Clinical Psychological Science最新文献

Driven exercise is a transdiagnostic maladaptive behavior, especially common in eating disorders (ED); however, its maintenance mechanisms remain poorly understood. To address this gap, we examined the applicability of previously empirically-derived and validated reinforcement function models in explaining driven exercise maintenance in studies varying across developmental stages and clinical presentations (Study 1: N=279 adolescents/adults oversampled for EDs; Study 2: N=118 adolescent/adult inpatients with severe EDs; Study 3: N=52 adults oversampled for athletes and/or EDs). Results supported the utility of a four-function model (automatic positive/negative reinforcement [APR/ANR; increase/decrease negative affect], social positive/negative reinforcement [SPR/SNR; engage in/avoid interpersonal situations]) in explaining driven exercise. APR was most frequently endorsed, followed by ANR, SNR, and SPR in all studies. APR correlated with last-month driven exercise episodes across studies; associations between other functions and ED psychopathology varied between studies. Further, results suggested a separate control function could be considered in samples with more severe EDs.

Bisexual people report greater mental-health problems (i.e., depression, anxiety, suicidality) compared with their monosexual (i.e., gay or lesbian) peers. Yet existing studies often use nonprobability samples, analyze few psychosocial stressors, and overlook bisexual people's considerable diversity. We analyzed data from a population-based study of sexual-minority young adults in Sweden (N = 748) that assessed identity-related stressors (e.g., family rejection) and general life stressors (e.g., financial loss). Bisexual respondents reported more mental-health problems and general life stressors, but fewer identity-related stressors, than monosexual respondents. Latent class analysis revealed three distinct bisexual subgroups with varying patterns of gender-based sexual attractions, gender of sexual partners, gender conformity, and sexual-identity centrality that were associated with unique patterns of psychosocial stressors and mental health. Findings show that general life stressors play an important role in bisexual people's mental health. Future research is needed, especially on the role these stressors play during critical developmental periods such as young adulthood.

In this study, we reduced the DSM-5 to its constituent symptoms and reorganized them based on patterns of covariation in individuals' (n = 14,762) self-reported experiences of the symptoms to form an empirically derived hierarchical framework of clinical phenomena. Specifically, we used the points of agreement among hierarchical principal components analyses and hierarchical clustering, as well as between the randomly split primary (n = 11,762) and hold-out (n = 3,000) samples, to identify the robust constructs that emerged to form a hierarchy ranging from symptoms and syndromes up to very broad superspectra of psychopathology. The resulting model had noteworthy convergence with the upper levels of the Hierarchical Taxonomy of Psychopathology (HiTOP) framework and substantially expands on HiTOP's current coverage of dissociative, elimination, sleep-wake, trauma-related, neurodevelopmental, and neurocognitive disorder symptoms. We also mapped some exemplar DSM-5 disorders onto our hierarchy; some formed coherent syndromes, whereas others were notably heterogeneous.

Given the substantial symptom overlap between anxiety and depressive disorders, researchers have sought to develop approaches for better differentiating these subdimensions of internalizing psychopathology. Neurophysiological indices of biobehavioral processes specific to either subdimension may provide a means for doing so. Here, we report evidence for opposing associations of a well-established neural indicator of reward responsiveness - the reward positivity (RewP) - with trait indices of depressive and phobic fear pathology. We show that these relationships were strengthened when controlling for their shared variance via regression modeling. Additionally, structural equation modeling revealed that broad negative affectivity (NA) constituted the shared variance between the two trait indices. Our findings point to the potential use of reduced RewP to improve differential diagnosis of depressive versus phobic fear conditions. They also indicate that variance shared between conditions of these types may operate to obscure their observed associations with neural indicators of core processes unique to each.