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With mental health being a field that is becoming progressively more familiar and researched in depth, an important subject of interest that should be addressed is child mental health, and the different factors that can influence it. In this paper, we use a dataset from the Substance Abuse and Mental Health Data Archive to analyze the impacts of child-mentor relationships on child mental health. Previous studies have come to similar conclusions: positive parent-student and teacher-student relationships often lead to signs of positive mental health in children. To expand upon these past findings, we used different measures of mental health and relationship qualities to create a predictive model. We conducted classification and coefficient weight analyses to see how strong of an impact different variables representing indicators of healthy relationships had on different aspects of child mental health. This information was used to create predictions of future cases. Like previous studies, we found that there was a general pattern that showed that good child-mentor relationships, defined specifically by the frequency of praise and fights, had an overall positive impact on child mental health, specifically when it came to symptoms of depression. Furthermore, parents seemed to have stronger impacts on child mental health than teachers did. Limitations include possibly biased respondents who may not be representative of the greater population, as well as the specificity of the variables that were chosen. Going forward, further steps to analyze different datasets and deepen the scope of the research will be helpful in finding patterns and developing more detailed conclusions.

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.

Here, we take a computational approach to understand the mechanisms underlying face perception biases in depression. Thirty participants diagnosed with major depressive disorder and 30 healthy control participants took part in three studies involving recognition of identity and emotion in faces. We used signal detection theory to determine whether any perceptual biases exist in depression aside from decisional biases. We found lower sensitivity to happiness in general, and lower sensitivity to both happiness and sadness with ambiguous stimuli. Our use of highly-controlled face stimuli ensures that such asymmetry is truly perceptual in nature, rather than the result of studying expressions with inherently different discriminability. We found no systematic effect of depression on the perceptual interactions between face expression and identity. We also found that decisional strategies used in our task were different for people with depression and controls, but in a way that was highly specific to the stimulus set presented. We show through simulation that the observed perceptual effects, as well as other biases found in the literature, can be explained by a computational model in which channels encoding positive expressions are selectively suppressed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Combined Cognitive Bias Hypothesis proposes that emotional information processing biases associate with each other and may interact to conjointly influence mental health. Yet, little is known about the interrelationships amongst cognitive biases, particularly in adolescence. We used data from the CogBIAS longitudinal study (Booth et al. 2017), including 451 adolescents who completed measures of interpretation bias, memory bias, and a validated measure of general mental health in a typical population. We used a moderated network modelling approach to examine positive mental health related moderation of the cognitive bias network. Mental health was directly connected to positive and negative memory biases, and positive interpretation biases, but not negative interpretation biases. Further, we observed some mental health related moderation of the network structure. Network connectivity decreased with higher positive mental health scores. Network approaches allow us to model complex relationships amongst cognitive biases and develop novel hypotheses for future research.

A label’s entrenchment, its degree of use by members of a community, affects its perceived explanatory value even if the label provides no substantive information (Hemmatian & Sloman, 2018). The repository contains the data and materials related to three experiments that show the susceptibility of laypersons and mental health professionals to the entrenchment effect for diagnostic categories. Participants saw entrenched psychiatric and non-psychiatric diagnostic labels as better explanations than non-entrenched labels even if they are circular. Using scenarios involving experts who discuss unfamiliar diagnostic categories, we show that this preference is not due to violations of conversational norms, lack of reflectiveness or attentiveness, and the characters’ familiarity or unfamiliarity with the label. In Experiment 1, whether a label provided novel symptom information or not had no impact on lay responses, while its entrenchment enhanced ratings of explanation quality. The effect persisted in Experiment 2 for causally incoherent categories and regardless of direct provision of mechanistic information. The effect of entrenchment was partly related to induced causal beliefs about the category, even when they contradict explicitly provided information. Most participants in both experiments did not report any effect of entrenchment and the effect was present for those who did not. In Experiment 3, mental health professionals showed the effect using diagnoses that were mere shorthands for symptoms, despite a tendency to rate all explanations as unsatisfactory. The data suggest that bringing experts’ attention to the manipulation eliminates the effect. This pre-registration relates to the fourth experiment in this series, which attempts to disambiguate the social and epistemic utility of labels, and to provide additional controls.

In 2015, the U.S. Congress passed one of the largest reforms of federal healthcare payment policy since the creation of Medicare/Medicaid and the passage of the Affordable Care Act. MACRA (the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015) was designed to reimburse healthcare providers based on the value of their service, not the volume of patients treated. Termed value-based care, this policy aligns with a population health model focused on the “health outcomes of a group of individuals including the distribution of such outcomes within the group” (Kindig & Stoddart, 2003). Clinical psychologists, especially those with training in (a) empirically supported, transdiagnostic, and process-based treatments (Hayes & Hofmann, 2018), (b) research methods, and (c) program evaluation are well-suited to lead the implementation of behavioral interventions in the new era of value-based care. We will outline the three primary goals of value-based care and discuss the role of clinical psychologists in achieving these goals. We conclude by describing how the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al., 2018) is a candidate treatment to implement in settings accountable to value-based incentives.

Clinicians aim to discern causal relations among features of mental disorders. Yet observational data are insufficient to confirm these relations. In the present study, we describe a causal graph approach to illustrate how one can discern causal relations among features of obsessive-compulsive disorder (OCD) by applying the Invariant Causal Prediction (ICP) algorithm and the Hidden Invariant Causal Prediction (HICP) algorithm, supplemented by findings from a literature review. Applying these methods to symptom severity data from four time points (before, during [twice], and after behavioral treatment) we estimated a causal graph for OCD. The resulting causal graph reveals multiple cycles between aspects of OCD that may play a role in the maintenance of the disorder. We conclude that the proposed design has great potential and could benefit clinicians with some adjustments and extensions.

Background: Anorexia nervosa (AN) is a serious mental disorder associated with high levels of psychological comorbidity, physical complications, and mortality. Treatment outcomes for AN with best available psychological therapies remain poor. Examination of AN comorbidities and prognostic variables have been highlighted as research areas with high potential. Methods: We examined data from the MOSAIC trial, a multi-site RCT for AN including 142 individuals. We conducted network analyses for (1) AN symptomatology and (2) AN comorbidity with depression and anxiety at all available time points. We conducted linear regressions to determine whether centrality of symptoms in the baseline network was predictive of patient recovery status and clinical impairment at 12-months follow-up.Results: Feeling fat, fear of weight gain, discomfort seeing one's own body, dissatisfaction with weight, and desire to lose weight were among the most central symptoms of AN. Feelings of worthlessness had the highest bridge centrality connecting depression to AN. Centrality of symptoms in the network at baseline was highly related to prognostic value in predicting post-treatment recovery status (r2 = 0.52, p < 0.001) and clinical impairment (r2 = 0.55, p < 0.001). Conclusions: We identified central symptoms of AN and bridge symptoms between AN, depression, and anxiety. These analyses generate useful hypotheses about the etiology and maintenance of AN and related comorbidities, and also generate hypotheses concerning ideal treatment. The validity of network theory in identifying important symptoms is supported by the finding that symptom centrality was closely related to prognostic utility.

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.

Please note: A peer-reviewed version of the paper is currently in press in the Journal of Speech, Language, and Hearing Research. Peer-reviewed publication DOI will be provided when available.Purpose: Using naturalistic synthesized speech, we determined the relative importance of acoustic cues in voice gender and, for the first time, vocal age perception in Cochlear Implant (CI) users.Method: We investigated 28 CI users’ abilities to utilize fundamental frequency (F0) and timbre in perceiving voice gender (Experiment 1) and additional timing cues in perceiving vocal age (Experiment 2). TANDEM-STRAIGHT-based parameter-specific voice morphing was used to control acoustics in voice stimuli. Individual differences in CI users’ performance were captured by quantifying deviations from a control group of 19 normal hearing (NH) listeners. Results: CI users’ gender perception seemed exclusively based on F0, whereas the NH listeners efficiently used timbre. For age perception, timbre was more informative than F0 for both groups, with minor contributions of temporal cues. While a few CI users performed comparable to NH listeners overall, others were at chance. Separate analyses confirmed that even in high performing CI users, gender perception was almost exclusively based on F0. While high performers could discriminate age in male and female voices, low performers were close to chance overall, but used F0 as misleading cue to age (classifying female voices as young and male voices as old). Satisfaction with CI generally correlated with performance.Conclusions: We confirmed that CI user gender classification bases mainly on F0, but high performers could make reasonable usage of TIMBRE cues in both gender and age perception. Overall, parameter-specific morphing is a promising approach to objectively assess individual profiles of CI users abilities to perceive nonverbal social-communicative vocal signals.

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.

The prevalence of obesity has driven searches for cognitive or behavioural economic factors related to Body Mass Index (BMI). One compelling candidate is delay discounting: those who prefer smaller sooner rewards over larger but later rewards are hypothesised to have higher BMI. The findings in the literature are mixed however, with meta analyses suggesting only a very small correlation between discounting and BMI. Here we present novel empirical data (N=381) and Bayesian analyses which suggest no such relationship between discounting of either monetary or weight loss rewards and BMI. We also find evidence against our novel proposal that discounting moderates the rate of BMI gain over time. We also present our data in the context of a random effects Bayesian meta-analytical result which does suggest the presence of a small correlation overall. The strength of the correlation is so weak (2.25% shared variance) that its practical significance may be minor to non existent. However because we found decisive evidence for unaccounted for study-level variance, due to study heterogeneity, we argue that we should treat such meta-analytic correlations with extreme caution. While the relationship between discounting and health outcomes such as BMI remain theoretically appealing, our empirical and meta-analytic results suggest we should be cautious in inferring a correlational, let alone a causal, role for discounting processes in driving BMI or moderating BMI gain with age.

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.

Background: Exposure to stress and trait impulsivity are independent predictors of relapse in recovering alcoholics, but potential mechanisms that link these two risk-factors in terms of their putative additive or interactive contributions to relapse are not known. The aim of this study was to use a model of stress-induced relapse to test the hypothesis that acute psychosocial stress increases craving for alcohol in social drinkers. We also tested the hypothesis that change in craving could be explained by variability in impulsivity and risk-taking.Methods: Participants completed questionnaires to assess drinking behaviour (Alcohol Dependence Questionnaire [ADQ]; and an Alcohol Use Disorders Identification Test [AUDIT]), craving (Desires for Alcohol Questionnaire [DAQ] and impulsivity (Barrett Impulsiveness Scale [BIS]). Participants also completed two computer tasks to assess risk-taking and impulsivity, the Balloon Analogue Risk Test (BART) and a continuous performance task (CPT). Participants then underwent the Trier Social Stress Test (TSST), and completed a final DAQ to assess post-stress craving.Results: Participants showed an increase in craving following exposure to the TSST. In addition, risk-taking was positively correlated with change in craving.Conclusions: Our data suggested that acute psychosocial stress increases subjective craving in social drinkers, but that the effects may be trait-dependent, with stress-induced increases in craving correlated with risk-taking.

The current study seeks to better understand the process by which medical professionals assess mental illness and their subsequent steps when mental illness is suspected or diagnosed (e.g., psychiatric or psychological referral, prescribing medication, etc.). Participants included 36 licensed medical professionals (80% physicians, 20% non-physicians) who are currently practicing in the United States. All participants completed an online survey that included questions about 1) participant demographics, 2) participant’s medical practice and training, 3) prevalence of mental illness in their patient population, 4) how they assess mental illness symptoms, and 5) steps they generally take if they recognize these symptoms in their patients. Additional questions asked about the specific referral processes for patients for whom the physician suspected low, moderate, and severe psychopathology. More than half (56.7%) of participants indicated they have not received training about mental health. Although nearly two-thirds (65.7%) of participants reported using routine screening measures, more than one third (35.3%) reported that non-medical professionals conduct these screenings. Results suggest that regardless of the severity of the patients’ mental illness the majority of participants referred the patient to a mental health professional; around three-quarters referred to specific providers. The second most common referral step was prescribing medications. This study highlights the importance of leveraging medical professionals’ interactions with their patients to improve mental health referrals for patients who may benefit from further mental health evaluation or treatment.

Although the application of network theory to posttraumatic stress disorder (PTSD) has yielded promising insights, the lack of equivalence between inter- and intraindividual variation limits the generalizability of these findings to any one individual with PTSD. Instead, a better understanding of how PTSD symptoms occur and vary over time within an individual requires exploring the idiographic network structure of PTSD. To do so, the present study used an intensive repeated-measures design to estimate intraindividual networks of PTSD symptoms on a person-by-person basis. Participants were 20 individuals who met criteria for PTSD and completed daily surveys assessing PTSD symptoms; surveys were completed four times per day for approximately 30 days. Employing a recently validated method provided by Fisher, Reeves, Lawyer, Medaglia, and Rubel (2017), we used these data to estimate a contemporaneous and temporal network of PTSD symptoms for individuals on a person-by-person basis. We then calculated centrality metrics to determine the relative importance of each symptom in each idiographic network. Across all contemporaneous networks, negative trauma-related cognitions and emotions were most commonly the most central symptoms. Further, across all temporal networks, (a) negative trauma-related emotions were the most common driver of variation in other symptoms over time and (b) distressing trauma-related dreams and sleep disturbance were the most common downstream consequences of variation in other PTSD symptoms over time. We also reviewed data from two randomly selected participants to illustrate how this approach could be used to identify maintenance factors of PTSD for each individual and guide individual treatment planning.

Research that fails to include sufficient representation from socially disadvantaged groups cannot make strong inferences about those groups. This relative lack of knowledge poses theoretical and clinical problems for health research. More effective community engagement with socially disadvantaged groups is often proposed as a way to increase research engagement. However, community engagement is a heterogeneous construct, including everything from how participants are contacted to whether researchers work with an organization within the community. Further, community engagement efforts vary widely in their effectiveness in recruiting and retaining participants from socially disadvantaged groups. Therefore, some types of community engagement may be more effective than others. We conducted a systematic review of randomized controlled trials attempting to increase recruitment or retention of socially disadvantaged groups. We then applied systematic distillation procedures to examine which components of community engagement interventions were associated with successful recruitment or retention outcomes. Generally, we found research process related variables (e.g. having a systematic contact plan) most frequently differentiated effective vs. ineffective recruitment or retention outcomes. Partial associations between components in effective interventions, including negative associations, were descriptively stronger than partial associations in the ineffective interventions, indicating targeted interventions may be more effective than more generalized interventions. The literature was also relatively sparse and at unclear-to-high-risk for bias. Future pre-registered, research process-oriented, and targeted recruitment and retention interventions may increase the research participation of socially disadvantaged groups in health research.

Background Negative beliefs about the effects of stress have been associated with poorer health and increased mortality. However, evidence on the psychological mechanisms linking stress beliefs to health is scarce, especially regarding real-life stress. Purpose The aim of the current study was to investigate the effects of stress beliefs on affect in the daily stress process in a population prone to health-impairing effects of stress: university students. Methods Using daily diaries, 98 university students reported on daily perceived social and work-related stressors as well as positive and negative affect for 10 consecutive days. Stress beliefs, depressive and anxiety symptoms, neuroticism, and demographic variables were assessed prior to the daily diary phase. Results Hierarchical linear models revealed a significant cross-level interaction between negative stress beliefs and the association of daily social stressors with negative affect (B = 0.24; 99% confidence interval [CI] = 0.08–0.41, p < .001). When experiencing social stress, participants who held high negative stress beliefs had higher daily negative affect (simple slope = 4.09; p < .001); however, for participants who held low negative stress beliefs the association between daily social stress and daily negative affect was considerably smaller (simple slope = 2.12; p < .001). Moreover, individuals believing stress to be controllable showed higher positive affect throughout the 10-day daily diary phase. Conclusions Negative stress beliefs were found to moderate the affective response to daily real-life stressors. Given the established relationship between affect and health, this study provides initial evidence of psychological mechanisms linking stress beliefs to health.

People suffering from chronic worries pay excessive attention to emotional information. In this study we examined whether a reduced ability to inhibit attention from fearful faces (i.e. inhibition of return; IOR) can be attributed to the low vagus nerve activity observed in high worriers. Our pre-registered hypothesis was that transcutaneous auricular vagus nerve stimulation (tVNS) would enhance IOR to fearful faces. Ninety-four students who scored above a pre-determined cut-off on the Penn State Worry Questionnaire were randomly allocated to receive either tVNS (n = 45) or sham stimulation of the earlobe (n = 49). Meanwhile, to assess IOR, they performed an emotional exogenous cueing task wherein neutral and fearful faces predicted the target location at chance level. Resting levels of HRV were also collected before stimulation onset. Results showed that levels of trait worry were associated with reduced IOR, but resting levels of HRV were not. Critically, tVNS did not affect performance on the exogenous cueing task when compared to sham stimulation. These findings did not confirm the hypothesized causal role of vagus nerve activity in maintaining disrupted IOR for emotional information. They also provide evidence that high levels of worry are associated with generally reduced IOR. This points to a clear need to understand the neurobiological basis of inhibitory problems in worriers.

Imagination is an adaptive ability that can be directed toward the pursuit of personal goals. Although there is a wealth of research on goals and on imagination, few studies lie at the intersection—little is known about individual differences in goal-directed imagination. In 153 adults, we examined how 28 aspects of goal setting, pursuit, and goal-directed imagination relate to mental health. Higher well-being and lower depressive symptoms were strongly linked (a) to having goals that were more attainable, under control, and expected to bring more joy and (b) to goal-directed imagination that was clearer, more detailed, more positive, and less negative. Importantly, the emotional valence of goal-directed imagination strongly predicted well-being at a 2-month follow-up even after controlling for mental health at baseline. These findings underscore the relevance of goal-directed imagination to well-being and depressive symptoms and highlight potential targets for goal- and imagery-based interventions to improve mental health.

Impairments in retrieving event-level, specific autobiographical memories, termed overgeneral memory (OGM), are recognised as a feature of clinical depression. A previous meta-analytic review assessing how OGM predicts the course of subsequent depressive symptoms showed small effects for correlations and regression analyses when baseline depressive symptoms were controlled for. We aimed to update this study and examine whether their findings replicate given the decade of research that has been published since. A systematic literature review using the same eligibility criteria as the previous meta-analysis led to a doubling of eligible studies (32 v. 15). The results provided more precise estimates of effect sizes, and largely support the finding that OGM predicts the course of depressive symptoms. The effects were generally small, but significantly larger among clinical samples, compared to studies with non-clinical samples. There was some evidence that higher age was associated with stronger effects, and longer follow-up was associated with weaker effects. The findings on other moderating variables that were analysed were mixed. Continued research into this modifiable cognitive process may help to provide an avenue to better understand and treat highly prevalent and impactful depressive disorders.

Currently, mental disorders are usually conceptualized as a hidden causal factor, manifested by its symptoms. This notion rests upon the reflective latent model, which is implicitly at work every time complex symptomatology gets summarized by a single number or a categorical state. The present paper reflects on the quantitative, testable implications of this psychometric model and shows how its restraints are untenable for most mental disorders. The observed data are instead consistent with mental disorders being complex dynamic systems. Instead of being treated as interchangeable measures of the same latent factor, symptoms likely act as independent causal entities, directly affecting each other. In recent years, this shift in ontological stance toward psychopathology has laid a basis for adapting the network theory. Under this theory, a mental disorder is a relatively stable emergent state, which arises due to a pronounced and recurrent interaction of causally linked symptoms. It is discussed how models embedded within the network theory can help provide insight into the etiopathogenesis of mental disorders and address clinical intervention. In conclusion, limits and future challenges to the network theory are discussed.

Atypical sensory processing one of the more ubiquitous symptoms in autism spectrum disorder, the exact nature of these sensory issues remains unclear, with different studies showing either enhanced or deficient sensory processing. Using a well-established continuous free-recall task that assesses visual working memory, the current study provides novel evidence reconciling these apparently discrepant findings by showing both enhanced and impaired sensory processing in the same individuals on distinct aspects of the same task and stimuli. Autistic children exhibited perceptual advantages in both likelihood of recall and recall precision relative to their typically-developed peers. When autistic children did make errors, however, they showed a higher probability of erroneously binding a given colour with the incorrect spatial location. These data indicate that although the initial perceptual representations of sensory inputs were maintained with enhanced fidelity, the subsequent cognitive process of binding multiple features of sensory information into one percept was impaired. These data align with neural-architecture models for feature binding in visual working memory, suggesting that atypical population-level neural noise in the report dimension (colour) and cue dimension (spatial location) may drive both the increase in probability of recall and precision of colour recall as well as the increase in proportion of binding errors, respectively. These changes are likely to impact core symptomatology associated with autism, as perceptual binding and working memory play significant roles in higher-order tasks, such as communication.

This systematic review draws together evidence from the literature for the pathological, neurological, cognitive, psychological, and behavioural outcomes of non-fatal strangulation in domestic and sexual violence. A systematic search of PubMed, PsycINFO, CINHAL, Proquest, ASSIA, Web of Science, WestLaw, Open Grey, and Ethos was conducted, with no date limits set, to identify eligible studies. Thirty empirical, peer-reviewed studies were found which met the inclusion criteria. Pathological changes included arterial dissection and stroke. Neurological consequences included loss of consciousness, indicating at least mild acquired brain injury, seizures, motor and speech disorders, and paralysis. Psychological outcomes included PTSD, depression, suicidality, and dissociation. Cognitive and behavioural sequelae were described less frequently, but included memory loss, increased aggression, compliance, and lack of help-seeking. However, no studies used formal neuropsychological assessment: the majority were medical case studies or based on self-report. Furthermore, few authors were able to control for possible confounds, including other physical violence and existing psychosocial difficulties. There is therefore a need for further neuropsychological research, focusing on cognitive and behavioural outcomes, using standardized tools, and control groups where possible. This is urgent, given societal normalization of strangulation, and legal systems which often do not reflect the act's severity and its consequences.

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.

For many students, the COVID-19 pandemic caused once-in-a-lifetime disruptions of daily life. In March 2020, during the beginning of the outbreak in the Netherlands, we used ecological momentary assessment to follow 80 undergraduate students four times per day for 14 days to assess mental health, social contact, and COVID-19-related variables. Despite rapidly increasing rates of infections and deaths, we observed decreases in anxiety, loneliness, and COVID-19-related concerns, especially in the first few days. Other mental health variables, such as stress levels, remained stable, whereas depressive symptoms increased. Despite social-distancing measures implemented by the Dutch government halfway through our study, students showed no changes in the frequency of in-person social activities. Dynamic network models identified potential vicious cycles between mental health variables and being alone, which predicted concerns about COVID-19 and was followed by further mental health problems. Findings and implications are discussed in detail.

Callous-unemotional (CU) traits are implicated in the development of severe and persistent antisocial behavior, and appear to arise from distinct behavioral, temperament, physiological, and neural risk factors to other types of externalizing psychopathology. Although existing etiological models have attempted to characterize specific mechanisms underlying the emergence of CU traits, prior empirical work is plagued by a host of inconsistent results. This inconsistency is particularly apparent in research that has investigated variation in physiological functioning, arousal, and reactivity. In this review, we summarize and evaluate studies that have examined the role of parasympathetic nervous system (PNS) functioning in child psychopathology, including studies of CU traits. We argue that the inclusion of measures of PNS activity can significantly enhance our understanding of the etiology of CU traits, provide clarity to the inconsistent findings of prior studies, and advance mechanistically-targeted interventions and treatments. We conclude the review by providing foundational and testable hypotheses about the role that disrupted PNS functioning could play in multiple pathways to CU traits beginning in infancy and across development.

BackgroundEarlier reports have shown that anxiety over the novel coronavirus may predict mental functioning during the pandemic. The objective of this study was to assess the links between persistent thinking about COVID-19, anxiety over SARS-CoV-2 and trauma effects. For the purpose of this study, the Polish adaptation of the Obsession with COVID-19 Scale (OCS) was imple-mented.Participants and procedureThe study involved 356 individuals aged 18-78 (58% females). In addition to OCS, the participants completed the following questionnaires: the Coronavirus Anxiety Scale and the Short Form of the Changes in Outlook Questionnaire.ResultsOCS was characterized by satisfactory psychometric properties (α = .82). Regression analysis indicated that persistent thinking about COVID-19 was associated with increased coronavirus anxiety and negative trauma effects. In addition, anxiety served as a partial mediator in the link between persistent thinking about COVID-19 and negative trauma effects.ConclusionsThe data obtained suggest that persistent thinking about the pandemic may be dysfunctional for mental health during the spread of the infectious disease.

Episodic autobiographical memories (EAMs) can come to mind through two retrieval routes, one direct (i.e., an EAM is retrieved almost instantaneously) and the other generative (i.e., by using autobiographical/general knowledge to cue an EAM). It is well established that normal cognitive aging is associated with a reduction in the retrieval of EAMs, but the contributions of direct or generative reconstruction to the age-related shift toward general memories remain unknown. Prior studies also have not clarified whether similar cognitive mechanisms facilitate the ability to successfully reconstruct EAMs and elaborate them in event-specific detail. To address these gaps in knowledge, young and older participants were asked to reconstruct EAMs using a “think-aloud” paradigm and then describe in detail a subset of retrieved memories. An adapted scoring procedure was implemented to categorize memories accessed during reconstruction, and the Autobiographical Interview (AI) scoring procedure was utilized for elaboration scoring. Results indicated that in comparison to young adults, older adults not only engaged in direct retrieval less often than young adults, but they also more often ended generative retrieval at general events instead of EAMs. The ability to elaborate EAMs with internal details was positively associated with the ability to use generative retrieval to reconstruct EAMs in both young and older adults, but there was no relationship between internal detail elaboration and direct retrieval in either age group. Taken together, these results indicate age-related differences in direct and generative retrieval contribute to overgeneral autobiographical memory and they support a connection between generative retrieval and elaboration.

BackgroundDepression is associated with broad deficits in cognitive control, including in visual selective attention tasks such as the flanker task. Previous computational modelling of depression and flanker task performance showed reduced pre-potent response bias and reduced executive control efficiency in depression. In the current study, we applied two computational models that account for the full dynamics of attentional selectivity.MethodAcross three large-scale online experiments (one exploratory experiment followed by two confirmatory – and pre-registered – experiments; total N = 923), we measured attentional selectivity via the flanker task and obtained measures of depression symptomology as well as anhedonia. We then fit two computational models that account for the dynamics of attentional selectivity: The dual-stage two-phase model, and the shrinking spotlight (SSP) model.ResultsNo behavioural measures were related to depression symptomology or anhedonia. However, a parameter of the SSP model that indexes the strength of perceptual input was consistently negatively associated with the magnitude of depression symptomatology.ConclusionsThe findings provide evidence for deficits in perceptual representations in depression. We discuss the implications of this in relation to the hypothesis that perceptual deficits potentially exacerbate control deficits in depression.

In 2001, Anderson and Green [2001. Suppressing unwanted memories by executive control. Nature, 410(6826), 366-369] showed memory suppression using a novel Think/No-think (TNT) task. When participants attempted to prevent studied words from entering awareness, they reported fewer of those words than baseline words in subsequent cued recall (i.e., suppression effect). The TNT literature contains predominantly positive findings and few null-results. Therefore we report unpublished replications conducted in the 2000s (N = 49; N = 36). As the features of the data obtained with the TNT task call for a variety of plausible solutions, we report parallel "universes" of data-analyses (i.e., multiverse analysis) testing the suppression effect. Two published studies (Wessel et al., 2005. Dissociation and memory suppression: A comparison of high and low dissociative individuals' performance on the Think-No think Task. Personality and Individual Differences, 39(8), 1461-1470, N = 68; Wessel et al., 2010. Cognitive control and suppression of memories of an emotional film. Journal of Behavior Therapy and Experimental Psychiatry, 41(2), 83-89. https://doi.org/10.1016/j.jbtep.2009.10.005, N = 80) were reanalysed in a similar fashion. For recall probed with studied cues (Same Probes, SP), some tests (sample 3) or all (samples 2 and 4) showed statistically significant suppression effects, whereas in sample 1, only one test showed significance. Recall probed with novel cues (Independent Probes, IP) predominantly rendered non-significant results. The absence of statistically significant IP suppression effects raises problems for inhibition theory and its implication that repression is a viable mechanism of forgetting. The pre-registration, materials, data, and code are publicly available (https://osf.io/qgcy5/).

Recent therapeutic approaches to auditory verbal hallucinations (AVH) exploit the person-like qualities of voices. Little is known, however, about how, why, and when AVH become personified. We aimed to investigate personification in individuals’ early voice-hearing experiences. We invited Early Intervention in Psychosis (EIP) service users aged 16–65 to participate in a semistructured interview on AVH phenomenology. Forty voice-hearers (M = 114.13 days in EIP) were recruited through 2 National Health Service trusts in northern England. We used content and thematic analysis to code the interviews and then statistically examined key associations with personification. Some participants had heard voices intermittently for multiple years prior to clinical involvement (M = 74.38 months), although distressing voice onset was typically more recent (median = 12 months). Participants reported a range of negative emotions (predominantly fear, 60%, 24/40, and anxiety, 62.5%, 26/40), visual hallucinations (75%, 30/40), bodily states (65%, 25/40), and “felt presences” (52.5%, 21/40) in relation to voices. Complex personification, reported by a sizeable minority (16/40, 40%), was associated with experiencing voices as conversational (odds ratio [OR] = 2.56) and companionable (OR = 3.19) but not as commanding or trauma-related. Neither age of AVH onset nor time since onset related to personification. Our findings highlight significant personification of AVH even at first clinical presentation. Personified voices appear to be distinguished less by their intrinsic properties, commanding qualities, or connection with trauma than by their affordances for conversation and companionship.

One of the most important function of selective attention is the efficient and accurate detection and identification of cues associated with threat. However, in pathological anxiety, this attentional mechanism seems to be dysfunctional, which leads to an exaggeration of threat processing and significant functional impairment. This attentional threat bias (ATB) has been proposed as a key mechanism in the etiology and maintenance of anxiety disorders. Recently, evidence has accumulated that the behavioral assessment of ATB by means of reaction times is compromised by conceptual and methodological problems. In this review paper we argue that a brain-based assessment of ATB, which includes different mechanistic aspects of biased attention, may provide neuromechanistic knowledge regarding the etiology and maintenance of anxiety, and potentially start identifying different targets for effective treatment. We summarize examples for such an approach, highlighting the strengths of electrophysiological measurements, which include the sensitivity to time dynamics, specificity to specific neurocomputational mechanisms, and the continuous/dimensional nature of the resulting variables. These desirable properties are a prerequisite for developing trans-diagnostic biomarkers of attentional bias, and hence may inform individually tailored treatment approaches.

This manuscript has been published in the Journal of Abnormal Psychology (https://psycnet.apa.org/doi/10.1037/abn0000540).Biased social cognition towards an enhanced processing of negative social information might contribute to instability in interpersonal relationships. Such interpersonal dysfunctions are important for the understanding of several mental disorders, among them borderline personality disorder (BPD). To experimentally test enhanced memory retrieval of negative social information, using a newly developed variant of a looking-at-nothing paradigm, 45 BPD patients and 36 healthy women learned positive and negative personality traits of different target persons. In a translational memory test, participants were asked to use the learned information to evaluate statements about the target person. In addition to behavioral measures of memory performance, we investigated eye gaze patterns to decompose memory retrieval processes. We hypothesized that BPD patients would retrieve negative as compared to positive person information more accurately than healthy controls, and show increased eye gaze towards spatial locations where negative information was provided during the learning phase. Results pointed to a more accurate retrieval of negative person attributes in the patient group as compared with healthy controls (HC), thereby corroborating a negativity bias in social cognition in an exemplary sample of patients with interpersonal problems. Interestingly, the observed negativity bias for person memory was associated with BPD severity, stronger expectancies to be rejected by others, and social detachment. No group differences regarding eye fixation behaviour were found. We propose that enhanced retrieval of negative person information might be associated with dysfunctional cognitive schemas as well as reduced behavioral trust, and be of relevance for mental disorders characterized by interpersonal difficulties.

Objective: Virtual reality (VR), a novel and highly immersive technology, offers promise in addressing potential psychological impacts of cancer treatments and hospitalization. The primary aim of this study was to examine multiple key user perspectives on the acceptability and feasibility of an Immersive VR therapeutic intervention for use with hospitalized patients with cancer. Secondary aims were to identify issues and opportunities related to the adoption and clinical implementation of VR in pediatric oncology settings. Method: The study was conducted at The Royal Children’s Hospital (RCH), Melbourne, Australia. Thirty multidisciplinary oncology health care professionals participated in an initial test of VR intervention usability (Stage 1). Ninety oncology inpatients (7-19 years) and their parent caregivers participated in a pilot randomized controlled study to examine the effectiveness of an Immersive VR therapeutic intervention (Stage 2). This mixed methods study reports Stages 1 and 2 quantitative and qualitative data related to VR feasibility and acceptability. Results: Results indicate favorable perceptions from health care professionals with respect to ease of use and usefulness of VR, and had positive intentions to use it in the future. Parent caregivers reported high acceptability of VR for their hospitalized child. Patients reported high satisfaction of the VR intervention within minimal adverse effects. Barriers and facilitators to VR use with seriously ill children and specific recommendations for content development were elicited. Conclusion: This study shows that there are several potential clinical uses for Immersive VR intervention, beyond medical procedural distraction, to support psychological adjustment to hospitalization and patient quality of life.

In the United States, pornography use is common, and it is increasingly a clinical concern under some circumstances. Excessive pornography use may qualify for the new diagnosis of compulsive sexual behavior disorder (CSBD) in the forthcoming 11th version of the International Classification of Diseases. There is also evidence, however, that moral incongruence (i.e., a misalignment of moral beliefs about sexual behavior and actual sexual behavior) may inflate self-reports of problems associated with pornography use. Prior work suggests religiousness may drive such moral incongruence. Using a large sample matched to U.S. representative norms (total: N = 2,519; past-year pornography users: n = 1,424, 66.4% men), we examined the interaction between pornography use and religiousness in predicting self-reported addiction to pornography. Results indicated that religiousness moderated the association between pornography use and self-reported addiction so that, despite a negative association between religiousness and use, at higher levels of religiousness, pornography use was more strongly related to self-reports of addiction.

Background Suicide rates are elevated among United States (U.S.) military service members. Research has found that service members with autism spectrum disorder-related (ASD-related) traits are at increased risk for suicide. Complementary lines of inquiry have suggested that unit cohesion is a protective factor against developing suicidal ideation in military service members. However, given the social difficulties inherent in ASD, it is unclear whether unit cohesion might protect against suicide risk in this population. Method Our sample consisted of 285 active duty U.S. military service members recruited online. We examined the interaction between ASD-related traits (as measured by the Autism Spectrum Quotient [AQ]), unit cohesion, and suicide risk (as measured by the Suicidal Behaviors Questionnaire-Revised [SBQ-R]). We also conducted exploratory analyses to examine whether unit cohesion attenuates the association between ASD-related traits and suicidal intent. Results Elevated ASD-related traits were independently associated with higher levels of global suicide risk; however, unit cohesion was not independently associated with suicide risk. Unit cohesion did not significantly interact with ASD-related traits to predict suicide risk. Finally, we found that elevated ASD-related traits and unit cohesion have an independent effect on current suicidal intent. Discussion Our findings suggest that unit cohesion might not buffer the effect of ASD-related traits on suicide risk. However, our results do show that greater unit cohesion may be independently associated with decreased suicidal intent. This study is limited by a cross-sectional design and use of self-report measures.

Predictive processing has become a popular framework in neuroscience and computational psychiatry, where it has provided a new understanding of various mental disorders. Here, we apply the predictive processing account to post-traumatic stress disorder (PTSD). We argue that the experience of a traumatic event in Bayesian terms can be understood as a perceptual hypothesis that is subsequently given a very high a-priori likelihood due to its (life-) threatening significance; thus, this hypothesis is re-selected although it does not fit the actual sensory input. Based on this account, we re-conceptualise the symptom clusters of PTSD through the lens of a predictive processing model. We particularly focus on re-experiencing symptoms as the hallmark symptoms of PTSD, and discuss the occurrence of flashbacks in terms of perceptual and interoceptive inference. This account provides not only a new understanding of the clinical profile of PTSD, but also a unifying framework for the corresponding pathologies at the neurobiological level. Finally, we derive directions for future research and discuss implications for psychological and pharmacological interventions.

Background Difficulty updating threat associations to safe associations has been observed in individuals who score high in self-reported Intolerance of Uncertainty (IU). Here we sought to determine whether an instruction based on fundamental principles of Cognitive Behavioural Therapy could promote safety learning in individuals with higher levels of IU, whilst controlling for self-reported trait anxiety (STICSA). Methods We measured skin conductance response, pupil dilation and expectancy ratings during an associative threat learning task in which participants either received a cognitive behavioural instruction or no instruction prior to threat extinction (n = 92). Results Analyses revealed that both self-reported IU and STICSA similarly predicted differences in skin conductance response. Only individuals with lower IU/STICSA in the cognitive behavioural instruction condition displayed successful safety learning via skin conductance response. Conclusions These initial results provide some insight into how simple cognitive behavioural instructions combined with exposure are applied differently in individuals with varying levels of self-reported anxiety. The results further our understanding of the role of basic cognitive behavioural principles and self-reported anxiety in safety learning.

The current study examines the measurement properties and validity of a novel, abbreviated youth version of the UPPS-P Impulsive Behavior Scale that was developed to maintain measurement consistency with the existing adult short form. Specifically, we examined this scale's (a) factor structure; (b) measurement and structural invariance across four demographic characteristics: gender, ethnicity, household income, and parental education; and (c) correlates using a subset of 4,521 preadolescent (9- and 10-year old) children (53% male) from the baseline wave of the Adolescent Brain and Cognitive Development (ABCD) study, a large, community-based sample. Our findings supported a correlated 5-factor model, as well as a hierarchical model that recaptured the covariation among these 5 lower-order factors in three higher-order factors. Both of these models are consistent with the commonly observed structure of the UPPS-P among adults. We established measurement invariance across all demographic characteristics. Finally, our UPPS-P scales evidenced good convergent and discriminant validity with a broad swath of theoretically relevant external criteria, including self- and parent-reported personality and psychopathology, as well as lab-based neurocognitive tasks. Our findings indicate that we can assess multidimensional impulsivity in children reliably and validly by means of self-report, allowing assessment of this critical domain at early stages of development. We hope that this measure will facilitate the study of impulsivity in large-scale samples to begin to understand the evolution and long-term consequences of impulsivity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A rise in the prevalence of depression underscores the need for accessible and effective interventions. The objectives of this study were to determine if the addition of a treatment component showing promise in treating depression, heart rate variability-biofeedback (HRV-B), to our original smartphone-based, 8-week digital intervention was feasible and whether patients in the HRV-B (“enhanced”) intervention were more likely to experience clinically significant improvements in depressive symptoms than patients in our original (“standard”) intervention. We used a quasi-experimental, non-equivalent (matched) groups design to compare changes in symptoms of depression in the enhanced group (n = 48) to historical outcome data from the standard group (n = 48). Patients in the enhanced group completed a total average of 3.86 h of HRV-B practice across 25.8 sessions, and were more likely to report a clinically significant improvement in depressive symptom score post-intervention than participants in the standard group, even after adjusting for differences in demographics and engagement between groups (adjusted OR 3.44, 95% CI [1.28–9.26], P = .015). Our findings suggest that adding HRV-B to an app-based, smartphone-delivered, remote intervention for depression is feasible and may enhance treatment outcomes. Electronic supplementary material The online version of this article (10.1007/s10484-020-09458-z) contains supplementary material, which is available to authorized users.

Objective Psychopathology research has relied on discrete diagnoses, which neglects the unique manifestations of each individual's pathology. Borderline personality disorder combines interpersonal, affective, and behavioral regulation impairments making it particularly ill-suited to a "one size fits all" diagnosis. Clinical assessment and case formulation involve understanding and developing a personalized model for each patient's contextualized dynamic processes, and research would benefit from a similar focus on the individual. Method We use group iterative multiple model estimation, which estimates a model for each individual and identifies general or shared features across individuals, in both a mixed-diagnosis sample (N = 78) and a subsample with a single diagnosis (n = 24). Results We found that individuals vary widely in their dynamic processes in affective and interpersonal domains both within and across diagnoses. However, there was some evidence that dynamic patterns relate to transdiagnostic baseline measures. We conclude with descriptions of 2 person-specific models as an example of the heterogeneity of dynamic processes. Conclusions The idiographic models presented here join a growing literature showing that the individuals differ dramatically in the total patterning of these processes, even as key processes are shared across individuals. We argue that these processes are best estimated in the context of person-specific models, and that so doing may advance our understanding of the contextualized dynamic processes that could identify maintenance mechanisms and treatment targets. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Children of combat deployed parents are at risk of behavioral problems. Parental emotion socialization (PES) has been theorized to influence children's behaviors; many studies lend support to this theory. However, longitudinal studies examining PES with experimental designs are sparse. In this study, we estimated PES growth trajectories following a parenting intervention and evaluated whether intervention induced improvements in PES predict child outcomes in postdeployed military families. National Guard/Reserve families with at least one deployed parent and a child aged 4-13 years were randomized into an intervention or control group. Data from all 255 2-parent married families, who were primarily Caucasian and middle-class, were analyzed. PES was indicated by self-reported nonsupportive and supportive reactions to children's negative emotions (baseline, 1-year, and 2-year follow-up). Child behaviors were assessed through averaged mother- and father- reports (baseline and 2-year follow-up). Results of latent growth models showed that mothers and fathers assigned to the intervention condition reported greater improvements in nonsupportive PES (steeper negative slopes) over 2 years relative to controls. Both mothers' and fathers' intervention-induced improvements in nonsupportive PES were associated with decreased child internalizing behaviors. Mothers' intervention-induced improvements in nonsupportive PES were associated with decreased child externalizing behaviors. No significant findings were detected for intervention effects on supportive PES growth trajectories. Our findings supported the indirect effects of the intervention on child behaviors through nonsupportive PES over two years. PES is an important, malleable skill that can be targeted in parenting interventions for postdeployed military families. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Experience of childhood abuse impairs complex social functioning in children; however, much less is known about its effects on basic socio-cognitive processes and even fewer studies have investigated these in adult survivors. Using two behavioral tasks, this study investigated spontaneous theory of mind (ToM) and imitative behavior in 41 women with childhood abuse (CA) and 26 unaffected comparison women (UC). In the spontaneous ToM task, UCs showed a larger ToM index than CAs, indicating more facilitation by knowledge of another’s false belief. In the imitation-inhibition task, CAs experienced less interference than UCs when observing another’s incongruent movements. After controlling for depression, differences in ToM became marginally significant, yet remained highly significant for inhibiting imitative behavior. The findings suggest childhood abuse survivors have altered perspective-taking, and are less influenced by others’ perspectives, potentially due to changes in self-other distinction. Clinical implications regarding therapeutic practice with survivors of childhood abuse are discussed.

Cigarette smoking is associated with increased risk for myriad health consequences including cognitive decline and dementia, but research on the link between smoking and brain structure is nascent. In the current study, we assessed the relationship of cigarette smoking with gray matter (GM) and white matter (WM) in the UK Biobank, controlling for numerous confounding demographic and health variables. We used negative-binomial regression to model the association of cigarette smoking (having ever smoked regularly, cigarettes per day, and duration smoked) with GM and WM (GM N = 19,615; WM N = 17,760), adjusting for confounders. Ever smoked and duration were associated with smaller total GM volume. Ever smoked was associated with reduced volume of the right VIIIa cerebellum and elevated WM hyperintensity volume. Smoking duration was associated with reduced total WM volume. Regarding specific tracts, ever smoked was associated with reduced fractional anisotropy in the left cingulate gyrus part of the cingulum, left posterior thalamic radiation, and bilateral superior thalamic radiation, and increased mean diffusivity in the middle cerebellar peduncle, right medial lemniscus, bilateral posterior thalamic radiation, and bilateral superior thalamic radiation. This study identified significant associations of cigarette exposure with global measures of GM and WM, and select associations of ever smoked, but not cigarettes per day or duration, with specific GM and WM regions. By controlling for important sociodemographic and health confounders, such as alcohol use, this study identifies distinct associations between smoking and brain structure, highlighting potential mechanisms of risk for common neurological sequelae (e.g., dementia).

Background: The Work and Social Adjustment Scale (WSAS) is a brief five-item global measure of functional impairment that is widely used as an outcome measure in adult mental health. We have adapted the WSAS for its use in youth, the WSAS-Youth version (WSAS-Y) and WSAS-Parent version (WSAS-P). This study evaluated the psychometric properties of the scale in a large sample of youth seeking help for a range of psychiatric disorders. Method: The internal consistency, factor structure, convergent and divergent validity, test-retest reliability and sensitivity to change of the WSAS-Y/P were studied in 525 children and adolescents with Obsessive-Compulsive Disorder and related disorders (including Body Dysmorphic Disorder, Tourette’s Syndrome, and body-focused repetitive behaviour disorders) receiving treatment across two specialist clinics in London and Stockholm.Results: The internal consistency of the WSAS-Y/P was excellent across diagnostic groups and time points. Exploratory factor analysis extracted a single-factor of functional impairment, explaining in excess of 85% of the variance. The test-retest reliability was adequate. As expected the WSAS-Y/P correlated more strongly with other measures of functional impairment than with measures of symptom severity, indicating good convergent/divergent validity. Finally, the WSAS-Y/P was highly sensitive to change after treatment.Conclusion: The WSAS-Y/P retains the sound psychometric properties of the original WSAS and is highly sensitive to change after treatment.

The Diagnostic and Statistical Manual of Mental Disorders’ (5th Edition) Alternative Model of Personality Disorders includes a dimensional trait model to describe individual differences in the manifestation of personality pathology. Empirically derived quantitative trait models of psychopathology address many of the structural problems of classical diagnostic schemes (e.g., nonbinary distributions, excessive comorbidity, and diagnostic heterogeneity). However, they are largely based on the structure of individual differences in the manifestation of psychopathology. In contrast, clinical theories of personality disorder, which are the foundation of intervention efforts, are based on the function of maladaptive behavior. This distinction is akin to the difference between morphology and physiology in the broader biological sciences. A structure-function divide in the focus of empirical and clinical work contributes to a lack of integration and difficulties with translation. Here we discuss this tension and argue for the need to bridge this divide and adopt research efforts that integrate structure and function of personality traits. Specifically, we suggest that between-person structure identifies the principal domains of functioning, but to understand dysfunction personality must be conceptualized and studied as an ensemble of contextualized dynamic processes.

Objectives: Suicide is a leading cause of mortality worldwide. Dysregulated hypothalamic-pituitary-adrenal axis activity, as measured by cortisol levels, has been identified as one potential risk factor. Evidence has indicated that childhood trauma is associated with dysregulated cortisol reactivity to stress in adulthood. The current study investigated for the first time whether childhood trauma and daily stressors and emotions were associated with diurnal cortisol levels over a 7-day study in individuals vulnerable to suicide. Methods: 142 participants were categorized according to their suicidal history into three groups: suicide attempt, suicidal ideation or control group. Participants completed questionnaires before commencing a 7-day study. Cortisol samples were provided immediately upon waking, at 15 mins, 30 mins, 45 mins, 3 hours, 6 hours, 9 hours and 12 hours on 7 consecutive days. Measures of daily stressors, mood, defeat and entrapment were completed at the end of each day. Results: Participants in the suicide attempt and ideation groups released significantly lower cortisol upon awakening (CAR) and had a tendency towards flatter wake-peak to 12 hour (WP-12) cortisol slopes compared to controls. Childhood trauma was found to be associated with significantly lower CAR and a tendency towards flatter WP-12 cortisol slope. Childhood trauma also had an indirect effect on suicide vulnerability group membership via lower daily CAR levels. Lower CAR was associated with increased suicide ideation at 1-month but not 6-months. Daily stress and emotion measures were not associated with cortisol levels. Conclusions: This is the first 7-day daily diary investigation of naturally fluctuating cortisol levels in individuals vulnerable to suicide. The results indicate that dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity is associated with suicidal ideation and behavior. Childhood trauma appears to be an important distal factor associated with HPA-axis dysregulation.

Cognitive behavioral therapy (CBT) is an efficacious treatment for child anxiety disorders, but 40-50% of youth do not respond fully to treatment, and time commitments for standard CBT can be prohibitive for some families and lead to long waiting lists for trained CBT therapists in the community. SmartCAT 2.0 is an adjunctive mobile health program designed to improve and shorten CBT treatment for anxiety disorders in youth by providing them with the opportunity to practice CBT skills outside of session using an interactive and gamified interface. It consists of an app and an integrated clinician portal connected to the app for secure 2-way communication with the therapist. The goal of the present study was to evaluate SmartCAT 2.0 in an open trial to establish usability, feasibility, acceptability, and preliminary efficacy of brief (8 sessions) CBT combined with SmartCAT. We also explored changes in CBT skills targeted by the app. Participants were 34 youth (ages 9-14) who met DSM-5 criteria for generalized, separation, and/or social anxiety disorder. Results demonstrated strong feasibility and usability of the app/portal and high satisfaction with the intervention. Youth used the app an average of 12 times between each therapy session (M = 5.8 mins per day). At post-treatment, 67% of youth no longer met diagnostic criteria for an anxiety disorder, with this percentage increasing to 86% at two-month follow-up. Youth showed reduced symptom severity over time across raters and also improved from pre- to post-treatment in CBT skills targeted by the app, demonstrating better emotion identification and thought challenging and reductions in avoidance. Findings support the feasibility of combining brief CBT with SmartCAT. Although not a controlled trial, when benchmarked against the literature, the current findings suggest that SmartCAT may enhance the utility of brief CBT for childhood anxiety disorders. This paper is currently in press in Behavior Therapy.