Sexual- and gender-minority (SGM) individuals are diagnosed with borderline personality disorder (BPD) more than cisgender heterosexuals. Using a large sample of mental-health practitioners in the United States and Canada ( N = 426), we examined bias in the diagnosis of BPD. Mental-health practitioners were randomly assigned to receive one of three clinical vignettes (cisgender heterosexual man, cisgender gay man, or transgender woman) and asked to provide psychiatric diagnoses based on the vignette. Mental-health practitioners demonstrated a predilection to diagnose BPD when presented with the transgender vignette (odds ratio [ OR] = 1.99, p = .01) but not the cisgender-gay vignette ( OR = 1.34, p = .29) compared with practitioners presented the cisgender-heterosexual vignette. Psychiatrists, mental-health counselors, and clinical social workers were significantly more inclined to diagnose BPD than psychologists, although reasons for underdiagnosis differed across groups. These findings bear important implications for future training given the nature of the mental-health workforce in the United States.
{"title":"Bias in the Diagnosis of Borderline Personality Disorder Among Sexual- and Gender-Minority Persons: Results From a Vignette-Based Experiment","authors":"Craig Rodriguez-Seijas, Marley Warren, Preetam Vupputuri, Skylar Hawthorne","doi":"10.1177/21677026241267954","DOIUrl":"https://doi.org/10.1177/21677026241267954","url":null,"abstract":"Sexual- and gender-minority (SGM) individuals are diagnosed with borderline personality disorder (BPD) more than cisgender heterosexuals. Using a large sample of mental-health practitioners in the United States and Canada ( N = 426), we examined bias in the diagnosis of BPD. Mental-health practitioners were randomly assigned to receive one of three clinical vignettes (cisgender heterosexual man, cisgender gay man, or transgender woman) and asked to provide psychiatric diagnoses based on the vignette. Mental-health practitioners demonstrated a predilection to diagnose BPD when presented with the transgender vignette (odds ratio [ OR] = 1.99, p = .01) but not the cisgender-gay vignette ( OR = 1.34, p = .29) compared with practitioners presented the cisgender-heterosexual vignette. Psychiatrists, mental-health counselors, and clinical social workers were significantly more inclined to diagnose BPD than psychologists, although reasons for underdiagnosis differed across groups. These findings bear important implications for future training given the nature of the mental-health workforce in the United States.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/21677026241267945
Sara Scheveneels, Iris Engelhard, Katharina Meyerbröker
Although research on virtual-reality (VR) exposure therapy (VRET) in anxiety disorders has primarily focused on effectiveness and acceptability, the underlying working mechanisms have received scant attention. To fill this knowledge gap, we discuss potential theoretical underpinnings of VRET based on three dominant theoretical accounts on exposure: inhibitory-learning theory (expectancy violation), emotional-processing theory (habituation), and self-efficacy theory. Whereas theoretically speaking, habituation and self-efficacy seem plausible candidate mechanisms to explain the effects of VRET, the role of expectancy violation is less straightforward. Because of the simulated nature of VR, some feared outcomes cannot occur, and therefore, possibilities to violate expectancies about their occurrence may be compromised. Empirical evidence on the working mechanisms of VRET is scarce and has important limitations. Avenues for future research are provided. Insights into the mechanisms of VRET not only are of theoretical importance but also can provide theory-based directions to optimize the application of VRET.
{"title":"Opening the Black Box: The Underlying Working Mechanisms in Virtual-Reality Exposure Therapy for Anxiety Disorders","authors":"Sara Scheveneels, Iris Engelhard, Katharina Meyerbröker","doi":"10.1177/21677026241267945","DOIUrl":"https://doi.org/10.1177/21677026241267945","url":null,"abstract":"Although research on virtual-reality (VR) exposure therapy (VRET) in anxiety disorders has primarily focused on effectiveness and acceptability, the underlying working mechanisms have received scant attention. To fill this knowledge gap, we discuss potential theoretical underpinnings of VRET based on three dominant theoretical accounts on exposure: inhibitory-learning theory (expectancy violation), emotional-processing theory (habituation), and self-efficacy theory. Whereas theoretically speaking, habituation and self-efficacy seem plausible candidate mechanisms to explain the effects of VRET, the role of expectancy violation is less straightforward. Because of the simulated nature of VR, some feared outcomes cannot occur, and therefore, possibilities to violate expectancies about their occurrence may be compromised. Empirical evidence on the working mechanisms of VRET is scarce and has important limitations. Avenues for future research are provided. Insights into the mechanisms of VRET not only are of theoretical importance but also can provide theory-based directions to optimize the application of VRET.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/21677026241267996
Sarah E. Racine, Vittoria Trolio, Alexia E. Miller, Adrienne Mehak, Ege Bicaker, Samantha Wilson, Stephen D. Benning
Negative urgency (i.e., the tendency to act impulsively when experiencing negative affect) is robustly associated with psychopathology, but the mechanisms underlying negative urgency and its relation to mental health are not well understood. In addition to interfering with cognitive control, negative emotions may lead to impulsive behavior by enhancing reward processing of desired stimuli. In this study, we tested an emotion-enhanced reward-processing model of negative urgency in 153 women who spanned the spectrum of binge-eating severity. Participants completed two experimental tasks under both stressful- and relaxed-mood conditions while physiological, behavioral, and self-report indices of reward processing of palatable food were assessed. Contrary to hypotheses, reward processing of food was not heightened when stressed versus relaxed either in the full sample or in participants with greater negative urgency or binge-eating frequency/severity. Findings are discussed considering study limitations and previous mechanistic work on negative urgency.
{"title":"Testing a Reward-Processing Model of Negative Urgency in Women With and Without Binge Eating","authors":"Sarah E. Racine, Vittoria Trolio, Alexia E. Miller, Adrienne Mehak, Ege Bicaker, Samantha Wilson, Stephen D. Benning","doi":"10.1177/21677026241267996","DOIUrl":"https://doi.org/10.1177/21677026241267996","url":null,"abstract":"Negative urgency (i.e., the tendency to act impulsively when experiencing negative affect) is robustly associated with psychopathology, but the mechanisms underlying negative urgency and its relation to mental health are not well understood. In addition to interfering with cognitive control, negative emotions may lead to impulsive behavior by enhancing reward processing of desired stimuli. In this study, we tested an emotion-enhanced reward-processing model of negative urgency in 153 women who spanned the spectrum of binge-eating severity. Participants completed two experimental tasks under both stressful- and relaxed-mood conditions while physiological, behavioral, and self-report indices of reward processing of palatable food were assessed. Contrary to hypotheses, reward processing of food was not heightened when stressed versus relaxed either in the full sample or in participants with greater negative urgency or binge-eating frequency/severity. Findings are discussed considering study limitations and previous mechanistic work on negative urgency.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1177/21677026241266580
Olutosin Adesogan, Justin A. Lavner, Sierra E. Carter, Steven R. H. Beach
Black Americans have demonstrated significant resilience in the face of stress caused by systemic oppression. This resilience is likely to stem from several factors across socioecological levels, including those internal to the individual (assets) and those external to the individual (resources), but existing work has yet to consider these within an integrated framework. To address this gap, in the current study, we used longitudinal data from 692 Black adults living in the rural southeastern United States to examine the univariate and multivariate effects of individual (religiosity and spirituality), relational (romantic partner support, general social support), and community (neighborhood support) factors on trajectories of depressive symptoms, sleep problems, and general health. Findings revealed univariate and multivariate effects on health, providing evidence of additive benefits from these assets and resources. Greater consideration of strengths and supports across socioecological systems may help inform enhanced preventive interventions for and promote health equity among Black Americans.
{"title":"Additive Benefits of Individual, Relational, and Community Factors on Physical- and Mental-Health Trajectories Among Black Americans","authors":"Olutosin Adesogan, Justin A. Lavner, Sierra E. Carter, Steven R. H. Beach","doi":"10.1177/21677026241266580","DOIUrl":"https://doi.org/10.1177/21677026241266580","url":null,"abstract":"Black Americans have demonstrated significant resilience in the face of stress caused by systemic oppression. This resilience is likely to stem from several factors across socioecological levels, including those internal to the individual (assets) and those external to the individual (resources), but existing work has yet to consider these within an integrated framework. To address this gap, in the current study, we used longitudinal data from 692 Black adults living in the rural southeastern United States to examine the univariate and multivariate effects of individual (religiosity and spirituality), relational (romantic partner support, general social support), and community (neighborhood support) factors on trajectories of depressive symptoms, sleep problems, and general health. Findings revealed univariate and multivariate effects on health, providing evidence of additive benefits from these assets and resources. Greater consideration of strengths and supports across socioecological systems may help inform enhanced preventive interventions for and promote health equity among Black Americans.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1177/21677026241266567
Simon B. Goldberg, Ashley D. Kendall, Matthew J. Hirshberg, Cortland J. Dahl, Inbal Nahum-Shani, Richard J. Davidson, Bethany C. Bray
Despite growing popularity, associations between dosage and outcomes in meditation-app interventions have not been established. We examined this relationship using a range of operationalizations of dosage (e.g., minutes of use, days of use, number and type of activities completed) and strategies for modeling outcomes (e.g., ordinary least squares regression, multilevel modeling, latent class analysis). We used data from a recently completed randomized controlled trial that tested a meditation app ( N = 662; 80.4% with elevated depression/anxiety) that included psychological distress as its preregistered primary outcome. Across 41 models, whether an association was detected and the shape and direction of this association varied. Although several models indicated that higher dosage was associated with larger decreases in psychological distress, many models failed to show this relationship, and some even showed the opposite. These results may have implications for optimizing and studying dosage in meditation apps and for open-science practices.
{"title":"Is Dosage of a Meditation App Associated With Changes in Psychological Distress? It Depends on How You Ask","authors":"Simon B. Goldberg, Ashley D. Kendall, Matthew J. Hirshberg, Cortland J. Dahl, Inbal Nahum-Shani, Richard J. Davidson, Bethany C. Bray","doi":"10.1177/21677026241266567","DOIUrl":"https://doi.org/10.1177/21677026241266567","url":null,"abstract":"Despite growing popularity, associations between dosage and outcomes in meditation-app interventions have not been established. We examined this relationship using a range of operationalizations of dosage (e.g., minutes of use, days of use, number and type of activities completed) and strategies for modeling outcomes (e.g., ordinary least squares regression, multilevel modeling, latent class analysis). We used data from a recently completed randomized controlled trial that tested a meditation app ( N = 662; 80.4% with elevated depression/anxiety) that included psychological distress as its preregistered primary outcome. Across 41 models, whether an association was detected and the shape and direction of this association varied. Although several models indicated that higher dosage was associated with larger decreases in psychological distress, many models failed to show this relationship, and some even showed the opposite. These results may have implications for optimizing and studying dosage in meditation apps and for open-science practices.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1177/21677026241263330
Galen P. Cassidy, Mikael Rubin, Santiago Papini, Michael J. Telch
The network theory of psychopathology is gaining popularity as a conceptualization of psychological disorders that may aid the identification of mechanisms of therapeutic change. However, many existing networks do not consider other relevant variables beyond the symptoms themselves. We present a large-scale ( n = 1,873), longitudinal Bayesian network analysis of panic disorder using the symptom items from the Panic Disorder Severity Scale (PDSS) and two respiratory biomarkers (respiration rate and end-tidal CO2) collected during routine monitoring of a capnometry-guided respiratory intervention (CGRI). Our findings offer support for avoidance and fear of panic as drivers of subsequent panic-disorder symptoms over the 4-week course of treatment. Moreover, respiration rate but not end-tidal CO2 was associated with downstream PDSS symptoms. These findings provide further evidence supporting the role of respiratory biomarkers in the maintenance of panic disorder and some support for normalization of dysfunctional breathing as one therapeutic mechanism governing CGRI.
{"title":"A Bayesian Longitudinal Network Analysis of Panic-Disorder Symptoms and Respiratory Biomarkers","authors":"Galen P. Cassidy, Mikael Rubin, Santiago Papini, Michael J. Telch","doi":"10.1177/21677026241263330","DOIUrl":"https://doi.org/10.1177/21677026241263330","url":null,"abstract":"The network theory of psychopathology is gaining popularity as a conceptualization of psychological disorders that may aid the identification of mechanisms of therapeutic change. However, many existing networks do not consider other relevant variables beyond the symptoms themselves. We present a large-scale ( n = 1,873), longitudinal Bayesian network analysis of panic disorder using the symptom items from the Panic Disorder Severity Scale (PDSS) and two respiratory biomarkers (respiration rate and end-tidal CO<jats:sub>2</jats:sub>) collected during routine monitoring of a capnometry-guided respiratory intervention (CGRI). Our findings offer support for avoidance and fear of panic as drivers of subsequent panic-disorder symptoms over the 4-week course of treatment. Moreover, respiration rate but not end-tidal CO<jats:sub>2</jats:sub> was associated with downstream PDSS symptoms. These findings provide further evidence supporting the role of respiratory biomarkers in the maintenance of panic disorder and some support for normalization of dysfunctional breathing as one therapeutic mechanism governing CGRI.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1177/21677026241263522
Maev Conneely, Domenico Giacco, Lauren M. Hickling, Stefan Priebe, Janelle M. Jones
Having more social connections is related to better quality of life in people with psychosis. However, little is known about the nature of these social connections or whether the personal significance of social connections matters for quality of life. We aimed to fill this gap by surveying 200 people with psychosis using social identity mapping (SIM), which allows people to name their groups, roles, and relationships and how they feel about these. SIM names were categorized into 10 groups, with “activities” (39%) and “family” (14%) being most common; “patient” (3%), “politics” (2%), and “local residence” (1%) were least common. Hierarchical regression revealed that the only variable associated with better quality of life was having a greater number of highly important connections. This was mediated by self-esteem. Clinicians and researchers should examine the potential of social identification, the internalization of social connections, as a means of improving quality of life.
{"title":"Social Identity Mapping and Psychotic Disorders: Understanding the Relationships Between Social Identity Features, Self-Esteem, and Quality of Life","authors":"Maev Conneely, Domenico Giacco, Lauren M. Hickling, Stefan Priebe, Janelle M. Jones","doi":"10.1177/21677026241263522","DOIUrl":"https://doi.org/10.1177/21677026241263522","url":null,"abstract":"Having more social connections is related to better quality of life in people with psychosis. However, little is known about the nature of these social connections or whether the personal significance of social connections matters for quality of life. We aimed to fill this gap by surveying 200 people with psychosis using social identity mapping (SIM), which allows people to name their groups, roles, and relationships and how they feel about these. SIM names were categorized into 10 groups, with “activities” (39%) and “family” (14%) being most common; “patient” (3%), “politics” (2%), and “local residence” (1%) were least common. Hierarchical regression revealed that the only variable associated with better quality of life was having a greater number of highly important connections. This was mediated by self-esteem. Clinicians and researchers should examine the potential of social identification, the internalization of social connections, as a means of improving quality of life.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-24DOI: 10.1177/21677026241260260
Peter T. Tanksley, Sarah J. Brislin, Jasmin Wertz, Ronald de Vlaming, Natasia S. Courchesne-Krak, Travis T. Mallard, Laurel L. Raffington, Richard Karlsson Linnér, Philipp Koellinger, Abraham A. Palmer, Sandra Sanchez-Roige, Irwin D. Waldman, Danielle Dick, Terrie E. Moffitt, Avshalom Caspi, K. Paige Harden
Failures of self-control can manifest as externalizing behaviors (e.g., aggression, rule-breaking) that have far-reaching negative consequences. Researchers have long been interested in measuring children’s genetic risk for externalizing behaviors to inform efforts at early identification and intervention. Drawing on data from the Environmental Risk Longitudinal Twin Study ( N = 862 twins) and the Millennium Cohort Study ( N = 2,824 parent–child trios), two longitudinal cohorts from the United Kingdom, we leveraged molecular genetic data and within-family designs to test for genetic associations with externalizing behavior that are not affected by common sources of environmental influence. We found that a polygenic index (PGI) calculated from genetic variants discovered in previous studies of self-controlled behavior in adults captures direct genetic effects on externalizing problems in children and adolescents when evaluated with rigorous within-family designs (βs = 0.13–0.19 across development). The PGI for externalizing behavior can usefully augment psychological studies of the development of self-control.
{"title":"Do Polygenic Indices Capture “Direct” Effects on Child Externalizing Behavior Problems? Within-Family Analyses in Two Longitudinal Birth Cohorts","authors":"Peter T. Tanksley, Sarah J. Brislin, Jasmin Wertz, Ronald de Vlaming, Natasia S. Courchesne-Krak, Travis T. Mallard, Laurel L. Raffington, Richard Karlsson Linnér, Philipp Koellinger, Abraham A. Palmer, Sandra Sanchez-Roige, Irwin D. Waldman, Danielle Dick, Terrie E. Moffitt, Avshalom Caspi, K. Paige Harden","doi":"10.1177/21677026241260260","DOIUrl":"https://doi.org/10.1177/21677026241260260","url":null,"abstract":"Failures of self-control can manifest as externalizing behaviors (e.g., aggression, rule-breaking) that have far-reaching negative consequences. Researchers have long been interested in measuring children’s genetic risk for externalizing behaviors to inform efforts at early identification and intervention. Drawing on data from the Environmental Risk Longitudinal Twin Study ( N = 862 twins) and the Millennium Cohort Study ( N = 2,824 parent–child trios), two longitudinal cohorts from the United Kingdom, we leveraged molecular genetic data and within-family designs to test for genetic associations with externalizing behavior that are not affected by common sources of environmental influence. We found that a polygenic index (PGI) calculated from genetic variants discovered in previous studies of self-controlled behavior in adults captures direct genetic effects on externalizing problems in children and adolescents when evaluated with rigorous within-family designs (βs = 0.13–0.19 across development). The PGI for externalizing behavior can usefully augment psychological studies of the development of self-control.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-24DOI: 10.1177/21677026241260249
Lara Khalifeh, Avshalom Caspi, Kallisse R. Dent, HonaLee Harrington, Madeline H. Meier, Richie Poulton, Sandhya Ramrakha, Terrie E. Moffitt, Leah S. Richmond-Rakerd
We evaluated the developmental epidemiology of midlife-onset alcohol dependence (AD) in the Dunedin Study ( N = 1,037), a population-representative cohort followed across 5 decades. At ages 18, 21, 26, 32, 38, and 45, past-year AD prevalence was 11.0%, 18.4%, 13.6%, 8.1%, 9.6%, and 11.3%, respectively. As expected, relative to never-diagnosed individuals, individuals with early onset AD (first diagnosis at age 18 or age 21, prevalence = 22.9%) were distinguished by a range of early life and adult correlates. Individuals with midlife-onset AD (first diagnosis at age 38 or age 45, prevalence = 5.6%) were distinguished by fewer early life correlates, but exhibited a family history of AD and adolescent dysregulation and marijuana use. They were characterized by an array of adult correlates, including internalizing disorders, mental-health-treatment contact, criminal behavior, perceived stress, coping by drinking, lower likelihood of marriage and parenthood, and reduced preparedness for old age. They also experienced more adult alcohol-related impairment than the early onset group. Results can guide efforts to reduce midlife alcohol-related problems and support healthy aging.
{"title":"Characterizing Midlife-Onset Alcohol Dependence: Implications for Etiology, Prevention, and Healthy Aging","authors":"Lara Khalifeh, Avshalom Caspi, Kallisse R. Dent, HonaLee Harrington, Madeline H. Meier, Richie Poulton, Sandhya Ramrakha, Terrie E. Moffitt, Leah S. Richmond-Rakerd","doi":"10.1177/21677026241260249","DOIUrl":"https://doi.org/10.1177/21677026241260249","url":null,"abstract":"We evaluated the developmental epidemiology of midlife-onset alcohol dependence (AD) in the Dunedin Study ( N = 1,037), a population-representative cohort followed across 5 decades. At ages 18, 21, 26, 32, 38, and 45, past-year AD prevalence was 11.0%, 18.4%, 13.6%, 8.1%, 9.6%, and 11.3%, respectively. As expected, relative to never-diagnosed individuals, individuals with early onset AD (first diagnosis at age 18 or age 21, prevalence = 22.9%) were distinguished by a range of early life and adult correlates. Individuals with midlife-onset AD (first diagnosis at age 38 or age 45, prevalence = 5.6%) were distinguished by fewer early life correlates, but exhibited a family history of AD and adolescent dysregulation and marijuana use. They were characterized by an array of adult correlates, including internalizing disorders, mental-health-treatment contact, criminal behavior, perceived stress, coping by drinking, lower likelihood of marriage and parenthood, and reduced preparedness for old age. They also experienced more adult alcohol-related impairment than the early onset group. Results can guide efforts to reduce midlife alcohol-related problems and support healthy aging.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1177/21677026241257852
Miriam K. Forbes, Ashley L. Watts, Maddison Twose, Angelique Barrett, Jennifer L. Hudson, Heidi J. Lyneham, Lauren McLellan, Nicola C. Newton, Gemma Sicouri, Cath Chapman, Anna McKinnon, Ronald M. Rapee, Tim Slade, Maree Teesson, Kristian Markon, Matthew Sunderland
More comprehensive modeling of psychopathology in youth is needed to facilitate a developmentally informed expansion of the Hierarchical Taxonomy of Psychopathology (HiTOP) model. In this study, we examined a symptom-level model of the structure of psychopathology in children and adolescents—most aged 11 to 17 years—bringing together data from large clinical, community, and representative samples ( N = 18,290) covering nearly all major forms of mental disorders and related content domains (e.g., aggression). The resulting hierarchical and dimensional model was based on the points of convergence among three statistical approaches and included 15 narrow dimensions nested under four broad dimensions of (a) internalizing, (b) externalizing, (c) eating pathology, and (d) uncontrollable worry, obsessions, and compulsions. We position these findings within the context of the existing literature and articulate implications for future research. Ultimately, these findings add to the rapidly growing literature on the structure of psychopathology in youth and move a step closer toward quantifying (dis)continuities in psychopathology’s structure across the life span.
{"title":"A Hierarchical Model of the Symptom-Level Structure of Psychopathology in Youth","authors":"Miriam K. Forbes, Ashley L. Watts, Maddison Twose, Angelique Barrett, Jennifer L. Hudson, Heidi J. Lyneham, Lauren McLellan, Nicola C. Newton, Gemma Sicouri, Cath Chapman, Anna McKinnon, Ronald M. Rapee, Tim Slade, Maree Teesson, Kristian Markon, Matthew Sunderland","doi":"10.1177/21677026241257852","DOIUrl":"https://doi.org/10.1177/21677026241257852","url":null,"abstract":"More comprehensive modeling of psychopathology in youth is needed to facilitate a developmentally informed expansion of the Hierarchical Taxonomy of Psychopathology (HiTOP) model. In this study, we examined a symptom-level model of the structure of psychopathology in children and adolescents—most aged 11 to 17 years—bringing together data from large clinical, community, and representative samples ( N = 18,290) covering nearly all major forms of mental disorders and related content domains (e.g., aggression). The resulting hierarchical and dimensional model was based on the points of convergence among three statistical approaches and included 15 narrow dimensions nested under four broad dimensions of (a) internalizing, (b) externalizing, (c) eating pathology, and (d) uncontrollable worry, obsessions, and compulsions. We position these findings within the context of the existing literature and articulate implications for future research. Ultimately, these findings add to the rapidly growing literature on the structure of psychopathology in youth and move a step closer toward quantifying (dis)continuities in psychopathology’s structure across the life span.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：