Clinical Psychological Science最新文献

Online self-guided single-session interventions (SSIs), which provide a complete mental health intervention in one brief experience, promise to increase global access to evidence-based support. One way to expand current SSIs' reach is to shorten them, but doing so could also compromise their effectiveness. We conducted two randomized trials to test if shortening evidence-based SSIs reduces their efficacy among adult online workers facing mental health struggles. In study 1 (n = 262), the 8-minute "Overcoming Loneliness" SSI reduced loneliness over eight weeks more than a 23-minute version of it (b = 2.64; d = 0.22; 95% CI 0.02, 0.41; p = .03). In study 2 (n = 1,145), 15-minute, 9-minute, 5-minute, and 3-minute versions of the "Action Brings Change" SSI did not significantly differ in how much they affected depression eight weeks later (ps > .14). Our results suggest that longer digital SSIs are not necessarily more helpful than shorter ones.

Social cognition is an important mechanism linking trauma to psychopathology; however, current models fail to explain individual differences in social cognition after trauma exposure. We investigated whether the interpersonal nature of trauma exposure helps to explain variability in social cognitive outcomes. Our sample was derived from the AURORA study, a national initiative involving intensive follow-up of trauma survivors for one year. We analyzed data from 2241 participants (M_age = 35.12, 64% female, 54% Black) who experienced an assault (n = 262) or a motor vehicle collision (n = 1979). Social cognition was assessed with the Multiracial Emotion Identification Task and the Belmont Emotion Sensitivity Test. Overall emotion identification accuracy declined over time among participants who experienced interpersonal trauma (β = -.10, p = .03), but not non-interpersonal trauma (β = .00, p = .83). These results may help to enhance the prediction of psychopathological outcomes following trauma exposure.

Current classification systems of psychopathology focus on cross-sectional symptomatology rather than continuity, discontinuity and comorbidity across development. Here, a community sample of 600 youth was assessed every 3 years from early childhood through late adolescence using semi-structured diagnostic interviews. We used longitudinal k-means clustering of joint-diagnostic trajectories to identify 6 distinct clusters (healthy, childhood anxiety, childhood/adolescent ADHD, adolescent depression/anxiety, adolescent depression/substance use, and early childhood disruptive behavior). When comparing psychopathology clusters to the healthy cluster on age 3 predictors (parental education and psychopathology, early environment, temperament, cognitive and social functioning) and age 18 functional outcomes, the clusters captured developmental patterning of psychopathology not apparent in cross-sectional nosology. The study serves as a proof of principle in applying a longitudinal clustering approach to common mental disorders, affording a rich perspective on the unfolding of sequential comorbidity and heterotypic continuity and identifying transdiagnostic subgroups with meaningful clinical, family, and temperamental correlates.

Some studies suggest a rise in anxiety prevalence and severity over the past decade, particularly among emerging adults, while others report stable rates. This preregistered study examines trends in anxiety symptom severity and explicit (self-reported) and implicit (using the Brief Implicit Association Test) associations about the self as anxious vs. calm. Using continuous cross-sectional data from 99,973 U.S. adults who visited the Project Implicit Health website between 2011-2022, we compared trends in anxiety outcomes between emerging adults (age 18-25) and adults age 26+, including during the COVID-19 pandemic. Contrary to hypotheses, average anxiety severity and strength of implicit/explicit self-as-anxious associations did not spike at the start of the pandemic, and rates of change did not significantly differ by age from 2011-2020, except for explicit, non-relative self-as-anxious ratings. Instead, anxiety mostly remained stable, with emerging adults exhibiting consistently higher anxiety symptom severity and stronger implicit/explicit self-as-anxious associations than adults age 26+.

Making causal statements regarding dose-response in treatments for posttraumatic stress disorder (PTSD) and alcohol/other drug use disorders (AODs; PTSD+AOD) is difficult because (a) dosage is rarely randomized and (b) self-selected dosage can be affected by treatment assignment. In the present study, we sought to clarify causal inferences regarding treatment-by-dosage interactions in PTSD+AOD treatment using Project Harmony, an individual-patient meta-analytic data set of behavioral, pharmacological, and combination PTSD+AOD treatments (k = 36; N = 4,046). Using propensity score weighting and moderated multilevel "net treatment difference" modeling, trauma-focused (TF) treatments, whether integrated or nonintegrated with AOD treatment, outperformed treatment as usual by greater margins on reductions in PTSD and alcohol use as dosage increased. Furthermore, appropriately treating dosage as a posttreatment covariate and moderator revealed effects for TF treatments on drug use that had not been detected in previous studies. Implications for approaches to increasing TF-treatment attendance and greater use of causal-inference methodologies with dose-response analyses are discussed.

Brain structural alterations have been associated with internalizing symptoms concurrently. Less is known about whether these alterations relate to change in internalizing psychopathology during adolescence, a sensitive period for the effects of stress on neurodevelopment and internalizing symptoms. We examined whether cortical thickness (CT) was prospectively related to change in an internalizing factor in 203 adolescents (aged 14-17) with depression and/or anxiety diagnoses or no diagnosis from the Boston Adolescent Neuroimaging of Depression and Anxiety study. We conducted residualized change regression models to determine whether baseline CT was associated with one-year change in internalizing factor scores, and whether chronic stress exposure moderated these relations. Lower bilateral temporal pole and left insula CT were associated with one-year increases in internalizing factor scores and were moderated by chronic stress. These novel results identify specific cortical structure features that might contribute to worsening depression and anxiety, particularly in adolescents with high chronic stress.

In this meta-analysis, we synthesized existing research on perseverative negative thinking, self-control, and executive functioning to better define their etiologic role in symptoms of depression and anxiety. After a review of leading models of perseverative negative thinking, self-control, executive functioning, and depressive and anxious symptoms, the relevant associations were meta-analyzed as reported in cross-sectional and longitudinal studies. A total of 223 studies met the inclusion criteria, providing 239 independent samples (28 of which provided longitudinal data), N = 50,987. According to both longitudinal and cross-sectional path analyses, self-control deficits predict depression and anxiety symptoms, and these symptoms then predict perseverative negative thinking. In the present research synthesis, we identified evidence that reduced self-control predicts increases in depressive and anxious symptoms, which, in turn, lead to perseverative negative thinking. All in all, this finding suggests an opportunity to treat depression and anxiety through training of self-control and emotional-regulation strategies.

Emotion-related impulsivity (ERI) shows robust longitudinal associations with psychiatric disorders, aggression, and suicidality, yet a parsimonious account of its neurocognitive correlates has not been offered. We connect ERI with the Glutamate Amplifies Noradrenergic Effects (GANE) model, a framework describing how norepinephrine tunes "hotspots" of brain activation during heightened physiological arousal. First, we systematically reviewed studies of ERI and task-based functional MRI. Meta-analysis of significant effects yielded one cluster in right inferior frontal gyrus. 26 of 30 significant effects systematically co-localized in neuroanatomical "hotspots" in each corresponding task, in line with GANE. Second, adults recruited for a range of psychopathology (n = 120) completed a reward/punishment Go No-Go task while undergoing functional MRI. ERI correlated with stronger nucleus accumbens activation for a model sensitive to heightened trial reward and in anterior cingulate for models sensitive to heightened trial arousal. Findings provide empirical support for the relevance of GANE "hotspot" mechanisms to ERI.

The ability to make valid conclusions in psychological science rests upon rigorous measure development. People with lived experience of psychological disorders can make invaluable contributions to the measure development process, but they are often excluded from this process by researchers. When people with lived experience are included, their contributions are limited to consultation early in the process. This review advocates for shared decision-making with people with lived experience throughout the measure development process. We provide an overview of the phases and steps involved in the development of self-report measures, highlighting the critical contributions of people with lived experience at each step. Next, guided by the continuum of community engagement in research, we review studies from the psychological science literature that embrace community-engaged measure development approaches inclusive of people with lived experience of psychological disorders. We conclude with a discussion of opportunities and challenges to community-engaged measure development in psychological science.