SSC. Participants self-reported overall psychological distress at baseline and two-week follow-up, along with levels of hopelessness and perceived agency at baseline and post-intervention. Participants also rated the SSC’s acceptability. Results. Of 90 treatment-seeking individuals offered an SSC, 46 (51.11%) scheduled an appointment, and 30 (65.21%) attended the session (M age = 31.2, 72.67% female). SSC recipients reported significant pre- to post-intervention improvements in perceived agency (d_z = 1.11, p < .001) and hopelessness (d_z = 1.43, p < .001). Psychological distress significantly decreased from baseline to follow-up (d_z = .73, p = .002). Participants rated SSC sessions as highly acceptable, useful, and worth recommending to others. Conclusions. A solution-focused single-session consultation was associated with improvements in hopelessness, agency, and psychological distress in treatment-seeking adults. Pending larger-scale controlled trials, the SSC may help prevent clinical deterioration among individuals on therapy wait-lists.

Background and Objectives: Individuals experiencing homelessness are frequently discriminated against, such as through reduced employment opportunities and interpersonal rejection, creating a vicious cycle that sustains homelessness. These external conditions of stigma often result in individuals developing an internal sense of self-stigma and intense shame, which can result in negative psychological and behavioral consequences. Psychological intervention may contribute to disrupting this vicious cycle. Acceptance and Commitment Therapy (ACT) has been demonstrated to treat shame and self-stigma in other domains, but never homelessness. Methods: We developed a single-session intervention suitable for this population, and tested it within a randomized multiple-baseline Single Case Experimental Design (SCED). Shame and experiential avoidance were measured daily via SMS messages for eighty-nine days in 9 individuals experiencing homelessness. Results: SCED analysis and meta-analysis across participants indicated that the intervention showed significant improvements in experiential avoidance and shame both within and between participants. Limitations: Limitations include a lack of assessment of overt behavior change and the results of single case studies may have limited generalizability. Conclusions: Results demonstrate the efficacy of a brief ACT intervention in reducing shame and experiential avoidance in a homeless population, as well as the general benefits of single case design methodologies when working with populations that are difficult to reach or recruit from.

Meta-analyses are susceptible to publication bias, the selective publication of studies with statistically significant results. If publication bias is present in psychotherapy research, the efficacy of interventions will likely be overestimated. This study has two aims: (1) investigate whether the application of publication bias methods is warranted in psychotherapy research on posttraumatic stress disorder (PTSD) and (2) investigate the degree and impact of publication bias in meta-analyses of the efficacy of psychotherapeutic treatment for PTSD. A comprehensive literature search was conducted and 26 meta-analyses were eligible for bias assessment. A Monte-Carlo simulation study closely resembling characteristics of the included meta-analyses revealed that statistical power of publication bias tests was generally low. Our results showed that publication bias tests had low statistical power and yielded imprecise estimates corrected for publication bias due to characteristics of the data. We recommend to assess publication bias using multiple publication bias methods, but only include methods that show acceptable performance in a method performance check that researchers first have to conduct themselves.

Recent evidence suggests the results of psychology studies replicate less than half the time. Replies are often then written by the authors of the original studies. This discourse often follows a predictable pattern: highly general claims are made in an original study, the replication produces null results, and the response by the original authors primarily focuses on reasons to disqualify the replication’s results from requiring consideration, rather than acknowledging that the original study’s finding may not in fact be replicable, or that the generality of the original claims may require revision or constraint. I illustrate these points using the example of a recently published trio of original study, failed replication, and response by original authors. I argue that our scientific goals would be better served by efforts to avoid falling into these writing tropes, and to instead move the discourse forward and reinforce the behaviours we want to see in our scientific community, such as the conduction of high-quality replication studies.

The prevention of sexual abuse among people with sexual attractions to minors is a field of study that is growing in both size and importance. While there is an increasing amount of research into this topic, particularly in relation to the stigmatisation of minor-attracted persons (MAPs) and the barriers to them seeking help, there is currently no theoretical framework within which to consider this prevention landscape. In this paper, we suggest that an extension of Göbbels, Ward, and Willis’ (2012) integrative theory of desistance from sexual offending could fill this gap in the literature. We explore what the aims of ‘prevention’ initiatives could, or perhaps should, be, before exploring how an extension and adaptation of the desistance framework could provide a framework for working with MAPs in their journey for sound mental health and, ultimately, the prevention of sexual offending.

The COVID-19 pandemic has precipitated the unplanned, widespread adoption of telepsychotherapy by mental health care professionals. Psychotherapy supervision is also undergoing a rapid shift to telepractice, though questions remain about the efficacy and regulatory standing of telesupervision. A critical unanswered question is: How does telesupervision compare to traditional in-person supervision? This study (completed before the COVID-19 pandemic) used a multiple baseline single-case design to compare the relative effectiveness of in-person supervision and telesupervision. For the small sample of supervisee participants, in-person supervision and telesupervision had equivalent outcomes; there was no significant decrease in participant-rated supervision satisfaction or supervisory working alliance after participants switched from the initial in-person supervision format to telesupervision. In follow-up interviews, participants discussed four themes which may be relevant to mental health care professionals adopting telesupervision: (a) differences between modalities, (b) characteristics of an effective supervisor, (c) the role of technology, and (d) personal preference. These results add to a small but growing evidence base that suggests telesupervision is a viable alternative to in-person supervision. Practical recommendations for telesupervision during the COVID-19 pandemic are also discussed.

Background: Manual coding of facial emotion expression, e.g.using the Facial Action Coding System (FACS), can be very time consuming. For psychotherapy research the change in emotion expressionand microexpressions over time is relevant. Hence, automatic emotionrecognition may be a promising tool. Method: We apply a Convolutionary Neural Network (CNN) for emotion recognition to video material from 389 psychotherapy sessions of 23 patients with borderline personality pathology. We cross-validate the findings with human ratings accordingto the Clients Emotional Arousal Scale (CEAS) and the outcome of psychotherapy. Results: Overall, machine learning ratings show substantial,however, numerically low agreement with human ratings, particularly with overall (non-specific) emotional arousal. Machine learning emotion recognition shows substantial predictive validity for therapy outcome, in particular the display of positive emotions (smiling and happiness). Discussion: Machine learning is a highly promising resource for tracking change in emotional expression over time. The results highlight thedifferential association of displayed positive and negative feelings to the treatment outcome.

The capacity to understand the behavior of oneself and others in terms of internal states as emotions, beliefs, and desires (Reflective function or mentalization) is a key factor in the development of Borderline Personality Disorder (BPD). The present study aimed to analyze the psychometric properties in the Spanish version of the Reflective Functioning Questionnaire (RFQ).

Son yıllarda hastalığa özgül yaklaşımların yerine tanı kategorilerinden bağımsız olarak, psikopatolojik belirti ve bulguların altında yatan ortak süreçlerin tespit edilmesi ve tedavide bu süreçlerin hedef alınmasını savunan transdiyagnostik (tanı ötesi, öte tanısal) yaklaşımın (TY) öne çıkan yönleri arasında eş hastalanma durumlarında hangi bozukluğun öncelikli olarak tedavi edileceği ikilemini çözmesi, eşik altı belirtileri olduğu için herhangi bir tanı tam olarak karşılamayan kişilere tedavi önerilebilmesi açısından önemlidirTransdiyagnostik süreçlerin neler olduğuna ve transdiyagnostik yaklaşımın etkinliğine dair çok sayıda araştırma alan yazında mevcut olmasına rağmen bu süreçleri toplu şekilde değerlendirmek üzere kullanılabilecek değerlendirme araçları Bilişsel ve Davranışçı Süreçler Ölçeği (BDSÖ) ile sınırlıdır Bu ölçeğin kullanıma girmesinden önce araştırmacılar farklı yöntemlerle ortak süreçleri saptamaya çalışmışlardır. BDSÖ Patel ve ark. tarafından bilişsel davranışçı kuramı temel alarak kişilerin karşılaştıkları sorun alanlarıyla uyumlu olacak şekilde, daha önce alan yazında tanımlanmış olan çekirdek süreçleri sorgulamaya imkân veren, öz bildirime dayalı bir ölçek olarak geliştirilmiştir.Bu araştırmada BDSÖ’nün Türkçe versiyonunun geçerlilik ve güvenilirliğinin incelenmesi amaçlanmıştır.

Caring Cards (CC) is a novel group-based approach to Veteran suicide prevention. Inspired by caring contacts for suicide prevention (Motto & Bostrom, 2001), CC creatively leverages Veterans’ lived experience with mental health conditions to help other Veterans at increased risk for suicide. In CC, Veterans meet weekly as a group to create one-of-a-kind cards that are sent to their peers. CC provides a safe, creative, and recovery-oriented space for Veterans with lived mental health experience to provide messages of hope, community, and resilience to their peers at risk for suicide. This treatment manual gives providers an overview of CC, it's current empirical support to date, a step-by-step guide on how to develop their own CC program with Veteran or non-Veteran populations, and recommendations for data collection and research collaboration.

The Personal Style of the Therapist Questionnaire (PST-Q) is an instrument with more than 20 years of theoretical and empirical developments at the international scenario, especially in Latin America. The main goal of the study was to provide preliminary evidence on its psychometric properties and factorial structure in a sample of Spanish licensed clinical psychologists (N = 350). 7 confirmatory factor analysis were performed to found a 20-item and 5-factor solution that had the best fit indices and internal consistency values. The original abbreviated model of the PST-Q was partially confirmed, since item 28 had to be eliminated because it had a factor weight less than .30. The alpha values were slightly lower than the original, but equivalent to those of the Portuguese validation. The implications of the findings for training and research in Psychotherapy and Clinical Psychology are discussed.

Background: We designed the online Spiritual Competency Training in Mental Health (SCT-MH) program to train providers across mental health fields in basic religious and spiritual (RS) competencies. The goal was to help address the professional training gap in RS aspects of multicultural diversity and integration. We hypothesized that providers completing the program would demonstrate an increase in attitudes, knowledge, and skills relevant to RS issues in mental health care. Methods: The SCT-MH program, offered online through the edX platform, consists of 8 hours of multi-media content. 169 participants across a broad range of mental health disciplines completed a pre- and post-training survey, which evaluated their spiritual competency using measures assessing their attitudes, knowledge, and skills in the intersection of RS and mental health. We also collected qualitative data to evaluate participants’ levels of satisfaction with the content and format of the program. Results: Participants showed significantly increased spiritual competency in all measures of attitudes, knowledge, and skills following their participation in the course. Participants reported high satisfaction with both the content and the online format of the training program, and a decrease in perceived barriers to integrating RS in practice.Conclusions: These results demonstrate that a brief, novel online training program can help address the current gap between the clinical need and professional requirements for spiritual competency and the general lack of graduate training in this area of multiculturalism. Suggestions for how this program and others like it can be integrated into graduate education and impact clinical care are discussed.

Religion and spirituality are areas of diversity and multiculturalism that have yet to be comprehensively addressed in most mental health training programs. Without this type of training, many practitioners lack the competence and confidence to engage in spiritually competent care–clinical practice that recognizes the importance of religion and spirituality in people’s identity, worldview, meaning-making and, therefore, their psychological well-being. Emerging research on treatment outcomes and client preferences, as well as professional ethical mandates, support the need for training in spiritual competencies for mental health care. To address the gap between current professional training and the needs and realities of clinical practice, we have developed an online training program to assist practitioners in building their competency and comfort levels in integrating religion and spirituality into treatment. Spiritual Competency Training in Mental Health (SCT-MH) is a seven hour asynchronous, online program consisting of eight modules. The modules are designed to develop basic competency in 16 empirically-derived spiritual competencies in mental health. The content was derived from numerous instructional materials and peer-reviewed publications, with input from leading experts in the field of spirituality and mental health. It is a multidisciplinary program, allowing mental health providers from any discipline and orientation to participate. The material is applicable for working with clients with a wide range of mental health issues from diverse religious and spiritual backgrounds. In this manuscript, we will discuss how the program was developed, what it entails, who it was developed for, and future efforts to test it empirically.

IntroductionPsychological difficulties are part of higher stakes health issues. What are the real effects and the difficulties to generate results of psychotherapies?Literature resultsPsychotherapy is efficient for multiple psychological disorders, as well in controlled as in naturalistic studies, and participate in reduction of health expenditure. However, all patients do not get real benefits from care, patients can deteriorate or drop-out treatment, and persistent side effects can occur; clinicians overestimate their efficiency and their performances decline during their career. Two promising methodologies seems to be associated with better outcomes: Routine Outcome Monitoring (ROM) and a specific form of training clinician expertise named “Deliberate Practice”.DiscussionUsing client feedback allows to implement ROM and “Deliberate Practice” in routine care.ConclusionImplementation of Routine Outcome Monitoring should be encouraged in French Speaking countries to produce evidence-informed practice for the delivering, the improvement and the payment for psychotherapy expenditure.; IntroductionLes difficultés psychologiques font partie des enjeux de santé publique les plus importants. Pour ces raisons, il est nécessaire de s’interroger sur les effets réels des psychothérapies et sur leurs difficultés à produire, parfois, des résultats tangibles.Résultats de la littératureLa psychothérapie est efficace pour des problématiques psychologiques variées, aussi bien dans les études contrôlées que dans les conditions réelles de terrain, et participe à la réduction des coûts de santé. Pourtant, tous les patients ne retirent pas de bénéfices des soins, certains sont à risque de se détériorer et d’abandonner leur traitement et des effets secondaires parfois persistants existent ; les cliniciens surestiment leur efficacité, et leurs performances accusent un déclin au cours de leur carrière. Deux méthodologies prometteuses paraissent associées à de meilleurs résultats : le suivi continu des résultats (SCR) ou Routine Outcome Monitoring (ROM) et l’entraînement spécifique des thérapeutes au développement de leur expertise nommée « Pratique délibérée » (Deliberate Practice).DiscussionUtiliser le feedback des patients permet d’assurer le suivi des résultats et de mettre en place une « pratique délibérée » en soins courants.ConclusionLa mise en place de la méthode du SCR-ROM devrait être encouragée dans les pays francophones, pour produire des données probantes quant à la délivrance, à l’amélioration de l’efficacité des psychothérapies et au possible remboursement des soins.

At present, the scientific community has not reached a consensus regarding whether or not people may be become addicted to or compulsive in use of pornography. Even so, a substantial number of people report feeling that their use of pornography is problematic or addictive in nature. Whereas prior works considered self-reported feelings of addiction dimensionally, the present work examined what might lead someone to specifically identify as a pornography addict. Consistent with prior research, pre-registered hypotheses predicted that religiousness, moral disapproval, and pornography use would emerge as consistent predictors of self-identification as a pornography addict. Three samples, involving adult pornography users (Sample 1, N=829, Mage = 33.3; SD = 9.4; Sample 2, N=424, Mage = 33.6; SD = 9.1) and undergraduates (Sample 3, N=231, Mage = 19.3; SD = 1.8), were collected. Across all three samples, male gender, moral incongruence, and pornography use behaviors consistently emerged as predictors of self-identification as a pornography addict. In contrast to prior literature indicating that moral incongruence and religiousness are the best predictors of self-reported feelings of addiction (measured dimensionally), results from all three samples indicated that male gender and pornography use behaviors were the most strongly associated with self-identification as a pornography addict.

Negative urgency predicts both internalizing and externalizing psychopathology. Although it is hypothesized that urgency is characterized by reflexive responses to negative emotion that focus on immediate relief from distress, little research has addressed this hypothesis. Using data from four independent samples of adolescents and college students ( n = 1,268), we estimated the association between trait negative urgency and emotion regulation strategies that reflect either reflexive responses or disengagement. We verified these effects in two ecological momentary assessment samples (EMA; n = 198). In retrospective data, negative urgency was correlated with using more disengagement or reflexive emotion regulation strategies relative to engagement strategies, r = .39, .38, 95% confidence interval (CI) = [0.30, 0.49], [0.18, 0.57]. This finding replicated in EMA data, r = .24, 95% CI = [0.11, 0.38]. Emotion regulation may be a key mechanism of the effects of urgency on psychopathology. Interventions targeting emotion regulation among those high on urgency may be warranted.

Multiple sclerosis (MS) is an inflammatory auto-immune disease of the central nervous system. It leads to many impairments including physical, cognitive, psychological, and social challenges. Our study examined gender and cultural associations with quality of life (QoL), personal characteristics, and benefits from having MS among those with MS.The study was conducted in Austria and the United States. The sample included 128 participants, 64 in each country, of whom 78 were women and 50 were men aged between 20 and 57 years. We used standard statistical tests, including analyses of covariance (ANCOVA) and partial correlations for the analysis of quantitative data. For the qualitative part of the survey we used semi-structured interviews, which we transcribed and coded to identify categories in the answers for qualitative analyses.Austrian participants with MS perceived a higher social-emotional QoL in comparison to American participants. American participants expressed a higher self-esteem in comparison to Austrian participants. Men reported a lower ability to express love than women. Independent of sex/gender and nationality, participants reported benefits through the disease, especially with regard to improved compassion, mindfulness, improved family relations and lifestyle gains. The qualitative interviews revealed additional gender differences for coping with the illness; and in experiences, expectations, and challenges related to MS.These insights can be used to develop targeted psychological and social support interventions aimed toward improving social-emotional QoL for persons with MS.

Background: The importance of social connectedness in supporting public mental health is well established. However, the reverse causal pathway (that psychological ill-health leads to reduced social connectedness) remains a dominant perspective among mental health practitioners. Our analysis aimed to provide a rigorous test of the directionality of this relationship. Method: A cross-lagged panel analysis of a large longitudinal national probability sample ( N ≈ 21,227), the New Zealand Attitudes and Values Survey, was used to assess the bidirectional longitudinal relationship between social connectedness and mental health, controlling for baseline levels of both variables and demographics. Results: Social connectedness was found to be a stronger and more consistent predictor of mental health year-on-year than mental health was of social connectedness. Conclusion: These results further demonstrate how the psychological resources conferred by social connectedness can act as a ‘social cure’ for psychological ill-health, and provide the strongest evidence to date for the direction of this relationship in the general community.

This paper provides a primer for researchers seeking an introduction to quantitative narrative research methods. It represents a consensus document of most common practices used by the co-authors. Key elements of conducting narrative research (e.g., asking narrative questions, designing narrative prompts, collecting narratives, coding narratives) are discussed, along with limitations to this approach and future directions.

The paper presents a detailed idiographic analysis of Chinese clinical psychology students’ lived experiences and understandings of their psychological health, distress and wellbeing. This is a qualitative, experience-near interview study using interpretative phenomenological analysis (IPA). Semi-structured interviews were carried out with an interpreter with eleven students who had begun their clinical placements in Bejing, China. There were ten females and one male. The interviews were audio-recorded and the transcripts subjected to IPA. Conflict of tradition and modernity was a major theme in the participants’ accounts of their psychological wellbeing. This comprised four subthemes: 1. Strict pragmatism in the family; 2. Emotion moderation; 3. Coordinating individual and relational selves; and 4. Conflict of gender inequality. Participants’ attempts to reconcile cultural tradition with postmodern, urbanised perspectives was a source of psychological malaise. We discuss the findings in terms of indigenous psychology and cultural modifications of psychotherapy for Chinese clients. The study suggests a role for phenomenological approaches especially attuned to the encounter with otherness.

El duelo complicado apenas está siendo reconocido en el campo de salud mental como un trastorno con un perfil y una etiología muy propios, que por lo tanto requiere de estrategias e intervenciones psicoterapéuticas especialmente adaptadas a sus factores particulares. La experiencia clínica en la psicoterapia ericksoniana, así como en la terapia sistémica de Bert Hellinger (Constelaciones Familiares), advierte la posibilidad de desarrollar, a partir de una integración de estos dos enfoques, un tratamiento eficiente que pueda ser impartido en forma grupal y en una sola sesión. Las ventajas de tal modelo de intervención son evidentes, ya que permitirá reducir de manera muy significativa tanto el tiempo como el costo del tratamiento por paciente, así ampliando su accesibilidad y disponibilidad para el público que lo necesite. Por lo tanto, la presente investigación se abocó a (1) desarrollar un modelo de tratamiento para duelo complicado, basado en una integración de la psicoterapia ericksoniana y de la terapia sistémica de Bert Hellinger (Constelaciones Familiares), para ser aplicado en forma grupal y en una sola sesión, y (2) aplicar dicho tratamiento en pacientes diagnosticados con duelo complicado y evaluar su eficacia para disminuir los síntomas del trastorno. Se espera que al alcanzar dichos objetivos, este trabajo sirva para mejorar las opciones de tratamiento disponibles para las personas que sufren del duelo complicado. ENGLISH: Complicated grief is only now gaining recognition in the mental health field as a disorder with its own distinct profile and etiology, and one that requires psychotherapeutic strategies and interventions specially adapted to its peculiar features. Clinical experience in both Ericksonian psychotherapy and Bert Hellinger's systemic therapy (Family Constellations), suggests that through an integration of these two methods, it is possible to develop an efficient treatment to be administered in a group format and in a single session. The advantages of such a treatment model are evident, as it provides a significant reduction in both the time and the per-patient treatment cost, thus making treatment more available and accessible for the public that needs it. For this reason, the present research has aimed at (1) developing a treatment model for complicated grief, based on an integration of Ericksonian psychotherapy and Bert Hellinger's systemic therapy (Family Constellations) and suitable for being administered in a group format and in a single session; (2) applying said treatment in patients diagnosed with complicated grief and evaluating its effectiveness in reducing the symptoms of the disorder. It is hoped that through meeting the above goals, this research will serve to improve the treatment options available to individuals suffering from complicated grief.

As a psychotherapist and bisexual I was concerned after reading studies showing bisexuals have worse wellbeing than others and hearing multiple anecdotes from bisexuals about poor support from mental health or counselling services.I organised a number of gatherings to collect UK bisexuals' experiences of emotional distress support and clustered the results.Participants wanted good therapeutic experiences and sometimes found tolerant therapists who would be with them on a sometimes confusing or distressing journey of self-understanding and acceptance. Some valued therapists who were able to work with people who could not label their sexuality.Some experiences with Lesbian, Gay, Bisexual and Trans (LGBT) services or therapists were positive, others were not.Bisexual clients may see multiple services over multiple episodes prompting confidentiality concerns, inappropriate psychiatric referrals, fatigue from needing to explain our sexuality multiple times and a lottery of whether a supplied therapist will be bi-friendly.Many participants had their bisexuality treated as pathological, as a symptom of underlying pathology or as the cause of their problems. Therapists seemed overly fixated on looking for a cause for a client's bisexuality.Therapist ignorance was often mentioned: Disclosing that they had never worked with a bi person, using an overly simplistic coming out model from straight to gay, being unaware of biphobia as a source of stress and incorrectly assuming all LGBT groups would welcome bisexuals.Many bisexuals reported therapists focussing on sexuality rather than the client's chosen area of concern, sometimes showing excessive interest in a client's sexual activity. Alternatively, some therapists avoided the issue. Some challenged a client to justify or prove their bisexuality in ways that clients thought would not have happened for lesbian, gay or heterosexual clients.Some reported experiences were gendered and/or sexist with women / women relationships being treated less seriously, bisexuality sometimes being seen as a defense and assumptions that all abuse was of women by men.Some respondents raised important intersectional issues around madness, race, class, religion, age and political climate.Some participants were also in education to provide emotional support professionally and reported a lack of course and tutor time, knowledge and interest on sexuality in general and challenges in being openly bi as a learner.While being aware of psychological dynamics affecting reports of therapy, a number of issues were commonly reported and I recommend should be addressed: Bisexuality is not an illness or logically connected with pathology. Bisexual clients should be listened to carefully and therapists should educate themselves outside of the clinic about the complexity and diversity of human sexuality. Therapists should process their own confusion or assumptions around sexuality in order to be in the right place to accompany clients on their journeys. More bisexual visibility is likely to be helpful.

Sudden gains are large and stable improvements in an outcome variable between consecutive measurements, for example during a psychological intervention with multiple assessments. Researching these occurrences could help understand individual change processes in longitudinal data. Three criteria are generally used to identify sudden gains in psychological interventions. However, applying these criteria can be time consuming and prone to errors if not fully automated. Adaptations to these criteria and methodological decisions such as how multiple gains are handled vary across studies and are reported with different levels of detail. These problems limit the comparability of individual studies and make it hard to understand or replicate the exact methods used. The R package suddengains provides a set of tools to facilitate sudden gains research. This article illustrates how to use the package to identify sudden gains or sudden losses and how to extract descriptive statistics as well as exportable data files for further analysis. It also outlines how these analyses can be customised to apply adaptations of the standard criteria. The suddengains package therefore offers significant scope to improve the efficiency, reporting, and reproducibility of sudden gains research.

A subtype of the posttraumatic stress disorder diagnosis for children 6 years and younger (PTSD-6Y) was introduced in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5). This study utilized confirmatory factor analytic techniques to evaluate the proposed DSM-5 PTSD-6Y factor structure and criterion and convergent validity against competing models. Data for N = 284 (3–6 years) trauma-exposed young children living in New Orleans were recruited following a range of traumas, including medical emergencies, exposure to Hurricane Katrina and repeated exposure to domestic violence. The model was compared to DSM-IV, a 4-factor ‘dysphoria’ model that groups symptoms also associated with anxiety and depression, and alternate 1- and 2- factor models. Convergent validity was established against the Child Behavior Checklist (CBCL). Criterion related validity was established by comparing each model to a categorical rating of impairment. The Dysphoria and PTSD-6Y models offered the better accounts of symptom structure, although neither satisfied minimum requirements for a good fitting model. These two models also only showed small levels of convergence with CBCL dimensions. The 1-factor model offered the most compelling balance of sensitivity and specificity, with the 2-factor model and the Dysphoria model following closely behind. These CFA results do not support the symptom clusters proposed within the DSM-5 for PTSD-6Y. Although a 4-factor Dysphoria model offers a better overall account of clustering patterns (relative to alternate models), alongside acceptable sensitivity and specificity for detecting clinical impairment, it also falls short of being an adequate model in this younger age group. Electronic supplementary material The online version of this article (10.1007/s10802-019-00561-2) contains supplementary material, which is available to authorized users.

Psychological science relies on behavioral measures to assess cognitive processing; however, the field has not yet developed a tradition of routinely examining the reliability of these behavioral measures. Reliable measures are essential to draw robust inferences from statistical analyses, and subpar reliability has severe implications for measures’ validity and interpretation. Without examining and reporting the reliability of measurements used in an analysis, it is nearly impossible to ascertain whether results are robust or have arisen largely from measurement error. In this article, we propose that researchers adopt a standard practice of estimating and reporting the reliability of behavioral assessments of cognitive processing. We illustrate the need for this practice using an example from experimental psychopathology, the dot-probe task, although we argue that reporting reliability is relevant across fields (e.g., social cognition and cognitive psychology). We explore several implications of low measurement reliability and the detrimental impact that failure to assess measurement reliability has on interpretability and comparison of results and therefore research quality. We argue that researchers in the field of cognition need to report measurement reliability as routine practice so that more reliable assessment tools can be developed. To provide some guidance on estimating and reporting reliability, we describe the use of bootstrapped split-half estimation and intraclass correlation coefficients to estimate internal consistency and test-retest reliability, respectively. For future researchers to build upon current results, it is imperative that all researchers provide psychometric information sufficient for estimating the accuracy of inferences and informing further development of cognitive-behavioral assessments.

Although exposure and response prevention (ERP) is currently the most effective treatment for obsessive-compulsive disorder (OCD), there are substantial refusal and dropout rates. Therefore, there is a need to find ways to make treatments for OCD more acceptable and increase efficacy. This report presents four patients with OCD who received a novel treatment, Habit Reversal Training (HRT). HRT is the treatment of choice for OCD-related disorders such as Trichotillomania, but has not been formally tested for OCD. Based on recent studies showing that excessive habit formation plays an important role in OCD, we examined whether HRT would be an effective and acceptable treatment for OCD. Single case methodology was used to investigate its feasibility, acceptability and preliminary efficacy for OCD treatment. After 9 sessions of HRT over 11 weeks, all four participants showed 32-48% reductions in OCD severity, and three showed a clinically significant treatment response. These gains were largely maintained at 3 months follow-up. All participants rated HRT as a highly acceptable treatment. This suggests that HRT could prove to be an effective, efficient, and acceptable new OCD treatment, with a novel mechanism of action – targeting the habit system.

Many clinical neuroscience investigations have suggested that trait anxiety is associated with increased neural reactivity to mistakes in the form of an event-related potential called the error-related negativity (ERN). Several recent meta-analyses indicated that the anxiety-ERN association was of a small-to-medium effect size, however, these prior investigations did not comprehensively adjust effect sizes for publication bias. Here, in an updated meta-analysis (k = 58, N = 3819), we found support for an uncorrected effect size of r = −0.19, and applied a range of methods to test for and correct publication bias (trim-and-fill, PET, PEESE, Peters' test, three-parameter selection model). The majority of bias-correction methods suggested that the correlation between anxiety and the ERN is non-zero, but smaller than the uncorrected effect size (average adjusted effect size: r = −0.12, range: r = −0.05 to −0.18). Moderation analyses also revealed more robust effects for clinical anxiety and anxious samples characterised by worry, however, it should be noted that these larger effects were also associated with elevated indicators of publication bias relative to the overall analysis. Mixed anxiety and sub-clinical anxiety were not associated with the amplitude of the ERN. Our results suggest that the anxiety-ERN relationship survives multiple corrections for publication bias, albeit not among all sub-types and populations of anxiety. Nevertheless, only 50% of the studies included in our analysis reported significant results, indicating that future research exploring the anxiety-ERN relationship would benefit from increased statistical power.

Current theories argue that hyper-sensitisation of social threat perception is central to paranoia. Affected people often also report misperceptions of group cohesion (conspiracy) but little is known about how paranoid ideation affects conspiracy thinking in live interactions. In a pre-registered experimental study, we used a large-scale game theory approach (n=1,165) to test whether the social cohesion of an opposing group affects paranoid attributions in a mixed online and lab-based sample. Participants spanning the full population distribution of paranoia played as proposers in a modified Trust Game against a lab-based panel. Participants were allocated a bonus and chose how much money to send to a pair of responders which was quadrupled before reaching the responders. Responders decided how much to return to the proposers through the same process. Participants played in one of two conditions: against a cohesive group who communicated and arrived at a joint decision, or a non-cohesive group who made independent decisions. After the exchange, proposers rated the extent to which the responders’ decisions were driven by (i) self-interest and (ii) intent to harm. Although the true motives are ambiguous, cohesive responders were reliably rated by participants as being more strongly motivated by intent to harm, indicating that group cohesion affects social threat perception. Highly paranoid participants attributed harmful intent more strongly overall but were equally reactive to social cohesion as other participants, suggesting paranoia involves a generally lowered threshold for social threat detection but an intact sensitivity for cohesion-related group characteristics.

The network theory of psychopathology posits that mental disorders are complex systems of mutually reinforcing symptoms. This overarching framework has proven highly generative but does not specify precisely how any specific mental disorder operates as such a system. We address this gap in the literature by developing a network theory of Panic Disorder and formalizing that theory as a computational model. We first review prior psychological theory and research on Panic Disorder in order to identify its core components as well as the plausible causal relations among those components. We then construct and evaluate a computational model of Panic Disorder as a non-linear dynamical system. We show that this model can explain a great deal, including individual differences in the propensity to experience panic attacks, key phenomenological characteristics of those attacks, the onset of Panic Disorder, and the efficacy of cognitive behavioral therapy. We also show that the model identifies significant gaps in our understanding of Panic Disorder and propose a theory-driven research agenda for Panic Disorder that follows from our evaluation of the model. We conclude by discussing the implications of the model for how we understand and investigate mental disorders as complex systems.

Objective. Emotion network density describes the degree of interdependence among emotion states across time, such that higher density reflects self-perpetuating emotions or rigidity in emotion functioning. Higher density in emotion networks appears to be a risk factor for depression in studies of adults. This paper extended research on emotion network density to adolescents and examined: 1) associations between emotion network density and a standard measure of emotion regulation and 2) associations between emotion network density and symptoms of depression. Method. Data from a daily diary study (t=21 days) of adolescents (N=151; 61.59% female; mean age=14.60 years) were used to construct emotion network density scores. Emotion regulation was measured using The Difficulties in Emotion Regulation Scale Short Form (DERS-SF). Associations between emotion network density and DERS-SF were examined through Pearson correlations. Multiple regression analyses examined associations between emotion network density and depression. Results. Emotion network density was not associated with the DERS-SF. Follow-up analyses showed that it was associated with nonacceptance of emotions (a subscale of the DERS-SF). Emotion network density was positively associated with depression. Discussion. Non-acceptance of emotions may encourage the spread of emotion across time and emotion states given that a feature of non-acceptance is to have secondary emotional responses to ones emotions. Rigidity in emotion function in the form of context-insensitive, self-perpetuating emotion networks may be a risk factor for adolescent depression.

Empirically supported treatments (or therapies; ESTs) are the gold standard in therapeutic interventions for psychopathology. Based on a set of methodological and statistical criteria, the APA has assigned particular treatment-diagnosis combinations EST status and has further rated their empirical support as Strong, Modest, and/or Controversial. Emerging concerns about the replicability of research findings in clinical psychology highlight the need to critically examine the evidential value of EST research. We therefore conducted a metascientific review of the EST literature, using clinical trials reported in an existing online APA database of ESTs, and a set of novel evidential value metrics (i.e., rates of misreported statistics, statistical power, R-Index, and Bayes Factors). Our analyses indicated that power and replicability estimates were concerningly low across almost all ESTs, and individually, some ESTs scored poorly across multiple metrics, with Strong ESTs failing to continuously outperform their Modest counterparts. Lastly, we found evidence of improvements over time in statistical power within the EST literature, but not for the strength of evidence of EST efficacy. We describe the implications of our findings for practicing psychotherapists and offer recommendations for improving the evidential value of EST research moving forward. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Theorists and clinicians have long noted the need for idiographic (i.e., individual-level) designs within clinical psychology. Results from idiographic work may provide a possible resolution of the therapist’s dilemma—the problem of treating an individual using information gathered via group-level research. Due to advances in data collection and time series methodology, there has been increasing interest in using idiographic designs to answer clinical questions. Although time series methods have been well-studied outside the field of clinical psychology, there is limited direction on how clinicians can use such models to inform their clinical practice. In this primer, we collate decades of published and word-of-mouth information on idiographic designs, measurement, and modeling. We aim to provide an initial guide on the theoretical and practical considerations that we urge interested clinicians to consider before conducting idiographic work of their own.

Psychosocial treatments for mood and anxiety disorders are generally effective, however, a number of treated individuals fail to demonstrate clinically-significant change. Consistent with the decades-old aim to identify ‘what works for whom,’ personalized and precision treatments have become a recent area of interest in medicine and psychology. The present study followed the recommendations of Fisher (2015) to employ a personalized modular model of cognitive-behavioral therapy. Employing the algorithms provided by Fernandez, Fisher, and Chi (2017), the present study collected intensive repeated measures data prior to therapy in order to perform person-specific factor analysis and dynamic factor modeling. The results of these analyses were then used to generated personalized modular treatment plans on a person-by-person basis. Thirty-two participants completed therapy. The average number of sessions was 10.38. Hedges g's for the Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Rating Scale (HARS) were 2.33 and 1.62, respectively. The change per unit time was g = .24/session for the HRSD and g = 0.17/session for the HARS. The current open trial provides promising data in support of personalization, modularization, and idiographic research paradigms.

Mind-wandering is associated with the simultaneous activation of a network of different brain regions known formally as the default mode network. Forward looking anxious mind-wandering (or worry) occurs when activity in this network is coupled with a biological fear response in the brain. The fear response constrains the con-tent of anxious mind-wandering, with imagined catastrophised scenarios pushing the mind-wanderer towards avoidant behaviours. There is an established relationship between dreaming and mind-wandering. During rapid eye moment (REM) sleep, where dreams most commonly occur, many of the brain regions within the default mode network are activated. This paper presents a novel argument that during REM sleep the brain is in a bio-logically relaxed state, and that this state acts as a constraint to the content of dreams, which in turn presents a possible function of dreaming. In direct contrast to anxious mind-wandering, dreams present imagined situations which demand confrontational, or un-avoidant, behaviours. Though the situations in dreams call for un-avoidant behaviour, dreamers act with avoidance. This difference between the in-dream behaviour (avoidant) and the behaviour the in-dream situation demands (un-avoidant) highlights an anxiety present in the dreamer which can then be used to direct the focus of therapeutic treatment. Fourteen examples of dreams are presented, including seven examples of interpretation, three examples of successful dream content prediction (a first for an interpretive theory of dreams), and four examples of dreams which demonstrate how in-dream behaviour changes during successful therapy, three of which are my own. Dreams focusing on anxieties developed during infancy as well as in adult moments of trauma (such as post-traumatic stress disorder) are discussed, with a focus on the former.

Considerable effort and funding have been spent on developing Attention Bias Modification (ABM) as a treatment for anxiety disorders, theorized to exert therapeutic effects through reduction of a tendency to orient attention toward threat. However, meta-analytical evidence that clinical anxiety is characterized by threat-related attention bias is thin. The largest meta-analysis to date included dot-probe data for n = 337 clinically anxious individuals. Baseline measures of biased attention obtained in ABM RCTs form an additional body of data that has not previously been meta-analyzed. This article presents a meta-analysis of threat-related dot-probe bias measured at baseline for 1,005 clinically anxious individuals enrolled in 13 ABM RCTs. Random-effects meta-analysis indicated no evidence that the mean bias index (BI) differed from zero (k = 13, n = 1005, mean BI = 1.8 ms, SE = 1.26 ms, p = .144, 95% confidence interval [-0.6, 4.3]. Additional Bayes factor analyses also supported the point-zero hypothesis (BF10 = .23), whereas interval-based analysis indicated that mean bias in clinical anxiety is unlikely to extend beyond the 0 to 5 ms interval. Findings are discussed with respect to strengths (relatively large samples, possible bypassing of publication bias), limitations (lack of control comparison, repurposing data, specificity to dot-probe data), and theoretical and practical context. We suggest that it should no longer be assumed that clinically anxious individuals are characterized by selective attention toward threat. Clinically anxious individuals enrolled in RCTs for Attention Bias Modification are not characterized by threat-related attention bias at baseline. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychological science is in a transitional period: Many findings do not replicate and theories appear not as robust as previously presumed. We suspect that a main reason for theories not appearing as robust is because they are too simple. In this paper, we provide an important step towards this transition in the field of interpersonal relationship research by 1) providing an overarching theoretical framework grounded in existing relationship science, and 2) outlining a novel approach - mobile social physiology – that relies on intelligent technologies like wearable sensors, actuators, and modern analytical methods. At the core of our theoretical principles is co-regulation (one partner’s [statistical] co-dependency on the other partner). Co-regulation has long existed in the literature, but has to date been largely untested. To test the outlined principles, we 3) present a newly programmed app – the Bio-App for Bonding (available on GitHub: https://github.com/co-relab/bioapp). By providing a paradigm shift for relationship research, the field can not only increase the accuracy of measurement and the generalizability of findings, it also allows for moving from the lab to real life situations. We discuss how the mobile social physiology approach is rooted in existing theoretical principles (e.g., Social Baseline and Attachment Theory), extends the concept of co-regulation to allow for specific measurements, and provides a research agenda to develop a model of interpersonal relationships that we hope will stand the test of time.

Objective: Network analysis allows us to identify the most interconnected (i.e., central) symptoms, and multiple authors have suggested that these symptoms might be important treatment targets. This is because change in central symptoms (relative to others) should have greater impact on change in all other symptoms. It has been argued that networks derived from cross-sectional data may help identify such important symptoms. We tested this hypothesis in social anxiety disorder. Method: We first estimated a state-of-the-art regularized partial correlation network based on participants with social anxiety disorder (n = 910) to determine which symptoms were more central. Next, we tested whether change in these central symptoms were indeed more related to overall symptom change in a separate dataset of participants with social anxiety disorder who underwent a variety of treatments (n = 244). We also tested whether relatively superficial item properties (infrequency of endorsement and variance of items) might account for any effects shown for central symptoms. Results: Centrality indices successfully predicted how strongly changes in items correlated with change in the remainder of the items. Findings were limited to the measure used in the network and did not generalize to three other measures related to social anxiety severity. In contrast, infrequency of endorsement showed associations across all measures. Conclusions: The transfer of recently published results from cross-sectional network analyses to treatment data is unlikely to be straightforward. (PsycINFO Database Record (c) 2018 APA, all rights reserved)