Journal of psychopathology and clinical science最新文献

This article discusses the general factor of psychological problems. Hundreds of published studies have advanced understanding of the general factor of psychological problems, but confusion still surrounds the hypothesis. This partly results from critics conflating the hypotheses with those of other authors, but they have created confusion ourselves by stating two hypotheses involving the general factor, which they better differentiate here. In the psychometric general factor hypothesis, the general factor is simply the term in bifactor models that quantifies the variance shared by all measured psychological problems, whereas two or more specific factors are defined by orthogonal pools of variance shared only by items loading on each specific factor. Although the psychometric bifactor model is sometimes viewed as an alternative to taxonomic models based on correlated factor models, it is not. Those models properly describe the overlapping dimensions of psychological problems experienced in everyday life. Because bifactor and correlated factors models serve different purposes, there is no need to compare their fits. The separate hierarchical causal hypothesis is that correlations among all problems that define the general factor result from some of their causes and mechanisms being directly or indirectly shared, whereas the specific factors are the result of other causes being shared by subsets of problems. There is growing evidence that some genetic and environmental causes-and their attendant psychobiological mechanisms-are shared to varying degrees with essentially all psychological problems. Other independent causes and mechanisms influence only subgroups of psychological problems (e.g., internalizing problems), and still others are problem-specific. At this point, the evidence is informative but only correlational. Nonetheless, there is evidence that some measured variables of potential causal and mechanistic significance are empirically correlated with the general factor term in bifactor models, whereas other risk factors are correlated with the terms for the specific factors of psychological problems. Other studies have shown that the general factor of psychological problems is robustly correlated with important psychological constructs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Suicidality is common among people at clinical high risk (CHR) for psychosis. Delineating causal pathways to suicidality and identifying its determinants would inform tailored intervention efforts for these individuals. To this end, we analyzed data on CHR samples from the second and third North American Prodrome Longitudinal Studies (NAPLS-2, n = 355; NAPLS-3, n = 266). Data on correlates of suicidality-including depression and attenuated psychosis symptoms, sleep, and childhood trauma-from two initial study timepoints were submitted to the greedy relaxations of the sparsest permutation algorithm. Intervention calculus was used to estimate the (lower bound) total empirically plausible causal effects of each variable on suicidality. Across both samples, greedy relaxations of the sparsest permutation suggested that symptoms of depression-particularly hopelessness, self-deprecation, and depressed mood-were likely direct causes of suicidality among people at CHR for psychosis. Across samples and measurement time points, intervention calculus indicated that depressed mood exerted the greatest influence over suicidality of all measured variables. This study provides data-driven, testable hypotheses about the causal pathways leading to suicidality among people at CHR for psychosis and suggests promising targets for interventions on suicidality tailored to these individuals. Future experimental research should test these hypotheses by, for example, comparing the suicide risk reduction afforded by interventions aimed at each aforementioned target. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Over half of U.S. military veterans with posttraumatic stress disorder (PTSD) use alcohol heavily, potentially to cope with their symptoms. This study investigated the neural underpinnings of PTSD symptoms and heavy drinking in veterans. We focused on brain responses to salient outcomes within predictive coding theory. This framework suggests the brain generates prediction errors (PEs) when outcomes deviate from expectations. Alcohol use might provide negative reinforcement by reducing the salience of negatively valenced PEs and dampening experiences like loss. We analyzed electroencephalography responses to unpredictable gain/loss feedback in n = 82 veterans of Operations Enduring and Iraqi Freedom. We used time-frequency principal components analysis of event-related potentials to isolate neural responses indicative of PEs, identifying mediofrontal theta linked to losses (feedback-related negativity) and central delta associated with gains (reward positivity). Intrusive reexperiencing symptoms of PTSD were associated with intensified mediofrontal theta signaling during losses, suggesting heightened negative PE sensitivity. Conversely, increased hazardous alcohol use was associated with reduced theta responses, implying a dampening of these negative PEs. The separate delta-reward positivity component showed associations with alcohol use but not PTSD symptoms. The findings suggest a common neural component of PTSD and hazardous alcohol use involving altered PE processing. We suggest that reexperiencing enhances the intensity of salient negative PEs, while chronic alcohol use may reduce their intensity, thereby providing negative reinforcement by muting posttraumatic distress and associated brain responses. Modifying the mediofrontal theta response could address the intertwined nature of PTSD symptoms and alcohol use, providing new avenues for treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Ecological momentary assessment is increasingly leveraged to better understand affective processes underlying substance use disorder treatment and recovery. Research in this area has yielded novel insights into the roles of mean levels of positive affect (PA) and negative affect (NA) in precipitating drug craving and substance use in daily life. Little of the extant substance use disorder treatment research, however, considers dynamic patterns of PA and NA, separately or in relation to one another, or how such patterns may differ from those observed among nonclinical samples. The current ecological momentary assessment study examined between-person differences in within-person affect dynamics-including intensity, variability, instability, inertia, polarity, and spillover-among patients in residential treatment (n = 73) for opioid use disorder (OUD), both collectively and separately according to posttreatment relapse status, relative to a demographically similar nonclinical comparison group (n = 37). The results revealed no group differences in PA dynamics. The OUD group did, however, report higher average NA intensity and within-day variability relative to the comparison group. Furthermore, relative to the comparison group, OUD patients who relapsed within 120 days posttreatment exhibited greater linear declines in NA intensity across days, whereas OUD patients who did not relapse demonstrated weaker affect polarity (i.e., the within-person correlation between PA and NA). Although PA dynamics alone did not differ between groups, weaker affect polarity differentiated OUD patients who avoided relapse from the comparison group. The capacity to experience PA separately from fluctuations in NA may reflect an adaptive tendency that could reduce vulnerability to relapse among individuals in OUD treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this viewpoint article, the authors contend that behavioral addiction (BA) research must move past substance use disorder paradigms. Under the most liberal definitions of BA, activities such as eating, exercise, work, smartphone use, and a litany of others could all become addictions. Abundant clinical evidence shows that people may frequently engage in behaviors in ways that become impairing. Yet, frequency of engagement in a behavior is insufficient evidence that addiction is occurring and may be of little evidentiary value at all. There are also severe problems with assuming equivalence between all behavioral processes and substance use. The conceptual problems manifest in methodological problems, meaning that many of the methodological approaches used in substance use research are likely not valid for BA research. Given abundant evidence that the behavior patterns commonly referred to as BAs are associated with distress and impairment, BAs are likely to continue to garner interest in both clinical care and clinical science. To better understand the phenomenology of BAs, research should first start with systematic and multimethod investigations among patients reporting such problems. That is, rather than simply co-opting methods and measures from substance use disorder (SUD) research, BA research should carefully consider the signs and symptoms reported by people experiencing real impairments from excessive and dysregulated behavioral engagements. Additionally, BA researchers should seek to engage with larger theoretical perspectives on psychopathology regarding the core processes that seem to be driving such impairments. For BA research to achieve scientific legitimacy, explain clinical phenomena, and, ultimately, reduce human suffering, the study of such disorders must move beyond SUD paradigms and addiction framing alone and instead strive for riskier tests of validity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

There has been longstanding speculation that enhanced creativity is associated with autism. Evidence for this association, however, is limited and derived from small-scale studies in nonclinical samples. Furthermore, nothing is known about autism-related creativity after accounting for general cognitive ability and attention-deficit/hyperactivity disorder (ADHD), that is, other factors known to predict creativity. Addressing these issues, we conducted preregistered comparisons of the creativity of autistic and nonautistic adults (N = 352), matched on age, sex, and general cognitive ability. We found clear evidence that there were no group differences on a divergent thinking creativity task. Autistic adults did self-report more real-world creative accomplishments and behaviors, but these differences did not hold after accounting for ADHD. We conclude that enhanced creativity, where observed in autistic people, is likely to be driven by co-occurring ADHD. The clinical and practical implications of these findings for strength-based approaches to psychopathology are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This article discusses the concept of "experience" in experience sampling. A central challenge of clinical science is understanding psychopathological constructs and their manifestations. In conventional definitions and measures of psychopathology, subjective experience of mental disorder is often lost. The authors argue for an integration of phenomenology-or prioritization of subjectivity-in psychopathological construct definition and measurement, particularly through experience sampling methods (ESMs). ESMs capture idiographic, contextual, and longitudinal elements of lived experience that can expand our current conceptualizations and classifications of psychopathology. The authors propose three novel applications and extensions: (a) leveraging ESM for subjective construct definition (i.e., phenomena detection), (b) mixed-methods approaches, like cognitive interviewing, to improve the validity of ESM measures and (c) incorporation of novel ESM approaches (e.g., audiovisual data capturing) to expand understanding of subjective, daily experience of psychopathology. Merging phenomenological tradition with ESM serves to expand our understanding of psychopathology and bring "experience" back into experience sampling. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The presentation of major depressive disorder (MDD) can vary widely due to its heterogeneity, including inter- and intraindividual symptom variability, making MDD difficult to diagnose with standard measures in clinical settings. Prior work has demonstrated that passively collected actigraphy can be used to detect MDD at a disorder level; however, given the heterogeneous nature of MDD, comprising multiple distinct symptoms, it is important to measure the degree to which various MDD symptoms may be captured by such passive data. The current study investigated whether individual depressive symptoms could be detected from passively collected actigraphy data in a (a) clinical subpopulation (i.e., moderate depressive symptoms or greater) and (b) general population. Using data from the National Health and Nutrition Examination Survey, a large nationally representative sample (N = 8,378), we employed a convolutional neural network to determine which depressive symptoms in each population could be detected by wrist-worn, minute-level actigraphy data. Findings indicated a small-moderate correspondence between the predictions and observed outcomes for mood, psychomotor, and suicide items (area under the receiver operating characteristic curve [AUCs] = 0.58-0.61); a moderate-large correspondence for anhedonia (AUC = 0.64); and a large correspondence for fatigue (AUC = 0.74) in the clinical subpopulation (n = 766); and a small-moderate correspondence for sleep, appetite, psychomotor, and suicide items (AUCs = 0.56-0.60) in the general population (n = 8,378). Thus, individual depressive symptoms can be detected in individuals who likely meet the criteria for MDD, suggesting that wrist-worn actigraphy may be suitable for passively assessing these symptoms, providing important clinical implications for the diagnosis and treatment of MDD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Social anxiety-which typically emerges in adolescence-lies on a continuum and, when extreme, can be devastating. Socially anxious individuals are prone to heightened fear, anxiety, and the avoidance of contexts associated with potential social scrutiny. Yet most neuroimaging research has focused on acute social threat. Much less attention has been devoted to understanding the neural systems recruited during the uncertain anticipation of potential encounters with social threat. Here we used a novel functional magnetic resonance imaging paradigm to probe the neural circuitry engaged during the anticipation and acute presentation of threatening faces and voices in a racially diverse sample of 66 adolescents selectively recruited to encompass a range of social anxiety and enriched for clinically significant levels of distress and impairment. Results demonstrated that adolescents with more severe social anxiety symptoms experience heightened distress when anticipating encounters with social threat, and reduced discrimination of uncertain social threat and safety in the bed nucleus of the stria terminalis, a key division of the central extended amygdala (EAc). Although the EAc-including the bed nucleus of the stria terminalis and central nucleus of the amygdala-was robustly engaged by the acute presentation of threatening faces and voices, the degree of EAc engagement was unrelated to the severity of social anxiety. Together, these observations provide a neurobiologically grounded framework for conceptualizing adolescent social anxiety and set the stage for the kinds of prospective-longitudinal and mechanistic research that will be necessary to determine causation and, ultimately, to develop improved interventions for this often-debilitating illness. (PsycInfo Database Record (c) 2025 APA, all rights reserved).