People who engage in nonsuicidal self-injury (NSSI) often state that it helps them feel better. We tested three hypotheses through which this mood modification might occur. Following a negative mood induction, adults reporting past year NSSI were randomized into a control (i.e., sitting alone quietly), mild distraction, or pain condition. All participants completed mood ratings at regular intervals. No mood repair occurred in the control condition. However, distraction improved mood both during and after the activity. Participants who self-administered pain reported no overall mood change, suggesting that contrary to popular NSSI theories, pain likely does not improve mood via distraction. However, as predicted, level of self-criticism moderated mood change during pain. Participants high on self-criticism felt significantly better during pain and participants low on self-criticism felt significantly worse during pain. Findings shed light on how NSSI improves mood by clarifying the circumstances under which different affect regulation processes may operate.
Personality traits in children predict numerous life outcomes. Although traits are generally stable, if there is personality change in youth, it could affect subsequent behavior in important ways. We found that the trait of urgency, the tendency to act impulsively when highly emotional, increases for some youth in early adolescence. This increase can be predicted from the behavior of young children: alcohol consumption and depressive symptom level in elementary school children (fifth grade) predicted increases in urgency 18 months later. Urgency, in turn, predicted increases in a wide range of maladaptive behaviors another 30 months later, at the end of the first year of high school. The mechanism by which early drinking behavior and depressive symptoms predict personality is not yet clear and merits future research; notably, the findings are consistent with mechanisms proposed by personality change theory and urgency theory.
Exaggerated anxious responding to unpredictable threat (U-threat) is a core feature of panic disorder (PD). However, it is unknown whether this abnormality is specific to the diagnosis of PD or would manifest along a continuum of panic symptomatology (PS). In addition, little is known about the neural processes underlying this abnormality among those high in PS. Finally, no studies have tested whether startle potentiation and limbic neural reactivity—commonly used indices of U-threat responsivity—are associated and therefore reflect common abnormalities. These questions were investigated in 42 adults with a range of PS. U-threat responding was measured twice during threat of shock—once with startle and once with functional magnetic resonance imaging. As hypothesized, PS positively predicted startle potentiation and dACC reactivity to U-threat. Startle potentiation and dACC activation to U-threat were positively associated. These results suggest a biobehavioral profile of aberrant responding to U-threat associated with PS.
Maladaptive emotion regulation and dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning are characteristic of depression and anxiety. However, little research examines whether and how emotion regulation affects HPA axis functioning. We utilized an experience sampling methodology to examine associations between three emotion regulation strategies (problem solving, disengagement, and emotional expression/support seeking) and diurnal cortisol rhythms and reactivity in everyday life. Participants were young adults with current, past, or no history of internalizing disorders (depression or anxiety; N = 182). Across participants, problem solving was associated with an elevated cortisol awakening response (CAR), whereas disengagement was associated with a steeper cortisol slope. Only for individuals with internalizing disorders was momentary problem solving and emotional expression/support seeking associated with higher cortisol reactivity and emotional expression/support seeking associated with a flatter diurnal slope and blunted CAR. Results provide insight into associations between emotion regulation and day-to-day HPA axis functioning.
Dimensional models of psychopathology that posit a general psychopathology factor (i.e., p factor), in addition to specific internalizing and externalizing factors, have recently gained prominence. However, the stability of these factors and the specificity with which they are related to one another over time (e.g., homotypic or heterotypic continuity) have not been investigated. The current study addressed these questions. We estimated bifactor models, with p, internalizing-specific, and externalizing-specific factors, with youth and caretaker reports of symptoms at two time points (18 months apart), in a large community sample of adolescents. Results showed strong stability over time with highly specific links (i.e., p factor at Time 1 to Time 2; internalizing-specific at Time 1 to Time 2 and externalizing-specific at Time 1 to Time 2), suggesting strong homotypic continuity between higher order latent psychopathology factors.
Cognitive subtyping may be essential for understanding shared mechanisms underlying attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Participants from a population-based sample (n = 360) and an ASD/ADHD clinic-based sample (n = 254), ages 5 to 17 years, were administered a broad cognitive battery. Latent class analyses revealed a similar four-cognitive-class solution in both samples mainly characterized by speed–accuracy tradeoff differences instead of specific strengths and weaknesses. The classes were strongly predictive of both ASD and ADHD (and comorbid) symptoms in the clinical, but not the population, sample. Results support the hypothesis that both disorders are manifestations of the same overarching disorder and illustrate the effectiveness of subtyping based on cognitive profiles. Results also support a step-function endophenotype model, in which cognitive problems mediate the gene–psychopathology associations but only in a clinically relevant way in the subgroup of children with high genetic susceptibility. Pre-onset longitudinal research is needed to corroborate this.
Individuals who are unhappy in their intimate partnerships are at risk for developing alcohol problems. But little is known about the mechanisms underlying this link. One possibility is that couples with poor relationship quality gain more reinforcement from alcohol in certain contexts—a possibility that has never previously been empirically examined. In the current study, 304 individuals (152 couples) were assigned to receive alcohol (target BAC .08%) or a nonalcoholic beverage. They then engaged in a conflict-resolution interaction with their partners. Videotaped interactions were coded by trained observers. Results revealed a significant interaction between alcohol and relationship quality across multiple measures. Alcohol decreased negative behaviors, decreased negative reciprocity, and enhanced self-reported experience to a greater extent during interactions involving individuals reporting low relationship quality and had comparatively little effect among those reporting high relationship quality. Findings point to a potential mechanism underlying problem drinking among couples with poor relationship quality.
This research assessed the association between the adherence to a Mediterranean lifestyle beyond the Mediterranean diet and the risk of depression in a prospective cohort of Spanish university graduates. Through a dynamic cohort study method, diet was assessed with a validated semiquantitative food-frequency questionnaire. The baseline assessment included a validated questionnaire on physical activity and average time spent with friends (socializing). Mediterranean lifestyle was defined as the joint exposure to Mediterranean diet, level of physical activity, and level of socializing. After a median follow-up of 8.5 years, 806 cases of depression among 11,800 participants were observed. Participants with the highest adherence to the Mediterranean lifestyle showed a 50% relative risk reduction in depression risk as compared to those participants with the lowest adherence (multivariable hazard ratio = 0.50; 95% confidence interval = [0.32, 0.81]). The Mediterranean lifestyle might reduce depression risk in the Seguimiento Universidad de Navarra cohort study beyond the known effects of the Mediterranean diet.
Recalling positive autobiographical memories is a powerful way to regulate emotion and repair low mood. However, depressed individuals often derive limited emotional benefit from such positive recollection. To identify the conditions under which positive memory recall is emotionally beneficial, we investigated whether memories perceived as discrepant from one’s current sense of self have a differential impact on low mood compared to memories perceived as concordant with the current self. Depressed participants (n = 39) recalled either a self-concordant or self-discrepant positive memory to alleviate sad mood and reported reduced sadness only when the memory was concordant with, but not discrepant from, their current sense of self. In contrast, never-depressed participants (n = 40) experienced mood improvement regardless of the type of memory recalled. These results suggest that the degree to which depressed individuals can identify with the self from a past positive event is an important determinate of the emotional consequences that follow.
There is a growing interest in understanding the role of inflammation in the diet–depression relationship. The present study examined whether the Dietary Inflammatory Index (DII; a measure of the inflammatory potential of individuals’ diets) is associated with recurrent depressive symptoms (DepS) (Center for Epidemiologic Studies Depression Scale score > 16 or taking antidepressants both at baseline and follow-up) assessed over 5 years in middle-aged men (n = 3,178) and women (n = 1,068) from the Whitehall II Study. For each increment of 1 SD of DII score, odds of recurrent DepS increased by 66% (95% confidence interval [CI] = [1.30, 2.12]) in women, whereas no significant association between DII and recurrent DepS was observed in men (odds ratio [OR] = 1.12; 95% CI = [0.92, 1.36]). This association was little attenuated after adjustment for confounders and after taking into account levels of interleukin-6 and C-reactive protein. In conclusion, there is an association between proinflammatory diet and recurrent DepS in women that seems to not be driven by circulating inflammatory markers.
Ruminative tendencies to think repetitively about negative events, like retrieval practice in laboratory experiments, should enhance long-term recall. To evaluate this claim, ruminators and nonruminators learned positive, negative, and neutral adjective–noun pairs. Following each of four study phases, "practice" participants attempted cued recall of nouns from positive or negative pairs; study-only participants performed a filler task. Half the pairs of each valence were tested after the four learning cycles, and all pairs were tested a week later. Large practice effects were found on both tests, even though ruminators showed a trait-congruent bias in recalling unpracticed negative pairs on the immediate test. Positive practice also improved the moods of ruminators. Thus, repetitive positive retrieval shows promise in counteracting ruminative recall and its consequences.
Sexual violence victimization is a significant problem among female U.S. military personnel. Preventive interventions for high-risk individuals might reduce prevalence but would require accurate targeting. We attempted to develop a targeting model for female Regular U.S. Army soldiers based on theoretically guided predictors abstracted from administrative data records. As administrative reports of sexual assault victimization are known to be incomplete, parallel machine learning models were developed to predict administratively recorded (in the population) and self-reported (in a representative survey) victimization. Capture–recapture methods were used to combine predictions across models. Key predictors included low status, crime involvement, and treated mental disorders. Area under the receiver operating characteristic curve was .83–.88. Between 33.7% and 63.2% of victimizations occurred among soldiers in the highest risk ventile (5%). This high concentration of risk suggests that the models could be useful in targeting preventive interventions, although final determination would require careful weighing of intervention costs, effectiveness, and competing risks.
Recent data show shifts in genetic and environmental influences on emotional eating across the menstrual cycle, with significant shared environmental influences during pre-ovulation and primarily genetic effects during post-ovulation. Factors driving differential effects are unknown, although increased estradiol during pre-ovulation and increased progesterone during post-ovulation are thought to play a role. We indirectly investigated this possibility by examining whether overall levels of estradiol and progesterone differentially impact genetic and environmental risk for emotional eating in adult female twins (N = 571) drawn from the Michigan State University Twin Registry. Emotional eating, estradiol levels, and progesterone levels were assessed daily and then averaged to create aggregate measures for analysis. As predicted, shared environmental influences were significantly greater in twins with high estradiol levels, whereas additive genetic effects increased substantially across low versus high progesterone groups. Results highlight significant and differential effects of ovarian hormones on etiologic risk for emotional eating in adulthood.
Postpartum depression is a major mental health issue for women and society. We examined stability and change in symptoms of depression over two consecutive pregnancies and tested life stress as a potential mechanism. The Community Child Health Network followed an ethnically/racially diverse sample from 1 month after a birth for 2 years. A subset of 228 women had a second birth. Interview measures of depressive symptoms (Edinburgh Postnatal Depression Scale) and life stress (life events, perceived stress, chronic stress, interpersonal aggression) were obtained during home visits. Three-quarters of the sample showed intraindividual stability in depressive symptoms from one postpartum period to the next, and 24% of the sample had clinically significant symptoms after at least one pregnancy (9% first, 7.5% second, 3.5% both). Each of the four life stressors significantly mediated the association between depressive symptoms across two postpartum periods. Stress between pregnancies for women may be an important mechanism perpetuating postpartum depression.
Adolescence marks the emergence of sex differences in internalizing symptoms and disorders, with girls at increased risk for depression and anxiety during the pubertal transition. However, the mechanisms through which puberty confers risk for internalizing psychopathology for girls, but not boys, remain unclear. We examined two pubertal indicators (pubertal status and timing) as predictors of the development of emotion regulation styles (rumination and emotional clarity) and depressive and anxiety symptoms and disorders in a three-wave study of 314 adolescents. Path analyses indicated that early pubertal timing, but not pubertal status, predicted increased rumination, but not decreased emotional clarity, in adolescent girls, but not boys. Additionally, rumination mediated the association between early pubertal timing and increased depressive, but not anxiety, symptoms and disorder onset among adolescent girls. These findings suggest that the sex difference in depression may result partly from early maturing girls’ greater tendency to develop ruminative styles than boys.
Survivors of violent conflict and atrocities, forcibly displaced persons (FDPs) are at risk for trauma-related mental health problems. Experimental clinical research key to the development of interventions tailored to FDPs is limited. We examined relations among attentional bias (AB) to trauma cues, posttraumatic stress symptom (PTS) severity, and behavioral avoidance of exposure to trauma-related stimuli. A total of 110 Sudanese male asylum seekers (age M = 32.7, SD = 6.5) were recruited from the community in Israel. AB temporal dynamics significantly predicted levels of PTS as well as behavioral avoidance of exposure to trauma stimuli specifically. No effects were observed when AB was quantified traditionally as an aggregated mean representing a static trait. Findings demonstrate the potential role of AB dynamics in PTS among FDPs, help disambiguate extant mixed findings between AB and PTS, and suggest that cognitive bias modification targeting AB dynamics may be a promising new direction for FDP mental health research.
Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (mean age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (mean age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization, and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs.
This study examined predictors of stigma attitudes toward common youth emotional behavioral problems to test the hypothesis that interdependent cultural values would be associated with differential stigma toward externalizing versus internalizing disorders. Furthermore, we examined whether problem-specific stigma attitudes would predict adolescents’ own self-reported manifestations of distress. A total of 1,224 Vietnamese American and European American adolescents completed measures of social distance stigma attitudes in response to vignettes depicting youth with internalizing (depression, social anxiety, somatization) and externalizing (alcohol use, aggressive behaviors, delinquency) disorders. A subset of 676 youth also provided self-reports on their own adjustment prospectively over 6 months. Measurement models revealed clear separation of negatively correlated factors assessing stigma toward externalizing versus internalizing problems. Values related to family interdependence were significantly associated with greater tolerance of internalizing disorders and lower tolerance of externalizing disorders. Stigma toward internalizing disorders was associated with lower concurrent self-reported internalizing symptoms, whereas stigma toward externalizing symptoms was associated with lower concurrent externalizing symptoms and greater decreases in externalizing symptoms over time. The results of the study suggest that stigma attitudes are differentiated by problem type and may represent one cultural factor shaping distress manifestations
African American youth who experience racial discrimination are at heightened risk to use drugs as a coping response to distress. Based on the buffer-stress hypothesis, we proposed that parental support would attenuate this effect. Participants were 1,521 African American youth between 4th and 12th grade. As hypothesized, a mediation pathway was observed among racial discrimination, depression symptoms, and drug use. This effect was observed for both genders, although the pathway was partially mediated for males. In addition, as hypothesized, parental support buffered the negative effect of depression symptomatology on drug use as a consequence of discrimination. Our findings highlight the impact racial discrimination has on health outcomes for African American youth and the importance of managing youths’ emotional responses to discrimination. Moreover, findings illuminate the protective role of supportive parenting within the risk model and should thus be considered as an important component within prevention programming for this population of youth.
This study investigates the association between polyunsaturated fatty acid (PUFA) intake and neurocognitive functions in children with attention-deficit/hyperactivity disorder (ADHD). We recruited 21 drug-naïve children diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders and 21 non-ADHD controls. The n-3 intake and essential fatty acid (EFA) deficiency severity were recorded while the children were assessed for inhibitory control, delay aversion, and temporal processing with the Go/No Go Task, Delayed Reaction Time Task, and Finger Tapping Task, respectively. The ADHD group had more EFA deficiency symptoms (p = .02) and poorer performance in delay aversion (p = .02) and temporal processing (p < .001). Moreover, ADHD symptoms correlated negatively with n-3 intake and positively with EFA deficiency. In addition, EFA deficiency was associated with higher delay aversion (p < .001). Children with ADHD had a higher deficiency of EFA, and EFA deficiency had a positive association with ADHD severity and delay aversion.
Although menstrual cycle-related changes in psychological and physical symptoms have been the focus of study for decades, important gaps remain in our understanding of these changes. In the present study we test for individual differences and covariations in cyclical changes across diverse symptom domains, including physical symptoms, affective disturbances, and attributional style. Using prospective daily reports across two full menstrual cycles from n = 163 young adult women (M = 19.54 years), the present study applies a combination of within-person analyses (cosine function regressions) and structural equation modeling to examine individual differences, factor structure, and symptom-specific associations. Results suggest that (a) individual differences in cyclical change are consistently significant and relatively more important than average levels of change, (b) cyclical change across diverse symptom types are best modeled as separate but correlated factors, and (c) future research should also consider attributional style, along with cyclical changes in affective and physical symptoms.
This study examined the genetic and environmental influences on rumination and its associations with several forms of psychopathology in a sample of adult twins (N = 744). Rumination was significantly associated with major depressive disorder, depressive symptoms, generalized anxiety disorder, eating pathology, and substance dependence symptoms. There were distinct patterns of etiological overlap between rumination and each form of psychopathology; rumination had considerable genetic overlap with depression, modest genetic overlap with eating pathology, and almost no genetic overlap with substance dependence. Findings further suggest considerable overlap between genetic and environmental influences on rumination and those contributing to the covariance between forms of psychopathology. Results were specific to ruminative thought and did not extend to self-reflection. These findings support the conceptualization of rumination as a transdiagnostic correlate and risk factor for psychopathology and also suggest that the biological and environmental mechanisms linking rumination to psychopathology may differ depending on the disorder.
Insomnia is a debilitating condition causing psychological distress and frequently comorbid with other mental health conditions. This study examined the effect of 8 weeks of treatment by broad spectrum micronutrients (vitamins and minerals) on insomnia using a multiple-baseline-across-participants open-label trial design. Seventeen adults were randomized to 1-, 2-, or 3-week baseline periods (14 completed). Self-report measures were the Consensus Sleep Diary–Morning (CSD-M), the Pittsburgh Insomnia Rating Scale (PIRS), and the Depression, Anxiety, Stress Scale (DASS). Baselines were generally stable. Treatment completers reported reliable and clinically significant change in insomnia severity (PIRS), in depression, stress, and anxiety (DASS), and on at least two aspects of sleep measured by the CDS-M. All completers were treatment-compliant, and side effects were minimal. Nutritional supplementation is shown to be a novel, beneficial treatment for insomnia in adults. Follow-up research using placebo-controlled designs as well as comparisons to cognitive-behavioral and other treatments is recommended.
Poor cognitive control is associated with nearly every mental disorder and has been proposed as a transdiagnostic risk factor for psychopathology, including depression and anxiety. What specific mechanisms might cause individuals with poor cognitive control to experience higher levels of psychopathology? The current research tests a new process model linking poor cognitive control to depression and anxiety symptoms via increased dependent stress (i.e., self-generated stressors) and subsequent rumination. This model was supported across two studies in youth during the key period for emergence of internalizing psychopathology. Study 1 provides longitudinal evidence for prospective prediction of change in symptoms. Study 2 confirms this model using well-established executive function tasks in a cross-sectional study. These findings have potential implications for understanding why cognitive control impairments may be broadly associated with psychopathology and suggest that interventions to prevent stress generation might be effective in preventing negative consequences of poor cognitive control.
Blunted reward response appears to be a trait-like marker of vulnerability for major depressive disorder (MDD). As such, it should be present in remitted individuals; however, depression is a heterogeneous syndrome. Reward-related impairments may be more pronounced in individuals with melancholic depression. The present study examined neural responses to rewards in remitted melancholic depression (rMD; n = 29), remitted nonmelancholic depression (rNMD; n = 56), and healthy controls (HC; n = 81). Event-related potentials to monetary gain and loss were recorded during a simple gambling paradigm. Relative to both the HC and the rNMD groups, who did not differ from one another, rMD was characterized by a blunted response to rewards. Moreover, the rMD and rNMD groups did not differ in course or severity of their past illnesses, or current depressive symptoms or functioning. Results suggest that blunted response to rewards may be a viable vulnerability marker for melancholic depression.
We previously reported on a 16-week, double-blind, randomized placebo-controlled trial (RCT) using 3 grams per day of N-acetyl cysteine (NAC) (1.5 grams twice per day) in 44 participants (aged 18–70) with DSM-5-diagnosed obsessive-compulsive disorder (OCD). We now report on an analysis of age, severity and duration of illness, OCD presentation type, baseline anxiety and depression scores, as well as the use of antidepressant medications as potentially modifying factors. Results revealed a significant effect (p = .037) for younger participants (under mean age of 34) responding to NAC. This remained significant using OCD severity as a covariate (p = .044). For those under 34 years of age with less than 17 years of OCD duration, this was also significant (p = .037). Regression analysis within the NAC treatment group also revealed that duration of OCD presentation was a significant predictor of Yale-Brown Obsessive Compulsive Scale (YBOCS) change at study endpoint (p = .019), whereas baseline Montgomery–Asberg Depression Rating Scale scores were also a trend-level predictor (p = .060) of YBOCS change in the NAC group.
Attentional bias for sleep-related negative information is believed to contribute to symptoms of insomnia by elevating arousal during the presleep period. In the present study, we examined whether the delivery of an attentional bias modification (ABM) procedure in the presleep period could produce transient benefits for sleep-disturbed individuals by reducing presleep cognitive arousal and improving ease of sleep onset. In a counterbalanced repeated A-B design, participants alternated completing an ABM training task and a nontraining control task across six nights and reported on presleep cognitive arousal and sleep onset latency. Significant reductions in presleep cognitive arousal and sleep onset latency were observed on nights where the ABM task was completed relative to nights where the control task was completed. These results suggest that delivery of ABM can attenuate cognitive arousal and sleep onset latency and highlights the possibility that targeted delivery of ABM could deliver real-world benefits for sleep-disturbed individuals.
We propose that depression can be viewed as an adaptation to conserve energy after the perceived loss of an investment in a vital resource such as a relationship, group identity, or personal asset. Tendencies to process information negatively and experience strong biological reactions to stress (resulting from genes, trauma, or both) can lead to depressogenic beliefs about the self, world, and future. These tendencies are mediated by alterations in brain areas/networks involved in cognition and emotion regulation. Depressogenic beliefs predispose individuals to make cognitive appraisals that amplify perceptions of loss, typically in response to stressors that impact available resources. Clinical features of severe depression (e.g., anhedonia, anergia) result from these appraisals and biological reactions that they trigger (e.g., autonomic, immune, neurochemical). These symptoms were presumably adaptive in our evolutionary history, but are maladaptive in contemporary times. Thus, severe depression can be considered an anachronistic manifestation of an evolutionarily based "program."
With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18 and 38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (N = 1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than was alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence.
Substance use is highly prevalent in our society, and substance use disorders are comorbid with most psychiatric disorders, including borderline personality disorder (BPD). Craving is a fundamental feature of addiction and disorder, yet the contexts in which craving occurs and is associated with substance use is still underresearched. We examined alcohol craving and consumption in a sample of 56 BPD individuals and a comparison group of community drinkers (COM; n = 60) who carried electronic diaries for approximately 21 days. BPD individuals reported more craving than COM individuals in most contexts. Compared with COM individuals, elevated craving in BPD individuals was paralleled by more drinking when at work, at home, and with romantic partners, coworkers, and children. These findings identify contexts of particular relevance to those with BPD and other mood/anxiety disorders in which craving may lead to risky and maladaptive alcohol use.
Previous studies investigating the hypothesis that elevated social anxiety vulnerability is characterized by an attentional bias to negative social information have yielded inconsistent findings. One possible explanation for this inconsistency is that most such studies have failed to distinguish bias in attentional engagement with, and in attentional disengagement from, negative social information. It has been proposed that only one of these two possible forms of attentional bias may be associated with elevated social anxiety vulnerability, potentially giving rise to observed inconsistencies when assessment approaches have failed to dissociate them. The few studies that have sought to investigate this issue have been hampered by methodological limitations, which have compromised their capacity to differentially assess these two facets of attentional selectivity. In the present study, we employed a recently developed variant of the attentional-probe task that has proven capable of dissociating attentional engagement bias and disengagement bias, to contrast the patterns of attentional selectivity shown by participants high and low in social anxiety. Our findings reveal that elevated social anxiety vulnerability is characterized only by facilitated attentional engagement with socially negative information and not by impaired attentional disengagement from socially negative information.
Although there is substantial support for the validity of the diagnosis of attention-deficit/hyperactivity disorder (ADHD), there is considerable disagreement about how to best capture developmental changes in the expression of ADHD symptomatology. This article examines the associations among the 18 individual ADHD symptoms using a novel network analysis approach, from preschool to adulthood. The 1,420 participants were grouped into four age brackets: preschool (ages 3–6, n = 109), childhood (ages 6–12, n = 548), adolescence (ages 13–17, n = 357), and young adulthood (ages 18–36, n = 406). All participants completed a multistage, multi-informant diagnostic process, and self and informant symptom ratings were obtained. Network analysis indicated ADHD symptom structure became more differentiated over development. Two symptoms, often easily distracted and difficulty sustaining attention, appeared as central, or core, symptoms across all age groups. Thus, a small number of core symptoms may warrant extra weighting in future diagnostic systems.
Neuroticism and several other traits have been proposed to confer vulnerability for unipolar mood disorders (UMDs) and anxiety disorders (ADs). However, it is unclear whether the associations of these vulnerabilities with these disorders are attributable to a latent variable common to all vulnerabilities, more narrow latent variables, or both. In addition, some researchers have suggested that neuroticism predicts UMDs, ADs, and substance use disorders (SUDs) with comparable strength, whereas other researchers have hypothesized that neuroticism is more strongly related to UMDs and ADs. We tested hypotheses about the factor structure of several vulnerabilities and the prospective associations of these latent variables with initial onsets of UMDs, ADs, and SUDs during a 3-year period in 547 participants recruited as high school juniors. Although a general neuroticism factor predicted SUDs, it predicted UMDs and ADs more strongly and especially predicted comorbid UMDs and ADs. There was also mixed support for specific associations involving more narrow latent vulnerabilities.
Individuals with social anxiety disorder (SAD) are motivated to conceal what they perceive to be personal inadequacies. They recognize, however, that their behavior does not convey who they genuinely are. Here, we examined whether increasing perceived authenticity facilitates positive social functioning in these individuals. Participants diagnosed with SAD (N = 72) engaged in two social interactions with experimental confederates. Prior to the second interaction, participants were randomly assigned to one of two conditions equated on all elements except a safety behavior reduction procedure intended to increase self-authenticity. As hypothesized, increased authenticity led to beneficial changes in the cognitive, affective, and motivation processes that promote relational functioning. These results suggest that the experience of expressing one’s authentic self may reduce SAD-related social impairment.
There is increasing interest in spontaneous thought, namely task-unrelated or rest-related mental activity. Spontaneous thought is an umbrella term for processes like mind-wandering, involuntary autobiographical memory, and daydreaming, with evidence elucidating adaptive and maladaptive consequences. In this theoretical framework, we propose that, apart from its positive functions, spontaneous thought is a precursor for cognitive vulnerability in individuals who are at risk for mood disorders. It is important that spontaneous thought mostly focuses on unattained goals and evaluates the discrepancy between current and desired status. In individuals who stably (i.e., trait negative affectivity) or transitorily (i.e., stress) experience negative emotions in reaction to goal-discrepancy, spontaneous thought fosters major cognitive vulnerabilities (e.g., rumination, hopelessness, low self-esteem, and cognitive reactivity), which, in turn, enhance depression. Furthermore, we also highlight preliminary links between spontaneous thought and bipolar disorder. The evidence for this framework is reviewed, and we discuss theoretical and clinical implications of our proposal.
We examined whether striatal dopamine moderates the impact of externalizing proneness (disinhibition) on reward-based decision making. Participants completed disinhibition and substance abuse subscales of the brief form Externalizing Spectrum Inventory and then performed a delay discounting task to assess preference for immediate rewards along with a dynamic decision making task that assessed long-term reward learning (i.e., inclination to choose larger delayed versus smaller immediate rewards). Striatal tonic dopamine levels were operationalized using spontaneous eyeblink rate. Regression analyses revealed that high disinhibition predicted greater delay discounting among participants with lower levels of striatal dopamine only, whereas substance abuse was associated with poorer long-term learning among individuals with lower levels of striatal dopamine, but better long-term learning in those with higher levels of striatal dopamine. These results suggest that disinhibition is more strongly associated with the wanting component of reward-based decision making, whereas substance abuse behavior is associated more with learning of long-term action-reward contingencies.
Seasonal affective disorder (SAD) is based on the theory that some depressions occur seasonally in response to reduced sunlight. SAD has attracted cultural and research attention for more than 30 years and influenced the DSM through inclusion of the seasonal variation modifier for the major depression diagnosis. This study was designed to determine if a seasonally related pattern of occurrence of major depression could be demonstrated in a population-based study. A cross-sectional U.S. survey of adults completed the Patient Health Questionnaire–8 Depression Scale. Regression models were used to determine if depression was related to measures of sunlight exposure. Depression was unrelated to latitude, season, or sunlight. Results do not support the validity of a seasonal modifier in major depression. The idea of seasonal depression may be strongly rooted in folk psychology, but it is not supported by objective data. Consideration should be given to discontinuing seasonal variation as a diagnostic modifier of major depression.
The association between violence and serious mental illness (SMI)—schizophrenia, other psychotic disorder, bipolar disorder, or major depressive disorder—was examined and guided by the I3 model to frame analysis of the National Epidemiologic Survey on Alcohol and Related Conditions Waves 1 and 2, enrolling N = 34,653 participants representative of the U.S. population. SMI was related to subsequent violent behavior but in multivariable analysis had the weakest link to severe violence. Risk factors postulated to increase dispositional impellance (anger, perceived threats), situational impellance (recent divorce/separation, financial crisis, victimization), and disinhibition (alcohol/drug abuse) fully mediated the relationship between SMI and violence. Clinical research, interventions, and policies on violence should use conceptual models and consider SMI not in isolation but relative to other risk factors. Violence prevention targeting only psychiatric diagnosis is likely to have limited impact given lack of a strong or direct connection found between SMI and violent behavior.
There is a gap in the literature concerning the temporal course, and the bidirectional nature, of the relationship between posttraumatic growth (PTG) and posttraumatic stress symptoms. This longitudinal study investigated PTG and posttraumatic stress in individuals directly exposed to the 2011 Oslo bombing (N = 240). To investigate the relationships between PTG and posttraumatic stress 10 (T1) and 22 (T2) months after the bombing, a cross-lagged autoregressive model was applied. High levels of PTG at T1 were associated with high levels of posttraumatic stress at T2. Furthermore, high levels of posttraumatic stress at T1 were associated with high levels of PTG at T2. The association between PTG and stress declined from 10 to 22 months and was not significant after 22 months. These findings indicate that PTG may be both a consequence and antecedent of posttraumatic stress.
Although hedonic capacity is diminished during clinical depression, it is unclear whether that deficit constitutes a risk factor or persists after depression episodes remit. To examine these issues, adolescents with current/past major depression (probands; n = 218), never-depressed biological siblings of probands (n = 207), and emotionally well controls (n = 183) were exposed to several positively valenced probes. Across baseline and hedonic probe conditions, controls consistently reported higher levels of positive affect than high-risk siblings, and siblings reported higher levels of positive affect than probands (remitted and depressed probands’ reports were similar). Extent of positive affect across the protocol predicted adolescents’ self-reports of social support network and parental reports of offspring’s use of various adaptive mood repair responses in daily life. Attenuated hedonic responding among youths remitted from depression offers partial support for anhedonia as a trait, whereas its presence among never-depressed high-risk siblings argues for anhedonia as a potential diathesis for clinical depression.
Facial-emotion-perception impairment in schizophrenia is currently viewed as abnormal affective processing. Facial-emotion perception also relies on visual processing. Yet visual cortical processing of facial emotion is not well understood in this disorder. We measured perceptual thresholds for detecting facial fear and happiness in patients (n = 23) and control participants (n = 23) and adjusted emotion intensity of facial stimuli (via morphing between images of neutral and emotive expressions) for each participant. We then evaluated activations of the visual cortex and amygdala during the performance of perceptually equated facial-emotion-detection tasks. Patients had significantly lower fear- and happiness-induced activations in the visual cortex and amygdala. Activations between the visual cortex and amygdala were largely correlated, but the correlations in patients occurred abnormally early in the response time course during fear perception. In schizophrenia, visual processing of facial emotion is deficient, and visual and affective processing of negative facial emotion may be prematurely associated.
Pediatric cancer caregivers are typically present at their child’s frequent, invasive treatments, and such treatments elicit substantial distress. Yet variability exists in how even the most anxious caregivers cope. Here we examined one potential source of this variability: caregivers’ tendencies to self-distance when reflecting on their feelings surrounding their child’s treatments. We measured caregivers’ self-distancing and trait anxiety at baseline, anticipatory anxiety during their child’s treatment procedures, and psychological distress and avoidance 3 months later. Self-distancing buffered high (but not low) trait anxious caregivers against short- and long-term distress without promoting avoidance. These findings held when controlling for other buffers, highlighting the unique benefits of self-distancing. These results identify a coping process that buffers vulnerable caregivers against a chronic life stressor while also demonstrating the ecological validity of laboratory research on self-distancing. Future research is needed to explicate causality and the cognitive and physiological processes that mediate these results.
Disruptions in activity are core features of mood states in bipolar disorder (BD). In this study, we sought to identify activity patterns that discriminate between mood states in BD. Locomotor activity was collected by using actigraphy for 6 weeks in participants with interepisode BD Type I (n = 37) or participants with no lifetime mood disorders (n = 39). The 24-hr activity pattern of each participant-day was characterized and within-person differences in activity patterns were examined across mood states. Results showed that among participants with BD, depressive days are distinguished from other mood states by an overall lower activity level and a pattern of later activity onset, a midday elevation of activity, and low evening activity. No distinct within-person activity patterns were found for hypomanic/manic days. Given that activity can be monitored noninvasively for extended time periods, activity pattern identification may be leveraged to detect mood states in BD, thereby providing more immediate delivery of care.
In this study, we assessed value-based decision making in individuals diagnosed with mental illness. Two meta-analyses were conducted of studies that used the Iowa Gambling Task (IGT) to assess value-based decision making. In the first meta-analysis (63 studies, combined N = 4,978), we compared IGT performance in healthy populations and populations with mental illness. In the second meta-analysis (40 studies, combined N = 1,813), we examined raw IGT performance scores as a function of type of mental illness. The first meta-analysis demonstrated that individuals with mental illness performed significantly worse than did healthy control individuals. The second meta-analysis demonstrated no performance differences based on type of mental illness. These findings suggest that value-based decision making is a promising target for transdiagnostic analyses of processes that go awry in mental illness. A critical priority for future work, given that impairment in the IGT could arise from changes in several decision processes, will be to investigate the specific decision processes affected in different mental illnesses.
Patients with and at risk for psychosis may have difficulty using associative strategies to facilitate episodic memory encoding and recall. In parallel studies, patients with first-episode schizophrenia (n = 27) and high psychosis risk (n = 28) compared with control participants (n = 22 and n = 20, respectively) underwent functional MRI during a remember-know memory task. Psychophysiological interaction analyses, using medial temporal lobe (MTL) structures as regions of interest, were conducted to measure functional connectivity patterns supporting successful episodic memory. During encoding, patients with first-episode schizophrenia demonstrated reduced functional coupling between MTL regions and regions involved in stimulus representations, stimulus selection, and cognitive control. Relative to control participants and patients with high psychosis risk who did not convert to psychosis, patients with high psychosis risk who later converted to psychosis also demonstrated reduced connectivity between MTL regions and auditory-verbal and visual-association regions. These results suggest that episodic memory deficits in schizophrenia are related to inefficient recruitment of cortical connections involved in associative memory formation; such deficits precede the onset of psychosis among those individuals at high clinical risk.
Emotional mental imagery occurs across anxiety disorders, yet is neglected in bipolar disorder despite high anxiety comorbidity. Furthermore, a heightened susceptibility to developing intrusive mental images of stressful events in bipolar disorder and people vulnerable to it (with hypomanic experience) has been suggested. The current study assessed, prospectively, whether significant hypomanic experience (contrasting groups scoring high vs. low on the Mood Disorder Questionnaire, MDQ) places individuals at increased risk of visual reexperiencing after experimental stress. A total of 110 young adults watched a trauma film and recorded film-related intrusive images for 6 days. Compared to the low MDQ group, the high MDQ group experienced approximately twice as many intrusive images, substantiated by convergent measures. Findings suggest hypomanic experience is associated with developing more frequent intrusive imagery of a stressor. Because mental imagery powerfully affects emotion, such imagery may contribute to bipolar mood instability and offer a cognitive treatment target.
In this study, we experimentally assessed whether participating in online research about nonsuicidal self-injury (NSSI) may produce iatrogenic effects. A sample of 847 college students was randomly assigned to either an experimental condition (n = 439), in which they were exposed to questionnaires assessing NSSI, or a control condition (n = 408) that did not include NSSI questions. Immediate effects were evaluated with pre- and postmeasures, and 3 weeks later, 472 participants (68%) participated in a follow-up assessment of reactions, NSSI behavior, and urge to self-injure. Overall, results indicated that responding to detailed questions about NSSI did not produce iatrogenic effects immediately or over the follow-up period and may have contributed to positive outcomes. The positive findings largely held true for participants who reported engaging in different severities of NSSI behavior. There do not appear to be significant short-term adverse or iatrogenic effects of participating in detailed, online NSSI research. Implications for researchers and ethics review boards are discussed.
Despite research that has documented the types of services that are being used by parents of children with autism spectrum disorder (ASD), researchers have yet to determine how intervention-related knowledge spreads to parents. In the current study, we sought to clarify the impact of parent social networks on intervention use in 244 parents of a child with ASD by examining the following: (a) Do social-network variables predict the use of evidence-based practices (EBPs) or non-EBPs? (b) Do social-network variables predict parent satisfaction with service use? and (c) Who are the referral sources of EBPs and non-EBPs? Results indicated that social-network variables predict parents’ EBP use and non-EBP use beyond income, education, and child ASD symptom severity. In addition, recommendations to EBPs and non-EBPs came from distinct referral sources. The results have implications for both the active provision of basic social-network support and psychoeducation at the onset of ASD diagnosis and the use of social networks to more effectively disseminate best-practice information on a larger scale.
Obsessions and compulsions are driven by the goal of preventing or neutralizing guilt. We investigated whether inducing deontological versus altruistic guilt in healthy volunteers could activate checking behaviors and physical cleaning. Participants were asked to listen to stories that induced deontological guilt, altruistic guilt, or a neutral control state, and then were asked to classify 100 colored capsules into 12 small pots (Study 1) or to clean a Plexiglas cube (Study 2). Before and after hearing the story and after completing the task, participants completed a visual analog scale that assessed their current emotions. Finally, participants completed a self-report questionnaire about discomfort, doubts, and perceived performance. Participants in the deontological group checked more (Study 1), cleaned the cube more times (Study 2), and scored higher in doubts and discomfort than did participants in the altruistic or control groups. These data suggest that deontological guilt is the mental state specifically related to checking and cleaning compulsions.
This research investigated the influence of culture and posttraumatic stress disorder (PTSD) on global autobiographical remembering (Study 1a) and on the phenomenological properties (Study 1b) and memory-content variables (Study 1c) of trauma-specific autobiographical remembering. Australian, British, and Iranian trauma survivors with and without PTSD completed the Autobiographical Memory Test, Self-Defining Memory Task, and Autobiographical Memory Questionnaire and provided trauma- and negative-memory narratives. We found that there were pan-cultural deficits and distortions in the global autobiographical remembering of participants with PTSD (Study 1a). In addition, the presence of PTSD moderated the usual effect of culture on the phenomenological properties of the trauma memory (Study 1b). Finally, participants with PTSD, regardless of cultural background, had significantly fewer expressions of autonomy and self-determination in their autobiographical remembering than did those without PTSD (Study 1c). The findings suggest that pan-culturally, individuals with PTSD have similar disruptions and distortions in their autobiographical remembering.
A considerable literature now shows that perceived criticism (PC) predicts clinical outcomes transdiagnostically. Recent work has begun to identify potential mechanisms underlying PC’s connection to clinical outcomes. For example, anomalies have been found in neural processing when individuals who rate their key relatives as highly critical listen to criticism. To explore whether high-PC individuals are also characterized by other processing abnormalities, we examined cognitive processing in a sample of community participants (N = 76) high or low on PC. We measured the executive control of attention when these two groups of individuals processed emotional information and interpreted acoustically presented ambiguous words. High-PC individuals showed impaired executive control of negative emotional information relative to low-PC individuals. They also made more negative interpretations of ambiguous words. These findings indicate that PC is associated with underlying vulnerabilities that may predispose individuals to develop psychopathology.
Rumination, a maladaptive self-reflection, is a risk factor for depression, thought to be maintained by executive control deficits that impair ruminators’ ability to ignore emotional information. The current research examined whether training individuals to exert executive control when exposed to negative stimuli can ease rumination. A total of 85 participants were randomly assigned to one of two training conditions. In the experimental condition activation of executive control was followed predominantly by the presentation of negative pictures, whereas in the control condition it was followed predominantly by neutral pictures. As predicted, participants in the experimental group showed reduced state rumination compared with those in the control group. Furthermore, trait rumination, and particularly its maladaptive subtype brooding, was associated with increased sadness only among participants in the control group, and not in the experimental group. We argue that training individuals to exert executive control when processing negative stimuli can alleviate ruminative thinking and rumination-related sad mood.
To understand cognitive bases of self-reported ruminative tendencies, we examined interpretations and subsequent memories of ambiguous situations depicting opportunities for rumination. In Experiment 1, we recruited students, randomly assigned them to a distracting or ruminative concentration task, and then measured their latencies to complete fragments that resolved situational ambiguity in either a ruminative or a benign direction. Students in the ruminative task condition who previously self-identified as brooders were quicker to complete ruminative fragments. In Experiment 2, we simulated this bias to investigate its possible contribution to rumination; nonbrooding students were trained to make ruminative or benign resolutions of ambiguous situations. Ruminative training led to more negative continuations of new, potentially ruminative situations in a subsequent transfer task. Next, ruminative training also caused more negatively valenced errors in recalling the ambiguous transfer situations. Finally, after reflection about a personal experience, state-rumination scores were higher in the ruminative condition. These results establish the causal role of interpretation biases in ruminative patterns of thought.
Although it is well established that bipolar I disorder (BD) is characterized by excessive positive emotionality, the cognitive and neural processes that underlie such responses are unclear. We addressed this issue by examining the role that an emotion regulatory process called self-distancing plays in two potentially different BD phenotypes—BD with versus without a history of psychosis—and healthy individuals. Participants reflected on a positive autobiographical memory and then rated their level of spontaneous self-distancing. Neurophysiological activity was continuously monitored using electroencephalogram. As predicted, participants with BD who have a history of psychosis spontaneously self-distanced less and displayed stronger neurophysiological signs of positive emotional reactivity compared with the other two groups. These findings shed light on the cognitive and neural mechanisms underlying excessive positive emotionality in BD. They also suggest that individuals with BD who have a history of psychosis may represent a distinct clinical phenotype characterized by dysfunctional emotion regulation.
Excessive temporal discounting undergirds addiction, and the quantitative relationships of changes in discounting have yet to be investigated. The quantitative relationship between pre- and posttreatment discount rates was examined using data from five of our studies with diverse interventions across different groups of substance users. Discounting and treatment-outcome drug-use data from 222 drug-dependent individuals were analyzed. The primary measures were discounting of delayed reinforcers and objective measures of drug use. Results revealed that change in discounting was inversely related to baseline rates of discounting, such that participants with low discount rates showed little change in discounting with treatment, whereas participants with high discount rates showed large reductions in discounting. As importantly, those treatments that produced the largest gains in drug abstinence had the largest effects on discount rates. Temporal discounting changes with the specific quantitative signature of rate dependence, and more efficacious treatments remediate high discounting rates.
In this study, we investigated the specificity of implicit-shame associations across individuals diagnosed with body dysmorphic disorder (n = 30), obsessive-compulsive disorder (n = 30), and social anxiety disorder (n = 29) and individuals in a mentally healthy control group (n = 33). All participants completed a series of Implicit Association Tests that tapped into shame associated with each disorder. Planned contrasts indicated that compared with individuals in the other groups, individuals in the body dysmorphic disorder group had greater body-relevant implicit shame and those in the obsessive-compulsive disorder group had greater implicit shame tied to obsessive thoughts. The social anxiety disorder group did not differ significantly from the other groups on implicit performance-relevant shame, although in comparison with the other clinical groups, means were in the expected direction. Our comparative design adds to existing cognitive-behavioral conceptualizations of body dysmorphic, obsessive-compulsive, and social anxiety disorders that have traditionally focused on strategic forms of cognition within a single disorder.
Genetic mutations and environmental factors dynamically influence gene expression and developmental trajectories at the neural, cognitive, and behavioral levels. The examples in this article cover different periods of neurocognitive development—early childhood, adolescence, and adulthood—and focus on studies in which researchers have used a variety of methodologies to illustrate the early effects of socioeconomic status and stress on brain function, as well as how allelic differences explain why some individuals respond to intervention and others do not. These studies highlight how similar behaviors can be driven by different underlying neural processes and show how a neurocomputational model of early development can account for neurodevelopmental syndromes, such as autism spectrum disorders, with novel implications for intervention. Finally, these studies illustrate the importance of the timing of environmental and genetic factors on development, consistent with our view that phenotypes are emergent, not predetermined.
Changes in ovarian hormones predict changes in emotional eating across the menstrual cycle. However, in prior studies, researchers have not examined whether the nature of associations varies across dysregulated-eating severity. In the current study, we determined whether the strength or nature of hormone/dysregulated-eating associations differ on the basis of the presence of clinically diagnosed binge episodes (BEs). Participants included 28 women with BEs and 417 women without BEs who provided salivary hormone samples, ratings of emotional eating, and BE frequency for 45 days. Results revealed stronger associations between dysregulated eating and ovarian hormones in women with BEs relative to women without BEs. The nature of associations also differed, as progesterone moderated the effects of lower estradiol levels on dysregulated eating in women with BEs only. Although hormone/dysregulated-eating associations are present across the spectrum of pathology, the nature of associations may vary in ways that have implications for etiological models and treatment.
Interest in the use of mobile technology to deliver mental-health services has grown in light of the economic and practical barriers to treatment. Yet research on alternative delivery strategies that are more affordable, accessible, and engaging is in its infancy. Attention-bias modification training (ABMT) has the potential to reduce treatment barriers as a mobile intervention for stress and anxiety, but the degree to which ABMT can be embedded in a mobile gaming format and its potential for transfer of benefits is unknown. In the present study, we examined effects of a gamified ABMT mobile application in highly trait-anxious participants (N = 78). A single session of the active training relative to the placebo training reduced subjective anxiety and observed stress reactivity. Critically, the long (45 min) but not the short (25 min) active training condition reduced the core cognitive process implicated in ABMT (threat bias) as measured by an untrained, gold-standard protocol.
Nonsuicidal self-injury is receiving increasing attention in empirical and clinical realms. Indeed, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders designated nonsuicidal self-injury as a condition that requires further study, which signals possible future official adoption. Despite growing interest in this perplexing phenomenon, much remains unknown about why nonsuicidal self-injury occurs, including fundamental features of its etiology and underlying mechanisms. In addition, no evidence-based interventions that directly target this maladaptive behavior currently exist. The recently developed, empirically supported four-function model posits that nonsuicidal self-injury is maintained by four distinct reinforcement processes. In this review, we used the four-function model to guide the understanding of important unanswered questions and suggest much-needed studies for future research in the field of self-injury.
Although pleasant events figure prominently in behavioral models of depression, little is known regarding characteristics that may predispose people to engage in pleasant events and derive pleasure from these events. The present study was conducted to evaluate genetic and environmental influences on the experience of pleasant events, depressive symptoms, and their covariation in a sample of 148 twin pairs. A multivariate twin modeling approach was used to examine the genetic and environmental covariance of pleasant events and depressive symptoms. Results indicated that the experience of pleasant events was moderately heritable and that the same genetic factors influence both the experience of pleasant events and depressive symptoms. These findings suggest that genetic factors may give rise to dispositional tendencies to experience both pleasant events and depression.
Positive emotion (PE) has not been well studied in anorexia nervosa. Low positive emotion differentiation (PED), which involves a diminished ability to distinguish between discrete PEs, may contribute to PE dysregulation in anorexia. Specifically, low PED may interact with elevated PE intensity to both motivate and reinforce weight-loss and evaluation behaviors. Using ecological momentary assessment, we examined PE and weight-loss behaviors reported during a 2-week period. As hypothesized, low PED predicted more vomiting, laxative use, exercising, weighing, checking for fat, and restricting. Furthermore, participants with low PED who experienced elevated average PE intensity reported even more frequent behaviors. Within-subjects analyses indicated that for participants with low PED, more weight-loss behaviors at one recording predicted elevated PE at the subsequent recording. Similarly, for participants with low PED, higher momentary PE predicted more subsequent weight-loss behaviors. Thus, low PED in anorexia may reinforce and motivate weight-loss behavior.
Growth-restricted fetuses and newborns are at increased risk for language deficits, and language impairments have been associated with increased risk for cognitive, social, emotional, and behavioral clinical disorders. Auditory-information processing was examined longitudinally in 167 fetuses in Study 1, 96 of whom were reexamined as newborns in Study 2. In Study 3, language was assessed at 15 months of age for 75 infants from Study 1. Compared with participants who were appropriately grown for gestational age, growth-restricted fetuses showed less sustained response to their mother’s voice; growth-restricted newborns showed less recovery to a novel word after habituation and no preference for their mother’s voice. At 15 months of age, those infants who had been born growth restricted showed expressive-language deficits on Mullen Scales of Early Learning and MacArthur-Bates Communicative Development Inventory subscales. Our results support the hypothesis that fetal growth restriction affects the development of auditory-system functioning and indicate that it may be possible to identify individual fetuses and newborns at risk for language deficits and to intervene early, when the foundation for language is being laid.
Mental disorders traditionally have been viewed as distinct, episodic, and categorical conditions. This view has been challenged by evidence that many disorders are sequentially comorbid, recurrent/chronic, and exist on a continuum. Using the Dunedin Multidisciplinary Health and Development Study, we examined the structure of psychopathology, taking into account dimensionality, persistence, co-occurrence, and sequential comorbidity of mental disorders across 20 years, from adolescence to midlife. Psychiatric disorders were initially explained by three higher-order factors (Internalizing, Externalizing, and Thought Disorder) but explained even better with one General Psychopathology dimension. We have called this dimension the p factor because it conceptually parallels a familiar dimension in psychological science: the g factor of general intelligence. Higher p scores are associated with more life impairment, greater familiality, worse developmental histories, and more compromised early-life brain function. The p factor explains why it is challenging to find causes, consequences, biomarkers, and treatments with specificity to individual mental disorders. Transdiagnostic approaches may improve research.
Marital dissolution is commonly assumed to cause increased depression among adults, but causality can be questioned based on directionality and third-variable concerns. The present study improves on past research by using a propensity score matching algorithm to identify a subsample of continuously married participants equivalent in divorce risk to participants who actually experienced separation/divorce between two waves of the nationally representative Midlife Development in the United States (MIDUS) study. After correcting for participants’ propensity to separate/divorce, we observed increased rates of depression at the second MIDUS assessment only among participants who (a) were depressed at the initial MIDUS assessment and (b) experienced a separation/divorce. Participants who were not depressed at the initial assessment but who experienced a separation/divorce were not at increased risk for a later major depressive disorder. Thus, both social selection and social causation contribute to the increased risk for a major depressive disorder found among separated/divorced adults.
Our goal in the current study was to further investigate the late neurodevelopmental hypothesis of schizophrenia by examining cross-sectional, age-related changes in cognitive function among young adult (a) siblings of individuals with schizophrenia (n = 66), (b) healthy control subjects (n = 77), and (c) the siblings of healthy control subjects (n = 77). All subjects participated in a battery of tasks in four domains: verbal IQ, working memory, episodic memory, and executive function. We found significant group differences in the relationships between age and performance in working memory and episodic memory, with similar patterns for executive function and verbal IQ. The siblings of individuals with schizophrenia showed impaired performance in working memory, episodic memory, and executive function. In addition, healthy control subjects and their siblings showed age-related improvements in all four cognitive domains, whereas the siblings of individuals with schizophrenia showed this result for verbal IQ only.
Autobiographical memories of trauma victims often are described as disturbed in two ways. First, the trauma frequently is reexperienced in the form of involuntary, intrusive recollections. Second, the trauma is difficult to recall voluntarily (strategically); important parts may be totally or partially inaccessible—a feature known as dissociative amnesia. These characteristics often are mentioned by posttraumatic stress disorder (PTSD) researchers and are included as PTSD symptoms in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR as well as DSM-5). In contrast, we have shown that both involuntary recall and voluntary recall are enhanced by emotional stress during encoding. We also have shown that the PTSD symptom in the diagnosis addressing dissociative amnesia—trouble remembering important aspects of the trauma—is less well correlated with the remaining PTSD symptoms than the conceptual reversal of having trouble forgetting important aspects of the trauma. Our findings contradict key assumptions that have shaped PTSD research during the past 40 years.
Elevated responding to safety cues in the context of threat is associated with anxiety disorder onset, but pathways underlying such responding remain unclear. In this study, we examined whether childhood/adolescent adversity was associated with larger startle reflexes during safe phases of a fear-potentiation startle paradigm (following delivery of an aversive stimulus) that predict anxiety disorders. Participants (N = 104) came from the Youth Emotion Project, a longitudinal study of risk factors for emotional disorders. Participants with no baseline psychopathology underwent a startle-modulation protocol and assessment for childhood and adolescent adversities using a validated interview. Adolescent adversity was associated with larger startle reflexes during the safe phases following an aversive stimulus. Neither child adversities nor adolescent adversities were associated with responding during any other phase of the protocol. These findings suggest a pathway between adolescent adversity and a risk factor for anxiety disorders in which adolescent adversity contributes to impaired responding to safety cues.
Visual attention is often hypothesized to play a causal role in the development of autism spectrum disorder (ASD). Because attention shapes perception, learning, and social interaction, early deficits in attention could substantially affect the development of other perceptual and cognitive abilities. Here we test two key attentional phenomena thought to be disrupted in autism: attentional disengagement and social orienting. We find in a free-viewing paradigm that both phenomena are present in high-functioning children with ASD (n = 44, ages 5–12 years) and are identical in magnitude to those in age- and IQ-matched typical children (n = 40). Although these attentional processes may malfunction in other circumstances, our data indicate that high-functioning children with ASD do not suffer from across-the-board disruptions of either attentional disengagement or social orienting. Combined with mounting evidence that other attentional abilities are largely intact, it seems increasingly unlikely that disruptions of core attentional abilities lie at the root of ASD.
Research on affect and self-esteem in social anxiety disorder (SAD) has focused on trait or average levels, but we know little about the dynamic patterns of these experiences in the daily lives of people with SAD. We asked 40 adults with SAD and 39 matched healthy controls to provide end-of-day reports on their affect and self-esteem over 2 weeks. Compared to healthy adults, participants with SAD exhibited greater instability of negative affect and self-esteem, though the self-esteem effect was driven by mean-level differences. The SAD group also demonstrated a higher probability of acute changes in negative affect and self-esteem (i.e., from one assessment period to the next), as well as difficulty maintaining positive states and improving negative states (i.e., dysfunctional self-regulation). Our findings provide insights on the phenomenology of SAD, with particular attention to the temporal dependency, magnitude of change, and directional patterns of psychological experiences in everyday life.
Posttraumatic stress disorder (PTSD), one of the most common disorders following trauma, has been associated with a tendency to remember past personal memories in a nonspecific, overgeneral way. The present study investigated whether such a bias also applies to projections of future personal events. Trauma survivors (N = 50) generated brief descriptions of imagined future experiences in response to positive and negative cues in a future-based Autobiographical Memory Test. Survivors with PTSD imagined fewer specific future events in response to positive, but not to negative, cues, compared to those without PTSD. This effect was independent of comorbid major depression. Reduced memory specificity in response to positive cues was related to appraisals of foreshortened future and permanent change. Training to enhance specificity of future projections may be helpful in PTSD and protect against potentially toxic effects of autobiographical memory overgenerality.
In this study, we sought to advance understanding of trait vulnerability to bipolar disorder (BD) by testing whether instability of the 24-hr activity rhythm was a biomarker of the trait. Locomotor activity was measured over 7 days using actigraphy in participants allocated to groups of high (n = 36) and low (n = 36) trait vulnerability for BD. As predicted, the high-vulnerability group recorded a significantly lower 24-hr activity rhythm amplitude than the low-vulnerability group, indicating a less stable activity pattern. Consistent with the notion of accumulating risk, results showed the lowest activity rhythm amplitudes in participants in the high-vulnerability group with a history of depression. Secondary investigations showed that mania proneness explained more variance than depression proneness, pointing to specificity of the findings for BD. The data reinforce claims that instability of daily rhythms is a biomarker of trait vulnerability to BD.
Biased attention toward negative stimuli is a known vulnerability for affective psychopathology. However, factors that contribute to the development of this cognitive bias are largely unknown. Variation within the serotonin transporter gene (i.e., 5-HTTLPR) is associated with increased susceptibility to environmental influence and biased processing of negative stimuli. Using a passive viewing eye-tracking paradigm, this study examined gaze fixation for emotion stimuli in 91 U.S. Army soldiers before and after deployment to Iraq. In addition, participants underwent genetic assay and provided in situ measures of war zone stress exposure. 5-HTTLPR short allele homozygotes were more likely than other genotype groups to develop a gaze bias toward negative stimuli as a function of increasing war zone stress, even when controlling for postdeployment posttraumatic stress disorder and depression severity. Short allele homozygotes appear especially sensitive to environmental influence, which likely contributes to the development of cognitive vulnerability to anxiety and mood disorders.
Many treatments for anxiety utilize associative learning theory and involve mental imagery components. However, the roles associative learning and imagery play in anxiety disorders and their treatments are still largely unknown. Here we show that voluntary mental imagery can undergo associative learning in the same manner as normal sensory perception. After conditioning voluntary mental images with emotion-evoking stimuli, perceptual stimuli of the same content were found to produce the associated emotional response—indicating generalization from imagery to perception. This associative learning with imagery was found to be orientation selective and could not be accounted for by alternative, non-imagery-based interpretations of the data. These results support pictorial theories of mental imagery by indicating the interchangeability of imagery and perception in associative learning and demonstrate that voluntary mental images can drive associative learning, providing a mechanistic account of clinical practice involving mental imagery.
Smoking and depression are related, and mood management interventions included in smoking cessation interventions can increase smoking abstinence rates. Could a mood management intervention embedded in an Internet-based smoking cessation intervention prevent major depressive episodes? Spanish- and English-speaking smokers (N = 17,430) from 191 countries were randomized to one of four online self-help intervention conditions (two with mood management). We analyzed preventive effects among those participants without a major depressive episode at baseline. The mood management intervention did not reduce the incidence of major depressive episodes in the following 12 months. However, we found a mood management by depression risk interaction (OR = 1.77, p = .004), such that high-risk participants who received the mood management intervention had an increased occurrence of major depressive episodes (32.8% vs. 26.6%), but not low-risk participants (11.6% vs. 10.8%). Further research on whether mood management interventions may have deleterious effects on subsets of smokers appears warranted.
Cognitive vulnerability is a potent risk factor for depression. Individual differences in cognitive vulnerability solidify in early adolescence and remain stable throughout the life span. However, stability does not mean immutability. We hypothesized that cognitive vulnerability would be susceptible to change during major life transitions when social milieus undergo significant changes (e.g., moving to college). Specifically, we tested the hypothesis that cognitive vulnerability could change via a contagion effect. We tested this hypothesis using a prospective longitudinal design with a sample of randomly assigned college freshmen roommate pairs (103 pairs). Results supported the hypotheses. Participants who were randomly assigned to a roommate with high levels of cognitive vulnerability were likely to "catch" their roommate’s cognitive style and develop higher levels of cognitive vulnerability. Moreover, those who experienced an increase in cognitive vulnerability had significantly greater levels of depressive symptoms over the prospective interval than those who did not.
We devised three measures of the general severity of events, which raters applied to participants’ narrative descriptions: (a) placing events on a standard normed scale of stressful events, (b) placing events into five bins based on their severity relative to all other events in the sample, and (c) an average of ratings of the events’ effects on six distinct areas of the participants’ lives. Protocols of negative events were obtained from two nondiagnosed undergraduate samples (n = 688 and 328), a clinically diagnosed undergraduate sample, all of whom had traumas and half of whom met posttraumatic stress disorder (PTSD) criteria (n = 30), and a clinically diagnosed community sample who met PTSD criteria (n = 75). The three measures of severity correlated highly in all four samples but failed to correlate with PTSD symptom severity in any sample. Theoretical implications for the role of trauma severity in PTSD are discussed.
Social anxiety disorder (SAD) is a pervasive problem associated with debilitating impairments in social settings. This research explored the affective and physiological reactions to social evaluation and examined the efficacy of an arousal reappraisal intervention in altering cardiovascular reactivity and affective responses. Across two studies, socially anxious participants exhibited a disjunction between subjective ratings and physiological responses. Whereas anxious individuals reported more anxiety and negative affect during a stressful public speaking task relative to nonanxious controls, no differences emerged in physiological reactivity as a function of anxiety. In the second experiment socially anxious and nonanxious participants instructed to reframe stress arousal as a positive coping tool exhibited reduced attentional bias and improvements in physiological functioning: decreased vasoconstriction and increased cardiac efficiency. This research suggests that outcomes in SAD may be improved by reappraising stress arousal.
Individuals differ strongly in their vulnerability to develop posttraumatic stress disorder (PTSD) in the aftermath of traumatic stress. This review on genetic risk factors in PTSD etiology employs the perspective of a psychobiological model, which proposes that intrusive memories, the core PTSD symptom, result from the formation of an associative neural fear network, which stores sensory-perceptual representations of traumatic memories. The current state of research on the genetics of PTSD, as well as common challenges, is presented in light of this framework. Because cumulative trauma exposure increases the fear memory strength, a standardized assessment of traumatic load and the investigation of Gene x Environment interactions are recommended. The investigation of genes involved in long-term memory formation, genome-wide association studies, pathway analyses, and the interplay of genetic and epigenetic factors could contribute to a deeper understanding of the molecular pathways involved in the formation and modification of the fear network.
Child sexual abuse can have devastating and long-lasting consequences for its victims, although some survivors manifest resilience or growth in the aftermath of abuse. This study explored resilience and thriving, assessed with life satisfaction ratings, in 47,869 self-identified survivors participating in a large cross-sectional national survey. Life satisfaction in survivors was associated with being younger, female, White, employed, better educated, better paid, and being in intimate relationships. The context of the abuse was not very important for predicting adult psychological status, but lesser severity of abuse and fewer additional traumatic experiences were positively associated with satisfaction. The Big Five personality variables were important predictors of satisfaction: Well-being was associated with greater extraversion, agreeableness, and conscientiousness, as well as lower openness and neuroticism. Studying thriving after trauma may be a fruitful avenue for future research and may assist in the development of treatment and prevention programs.