Cognitive Therapy and Research最新文献

Background

Undergraduates with higher levels of social anxiety may be motivated to participate in high-risk drinking events (e.g., playing drinking games [DG]) as a way to “fit in” or facilitate socialization with peers), putting them at an elevated risk of experiencing alcohol-related negative consequences (e.g., blacking out). The present study sought to test associations between social anxiety symptoms, DG behaviors and consequences, and DG-specific motives among a large, multisite sample of undergraduates.

Methods

Participants were 7,528 undergraduate students who endorsed current (past month) drinking. Participants completed a cross-sectional, self-report survey that included measures of DG behaviors, DG motives, and DG negative consequences as part of a large, multisite observational study.

Results

Consistent with prior work, social anxiety symptoms were negatively associated with lifetime history of DG participation. Among participants who endorsed playing DG in the past 30 days, social anxiety was not associated with DG frequency or quantity, but it was positively associated with all DG motives and cumulative negative DG consequences.

Conclusions

Although undergraduates with higher social anxiety levels were less likely to participate in DGs than those with lower social anxiety levels, among undergraduates who chose to participate in DGs, social anxiety was positively associated with multiple motivations to play DGs and alcohol-related consequences as a result of playing DGs.

Purpose

Although there is research establishing that physical pain is a risk factor for suicidal ideation, there is limited understanding of how physical pain confers risk.

Methods

The current study uses ecological momentary assessment to explore hopelessness as a potential mechanism of physical pain’s effect on suicidal ideation in two distinct samples: an undergraduate population reporting elevated levels of suicidal ideation and an outpatient population with borderline personality disorder receiving comprehensive dialectical behavior therapy.

Results

Our results demonstrated that hopelessness significantly mediated the relationship between physical pain and suicidal ideation in both samples. This implies that physical pain might increase hopelessness, which may in turn increase suicidal ideation.

Conclusions

Our study adds to a growing body of research of risk factors for suicide, and future research should explore this relationship between physical pain and hopelessness with suicidal behavior.

Abstract

Background/Purpose

Anxiety sensitivity (AS) is a transdiagnostic risk factor for mental health disorders. While its lower order factors – social, physical, and cognitive concerns – and their associations with emotional disorders have been examined independently of each other, research has not fully appreciated that these factors might appear to different degrees in individuals, with psychopathology implications.

Methods

We used cluster analysis to investigate how the lower order AS factors appear in treatment-seekers with high AS and how these manifestations of AS (i.e., the different clusters) are uniquely associated with psychopathology. Participants (N = 154; from two studies) were high AS treatment-seeking adults with anxiety and/or depressive disorders who completed a diagnostic interview and self-report measures of AS and anxiety and depression symptoms.

Results

A four-cluster solution emerged including a Multidimensional cluster (33.8% of the sample) and Social (28.6%), Physical (21.4%), and Cognitive (16.2%) clusters. Validation analyses revealed cross-cluster differences in age, gender, ethnicity, and psychopathology, the latter reflecting known associations between AS and mental health (e.g., depression symptoms were significantly highest in the Cognitive and Multidimensional clusters).

Conclusions

Results provide valuable insight into the heterogeneity of high AS as it appears clinically, with implications for best matching treatment approaches for this population.

Purpose

There has been limited research conducted on the nature and consequences of excessive reassurance seeking in individuals with social anxiety, who tend to worry about the impression they make in evaluative social contexts. We examined the effects of self-reported trait social anxiety, low self-certainty, and engagement in post-event processing on reassurance seeking behaviours.

Methods

The sample consisted of 399 non-clinical undergraduate participants who completed self-report questionnaires in an online pre-registered correlational study.

Results

Partially consistent with our preregistered hypothesis, hierarchical regression analyses revealed that each predictor variable explained unique variance in reassurance seeking behaviours over and above the others, but interaction effects were non-significant for the main outcome variable measuring overall reassurance-seeking. Ancillary analyses revealed a significant three-way interaction between social anxiety symptoms, self-certainty, and post-event processing on engagement in evaluative threat-related reassurance seeking specifically.

Conclusions

Future prospective, naturalistic, and experimental research is needed to verify that evaluative threat-related reassurance seeking in social anxiety may be driven by heightened self-doubt and engagement in post-event processing, which may hinder socially anxious individuals from receiving high-quality support from those in their social network.

Background

Research suggests that exposure therapy delivered in the morning is more successful than delivered in the evening, which is often explained by higher diurnal endogenous cortisol levels. However, this “morning exposure effect” might also be explained by other factors such as sleep or vigilance.

Methods

The current study aimed to disentangle these effects by assessing the impact of video-based exposure therapy delivered in the morning or in the evening, whilst considering pre-exposure sleep quality, vigilance, and cortisol levels. To this end, 80 snake fearful individuals were randomly assigned to receive exposure treatment in the morning or evening.

Results

Contrary to previous findings, groups did not differ in their pre-post and post-follow up decrease of snake anxiety. However, higher vigilance was found to be associated with a greater pre-post and post-follow-up decrease in snake anxiety. Moreover, pre-exposure sleep efficiency moderated the post-follow-up decrease in snake anxiety across groups: In individuals with high pre-exposure sleep efficiency, those receiving exposure in the morning were estimated to show a stronger decrease in snake anxiety than those receiving exposure in the evening. The opposite pattern was found in individuals with low pre-exposure sleep efficiency.

Conclusions

The results of this study illustrate that diurnal effects on exposure therapy might be more complex than previously assumed.

Trial Registration

The study was prospectively preregistered at the German Clinical Trial Register (https://drks.de/search/en/trial/DRKS00016183).

Background

CBASP is a learning acquisition model of psychotherapy and until this present study, has not been systematically dismantled to identify the active ingredient.

Methods

The present investigation is the first formal dismantling pilot-study conducted to date on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). The two major treatment components of CBASP, Situational Analysis (SA) and the Interpersonal Discrimination Exercise (IDE), were administered alone and with CBASP treatment-as-usual (the combination of both) to determine if there were active ingredients operative in the model. Secondly, we questioned if the dismantling of CBASP should continue in a larger study in an effort to answer the greater dismantling question of whether to administer both SA and IDE separately based on the active ingredient outcomes.

Results

The study did achieve visually inspected differential data patterns across the three groups of the dependent measures. Based on these outcomes, a larger dismantling study seems warranted and is recommended.

Conclusions

We strongly urge that a larger dismantling study using a similar design be conducted in an effort to further the dismantling process of the CBASP model.

Background

Shame is an important emotion in social anxiety disorder (SAD). However, gender differences in shame, as well as the temporal relationship between shame and anxiety in SAD have not been examined. The present study aimed to address these gaps.

Methods

Participants were 88 individuals (44 with SAD and 44 without SAD) who completed a 21-day experience sampling measurement (ESM). Specifically, participants reported on their emotions once a day at random times.

Results

Hierarchical Linear Modeling indicated that individuals with SAD reported significantly more shame compared to individuals without SAD. In addition, women reported significantly more shame compared to men. Importantly, gender differences in shame were more pronounced among individuals with SAD compared to those without SAD. Finally, we found that for individuals without SAD, shame on a given day significantly predicted anxiety on the following day among men but not among women, whereas for individuals with SAD, shame on a given day significantly predicted anxiety on the following day among both men and women.

Conclusions

Our findings suggest that shame may play a role in the maintenance of SAD. In addition, our findings suggest that social anxiety disorder may impact women’s experience of shame more than men’s.