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Background Anxiety sensitivity (AS) is a well-studied transdiagnostic risk construct that is believed to amplify responses to many forms of stress. The COVID-19 pandemic is a broad stressor with significant physical and social threats. In the current study, we were interested in ascertaining the degree to which AS would relate to distress and disability in the context of COVID-19. We hypothesized that AS would be associated with increased distress and disability. Moreover, we hypothesized that AS would be uniquely predictive while controlling for other relevant risk factors such as age, race, and perceived local COVID-19 infection rates. Method Participants (N = 249) were U.S. adults assessed using online data resourcing and re-assessed one month later. Results At the first time point, during the beginning phases of the COVID-19 pandemic, AS was significantly related to COVID-19 distress and disability with a moderate effect size. AS was longitudinally associated with higher COVID-19 worry and depression. Limitations Our findings are limited by the use of a relatively small online sample. Additionally, assessment of pre-pandemic and post-pandemic symptoms and functioning would be beneficial for future research. Conclusions Taken together, the current study provided evidence consistent with AS as a causal risk factor for the development of distress and depression during the COVID-19 pandemic.

As a result of the COVID–19 pandemic, many individuals have experienced disruptions in social, occupational, and daily life activities. Individuals with mental health difficulties, particularly those with elevated posttraumatic stress symptoms (PTSS), may be especially vulnerable to increased impairment as a result of COVID–19. Additionally, demographic factors, such as age, gender, and race/ethnicity, may impact individual difficulties related to the pandemic. The current study examined the concurrent and prospective associations between posttraumatic stress disorder (PTSD) symptoms, broader anxiety and depression symptoms, and COVID–19–related disability. Participants recruited through Amazon's Mechanical Turk (N = 136) completed questionnaire batteries approximately 1 month apart during the COVID–19 pandemic (i.e., Wave 1 and Wave 2). The results indicated that PTSD, anxiety, and depressive symptoms were all associated with increased COVID–19–related disability across assessment points, rs = .44–.68. PTSD symptoms, specifically negative alterations in cognition and mood, significantly predicted COVID–19–related disability after accounting for anxiety and depressive symptoms as well as demographic factors, βs = .31–.38. Overall, these findings suggest that individuals experiencing elevated PTSS are particularly vulnerable to increased functional impairment as a result of COVID–19 and suggest a need for additional outreach and clinical care among individuals with elevated PTSD symptoms during the pandemic.

Research has consistently demonstrated a relationship between peer victimization, a major issue in early adolescence, and depression. However, longitudinal studies examining the relationship between peer victimization and depressive symptoms have yielded mixed results. Thus, the current study examined how specific aspects of peer victimization and subtypes of depressive symptoms are related over a two-year period. Adolescent females (N = 265) completed a questionnaire battery at baseline and two-year follow-up. Results indicated that baseline depressive symptoms prospectively predict peer overt victimization, relational victimization, and decreased prosocial behaviors at follow-up; baseline peer victimization did not predict depressive symptoms at follow-up. Further, results demonstrate the differential predictive value of specific depressive symptoms for overt vs. relational aggression and decreased prosocial behavior. Taken together, this study provides insight into the impact of depressive symptoms on peer victimization and the importance of addressing peer relations in the context of treatment for adolescent depression.

The association between posttraumatic stress disorder (PTSD) and suicidal ideation is well-established and recent prospective studies have demonstrated the unique role of hyperarousal symptoms. In particular, over-arousal may elevate suicide risk in the presence of interpersonal vulnerability factors including thwarted belongingness, perceived burdensomeness, and acquired capability. Therefore, the current study sought to examine the differential associations between PTSD symptom clusters and suicidality and the impact of interpersonal risk factors. Trauma-exposed adults (N = 247) completed a questionnaire battery at baseline and three-month follow-up, as part of a larger randomized controlled trial of computerized interventions for suicide risk. Given the focus of the current study, treatment condition was controlled for in all analyses. Results indicated that hyperarousal symptoms significantly predict suicidality, while reexperiencing and avoidance symptoms do not. Specifically, greater hyperarousal symptoms predicted increased suicidal ideation among individuals with high perceived burdensomeness. Although the interaction effect was not significant, hyperarousal symptoms were also pertinent among individuals with high acquired capability. Taken together, findings suggest that assessment of hyperarousal symptoms and perceived burdensomeness may serve to identify trauma-exposed individuals at greater risk for suicide. Additionally, these factors may serve as effective intervention targets.

Despite the high prevalence and burden of mental health disorders, the majority of affected individuals go untreated. Therefore, increased efforts have been made to develop and examine brief online interventions as a cost-effective, broadly disseminable alternative to traditional psychotherapy. In particular, recent studies have demonstrated the efficacy of online interventions targeting transdiagnostic risk factors such as anxiety sensitivity (AS), thwarted belongingness (TB), and perceived burdensomeness (PB). Although improved psychosocial functioning is an important indicator of successful treatment, no studies to our knowledge have examined the impact of brief web-based interventions on functional outcomes. The current study examined the effects of brief online interventions targeting AS, TB, and PB on occupational, social, and family life functioning in two samples (N = 74; N = 247). In Study 1, results demonstrate a significant impact of an AS treatment on social functioning at one-month follow-up, mediated by pre-to-post reductions in AS. In Study 2, results demonstrate a significant impact of a mood intervention targeting TB and PB on social functioning at one-month follow-up. The results of the current study suggest that brief online interventions may have a significant impact on functional impairment, particularly social functioning. This provides further support for the continued development and implementation of brief online interventions.

Background Women who have experienced a recent sexual assault (SA) are at high risk for posttraumatic stress disorder (PTSD) and related conditions, with approximately half of women experiencing SA meeting criteria for PTSD. There are no guidelines for the prevention of PTSD and other common mental health disorders after SA. Thus, the purpose of this systematic review and meta-analysis is to synthesize research on secondary preventions for PTSD after SA, determine efficacy whether any intervention seems promising, and ascertain when, how, and to whom interventions should be delivered. Methods After searching electronic databases for secondary preventions for PTSD and related conditions among women who have experienced a recent SA, 17 studies were reviewed, their quality was rated on the clinical trial assessment measure, and 10 studies were meta-analyzed (7 were excluded, as they were not randomized controlled trials or due to the absence of heterogeneity). Results Results suggested a small-to-moderate effect of prevention on reducing PTSD and related symptoms. There was no moderating effect of medication versus psychosocial interventions, timing, treatment modality, or targeted versus universal prevention. Half of the studies were of high quality. Conclusion Cognitive-behavioral secondary preventions for PTSD appear to be safe and effective among women who have experienced a recent SA. Future research should identify best practices and mechanisms of treatment, and once identified, it should move toward implementation science.

Theoretical models emphasize the importance of both affective and cognitive risk factors in the development of posttraumatic stress symptoms (PTSS). Two such factors predicting PTSS have been studied extensively: distress intolerance (DI) – an affective factor indicative of the ability to tolerate negative affective states – and attentional control (AC), a cognitive factor reflecting the ability to flexibly shift and maintain attention to goal-relevant tasks. Previous work primarily highlights the independent contributions of DI and AC and their interaction to predict PTSS. Some models, however, suggest a mediational pathway such that AC indirectly affects PTSS via diminished DI. The current paper addressed this gap by first attempting to replicate prior findings, while also exploring this mediation model. Results were examined in two clinical samples – a trauma-exposed sample of adults (study 1; N = 73) and trauma-exposed treatment-seeking adults (study 2; N = 204). Results partially supported our hypotheses; both studies failed to replicate prior moderation findings, but our mediational hypothesis was supported in both samples. Low AC appears to decrease an individual's tolerance for distressing situations, which in turn increases the severity of PTSS. Results suggest that PTSD treatments may benefit by incorporating components of AC, DI, or a combination of the two to mitigate PTSS. Taken together, this study provides a novel examination of how cognitive and affective risk factors, namely AC and DI, work in tandem to increase PTSS.

This review highlights recent research regarding gender differences in OCD, with a focus on prevalence, course of illness, symptom presentation, comorbidity, and treatment response. Overall, findings remain mixed. OCD may be more common among males in childhood, but is more common among females in adolescence and adulthood. Males tend to report an earlier age of onset and present with symptoms related to blasphemous thoughts. Females often describe symptom onset as occurring during or after puberty or pregnancy and present with symptoms related to contamination and/or aggressive obsessions. Females also tend to report significantly higher depression and anxiety. There are no reported gender differences in treatment outcome. Gender may play a role in the onset, presentation, and impact of OCD symptoms. However, more work is needed to account for differences across studies, with one promising future direction being the study of reproductive hormones.

Research supporting the therapeutic efficacy of cannabis remains scant, with the majority of empirical work having focused on the therapeutic potential of Δ9-tetrahydrocannabinol (THC). The aim of the present review is to document recent advances in the study of “secondary” (non-THC) cannabinoids so as to highlight promising avenues for continued research. A number of reviewed studies demonstrate the therapeutic potential of cannabidiol (CBD) for anxiety, depression, pain, psychosis, and epilepsy. Other work has documented the effects of CBD in combination with THC, showing efficacy in the treatment of multiple sclerosis-related spasticity, with mixed evidence for the treatment of neuropathic pain. Though less comprehensively studied, emerging research has also demonstrated the therapeutic potential of other cannabinoids in terms of anticonvulsant effects, reduced inflammation, neuroprotective effects, and improvement of insulin sensitivity. Evidence suggests that further and more nuanced research on cannabinoids is paramount, particularly for CBD and other “secondary” cannabinoids.

Intolerance of uncertainty (IU) is an important transdiagnostic risk factor across internalizing conditions. Little research has focused on establishing temporal relationships between IU and these conditions. The current study examined whether changes in IU across one year would lead to increased internalizing symptoms and elevations across diagnostic indicators. 138 students completed a diagnostic interview and battery of questionnaires at baseline and one-year follow-up. Changes in IU were significantly associated with increases in symptoms of social anxiety, worry, depression, and negative affect. Further, changes in IU were significantly related to an increased incidence of DSM-5 diagnosis and panic attacks from baseline to one-year follow-up. Changes in IU were not associated with increases in symptoms of obsessive-compulsive disorder. Further, we did not find evidence for temporal precedence—baseline IU was not significantly associated with increases in internalizing symptoms or diagnostic indicators. Our results corroborate previous research suggesting that IU is an important transdiagnostic risk and extend prior work by showing that changes in IU are associated with changes in diagnostic outcomes. We did not find evidence showing temporal precedence for IU. Given the malleability of IU, these findings are clinically relevant and developing protocols aimed at reducing IU would be important.

Background: The United States has recently experienced extensive changes in state policy regarding the use of cannabis for recreational and medicinal purposes. Despite its rapidly increasing accessibility and social acceptance, there is a striking dearth of research on cannabis as a treatment for medical and psychological conditions. Research on cannabis is difficult to conduct as it is classified as a schedule I drug with high potential for abuse and currently not accepted to be medically used in treatment. As a result, no standard dosing procedures exist and the lack of conclusive scientific evidence has left clinical providers without evidence-based guidelines about if, when, and how to guide clients on using cannabis safely. Objective: To (1) provide critical psychoeducational information about cannabis and cannabis problems to guide client-provider conversations about cannabis use and (2) describe common clinical concerns around cannabis use, highlight special considerations for vulnerable populations, and review harm reduction techniques and practical resources that may help clinicians and their clients navigate safer cannabis use. Conclusion: The removal of regulatory barriers would enable researchers to address key public health questions about the potential therapeutic and adverse effects of cannabis use. Additionally, funds for research, clinician education, and public health education initiatives are necessary to reduce risks associated with cannabis use in the United States.

Objective To examine sociodemographic and military characteristics of US veterans who do and do not utilize Veterans Affairs (VA) health care services as their primary source of health care and examine the relationship between VA utilization and medical and psychosocial characteristics. Methods Participants were a nationally representative sample of 3,152 military veterans (89.8% male, 83.5% white, 6.0% black, mean age = 62.0 [SD = 13.1] years) who completed a survey in 2011 assessing health care utilization, sociodemographic, military service, medical, and psychosocial characteristics. Receiver operator characteristic analyses and logistic and linear regressions were conducted to provide a comprehensive and multivariate examination of factors associated with VA utilization. Results Veterans who used VA services were more likely to be black, younger, female, unmarried, and less educated and to have lower household incomes. They were also more likely to have served longer in the military and in combat. VA users were more likely to screen positive for lifetime psychopathology, endorse current suicidality, and report enduring more traumas. VA users were also more likely to report more medical conditions, endorse a disability, and score lower on measures of functioning. The primary factor differentiating VA users from those that did not use VA services was presence of lifetime psychopathology. Conclusions Results provide a comprehensive profile of veterans who do and do not utilize VA services and suggest that veterans who use VA services have a substantially elevated health burden compared to other veterans. Results may help inform outreach and engagement initiatives targeting the unique health care needs of veterans who do and do not utilize VA services.

To examine the prevalence of self-reported insomnia symptoms, identify subgroups of female veterans with clinically significant insomnia symptoms, and examine the effect on psychosocial functioning and health care utilization.Cross-sectional analysis of insomnia symptoms and associated characteristics among a stratified random sample of female veterans using Department of Veterans Affairs primary care facilities between October 1, 2010 and September 30, 2011 (n = 6,261) throughout the United States. The primary outcome was reported presence of insomnia symptoms. Other variables included psychological disorders, chronic conditions, chronic pain, and demographic variables.Overall, 47.39% of female veterans screened positively for insomnia symptoms. They differed demographically from those without insomnia symptoms and reported more substance use, chronic physical conditions, and psychological conditions. Receiver operating characteristic analysis indicated the primary factor that differentiated those with versus those without insomnia symptoms was depression. Individuals were further differentiated based on presence of pain and posttraumatic stress disorder. Results yielded eight homogenous subgroups of women at low and high risk of experiencing insomnia symptoms.Sleep problems are common among female veterans (47.39%) despite limited diagnosis of sleep disorders (0.90%). Eight unique subgroups of female veterans with both low and high insomnia symptoms were observed. These subgroups differed in terms of psychosocial functioning and health care utilization, with those with depression, posttraumatic stress disorder, and pain having the poorest outcomes. These results shed light on the prevalence of insomnia symptoms experienced among female veterans and the effect on psychosocial functioning and health care utilization. Results can inform targeted detection and customized treatment among female veterans.

The current review aims to summarize the state of research on cannabis and sleep up to 2014 and to review in detail the literature on cannabis and specific sleep disorders from 2014 to the time of publication. Preliminary research into cannabis and insomnia suggests that cannabidiol (CBD) may have therapeutic potential for the treatment of insomnia. Delta-9 tetrahydrocannabinol (THC) may decrease sleep latency but could impair sleep quality long-term. Novel studies investigating cannabinoids and obstructive sleep apnea suggest that synthetic cannabinoids such as nabilone and dronabinol may have short-term benefit for sleep apnea due to their modulatory effects on serotonin-mediated apneas. CBD may hold promise for REM sleep behavior disorder and excessive daytime sleepiness, while nabilone may reduce nightmares associated with PTSD and may improve sleep among patients with chronic pain. Research on cannabis and sleep is in its infancy and has yielded mixed results. Additional controlled and longitudinal research is critical to advance our understanding of research and clinical implications.