Behaviour Research and Therapy最新文献

Most theories of suicide propose within-person changes in psychological states cause suicidal thoughts/behaviors; however, most studies use between-person analyses. Thus, there are little empirical data exploring current theories in the way they are hypothesized to occur. We used a form of statistical modeling called group iterative multiple model estimation (GIMME) to explore one theory of suicide: The Interpersonal Theory of Suicide (IPTS). GIMME estimates personalized statistical models for each individual and associations shared across individuals. Data were from a real-time monitoring study of individuals with a history of suicidal thoughts/behavior (adult sample: participants = 111, observations = 25,242; adolescent sample: participants = 145, observations = 26,182). Across both samples, none of theorized IPTS effects (i.e., contemporaneous effect from hopeless to suicidal thinking) were shared at the group level. There was significant heterogeneity in the personalized models, suggesting there are different pathways through which different people come to experience suicidal thoughts/behaviors. These findings highlight the complexity of suicide risk and the need for more personalized approaches to assessment and prediction.

Given the bidirectional association between psychopathology and relationship distress, an in-depth understanding of couples' interaction processes that contribute to psychopathology is needed. This study examined the interpersonal dynamics of vocally-encoded emotional arousal (fundamental frequency, f₀) during couple conversations and their associations with depressive symptoms, anxiety symptoms, and relationship distress. Data from eight samples were pooled (N = 404 couples) to examine (a) overall trajectories of f₀ across the interaction and (b) moment-by-moment intraindividual changes in and interpersonal reactivity to partners' f₀. Multilevel growth models and repeated-measures actor-partner interdependence models demonstrated that individuals with more severe depression showed more synchronizing reactivity to their partners' f₀ on a moment-by-moment basis, and their overall baseline level of f₀ was lower. More severe relationship distress was associated with more steeply increasing trajectories of f₀ and with greater synchronizing reactivity to partners' f₀. Relative differences in depressive symptoms between the two members of a couple were associated with interpersonal dynamics of f₀ as well. There were no associations with anxiety symptoms. Thus, depressive symptoms were associated with characteristic interpersonal dynamics of vocally-encoded emotional arousal; yet, most consistent associations emerged for relationship distress, which future studies on individual psychopathology should take into account.

Disrupting the accessibility of the mental representation of suicide may be a possible pathway to a strategy for suicide prevention. Our study aims to theoretically evaluate this perspective by examining the impact of temporarily disrupting the concept of suicide on perceptions of suicide. Using a within-subject design, we tested the effects of semantic satiation targeting the word “suicide” on the perceptual judgment of suicide-relevant pictures in 104 young adults. On each trial, participants repeated aloud one of the three words (i.e., “accident,” “murder,” or “suicide”) either three times (priming) or 30 times (satiation) and indicated whether a subsequent picture matched with the word. Results indicated that satiation of the word “suicide” slowed the accurate categorization of pictures related to all three words, and satiation of “murder” and “accident” delayed participants’ judgment of suicide-relevant pictures. Our findings support that semantic satiation can render the suicide concept temporarily less accessible, thereby providing preliminary support for the strategy of concept disruption in suicide prevention.

Although recent research suggests that, for community youth, greater specific (episodic) detail in self-relevant turning point memory narratives predicts depressive symptoms over time, no research has investigated whether the narratives’ specificity similarly predicts depression. Therefore, we investigated whether recalling a specific (unique, 24-hour or less) turning point narrative predicted youth depressive symptoms concurrently and across 6 months (Study 1), and, for a subset of participants, three years (Study 2). We also examined whether the valence of the implication of the experience for self (the resolution) explained additional variance and interacted with memory specificity. For Study 1 (N = 320, M = 16.9 years, 81% female), a specific (rather than a non-specific) turning point predicted greater depressive symptoms concurrently but not longitudinally, whereas a negative resolution predicted both concurrent and longitudinal depressive symptoms. The moderation result showed that a specific turning point predicted escalating depressive symptoms across six months when the resolution was negative. Study 2 (N = 68) additionally showed that a specific turning point predicted increased depressive symptoms three years later. These findings contrast with research suggesting that specific memories are related to better mental health and highlight the complexity of the role of memory in emerging youth depression.

The present study examined cognitive mechanisms underpinning the increased tendency of individuals with high trait anxiety to experience inflation of negative affect when approaching potential stressors. Specifically, the roles of (1) disproportionately negative relative to positive expectancies (i.e., negative expectancy bias) and (2) disproportionately interrogating negative relative to positive information (i.e., negative interrogation bias), each concerning the potential stressor, were examined. High and low trait anxiety participants (N = 286) completed the experimental session, in which they were informed they may view a potentially stressful film. As participants approached the putative film viewing, participants' negative and positive affect, as well as their negative and positive expectancies were assessed. Additionally, negative interrogation bias was assessed by providing participants the opportunity to selectively interrogate information from a larger pool of negative and positive information concerning the putative film viewing. Our findings provide evidence indirect associations between trait anxiety and inflation of negative affect is serially mediated via negative interrogation bias and, in turn, negative expectancy bias. Findings are discussed with regards to limitations and potential implications for public health campaigns, and cognitive interventions for anxiety, highlighting the utility of further examining negative interrogation bias as an avenue for improving the efficacy of each.

Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners.

Evidence supports a causal role of insomnia in the development and maintenance of depression, yet mechanisms underlying this association in young people are not well established. Attention biases have been implicated separately in the sleep and depression fields and represents an important candidate mechanism. Poor sleep may lead to a negative attention bias (characteristic of depression) by impacting attentional control. This study assessed the hypothesis that attentional control and negative attention bias would sequentially mediate the relationship between insomnia and depressive symptoms in an unselected sample of young people (17–24 years). Concerns have been raised regarding the psychometric properties of tasks used to measure attention bias, and a Dual-Probe Task is emerging as a more reliable measure. Participants (N = 275, Male = 59, M_age = 19.40) completed the Dual-Probe Task, a behavioural measure of attentional control, and self-report measures of insomnia and depression. Participants completed a one-week sleep diary. Results were consistent with negative attention bias, but not attentional control, as a mechanism which partially accounts for the relationship between sleep (i.e., insomnia severity, sleep duration, sleep efficiency, sleep latency) and depression. This study highlights sleep and negative attention bias as potentially modifiable risk factors to reduce depressive symptoms in young people.

Trichotillomania (TTM) is associated with impairments in response inhibition and cognitive flexibility, but it is unclear how such impairments relate to treatment outcome. The present study examined pre-treatment response inhibition and cognitive flexibility as predictors of treatment outcome, change in these domains from pre-to post-treatment, and associations with TTM severity. Participants were drawn from a randomized controlled trial comparing acceptance-enhanced behavior therapy (AEBT) to psychoeducation and supportive therapy (PST) for TTM. Adults completed assessments at pre-treatment (n = 88) and following 12 weeks of treatment (n = 68). Response inhibition and cognitive flexibility were assessed using the Stop Signal Task and Object Alternation Task, respectively. Participants completed the MGH-Hairpulling Scale. Independent evaluators administered the NIMH-Trichotillomania Severity Scale and Clinical Global Impressions-Improvement Scale. Higher pre-treatment TTM severity was associated with poorer pre-treatment cognitive flexibility, but not response inhibition. Better pre-treatment response inhibition performance predicted positive treatment response and lower post-treatment TTM symptom severity, irrespective of treatment assignment. Cognitive flexibility did not predict treatment response. After controlling for age, neither neurocognitive variable changed during treatment. Response inhibition and cognitive flexibility appear uniquely related to hair pulling severity and treatment response in adults with TTM. Implications for treatment delivery and development are discussed.

Stressful life events (SLEs) are tightly coupled with the emergence of anxiety and depression symptoms among adolescents, but the mechanisms underlying this relationship remain poorly understood. We investigated within-person fluctuations in emotion regulation as a mechanism linking SLEs and internalizing psychopathology in an intensive longitudinal study. We examined how monthly fluctuations in SLEs were related to engagement in three emotion regulation strategies—acceptance, reappraisal, and rumination—and whether these strategies were associated with changes in internalizing symptoms in adolescents followed for one year (N = 30; n = 355 monthly observations). Bayesian hierarchical models revealed that on months when adolescents experienced more SLEs than was typical for them, they also engaged in more rumination, which, in turn, was associated with higher anxiety and depression symptoms and mediated the prospective relationship between SLEs and internalizing symptoms. In contrast, greater use of acceptance and reappraisal selectively moderated the association between stressors and internalizing symptoms, resulting in stronger links between SLEs and symptoms. These results suggest that emotion regulation strategies play different roles in the stress-psychopathology relationship. Understanding how changes in emotion regulation contribute to increases in internalizing symptoms following experiences of stress may provide novel targets for interventions aimed at reducing stress-related psychopathology.