Pub Date : 2024-04-13DOI: 10.1177/21677026231217316
Cheri A. Levinson, Caroline Christian, Carolyn B. Becker
The research–practice gap refers to the fact that most evidence-based treatments created by researchers are not used in routine clinical care, which affects real-world treatment outcomes negatively. One key reason that evidence-based care is not used more frequently is its nonpersonalized format. For example, most evidence-based treatments are based on averages and are limited in addressing comorbidity, heterogeneity, and the needs of clients with minoritized identities. These limitations reduce therapist uptake of evidence-based treatment at large. As a result, most patients seeking treatment in community settings do not receive evidence-based care, which could more quickly and effectively reduce mental-health suffering. Furthermore, even clinicians who want to engage in evidence-based practice must still rely on their clinical judgment in decision-making when treatments fail to address client-specific needs. This reliance on decision-making can influence outcomes negatively. We propose that idiographic (i.e., one-person; N = 1) methodologies (data analysis of one person’s data) combined with digital mental-health technology could help reduce the research–practice gap and improve treatment outcomes. In this article, we outline the many issues contributing to these problems and how idiographic methods of personalization can address these issues. We provide an overview of idiographic methodologies and examples of how to use these methods to personalize existing evidence-based treatments with patients. Finally, we conclude with recommendations for future research and movement within the field that is needed to propel this type of personalization into routine clinical care to reduce the research–practice gap and improve treatment outcomes broadly.
{"title":"How Idiographic Methodologies Can Move the Clinical-Science Field Forward to Integrate Personalized Treatment Into Everyday Clinical Care and Improve Treatment Outcomes","authors":"Cheri A. Levinson, Caroline Christian, Carolyn B. Becker","doi":"10.1177/21677026231217316","DOIUrl":"https://doi.org/10.1177/21677026231217316","url":null,"abstract":"The research–practice gap refers to the fact that most evidence-based treatments created by researchers are not used in routine clinical care, which affects real-world treatment outcomes negatively. One key reason that evidence-based care is not used more frequently is its nonpersonalized format. For example, most evidence-based treatments are based on averages and are limited in addressing comorbidity, heterogeneity, and the needs of clients with minoritized identities. These limitations reduce therapist uptake of evidence-based treatment at large. As a result, most patients seeking treatment in community settings do not receive evidence-based care, which could more quickly and effectively reduce mental-health suffering. Furthermore, even clinicians who want to engage in evidence-based practice must still rely on their clinical judgment in decision-making when treatments fail to address client-specific needs. This reliance on decision-making can influence outcomes negatively. We propose that idiographic (i.e., one-person; N = 1) methodologies (data analysis of one person’s data) combined with digital mental-health technology could help reduce the research–practice gap and improve treatment outcomes. In this article, we outline the many issues contributing to these problems and how idiographic methods of personalization can address these issues. We provide an overview of idiographic methodologies and examples of how to use these methods to personalize existing evidence-based treatments with patients. Finally, we conclude with recommendations for future research and movement within the field that is needed to propel this type of personalization into routine clinical care to reduce the research–practice gap and improve treatment outcomes broadly.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"48 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140584883","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 : 2024-04-03DOI: 10.1177/21677026241229663
Stefan Westermann, Sven Banisch
Capturing the complexity of interpersonal dynamics—emerging from approach and avoidance motives of two individuals in dyadic interplay—remains challenging. In line with calls for embracing complexity in psychological research using formal modeling, we employed evolutionary game theory to investigate the underlying mechanisms of affiliative interpersonality. We constructed a relational state space that represents the ways of relating available in the momentary state of an interpersonal relationship. Next, we modeled relationships as trajectories in that relational space. Qualitatively different interpersonal dynamics emerged: (a) global stability with only one relational attractor (e.g., pure reciprocal friendliness), (b) bistability with two mutually exclusive attractors (e.g., either pure friendliness or pure distance), and (c) cycles between friendliness and distance in the relational space. The bistable dynamics appear to resemble the phenomenon of interpersonal complementarity (e.g., friendliness invites friendliness). Furthermore, the model generates psychopathologically relevant dynamics (e.g., oscillating, unstable interpersonal relationships in borderline personality disorder).
{"title":"A Formal Model of Affiliative Interpersonality","authors":"Stefan Westermann, Sven Banisch","doi":"10.1177/21677026241229663","DOIUrl":"https://doi.org/10.1177/21677026241229663","url":null,"abstract":"Capturing the complexity of interpersonal dynamics—emerging from approach and avoidance motives of two individuals in dyadic interplay—remains challenging. In line with calls for embracing complexity in psychological research using formal modeling, we employed evolutionary game theory to investigate the underlying mechanisms of affiliative interpersonality. We constructed a relational state space that represents the ways of relating available in the momentary state of an interpersonal relationship. Next, we modeled relationships as trajectories in that relational space. Qualitatively different interpersonal dynamics emerged: (a) global stability with only one relational attractor (e.g., pure reciprocal friendliness), (b) bistability with two mutually exclusive attractors (e.g., either pure friendliness or pure distance), and (c) cycles between friendliness and distance in the relational space. The bistable dynamics appear to resemble the phenomenon of interpersonal complementarity (e.g., friendliness invites friendliness). Furthermore, the model generates psychopathologically relevant dynamics (e.g., oscillating, unstable interpersonal relationships in borderline personality disorder).","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"42 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140584426","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 : 2024-03-13DOI: 10.1177/21677026241233262
Matthew J. Hirshberg, Cortland J. Dahl, Daniel Bolt, Richard J. Davidson, Simon B. Goldberg
Understanding why interventions work is essential to optimizing them. Although mechanistic theories of meditation-based interventions (MBIs) exist, empirical evidence is limited. We randomly assigned 662 adults (79.9% reported clinical levels of anxiety or depressive symptoms) to a 4-week smartphone-based MBI or wait-list control condition early in the COVID-19 pandemic. Psychological distress and four theory-driven preregistered psychological mediators of well-being (mindful action, loneliness, cognitive defusion, and purpose) were assessed five times during the intervention period and at 3-month follow-up. In preregistered analyses, assignment to the intervention predicted significant gains on all mediators, which, in turn, significantly mediated follow-up distress (21.9%–62.5% of intervention effect on distress). No significant mediation pathway was observed in an exploratory multiple mediator analysis, but reduced loneliness accounted for 61.7% of the combined indirect effect. Multiple psychological pathways may mediate reduced distress in a digital MBI.
了解干预措施发挥作用的原因对于优化干预措施至关重要。虽然存在基于冥想的干预（MBI）的机理理论，但经验证据却很有限。在 COVID-19 大流行的早期，我们将 662 名成年人（79.9% 的人报告有临床水平的焦虑或抑郁症状）随机分配到为期 4 周的基于智能手机的 MBI 或等待对照组中。在干预期间和 3 个月的随访中，对心理困扰和四种理论驱动的幸福感心理中介（正念行动、孤独感、认知化解和目的）进行了五次评估。在预先登记的分析中，干预的分配预示着所有中介因子的显著提高，而这些中介因子反过来又对后续的困扰有显著的中介作用（干预对困扰影响的 21.9%-62.5% ）。在探索性的多重中介分析中，没有观察到明显的中介途径，但孤独感的减少占了综合间接效应的61.7%。在数字 MBI 中，多种心理途径都可能对减轻困扰起到中介作用。
{"title":"Psychological Mediators of Reduced Distress: Preregistered Analyses From a Randomized Controlled Trial of a Smartphone-Based Well-Being Training","authors":"Matthew J. Hirshberg, Cortland J. Dahl, Daniel Bolt, Richard J. Davidson, Simon B. Goldberg","doi":"10.1177/21677026241233262","DOIUrl":"https://doi.org/10.1177/21677026241233262","url":null,"abstract":"Understanding why interventions work is essential to optimizing them. Although mechanistic theories of meditation-based interventions (MBIs) exist, empirical evidence is limited. We randomly assigned 662 adults (79.9% reported clinical levels of anxiety or depressive symptoms) to a 4-week smartphone-based MBI or wait-list control condition early in the COVID-19 pandemic. Psychological distress and four theory-driven preregistered psychological mediators of well-being (mindful action, loneliness, cognitive defusion, and purpose) were assessed five times during the intervention period and at 3-month follow-up. In preregistered analyses, assignment to the intervention predicted significant gains on all mediators, which, in turn, significantly mediated follow-up distress (21.9%–62.5% of intervention effect on distress). No significant mediation pathway was observed in an exploratory multiple mediator analysis, but reduced loneliness accounted for 61.7% of the combined indirect effect. Multiple psychological pathways may mediate reduced distress in a digital MBI.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"33 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140124719","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 : 2024-03-13DOI: 10.1177/21677026241230335
Megan E. Mikhail, S. Alexandra Burt, Michael C. Neale, Pamela K. Keel, Debra K. Katzman, Kelly L. Klump
Internalizing (e.g., anxiety, depression) and disordered eating (DE; e.g., binge eating, dietary restraint) are highly comorbid, but the mechanisms underlying their comorbidity remain unknown. This was the first twin study to examine whether their co-occurrence may be driven by genetic and/or environmental influences on emotion regulation (ER; ability to modulate duration/intensity of emotions). Analyses included 688 adult female twins from the Michigan State University Twin Registry. Cholesky decomposition twin models showed that comorbidity between dimensionally modeled internalizing and DE was due to overlapping genetic ( r = .55; 69.3% of shared variance) and nonshared environmental influences ( r = .26; 30.7% of shared variance). When ER was added into the model, all genetic influences shared between internalizing and DE were attributable to ER, suggesting genetic influences on ER are the primary driver of comorbidity between internalizing and DE. Shared genes may shape affective processing, interoceptive sensitivity, or other brain-based processes (e.g., cognitive control) implicated in ER.
{"title":"Comorbidity Between Internalizing Symptoms and Disordered Eating Is Primarily Driven by Genetic Influences on Emotion Regulation in Adult Female Twins","authors":"Megan E. Mikhail, S. Alexandra Burt, Michael C. Neale, Pamela K. Keel, Debra K. Katzman, Kelly L. Klump","doi":"10.1177/21677026241230335","DOIUrl":"https://doi.org/10.1177/21677026241230335","url":null,"abstract":"Internalizing (e.g., anxiety, depression) and disordered eating (DE; e.g., binge eating, dietary restraint) are highly comorbid, but the mechanisms underlying their comorbidity remain unknown. This was the first twin study to examine whether their co-occurrence may be driven by genetic and/or environmental influences on emotion regulation (ER; ability to modulate duration/intensity of emotions). Analyses included 688 adult female twins from the Michigan State University Twin Registry. Cholesky decomposition twin models showed that comorbidity between dimensionally modeled internalizing and DE was due to overlapping genetic ( r = .55; 69.3% of shared variance) and nonshared environmental influences ( r = .26; 30.7% of shared variance). When ER was added into the model, all genetic influences shared between internalizing and DE were attributable to ER, suggesting genetic influences on ER are the primary driver of comorbidity between internalizing and DE. Shared genes may shape affective processing, interoceptive sensitivity, or other brain-based processes (e.g., cognitive control) implicated in ER.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"68 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140124789","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 : 2024-03-13DOI: 10.1177/21677026241230458
Cele Richardson, Natasha R. Magson, Ella Oar, Jasmine Fardouly, Carly Johnco, Justin Freeman, Ron M. Rapee
Sleep problems commonly co-occur alongside generalized and social anxiety, depression, and eating disorders in young people. Yet it is unclear if sleep disturbance conveys risk for these social-emotional disorders across early to middle adolescence and whether repetitive negative thinking (RNT) mediates this association. In this study, we examined longitudinal relationships between sleep (morning/eveningness, school-night sleep duration, and sleepiness), general and presleep RNT, and symptoms of generalized and social anxiety, depression, and eating disorders across 5 years. As part of the wider Risks to Adolescent Wellbeing Project, these constructs were assessed in a cohort of 528 youths over six annual waves of data collection, spanning ages 11 to 16. Cross-lagged panel models that examined direct, indirect, and bidirectional associations showed that worse adolescent sleep predicted increases in symptoms of generalized anxiety, social anxiety, depression, and eating disorders across each wave directly and indirectly through general and presleep RNT. Symptoms of social-emotional disorders did not predict worsening in sleep. Results suggest that sleep disturbance and RNT should be targeted simultaneously in the prevention and treatment of social-emotional disorders in adolescence, although limitations around the use of self-report and nondiagnostic symptom measures are noted.
{"title":"Repetitive Negative Thinking Mediates the Relationship Between Sleep Disturbance and Symptoms of Generalized Anxiety, Social Anxiety, Depression, and Eating Disorders in Adolescence: Findings From a 5-Year Longitudinal Study","authors":"Cele Richardson, Natasha R. Magson, Ella Oar, Jasmine Fardouly, Carly Johnco, Justin Freeman, Ron M. Rapee","doi":"10.1177/21677026241230458","DOIUrl":"https://doi.org/10.1177/21677026241230458","url":null,"abstract":"Sleep problems commonly co-occur alongside generalized and social anxiety, depression, and eating disorders in young people. Yet it is unclear if sleep disturbance conveys risk for these social-emotional disorders across early to middle adolescence and whether repetitive negative thinking (RNT) mediates this association. In this study, we examined longitudinal relationships between sleep (morning/eveningness, school-night sleep duration, and sleepiness), general and presleep RNT, and symptoms of generalized and social anxiety, depression, and eating disorders across 5 years. As part of the wider Risks to Adolescent Wellbeing Project, these constructs were assessed in a cohort of 528 youths over six annual waves of data collection, spanning ages 11 to 16. Cross-lagged panel models that examined direct, indirect, and bidirectional associations showed that worse adolescent sleep predicted increases in symptoms of generalized anxiety, social anxiety, depression, and eating disorders across each wave directly and indirectly through general and presleep RNT. Symptoms of social-emotional disorders did not predict worsening in sleep. Results suggest that sleep disturbance and RNT should be targeted simultaneously in the prevention and treatment of social-emotional disorders in adolescence, although limitations around the use of self-report and nondiagnostic symptom measures are noted.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"15 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140124798","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 : 2024-03-13DOI: 10.1177/21677026241234319
Tyler R. Pritchard, Jennifer L. Buckle, Kristel Thomassin, Stephen P. Lewis
Suicide is a public-health concern that has been linked to multiple biological, psychological, and social risk factors. Rural living is purported to be a unique risk for suicide for myriad reasons. Yet there are some concerns with rural suicidology, notably regarding defining and operationalizing “rural.” Furthermore, the last comprehensive review of rural suicide is approximately 10 years old. With this in mind, in the current review, we offer (a) a comprehensive and updated overview of the operationalization and variability of rural in rural suicidology and (b) a summary of differences in direct and indirect suicide factors between rural and nonrural regions and whether potential differences depend on how rural is operationalized. Results indicate a high degree of heterogeneity in defining rural, rendering conclusions about both direct and indirect rural suicide risks unclear. We therefore present a set of recommendations for rural suicidologists to apply to enhance the understanding of suicide and, ultimately, prevent death by suicide in rural regions.
{"title":"Rural Suicide: A Systematic Review and Recommendations","authors":"Tyler R. Pritchard, Jennifer L. Buckle, Kristel Thomassin, Stephen P. Lewis","doi":"10.1177/21677026241234319","DOIUrl":"https://doi.org/10.1177/21677026241234319","url":null,"abstract":"Suicide is a public-health concern that has been linked to multiple biological, psychological, and social risk factors. Rural living is purported to be a unique risk for suicide for myriad reasons. Yet there are some concerns with rural suicidology, notably regarding defining and operationalizing “rural.” Furthermore, the last comprehensive review of rural suicide is approximately 10 years old. With this in mind, in the current review, we offer (a) a comprehensive and updated overview of the operationalization and variability of rural in rural suicidology and (b) a summary of differences in direct and indirect suicide factors between rural and nonrural regions and whether potential differences depend on how rural is operationalized. Results indicate a high degree of heterogeneity in defining rural, rendering conclusions about both direct and indirect rural suicide risks unclear. We therefore present a set of recommendations for rural suicidologists to apply to enhance the understanding of suicide and, ultimately, prevent death by suicide in rural regions.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"113 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140124788","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 : 2024-03-11DOI: 10.1177/21677026231226312
Juhyun Park, Kristin Naragon-Gainey
Emotion regulation (ER) encompasses multiple, interdependent aspects (e.g., abilities, strategies, goals) whose collective contribution to mental-health outcomes is not well understood. To provide a more holistic picture of ER and better identify individuals who may be more susceptible to maladaptive ER and internalizing psychopathology, we examined latent profiles of positive and negative ER abilities and their associations with other aspects of ER (e.g., strategies, goals, success) and internalizing symptoms among adults cross-sectionally (Study 1) and daily (Study 2). In both studies, profiles characterized by pronounced deficits in positive ER abilities and below-average negative ER abilities were associated with maladaptive ER strategies and internalizing symptoms. Individuals with these profiles were also more likely to want to down-regulate positive emotions and use strategies reflecting disengagement from positive emotions in daily life. These findings provide insight into characteristics of vulnerable individuals, which can help refine current theory of ER and intervention efforts.
{"title":"Positive and Negative Emotion-Regulation Ability Profiles: Links With Strategies, Goals, and Internalizing Symptoms","authors":"Juhyun Park, Kristin Naragon-Gainey","doi":"10.1177/21677026231226312","DOIUrl":"https://doi.org/10.1177/21677026231226312","url":null,"abstract":"Emotion regulation (ER) encompasses multiple, interdependent aspects (e.g., abilities, strategies, goals) whose collective contribution to mental-health outcomes is not well understood. To provide a more holistic picture of ER and better identify individuals who may be more susceptible to maladaptive ER and internalizing psychopathology, we examined latent profiles of positive and negative ER abilities and their associations with other aspects of ER (e.g., strategies, goals, success) and internalizing symptoms among adults cross-sectionally (Study 1) and daily (Study 2). In both studies, profiles characterized by pronounced deficits in positive ER abilities and below-average negative ER abilities were associated with maladaptive ER strategies and internalizing symptoms. Individuals with these profiles were also more likely to want to down-regulate positive emotions and use strategies reflecting disengagement from positive emotions in daily life. These findings provide insight into characteristics of vulnerable individuals, which can help refine current theory of ER and intervention efforts.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"54 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140106262","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 : 2024-03-05DOI: 10.1177/21677026231215341
Michelle J. Zaso, Ian R. Troidl, Jennifer P. Read
Trauma and posttraumatic stress disorder (TR/PTSD) are implicated in deleterious alcohol outcomes, yet the processes that undergird these associations remain elusive. Affective (i.e., emotionally laden) cognitions may play key roles in TR/PTSD-related drinking that could inform prevention and intervention. In the present review, we synthesized extant literature ( k = 58) on affective cognitions and their role in negative- and positive-reinforcement TR/PTSD-related drinking, including alcohol-specific (e.g., drinking motives, alcohol expectancies) and non-alcohol-specific (e.g., emotion-regulation cognitions, perception and attentional biases) cognitions. Findings generally supported the importance of alcohol-specific cognitions in negative-reinforcement drinking more so than positive-reinforcement drinking. Non-alcohol-specific affective cognitions were considerably less researched. Several gaps in the knowledge base emerged; studies were overwhelmingly cross-sectional, conducted mainly within homogeneous college samples, and often did not disaggregate effects of trauma exposure from those of PTSD. Future research is needed to address these gaps to optimally inform clinical efforts to reduce TR/PTSD-related drinking risk.
{"title":"What Is the Role of Affective Cognition in Trauma and Posttraumatic-Stress-Disorder-Related Drinking? A Systematic Review","authors":"Michelle J. Zaso, Ian R. Troidl, Jennifer P. Read","doi":"10.1177/21677026231215341","DOIUrl":"https://doi.org/10.1177/21677026231215341","url":null,"abstract":"Trauma and posttraumatic stress disorder (TR/PTSD) are implicated in deleterious alcohol outcomes, yet the processes that undergird these associations remain elusive. Affective (i.e., emotionally laden) cognitions may play key roles in TR/PTSD-related drinking that could inform prevention and intervention. In the present review, we synthesized extant literature ( k = 58) on affective cognitions and their role in negative- and positive-reinforcement TR/PTSD-related drinking, including alcohol-specific (e.g., drinking motives, alcohol expectancies) and non-alcohol-specific (e.g., emotion-regulation cognitions, perception and attentional biases) cognitions. Findings generally supported the importance of alcohol-specific cognitions in negative-reinforcement drinking more so than positive-reinforcement drinking. Non-alcohol-specific affective cognitions were considerably less researched. Several gaps in the knowledge base emerged; studies were overwhelmingly cross-sectional, conducted mainly within homogeneous college samples, and often did not disaggregate effects of trauma exposure from those of PTSD. Future research is needed to address these gaps to optimally inform clinical efforts to reduce TR/PTSD-related drinking risk.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"26 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140043969","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 : 2024-02-29DOI: 10.1177/21677026231223755
P. Priscilla Lui, Craig Rodriguez-Seijas
Mental health disparities persist in countries such as the United States and across the world. Research with disparity populations is underrepresented in mainstream clinical psychological journals, and existing science has not focused on group specific lived experiences. Achieving mental health equity requires examination of determinants of psychopathology and health disparities and personal and cultural attributes that promote mental health. Clinical psychological science ideally also encourages and values research with underrepresented minority and underserved populations, novel and underused study designs, and research produced by diverse scholars. Our special issue highlights research that considers systematically culture specific processes, examines not only individual- but also community-level factors that relate to psychopathology and mental-health care, and challenges structural limitations in the current literature. We review these articles that incorporate innovative and community engaged approaches and showcase the importance of diversity in researcher and research participant demographics and perspectives in the advancement of equity in clinical psychological science.
{"title":"Understanding Ethnoracial Disparities and Advancing Mental Health Equity Through Clinical Psychological Science: Introduction to Special Issue","authors":"P. Priscilla Lui, Craig Rodriguez-Seijas","doi":"10.1177/21677026231223755","DOIUrl":"https://doi.org/10.1177/21677026231223755","url":null,"abstract":"Mental health disparities persist in countries such as the United States and across the world. Research with disparity populations is underrepresented in mainstream clinical psychological journals, and existing science has not focused on group specific lived experiences. Achieving mental health equity requires examination of determinants of psychopathology and health disparities and personal and cultural attributes that promote mental health. Clinical psychological science ideally also encourages and values research with underrepresented minority and underserved populations, novel and underused study designs, and research produced by diverse scholars. Our special issue highlights research that considers systematically culture specific processes, examines not only individual- but also community-level factors that relate to psychopathology and mental-health care, and challenges structural limitations in the current literature. We review these articles that incorporate innovative and community engaged approaches and showcase the importance of diversity in researcher and research participant demographics and perspectives in the advancement of equity in clinical psychological science.","PeriodicalId":54234,"journal":{"name":"Clinical Psychological Science","volume":"76 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140009858","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 : 2024-02-20DOI: 10.1177/21677026241227886
Jack J. Blanchard, Jason F. Smith, Melanie E. Bennett, Ryan D. Orth, Christina L. G. Savage, Julie M. McCarthy, James A. Coan, Alexander J. Shackman
In psychotic disorders, motivation and pleasure (MAP) deficits are associated with decreased affiliation and heightened functional impairment. We leveraged a transdiagnostic sample enriched for psychosis and a multimethod approach to test the hypothesis that MAP deficits undermine the stress-buffering benefits of affiliation. Participants completed the social-affiliation-enhancement task (SAET) to cultivate affiliation with an experimental partner. Although the SAET increased perceived affiliation and mood, individuals with greater negative symptoms derived smaller emotional benefits from the partners, as indexed by self-report and facial behavior. We then used the handholding functional MRI paradigm, which combines threat anticipation with affiliative physical contact, to determine whether MAP deficits undermine the social regulation of distress. Individuals with greater MAP deficits showed diminished neural “benefits”—reduced dampening of threat-elicited activation—from affiliative touch in key frontoparietal nodes of the dorsal attention network. In short, MAP symptoms disrupt the emotional and neuroregulatory benefits of affiliation.
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