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Katz-Vago I, Benita M. Mastery-approach and performance-approach goals predict distinct outcomes during personal academic goal pursuit. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2024; 94:309-327. [PMID: 37994118 DOI: 10.1111/bjep.12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Mastery and performance goals are typically measured as trait-like abstract goals. However, in their daily academic pursuits, students pursue more concrete goals. The pursuit of these goals is replete with obstacles that can lead to an action crisis. AIMS We examined how mastery and performance goals affect progress, effort and well-being during academic goal pursuit. We also asked whether these goals moderated relations between an action crisis and goal pursuit. SAMPLE 154 Israeli students (average age = 23.59 years, SD = 2.17; 62% female) preparing for an exam. METHODS In this daily diary study, participants first reported the date of their most stressful exam, two related goals, and their trait-like achievement goals (mastery, performance). They then completed daily questionnaires assessing their progress, effort, well-being and action crisis on the 10 days leading up to the exam. RESULTS Multilevel modelling showed mastery goals positively predicted daily goal effort and progress and negatively predicted daily action crises, while performance goals positively predicted daily negative affect and action crises. An action crisis was negatively correlated with next-day goal progress and positive affect among students with high-performance goals. In students with low-performance goals, an action crisis positively predicted next-day positive affect. Finally, for students high on mastery goals, an action crisis was unrelated to negative affect on the same day. CONCLUSIONS Different trait-like achievement goals can be mapped onto a common personal goal and affect its pursuit differently. Mastery goals predict optimal goal pursuit, and performance goals are associated with non-optimal goal pursuit.
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Affiliation(s)
- Inbar Katz-Vago
- School of Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Moti Benita
- School of Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Falkenström F. Time-lagged panel models in psychotherapy process and mechanisms of change research: Methodological challenges and advances. Clin Psychol Rev 2024; 110:102435. [PMID: 38703437 DOI: 10.1016/j.cpr.2024.102435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 05/06/2024]
Abstract
In recent years, there has been increasing interest in utilizing time-lagged panel models to study mechanisms of change in psychotherapy. These models offer valuable insights into the dynamic relationships between variables over time and offer stronger causal inference capabilities than cross-sectional analyses. Therefore, they are well-suited for modeling the intricate relationships between mechanisms of change and outcomes in psychotherapy studies, which are typically beyond experimental control. However, their complexity, coupled with the fact that detailed explanations are often embedded in dense statistical or econometric texts, poses challenges. This paper provides a background on cross-lagged panel models and delves deeper into explaining the issues of 1) dynamic panel bias, 2) long-run effects, and 3) testing whether different treatments work by different mechanisms. Using data from a psychotherapy study on treatment of adolescent depression, I demonstrate how these issues manifest in real data. In conclusion, I recommend using structural equation modeling to circumvent dynamic panel bias, reporting long-run effects to reveal the long-term impact of sustained therapeutic work on mechanisms of change, and carefully considering whether mediation, moderation, or a combination of both, best describes differential effects of mechanisms between treatments.
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Park IJK, Wang L, Li R, Yip T, Valentino K, Cruz-Gonzalez M, Giraldo-Santiago N, Lorenzo K, Zhen-Duan J, Alvarez K, Alegría M. A daily diary study of discrimination and distress in Mexican-origin adolescents: Testing mediating mechanisms. Child Dev 2024. [PMID: 38698702 DOI: 10.1111/cdev.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
The present 21-day daily diary study (conducted 2021-2022) tested anger and racism-related vigilance as potential transdiagnostic mediators linking exposure to racial and ethnic discrimination (RED) to distress (negative affect and stress, respectively). The data analytic sample included N = 317 Mexican-origin adolescents (Mage = 13.5 years; 50.8% male, 46.7% female; 2.5% non-binary) from the Midwestern United States. Results from longitudinal mediation models revealed significant mediation effects through anger and racism-related vigilance, respectively, in the association between daily RED and daily distress, both within and across adolescents. Implications for theory, research, and practice are discussed so that future work can leverage these novel findings toward promoting the well-being of Mexican-origin adolescents, especially those who live in contexts of ethnoracial adversity.
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Affiliation(s)
- Irene J K Park
- Department of Psychiatry, Indiana University School of Medicine-South Bend, South Bend, Indiana, USA
| | - Lijuan Wang
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Ruoxuan Li
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Kristin Valentino
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Natalia Giraldo-Santiago
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kyle Lorenzo
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Kiara Alvarez
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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4
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Hochheimer M, Strickland JC, Ellis JD, Rabinowitz JA, Hobelmann JG, Ford M, Huhn AS. Age moderates the association of optimism on craving during substance use disorder treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209297. [PMID: 38281707 PMCID: PMC11060931 DOI: 10.1016/j.josat.2024.209297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/25/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Optimism, characterized by a positive expectancy toward future outcomes, has garnered attention for its potential role in influencing well-being and may be a protective factor in substance use disorder (SUD) treatment. This study evaluated the relationship of optimism and craving among those in substance use disorder SUD treatment. METHODS Drawing from a cohort of 4201 individuals in residential SUD treatment programs, this study used both cross-sectional and longitudinal assessment to examine tonic (steady-state) and cue-induced (phasic) cravings across individuals primarily using eight classes of substances. Previous research established that optimism increases during adulthood and peaks during an individual's 50s. This study sought to establish if the association between optimism and craving is moderated by age during the first week of treatment and if that relationship changes over the course of treatment both within and between-person. RESULTS This study found a negative correlation between optimism and craving intensity. Elevated optimism scores correlated with substantially reduced levels of both tonic (β = -0.31, p < 0.001) and cue-induced (β = -0.29, p < 0.001) cravings. Age was a significant moderator of the relationship between optimism and craving such that as individuals age, the potency of optimism in mitigating cravings gradually attenuates (interaction for tonic craving: β = 0.06, p < 0.001; interaction for cue-induced craving: β = 0.05, p < 0.001). Reflected in the fact that in older individuals' cravings tended to converge toward lower or moderate levels, regardless of their optimism scores. CONCLUSIONS By delineating the contemporaneous association between high optimism and lower cravings, the study suggests that interventions aimed at fostering optimism may represent an avenue to improve the effectiveness of SUD treatment, especially in emerging adults.
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Affiliation(s)
- Martin Hochheimer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer D Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Maggie Ford
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Gutierrez-Colina AM, Aichele S, Lavender JM, Sanchez N, Thorstad I, Gulley LD, Emerick JE, Schrag R, Thomas V, Spinner H, Arnold T, Heroy A, Haigney MC, Tanofsky-Kraff M, Shomaker LB. Associations of social and cognitive-behavioral variables with disinhibited eating and anxiety: An ecological momentary assessment study. Int J Eat Disord 2024; 57:1213-1223. [PMID: 38415929 DOI: 10.1002/eat.24177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Among adolescents, disinhibited eating and anxiety commonly co-occur. Precision intervention approaches targeting unique mechanistic vulnerabilities that contribute to disinhibited eating and anxiety may therefore be helpful. However, the effectiveness of such interventions hinges on knowledge of between- and within-person associations related to disinhibited eating, anxiety, and related processes. METHOD A sample of 39 adolescent females (12-17 years) with elevated anxiety and above-average weight (BMI %ile ≥ 75th) completed measures of theoretically driven social and cognitive-behavioral variables, disinhibited eating, and anxiety via ecological momentary assessment over 7 days. Data were analyzed using mixed-effects models. RESULTS Between-person differences in social stressors were linked to emotional eating, eating in the absence of hunger, and anxiety, whereas between-person differences in negative thoughts were associated with all disinhibited eating variables and anxiety. Between-person differences in avoidance were not related to any outcome. Additionally, between-person differences in social stressors and negative thoughts-as well as within-person deviations (from person-average levels) of social stressors, negative thoughts, and avoidance-were associated with anxiety. In turn, between-person differences in anxiety predicted eating in the absence of hunger and emotional eating, and within-person deviations in anxiety were associated with emotional eating at any given time point. DISCUSSION Findings support elements of both the interpersonal and cognitive-behavioral models of disinhibited eating. Differential trigger effects on anxiety, both at the between- and within-person levels, and significant associations between anxiety and all eating-related outcomes, highlight the potential utility of interventions targeting individual differences in sensitivity to anxiety triggers. PUBLIC SIGNIFICANCE Findings provide support for the interpersonal and cognitive-behavioral models of disinhibited eating, highlighting anxiety as a salient vulnerability and potential mechanistic factor underlying disinhibited eating. Social, cognitive, and behavioral variables were differentially related to anxiety across participants, suggesting potential for future intervention tailoring and intervention selection based on adolescents' sensitivity to anxiety as a trigger for disinhibited eating behavior.
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Affiliation(s)
- Ana M Gutierrez-Colina
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Stephen Aichele
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Aurora, Colorado, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jill E Emerick
- Department of Pediatrics, Uniformed Services University, Bethesda, Maryland, USA
| | - Ruby Schrag
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Victoria Thomas
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Thomas Arnold
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Andrew Heroy
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Mark C Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, Maryland, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
- Colorado School of Public Health, Aurora, Colorado, USA
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6
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Chen X, Leung FKS. Control-value appraisals and academic emotions: An intensive longitudinal examination of reciprocal effects. Child Dev 2024; 95:972-987. [PMID: 38044498 DOI: 10.1111/cdev.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 10/20/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023]
Abstract
This study examined the reciprocal relation between lesson-specific perceived cognitive appraisals and academic emotions on an intra-individual level. A daily diary study was conducted using a sample of 266 Chinese Han students (Grades 7-8; 56.8% boys; Mage = 13.70, SDage = 0.52) during 10 mathematics lessons in 2022. Standardized questionnaires were also administered to these students before the daily diary study. The results of the dynamic structural equation modeling revealed significant reciprocal relations between cognitive appraisals and academic emotions within early adolescents and highlighted the role of emotions in guiding cognitive appraisals. Additionally, the study identified similarities and differences in the inter-individual relation between appraisals and emotions across self-reported questionnaires and daily diary measures.
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Affiliation(s)
- Xin Chen
- Unit of Teacher Education and Learning Leadership, Faculty of Education, The University of Hong Kong, Hong Kong
| | - Frederick K S Leung
- Unit of Teacher Education and Learning Leadership, Faculty of Education, The University of Hong Kong, Hong Kong
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Paoletti J, Argueta DL, Wu-Chung EL, Chen MA, Brown RL, LeRoy AS, Murdock KW, Thayer JF, Fagundes CP. High Heart Rate Variability Buffers the Effect of Attachment Insecurity on Sleep Quality. Psychosom Med 2024; 86:349-358. [PMID: 38446714 PMCID: PMC11081832 DOI: 10.1097/psy.0000000000001295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Sleep quality is an important health-protective factor. Psychosocial factors, including attachment orientation, may be valuable for understanding who is at risk of poor sleep quality and associated adverse health outcomes. High attachment anxiety is reliably associated with adverse health outcomes, whereas high attachment avoidance is associated with adverse health outcomes when co-occurring with poor self-regulatory capacity, indexed by heart rate variability (HRV). We examined the associations between attachment anxiety, attachment avoidance, HRV, and sleep quality. METHODS Using longitudinal data from a sample of 171 older adults measured four times over 1 year ( M = 66.18 years old; 67.83% women), we separated the between-person variance (which we call "trait") and within-person variance (which we call "state") for attachment anxiety, attachment avoidance, and HRV (via the root mean square of successive differences). Sleep quality was measured with the Pittsburgh Sleep Quality Index. RESULTS Higher trait attachment anxiety was associated with poorer global sleep quality ( B = 0.22, p = .005). Higher state attachment avoidance was associated with poorer sleep quality ( B = -0.13, p = .01), except for those with higher trait HRV. Higher state attachment anxiety was associated with poorer sleep quality ( B = -0.15, p = .002), except for those with higher or mean trait HRV. Higher trait attachment anxiety was associated with poorer sleep quality ( B = -0.31, p = .02), except for those with higher trait HRV. CONCLUSIONS High trait HRV mitigated the adverse effects of attachment insecurity on sleep quality. Our results suggest that people with high trait HRV had greater self-regulation capacity, which may enable them to enact emotion regulation strategies effectively.
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Affiliation(s)
| | | | | | | | - Ryan L. Brown
- University of California San Francisco, Department of Psychiatry and Behavioral Sciences
| | - Angie S. LeRoy
- Baylor University, Department of Psychology & Neuroscience
| | - Kyle W. Murdock
- Pennsylvania State University, Department of Biobehavioral Health
| | - Julian F. Thayer
- University of California Irvine, Department of Psychological Sciences
| | - Christopher P. Fagundes
- Rice University, Department of Psychological Sciences
- University of Texas MD Anderson Cancer Center, Department of Behavioral Science
- Baylor College of Medicine, Department of Psychiatry
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Karacaoglu M, Peerdeman KJ, Karch JD, van Middendorp H, Evers AWM. Nocebo hyperalgesia and other expectancy-related factors in daily fibromyalgia pain: Combining experimental and electronic diary methods. J Psychosom Res 2024; 182:111676. [PMID: 38688078 DOI: 10.1016/j.jpsychores.2024.111676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Expectancies are known to shape pain experiences, but it remains unclear how different types of expectancies contribute to daily pain fluctuations in fibromyalgia. This combined experimental and diary study aims to provide insights into how experimentally-derived nocebo hyperalgesia and other, diary-derived, expectancy-related factors are associated with each other and with daily pain in fibromyalgia. METHODS Forty-one female patients with fibromyalgia first participated in a lab procedure measuring nocebo hyperalgesia magnitude, then filled out an electronic diary 3 times a day over 3 weeks regarding the expectancy-related factors of pain expectancy, anxiety, optimism, and pain-catastrophizing thoughts, and current pain intensity. RESULTS Our results indicate that experimentally-induced nocebo hyperalgesia was not significantly related to diary-assessed expectancy-related factors and did not predict daily fibromyalgia pain. Higher levels of the self-reported expectancy-related factors pain expectancy and pain catastrophizing, but not anxiety and optimism, predicted moment-to-moment pain increases in fibromyalgia, after controlling for current pain, moment-of-day and all other expectancy-related factors. CONCLUSION Our exploratory research findings indicate that self-reported expectancy-related factors, particularly pain expectancy and pain catastrophizing, are potentially more relevant for predicting daily pain experience than experimentally-induced nocebo hyperalgesia. Further translation of nocebo hyperalgesia is needed from experimental to Ecological Momentary Assessment research. Our findings imply that targeting the decrease in pain expectancy and catastrophizing thoughts e.g., via Cognitive Behavioral Therapy, have potential for improving daily pain levels in fibromyalgia.
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Affiliation(s)
- Merve Karacaoglu
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands; Center for Interdisciplinary Placebo Studies Leiden, Leiden University, The Netherlands.
| | - Kaya J Peerdeman
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands; Center for Interdisciplinary Placebo Studies Leiden, Leiden University, The Netherlands
| | - Julian D Karch
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Henriët van Middendorp
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands; Center for Interdisciplinary Placebo Studies Leiden, Leiden University, The Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands; Center for Interdisciplinary Placebo Studies Leiden, Leiden University, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Medical Delta, Erasmus University Rotterdam, Leiden University & Delft University of Technology, Rotterdam/Leiden/Delft, The Netherlands
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9
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Valentino K, Park IJK, Cruz-Gonzalez M, Zhen-Duan J, Wang L, Yip T, Lorenzo K, Dias D, Alvarez K, Alegría M. Family-level moderators of daily associations between discrimination and distress among Mexican-origin youth. Dev Psychopathol 2024:1-16. [PMID: 38584283 DOI: 10.1017/s0954579424000749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
The current study evaluated cultural values and family processes that may moderate associations between daily racial-ethnic discrimination and distress among Mexican-origin youth. Integrating micro-time (daily diary) and macro-time (longitudinal survey) research design features, we examined familism, family cohesion, and ethnic-racial socialization from youth-, mother-, and father- reports as potential buffers of daily associations between youth racial-ethnic discrimination and youth distress (negative affect and anger). The analytic sample, drawn from the Seguimos Avanzando study, included 317 Mexican-origin adolescents (Mage = 13.5 years) and their parents, recruited from the Midwestern United States. Results indicated that youth-reported familism and family cohesion significantly buffered daily associations between youth racial-ethnic discrimination and youth distress. In contrast, parent-reported familism and family cohesion and some aspects of ethnic-racial socialization exacerbated the discrimination to distress link. The implications of these results are discussed to inform efforts supporting the healthy development of Mexican-origin youth and their families.
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Affiliation(s)
| | - Irene J K Park
- Department of Psychiatry, Indiana University School of Medicine-South Bend, South Bend, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, USA
- Department of Medicine, Harvard Medical School, Boston, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Lijuan Wang
- Department of Psychology, University of Notre Dame, Notre Dame, USA
| | - Tiffany Yip
- Department of Psychology, Fordham University, New York, USA
| | - Kyle Lorenzo
- Department of Psychology, Fordham University, New York, USA
| | - David Dias
- Department of Psychology, University of Notre Dame, Notre Dame, USA
| | - Kiara Alvarez
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, USA
- Department of Medicine, Harvard Medical School, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
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10
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Zalaznik D, Zlotnick E, Barzilay S, Ganor T, Sorka H, Ebert DD, Andersson G, Huppert JD. Interpersonal factors in internet-based cognitive behavioral therapy for depression: Attachment style and alliance with the program and with the therapist. Psychother Res 2024:1-16. [PMID: 38581409 DOI: 10.1080/10503307.2024.2325510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/27/2024] [Indexed: 04/08/2024] Open
Abstract
Objective This open-trial study examined effects of a culturally-adapted Hebrew version of guided internet-based cognitive behavioural therapy (ICBT) for depression. We examined therapeutic alliance with the therapist and with the programme (content) as potential predictors of outcomes. Furthermore, we examined whether anxious and avoidant attachment styles improved, although relationships were not the focus of treatment. Method: We examined alliance with therapist and alliance with programme and their time-lagged (1 week), longitudinal relationship with depression outcomes, and change in anxious and avoidant attachment during treatment. Results: Depression and insomnia improved significantly (Cohen's d: depression = 1.34, insomnia = 0.86), though dropout was relatively high (49%). Alliance with programme and with the therapist predicted adherence and dropout, whereas only alliance with therapist predicted symptom improvement. Avoidant attachment decreased over treatment whereas anxious attachment did not. Conclusion: A culturally-adapted version of ICBT for depression showed that alliance with therapist and alliance with programme both can play an important role in its effectiveness: alliance with programme and the therapist drive adherence and dropout and alliance with therapist is related to symptom improvement. Although the focus of treatment is not interpersonal, avoidant attachment style can improve following ICBT.
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Affiliation(s)
- Dina Zalaznik
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elad Zlotnick
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Snir Barzilay
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Ganor
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hila Sorka
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Daniel Ebert
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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11
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McAlpine T, Mullan B, Clarke PJF. Assessing the daily association of sleep hygiene behaviours with sleep: A between and within persons approach. J Behav Med 2024; 47:255-270. [PMID: 37702911 PMCID: PMC10944446 DOI: 10.1007/s10865-023-00448-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 08/19/2023] [Indexed: 09/14/2023]
Abstract
Sleep hygiene behaviours are recommendations given to both clinical and non-clinical populations with a focus on modifying behaviours to maximise sleep outcomes. However, methodological issues present in sleep hygiene research make it difficult to conclusively determine the impact of each behaviour. This study aimed to address these issues by adopting a two-week, repeated measures design which incorporated objective sleep measures and used linear mixed effect modelling to assess the daily association of a wide range of sleep hygiene behaviours on sleep in a non-clinical, university sample. Between-persons effects revealed that bedtime and frequency of daytime napping, alcohol use, and social media use were negatively related to sleep duration while waketime and frequency of too much water consumption were positively related to sleep duration. Within-person effects revealed that later than usual bedtime, earlier than usual waketime, no sunlight exposure, poor ventilation, having an unpleasant conversation before bed were negatively associated with sleep duration whereas using alcohol to deliberately help full asleep was positively related to sleep duration. In contrast, disproportionately more behaviours were not significantly related to either sleep outcome, only some of which could be explained by individual differences, which suggests that more research is needed to determine the conditions under which these behaviours affect sleep, if at all.
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Affiliation(s)
- Thomas McAlpine
- enAble Institute, Curtin University, Bentley, WA, 6102, Australia
- School of Population Health, Curtin University, Bentley, WA, 6102, Australia
| | - Barbara Mullan
- enAble Institute, Curtin University, Bentley, WA, 6102, Australia.
- School of Population Health, Curtin University, Bentley, WA, 6102, Australia.
| | - Patrick J F Clarke
- enAble Institute, Curtin University, Bentley, WA, 6102, Australia
- School of Population Health, Curtin University, Bentley, WA, 6102, Australia
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12
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Bai L, Chimed-Ochir U, Teti DM. Coparenting as a family-level construct: Parent and child inputs across the first two years. FAMILY PROCESS 2024. [PMID: 38533685 DOI: 10.1111/famp.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/19/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
This study examined the effects of infant negative affectivity (NA) and maternal and paternal depressive symptoms on fathers' and mothers' perceptions of coparenting across the first 2 years following an infant's birth. A total of 147 two-parent families (most couples were White, married, and living together) with healthy, full-term infants were recruited. At each time point, fathers and mothers separately reported their coparenting perceptions via the Coparenting Relationship Scale and their depressive symptoms using the depression subscale of Symptom Checklist-90-Revised. Mothers also reported their children's NA via the Infant Behavior Questionnaire-Revised at 3 to 12 months and the Early Child Behavior Questionnaire at 18 and 24 months. Findings from growth curve models in an actor-partner interdependence model framework suggested that among parents with higher depression, there were steeper declines in coparenting quality reported by parents and their spouses across 3-24 months. In addition, three separate two-way interactions between variables including higher-than-usual parental and spousal depression, as well as higher-than-usual infant NA predicted poorer-than-usual coparenting experiences. Findings indicate that coparenting is a dynamically unfolding construct that is impacted by ongoing changes in the parents' social-ecological niche and suggest the need to consider both parent and child characteristics, and to include spousal influences, to get a comprehensive, whole-family understanding of levels and changes in coparenting relationships. The findings also confirm that coparenting dynamics may benefit from interventions engaging both couples and addressing multiple risk factors from both parents (e.g., depression) and children (e.g., NA).
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Affiliation(s)
- Liu Bai
- Research Center for Child Development, Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Ulziimaa Chimed-Ochir
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Douglas M Teti
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
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13
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Hagemann V, Rieth M, Klasmeier KN. The analysis of collective orientation and process feedback in relation to coordination and performance in interdependently working teams. PLoS One 2024; 19:e0297565. [PMID: 38512956 PMCID: PMC10956848 DOI: 10.1371/journal.pone.0297565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/05/2024] [Indexed: 03/23/2024] Open
Abstract
Effective teamwork is not only essential for teams themselves, but also for organizations and our society. To facilitate team processes and enhance team performance, feedback interventions are a widely used means. However, different types of feedback (i.e., individual vs. team-level feedback, performance vs. process feedback) can have various effects leaving the question of their effectiveness unanswered. This is especially important when team members' attitudes (namely collective orientation) are considered. Thus, understanding the interplay between types of feedback and team members' attitudes would reveal new opportunities for fostering reliable teamwork. The methodology of the present study is based on a laboratory approach. Teams (N = 142) of two worked together over four scenarios to extinguish forest fires in a microworld. We examined the effects of collective orientation on team coordination and team performance. To understand the interplay between feedback and attitudes we examined the effect of different feedback interventions on team performance and on a change in collective orientation. For analyzing multilevel mediation and changes over time, Bayesian multilevel models were applied. Results show a positive relationship between collective orientation and team performance mediated by coordination. Additionally, team-level process and performance feedback seem to be slightly more beneficial for maintaining performance over time with increasing difficulty of the task compared to individual-level process feedback. Feedback can lead to an increase in collective orientation if these values are low at the beginning. Our research highlights the importance of collective orientation and feedback interventions on team processes and performance for interdependently working teams.
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Affiliation(s)
- Vera Hagemann
- Faculty of Business Studies and Economics, Business Psychology & Human Resource Management, University of Bremen, Bremen, Germany
| | - Michèle Rieth
- Faculty of Business Studies and Economics, Business Psychology & Human Resource Management, University of Bremen, Bremen, Germany
| | - Kai N. Klasmeier
- Federal Institute for Occupational Safety and Health, Dortmund, Germany
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14
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Vaid SS, Kroencke L, Roshanaei M, Talaifar S, Hancock JT, Back MD, Gosling SD, Ram N, Harari GM. Variation in social media sensitivity across people and contexts. Sci Rep 2024; 14:6571. [PMID: 38503817 PMCID: PMC10951328 DOI: 10.1038/s41598-024-55064-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/20/2024] [Indexed: 03/21/2024] Open
Abstract
Social media impacts people's wellbeing in different ways, but relatively little is known about why this is the case. Here we introduce the construct of "social media sensitivity" to understand how social media and wellbeing associations differ across people and the contexts in which these platforms are used. In a month-long large-scale intensive longitudinal study (total n = 1632; total number of observations = 120,599), we examined for whom and under which circumstances social media was associated with positive and negative changes in social and affective wellbeing. Applying a combination of frequentist and Bayesian multilevel models, we found a small negative average association between social media use AND subsequent wellbeing, but the associations were heterogenous across people. People with psychologically vulnerable dispositions (e.g., those who were depressed, lonely, not satisfied with life) tended to experience heightened negative social media sensitivity in comparison to people who were not psychologically vulnerable. People also experienced heightened negative social media sensitivity when in certain types of places (e.g., in social places, in nature) and while around certain types of people (e.g., around family members, close ties), as compared to using social media in other contexts. Our results suggest that an understanding of the effects of social media on wellbeing should account for the psychological dispositions of social media users, and the physical and social contexts surrounding their use. We discuss theoretical and practical implications of social media sensitivity for scholars, policymakers, and those in the technology industry.
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Affiliation(s)
- Sumer S Vaid
- Department of Communication, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA.
- Negotiations, Organizations and Marketing Unit, Harvard Business School, Boston, USA.
| | | | - Mahnaz Roshanaei
- Department of Communication, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
| | | | - Jeffrey T Hancock
- Department of Communication, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
| | | | - Samuel D Gosling
- University of Texas at Austin, Austin, USA
- Melbourne University, Melbourne, Australia
| | - Nilam Ram
- Department of Communication, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
| | - Gabriella M Harari
- Department of Communication, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
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Fruhbauerova M, Terrill DR, Semcho SA, Stumpp NE, McCann JP, Sauer-Zavala S, Southward MW. Skill Use Mediates the Within-Person Effect of the Alliance on Session-to-Session Changes in Anxiety and Depression in the Unified Protocol. JOURNAL OF MOOD AND ANXIETY DISORDERS 2024; 5:100043. [PMID: 38523702 PMCID: PMC10959249 DOI: 10.1016/j.xjmad.2023.100043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Objective Both the therapeutic alliance and the specific skills taught in treatment are thought to contribute to change in cognitive-behavior therapy (CBT), but it is unclear if or how these processes influence each other and outcomes in treatment. We tested the hypothesis that the degree to which patients used CBT skills would mediate the relation between the alliance and session-to-session changes in anxiety and depression. Method Adult participants (N = 70; Mage = 33.74, 67% female, 70% White) with emotional disorders were randomized to receive 6 or 12 sessions of the Unified Protocol. Before each session, participants reported anxiety and depression severity and past-week skillfulness. After each session, participants rated the strength of the alliance. We tested whether greater within-person skillfulness mediated the relation between within-person alliance strength and session-to-session changes in anxiety and depression. Results Skillfulness significantly mediated the effect of the alliance on session-to-session changes in anxiety, ab = -.02, p = .04, and depression, ab = -.02, p = .02, such that a stronger alliance predicted greater next-session skillfulness, which predicted session-to-session decreases in anxiety and depression. When alliance subscales were examined separately, the strongest effect was observed for agreement on therapy tasks. Conclusions Improvements in the alliance may facilitate skill use and indirectly predict reductions in anxiety and depression through skill use in CBT. We encourage research on how to enhance both the alliance and skillfulness in CBT.
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Bierman A, Upenieks L, Lee Y, Mehrabi F. Mattering and Self-Esteem as Bulwarks Against the Consequences of Financial Strain for Loneliness in Later Life: Differentiating Between- and Within-Person Processes. Res Aging 2024; 46:241-257. [PMID: 38146167 PMCID: PMC10868150 DOI: 10.1177/01640275231221326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Financial strain likely constitutes a principal risk for loneliness in later-life, but a strong sense of mattering and self-esteem may mitigate these consequences by both offsetting and buffering the influence of financial strain. We test these arguments using data from a national longitudinal survey of older adults gathered between 2021 and 2022 (N = 2384), as nations emerged from the COVID-19 pandemic. Application of a within-between modelling strategy facilitates differentiation of inter-individual (i.e., between-person) and intra-individual (i.e., within-person) factors. Between-person financial strain is associated with greater loneliness, but within- and between-person mattering and self-esteem offset this association by forestalling loneliness. Between-person mattering buffers between-person financial strain, but between-person self-esteem buffers within-person financial strain. Consequently, within-person financial strain is associated with greater loneliness only at low levels of between-person self-esteem. In summary, accruing a strong sense of worth contributes to protecting older adults from the adverse consequences of financial strain for loneliness.
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Affiliation(s)
- Alex Bierman
- Department of Sociology, University of Calgary, Calgary, AB, Canada
| | - Laura Upenieks
- Department of Sociology, Baylor University, Waco, TX, USA
| | - Yeonjung Lee
- School of Social Welfare, Chung-Ang University, Seoul, Korea
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Fahimeh Mehrabi
- Department of Sociology, University of Calgary, Calgary, AB, Canada
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17
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Jacoby RJ, Brown ML, Wieman ST, Rosenfield D, Hoeppner SS, Bui E, Hoge EA, Khalsa SBS, Hofmann SG, Simon NM. Effect of cognitive behavioural therapy and yoga for generalised anxiety disorder on sleep quality in a randomised controlled trial: the role of worry, mindfulness, and perceived stress as mediators. J Sleep Res 2024; 33:e13992. [PMID: 37577773 PMCID: PMC10840983 DOI: 10.1111/jsr.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 08/15/2023]
Abstract
Sleep disturbances are present in ~65% of individuals with generalised anxiety disorder (GAD). Although both Kundalini yoga (KY) and cognitive behavioural therapy (CBT) are effective treatment options for GAD, little is known about how these treatments compare in improving sleep for GAD and what drives these changes. Accordingly, we examined the effects of CBT, KY, and stress education (SEdu; an attention control condition) on subjective sleep quality (as measured by the Pittsburgh Sleep Quality Index [PSQI] and Insomnia Severity Index [ISI]) in a randomised controlled trial of 226 adults with GAD (mean age 33.37 years; 70% female; 79% White). We hypothesised that both CBT and KY would outperform SEdu in improving sleep disturbances. Three potential mediators of sleep improvement (worry, mindfulness, perceived stress) were also examined. In line with hypotheses, PSQI and ISI scores significantly improved from pre- to post-treatment for all three treatment groups (all p < 0.001, all d > 0.97). However, contrary to predictions, sleep changes were not significantly greater for CBT or KY compared to SEdu. In mediation analyses, within-person deviations in worry, mindfulness, and stress each significantly mediated the effect of time on sleep outcomes. Degree of change in sleep attributable to worry (CBT > KY > SEdu) and perceived stress (CBT, KY > SEdu) was moderated by treatment group. Personalised medicine as well as combined treatment approaches should be studied to help reduce sleep difficulties for patients with GAD who do not respond.
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Affiliation(s)
- Ryan J. Jacoby
- Massachusetts General Hospital / Harvard Medical School, Department of Psychiatry, 185 Cambridge St, Suite 2000, Boston, MA 02114, USA
| | - Mackenzie L. Brown
- University of Louisville, Department of Psychology, 2301 S 3rd St, Louisville, KY 40292, USA
| | - Sarah T. Wieman
- Suffolk University, Department of Psychology, 73 Tremont St., Boston, MA 02108, USA
| | - David Rosenfield
- Southern Methodist University, Department of Psychology, P.O. Box 750442, Dallas, TX 75275, USA
| | - Susanne S. Hoeppner
- Massachusetts General Hospital / Harvard Medical School, Department of Psychiatry, 185 Cambridge St, Suite 2000, Boston, MA 02114, USA
| | - Eric Bui
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders”, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), GIP Cyceron, Caen, France & Centre Hospitalier Universitaire Caen Normandie, Caen, France
| | - Elizabeth A. Hoge
- Georgetown University Medical Center, Department of Psychiatry, 2115 Wisconsin Ave, NW, Suite 200, Washington, DC, 20007, USA
| | - Sat Bir S. Khalsa
- Brigham and Women’s Hospital / Harvard Medical School, Division of Sleep and Circadian Disorders, Department of Medicine, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Stefan G. Hofmann
- Philipps-University Marburg, Department of Clinical Psychology, Schulstrasse 12, 35037 Marburg/Lahn, Germany
| | - Naomi M. Simon
- New York University Grossman School of Medicine, Department of Psychiatry, One Park Avenue, 8th Floor, New York NY 10016, USA
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18
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Huang J, Chen S, Yang W, Wang Y. The network dynamics of self-compassion components and psychological symptoms during an intervention. Appl Psychol Health Well Being 2024; 16:296-314. [PMID: 37668285 DOI: 10.1111/aphw.12488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
The change process of psychological interventions is complex and should be understood with a systems perspective. This study sought to examine the network dynamics of self-compassion components and psychological symptoms during an intervention. A total of 139 participants completed daily assessments during a 28-day intervention. Utilizing multilevel vector autoregressive (VAR) model, temporal and contemporaneous networks were generated and group differences in network dynamics were evaluated through descriptive assessment and permutation tests. The intervention group displayed a significant increase in self-compassion and decrease in psychological symptoms, with self-compassion mediating the intervention effects on symptoms. Network analysis revealed some network dynamics that might be relevant to desirable therapeutic changes in the intervention group. The intervention group demonstrated a significantly less connected contemporaneous depression network, indicating a decreased vulnerability to symptom activation. Additionally, the intervention group showed significantly more temporal connections from self-compassion to anxiety, indicating an increased influence of self-compassion on anxiety. These findings suggest that the intervention may have reshaped the interconnection pattern of symptoms and that between self-compassion components and symptoms.
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Affiliation(s)
- Jiasheng Huang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Siyu Chen
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Wanting Yang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yuyin Wang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
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19
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Bayliss LT, Hughes CD, Lamont-Mills A, du Plessis C. Fluidity in capability: Longitudinal assessments of suicide capability using ecological momentary assessments. Suicide Life Threat Behav 2024; 54:138-153. [PMID: 38009897 DOI: 10.1111/sltb.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Suicide capability is posited to facilitate the movement from ideation-to-action. Emerging evidence suggests capability comprises both trait- and state-like facets. This study examined fluctuations in and associations of acquired, dispositional, practical, and perceived capabilities, and suicidal mental imagery, and suicidal ideation. METHOD Seventy-five adults (48 females, Mage = 36.53 years) with lived experience of suicidal ideation and/or attempt responded to four prompts per day for 2 weeks that assessed suicide capability and suicidal ideation. Mean-squared successive differences and probability of acute change indices and multilevel models were used for analyses. RESULTS All facets of suicide capability fluctuated. Acquired and dispositional capabilities were trait-like, with practical and perceived capabilities being state-like. Suicidal mental imagery was the only facet of suicide capability that distinguished participants with a suicide attempt in the past 12 months from participants with a suicide attempt more than 1 year ago and suicide ideators. Suicidal mental imagery was associated with concurrent suicidal ideation and predictive of next assessment suicidal ideation. CONCLUSION Suicidal mental imagery may be uniquely associated with suicide capability. This study suggests there are trait- and state-like facets of capability that can combine to potentially ready an individual to engage in suicidal behaviors.
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Affiliation(s)
- Luke T Bayliss
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Christopher D Hughes
- Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Andrea Lamont-Mills
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- Academic Affairs Division, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
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20
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Hoffman L, Hall GJ. Considering between- and within-person relations in auto-regressive cross-lagged panel models for developmental data. J Sch Psychol 2024; 102:101258. [PMID: 38143095 DOI: 10.1016/j.jsp.2023.101258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/02/2023] [Accepted: 10/26/2023] [Indexed: 12/26/2023]
Abstract
Longitudinal data can provide inferences at both the between-person and within-person levels of analysis, but only to the extent that the statistical models chosen for data analysis are specified to adequately capture these distinct sources of association. The present work focuses on auto-regressive cross-lagged panel models, which have long been used to examine time-lagged reciprocal relations and mediation among multiple variables measured repeatedly over time. Unfortunately, many common implementations of these models fail to distinguish between-person associations among individual differences in the variables' amounts and changes over time, and thus confound between-person and within-person relations either partially or entirely, leading to inaccurate results. Furthermore, in the increasingly complex model variants that continue to be developed, what is not easily appreciated is how substantial differences in interpretation can be created by what appear to be trivial differences in model specification. In the present work, we aimed to (a) help analysts become better acquainted with the some of the more common model variants that fall under this larger umbrella, and (b) explicate what characteristics of one's data and research questions should be considered in selecting a model. Supplementary Materials include annotated model syntax and output using Mplus, lavaan in R, and sem in Stata to help translate these concepts into practice.
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21
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Yang M, Schick MR, Sullivan TP, Weiss NH. Predicting Completion of Ecological Momentary Assessments Among Substance-Using Women Experiencing Intimate Partner Violence. Assessment 2024:10731911231216948. [PMID: 38174693 DOI: 10.1177/10731911231216948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Noncompletion of ecological momentary assessment (EMA) surveys is a common issue and may yield bias in results if not properly handled. Using data observed at scheduled times as well as data retrieved later to fill missing responses, this study aims to investigate predictors of EMA completion, including demographic characteristics, time-related factors, and momentary experiences/behaviors. Data were from a 30-day EMA study including 145 women currently experiencing intimate partner violence (IPV) and using substances. The average rate of EMA completion was initially 51.4% at the scheduled times and increased to 72.6% after incorporating data from later-retrieved surveys. Participants who were younger, had more children, or had lower mean levels of negative affect dysregulation showed lower completion rates. At the momentary survey level, more days into the study and afternoon/evening reports (vs. morning reports) were associated with lower completion; lower levels of negative affect dysregulation, less smoking or alcohol use, and experiencing IPV were linked to lower momentary completion. Implications of the results for handling missing data in EMA are discussed and have important ramifications for future research, practice, and theory.
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22
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Stumpp NE, Southward MW, Sauer-Zavala S. Assessing Theories of State and Trait Change in Neuroticism and Symptom Improvement in the Unified Protocol. Behav Ther 2024; 55:93-105. [PMID: 38216240 PMCID: PMC10787156 DOI: 10.1016/j.beth.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 01/14/2024]
Abstract
Researchers have shown neuroticism decreases with treatment (Roberts et al., 2017), although it is unclear if this reflects fleeting state-level changes (state-artifact position) or trait-level change (cause-correction hypothesis). These theories further propose that changes in neuroticism predict symptom change (cause-correction hypothesis) or are predicted by symptom change (state-artifact position). We compared these theories in a clinical trial of the Unified Protocol (UP). Participants (N = 38; Mage = 34.55, 71.1% female, 78.9% Caucasian) meeting DSM-5 criteria for a primary emotional disorder completed up to 12 weekly sessions of the UP. Neuroticism exhibited state-level changes by Session 6 but trait-level changes by Session 12. Within-person reductions in neuroticism exhibited bidirectional relations with anxiety symptom change but predicted unidirectional session-to-session reductions in depression. These findings provide relatively more nuanced support for the cause-correction hypothesis that the UP leads to trait changes in neuroticism that tend to precede symptom change.
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23
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Holtmann J, Eid M, Santangelo PS, Kockler TD, Ebner-Priemer UW. Modeling Heterogeneity in Temporal Dynamics: Extending Latent State-Trait Autoregressive and Cross-lagged Panel Models to Mixture Distribution Models. MULTIVARIATE BEHAVIORAL RESEARCH 2024; 59:148-170. [PMID: 37130226 DOI: 10.1080/00273171.2023.2201824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Longitudinal models suited for the analysis of panel data, such as cross-lagged panel or autoregressive latent-state trait models, assume population homogeneity with respect to the temporal dynamics of the variables under investigation. This assumption is likely to be too restrictive in a myriad of research areas. We propose an extension of autoregressive and cross-lagged latent state-trait models to mixture distribution models. The models allow researchers to model unobserved person heterogeneity and qualitative differences in longitudinal dynamics based on comparatively few observations per person, while taking into account temporal dependencies between observations as well as measurement error in the variables. The models are extended to include categorical covariates, to investigate the distribution of encountered latent classes across observed groups. The potential of the models is illustrated with an application to self-esteem and affect data in patients with borderline personality disorder, an anxiety disorder, and healthy control participants. Requirements for the models' applicability are investigated in an extensive simulation study and recommendations for model applications are derived.
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Affiliation(s)
- Jana Holtmann
- Wilhelm Wundt Institute of Psychology, Leipzig University, Leipzig, Germany
| | - Michael Eid
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | | | - Tobias D Kockler
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich W Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg
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24
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Metts AV, Roy-Byrne P, Stein MB, Sherbourne CD, Bystritsky A, Craske MG. Reciprocal and Indirect Effects Among Intervention, Perceived Social Support, and Anxiety Sensitivity Within a Randomized Controlled Trial for Anxiety Disorders. Behav Ther 2024; 55:80-92. [PMID: 38216239 DOI: 10.1016/j.beth.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 01/14/2024]
Abstract
Social support may facilitate adaptive reappraisal of stressors, including somatic symptoms. Anxiety sensitivity refers to negative beliefs about somatic symptoms of anxiety, which may influence one's perception of social support. Evidence-based treatment may impact these associations. The current longitudinal study evaluated reciprocal relationships between perceived social support and anxiety sensitivity, and explored indirect intervention effects, in a randomized controlled trial for anxiety disorders that compared cognitive behavioral therapy with or without medications (CALM) to usual care. Data collected over 18 months from 940 primary care patients were examined in random intercept cross-lagged panel models. There were significant reciprocal associations between perceived social support increases and anxiety sensitivity decreases over time. There were significant indirect effects from intervention to perceived social support increases through anxiety sensitivity decreases and from intervention to anxiety sensitivity decreases through perceived social support increases. These data suggest that, relative to usual care, CALM predicted changes in one construct, which predicted subsequent changes in the other. Secondary analyses revealed an influence of anxiety and depressive symptoms on reciprocal associations and indirect effects. Findings suggest that future treatments could specifically address perceived social support to enhance reappraisal of somatic symptoms, and vice versa.
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25
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Davis EF, Crousillat DR, Peteiro J, Lopez-Sendon J, Senior R, Shapiro MD, Pellikka PA, Lyubarova R, Alfakih K, Abdul-Nour K, Anthopolos R, Xu Y, Kunichoff DM, Fleg JL, Spertus JA, Hochman J, Maron D, Picard MH, Reynolds HR. Global Longitudinal Strain as Predictor of Inducible Ischemia in No Obstructive Coronary Artery Disease in the CIAO-ISCHEMIA Study. J Am Soc Echocardiogr 2024; 37:89-99. [PMID: 37722490 PMCID: PMC10842002 DOI: 10.1016/j.echo.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/18/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Global longitudinal strain (GLS) is a sensitive marker for identifying subclinical myocardial dysfunction in obstructive coronary artery disease (CAD). Little is known about the relationship between GLS and ischemia in patients with myocardial ischemia and no obstructive CAD (INOCA). OBJECTIVES To investigate the relationship between resting GLS and ischemia on stress echocardiography (SE) in patients with INOCA. METHODS Left ventricular GLS was calculated offline on resting SE images at enrollment (n = 144) and 1-year follow-up (n = 120) in the CIAO-ISCHEMIA (Changes in Ischemia and Angina over One year in International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial screen failures with no obstructive CAD on computed tomography [CT] angiography) study, which enrolled participants with moderate or severe ischemia by local SE interpretation (≥3 segments with new or worsening wall motion abnormality and no obstructive (<50% stenosis) on coronary computed tomography angiography. RESULTS Global longitudinal strain values were normal in 83.3% at enrollment and 94.2% at follow-up. Global longitudinal strain values were not associated with a positive SE at enrollment (GLS = -21.5% positive SE vs GLS = -19.9% negative SE, P = .443) or follow-up (GLS = -23.2% positive SE vs GLS = -23.1% negative SE, P = .859). Significant change in GLS was not associated with positive SE in follow-up (P = .401). Regional strain was not associated with colocalizing ischemia at enrollment or follow-up. Changes in GLS and number of ischemic segments from enrollment to follow-up showed a modest but not clinically meaningful correlation (β = 0.41; 95% CI, 0.16, 0.67; P = .002). CONCLUSIONS In this cohort of INOCA patients, resting GLS values were largely normal and did not associate with the presence, severity, or location of stress-induced ischemia. These findings may suggest the absence of subclinical myocardial dysfunction detectable by echocardiographic strain analysis at rest in INOCA.
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Affiliation(s)
- Esther F Davis
- Echocardiography Laboratory, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts; Victorian Heart Institute and Victorian Heart Hospital, Victoria, Australia
| | - Daniela R Crousillat
- Echocardiography Laboratory, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts; Division of Cardiovascular Sciences, Department of Medicine, University of South Florida, Tampa, Florida; Department of Obstetrics and Gynecology, Tampa General-Heart and Vascular Institute, University of South Florida, Tampa, Florida
| | - Jesus Peteiro
- CHUAC, Universidad de A Coruña, CIBER-CV, A Coruna, Spain
| | | | - Roxy Senior
- Northwick Park Hospital-Royal Brompton Hospital, London, United Kingdom
| | - Michael D Shapiro
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | | | | | | | - Rebecca Anthopolos
- Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York
| | - Yifan Xu
- Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York
| | - Dennis M Kunichoff
- Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York
| | - Jerome L Fleg
- National Institute of Health-National Heart Lung, and Blood Institute, Bethesda, Maryland
| | - John A Spertus
- Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City, Kansas City, Missouri
| | - Judith Hochman
- Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York
| | - David Maron
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Michael H Picard
- Echocardiography Laboratory, Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Harmony R Reynolds
- Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York.
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Simić A, Sacchi S, Perugini M. When Future Leads to a Moral Present: Future Self-Relatedness Predicts Moral Judgments and Behavior in Everyday Life. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231211128. [PMID: 38053500 DOI: 10.1177/01461672231211128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Future self-perceptions seem to promote far-sighted decisions in intertemporal choices. Previous work suggested that future self-relatedness, the extent to which we feel similar and connected to our future self, is associated with moral concerns. We aimed to extend these findings to everyday moral judgments and behavior using experience sampling methods. In addition, we assessed how moral foundation concerns mediate the relationship between future self-relatedness and moral behavior. Participants (N = 151) reported their state-levels of future self-relatedness, individualizing, and binding moral foundations and answered whether they performed a moral action five times a day for seven days. Within- and between-participants future self-relatedness predicted daily fluctuations in individualizing and binding moral foundations concerns. On the behavioral level, only within-participants future self-relatedness predicted individualizing moral actions with individualizing moral foundations mediating this effect. Our findings suggest that within- and between-person changes in future self-relatedness might be used to predict everyday moral concerns and behavior.
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Lavi-Rotenberg A, Kivity Y, Igra L, Atzil-Slonim D, Hasson-Ohayon I. A dyadic session-by-session assessment of therapeutic alliance and short-term outcome among clients with schizophrenia in comparison with clients with emotional disorders. Psychol Psychother 2023; 96:1029-1043. [PMID: 37665174 DOI: 10.1111/papt.12494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE Although the clinical significance of the therapeutic alliance (TA) is well documented, the literature regarding the establishment of TA and the relation between client-therapist agreement on it to short-term outcome among various diagnostic groups-and specifically among clients diagnosed with serious mental illness (SMI)-is sparse. The aim of the present study was to examine the effect of client diagnosis on the abovementioned TA characteristics. METHOD Dyadic analyses of session-by-session (SBS) data were used to compare clients diagnosed with schizophrenia and clients diagnosed with emotional disorders (based on a clinical interview) in their TA characteristics. RESULTS TA as initially rated by clients was stronger in the emotional disorders group than in the schizophrenia group. Higher TA ratings, regardless of whether these were provided by the therapist or the client, predicted better subsequent functioning in the emotional disorders group, whereas in the schizophrenia group, this association was observed only among good-outcome cases. CONCLUSIONS Establishing TA, having client-therapist agreement on it, and having clients derive therapeutic benefit from it might be more challenging with clients with schizophrenia than with clients with emotional disorders. Special attention should be given to specific challenges and needs regarding clients' diagnosis in order to enhance favourable therapy outcomes.
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Affiliation(s)
| | - Yogev Kivity
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Libby Igra
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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Irvin RL, Wu D, Fetterman AK, Robinson MD. Heads of Worry, Hearts of Joy: Daily Diary Investigations of Self-Location and Well-Being. AFFECTIVE SCIENCE 2023; 4:744-756. [PMID: 38156254 PMCID: PMC10751275 DOI: 10.1007/s42761-023-00196-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/02/2023] [Indexed: 12/30/2023]
Abstract
When people are asked to locate the self, they frequently choose the head and heart regions of the body. These bodily regions, in turn, are linked to an extensive set of metaphors, including those that conceptualize the heart as the locus of authenticity, love, and passion. Based on such considerations as well as frameworks within the self and well-being literatures, four samples of participants in three studies (total N = 527) were asked whether, on particular days, they perceived themselves to be located in their head regions of their bodies or their heart regions. When the self was perceived to be in the heart to a greater extent, participants reported higher levels of affective and eudaimonic well-being, as mediated by processes related to reward perception (Study 1), savoring (Study 2), and social activity (Study 3). In terms of daily experiences, the heart-located self is a happier self.
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Affiliation(s)
- Roberta L. Irvin
- North Dakota State University, Psychology, NDSU Dept 2765, PO Box 6050, ND 58108-6050 Fargo, USA
| | - Dongjie Wu
- University of Houston, Houston, Texas USA
| | | | - Michael D. Robinson
- North Dakota State University, Psychology, NDSU Dept 2765, PO Box 6050, ND 58108-6050 Fargo, USA
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Usami S. Within-Person Variability Score-Based Causal Inference: A Two-Step Estimation for Joint Effects of Time-Varying Treatments. PSYCHOMETRIKA 2023; 88:1466-1494. [PMID: 35982380 PMCID: PMC10656338 DOI: 10.1007/s11336-022-09879-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 06/10/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Behavioral science researchers have shown strong interest in disaggregating within-person relations from between-person differences (stable traits) using longitudinal data. In this paper, we propose a method of within-person variability score-based causal inference for estimating joint effects of time-varying continuous treatments by controlling for stable traits of persons. After explaining the assumed data-generating process and providing formal definitions of stable trait factors, within-person variability scores, and joint effects of time-varying treatments at the within-person level, we introduce the proposed method, which consists of a two-step analysis. Within-person variability scores for each person, which are disaggregated from stable traits of that person, are first calculated using weights based on a best linear correlation preserving predictor through structural equation modeling (SEM). Causal parameters are then estimated via a potential outcome approach, either marginal structural models (MSMs) or structural nested mean models (SNMMs), using calculated within-person variability scores. Unlike the approach that relies entirely on SEM, the present method does not assume linearity for observed time-varying confounders at the within-person level. We emphasize the use of SNMMs with G-estimation because of its property of being doubly robust to model misspecifications in how observed time-varying confounders are functionally related to treatments/predictors and outcomes at the within-person level. Through simulation, we show that the proposed method can recover causal parameters well and that causal estimates might be severely biased if one does not properly account for stable traits. An empirical application using data regarding sleep habits and mental health status from the Tokyo Teen Cohort study is also provided.
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Affiliation(s)
- Satoshi Usami
- Department of Education, University of Tokyo, Tokyo, Japan.
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30
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Cohen-Eick N, Shuman E, van Zomeren M, Halperin E. Should I Stay or Should I Go? Motives and Barriers for Sustained Collective Action Toward Social Change. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231206638. [PMID: 37921088 DOI: 10.1177/01461672231206638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Israel's year-long protest calling for Prime Minister Netanyahu's resignation created an opportunity to examine unique factors influencing sustained collective action (SCA; i.e., repeated participation in social movement action for the same cause). As little is known about how to explain such dedication, we compared a well-established set of predictors of one-time collective action (CA) with a new predictors set of SCA, focusing on collective instrumental and socio-emotional (CISE) motivations grounded in previous participation experience, to predict subsequent participation. In a unique longitudinal design, we tracked protestors over 6 weeks. Our findings showed that less emotional exhaustion, more subjective effort into participation, and a perceived closer timeframe for desired social change positively predicted SCA. This differentiates SCA from CA-moreover, as one-time CA predictors did not predict SCA, this suggests a need for a new model to explain SCA based on CISE motivations that reflect continuous goal pursuit.
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Affiliation(s)
- Noa Cohen-Eick
- The Hebrew University of Jerusalem, Israel
- University of Groningen, the Netherlands
| | - Eric Shuman
- New York University, USA
- Harvard Business School, Cambridge, MA, USA
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31
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Wrede N, Töpfer NF, Wilz G. Between- and within-person effects of affective experiences on coping in CBT: Direct effects and interplay with therapeutic alliance and resource activation. Psychother Res 2023:1-15. [PMID: 37922397 DOI: 10.1080/10503307.2023.2277290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/25/2023] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVE The role of affective experiences (AE) in cognitive-behavioral therapy (CBT) has rarely been investigated. We examined between- and within-person effects of AE on coping in CBT for family caregivers and interactions with therapeutic alliance and resource activation. METHODS 67 family caregivers rated AE, therapeutic alliance, resource activation, and coping after each of 12 sessions of telephone-based CBT. We examined direct session-to-session effects of AE on coping in structural equation modeling and interactions of AE with therapeutic alliance and resource activation in multilevel models. RESULTS AE did not directly predict coping. Instead, within-person effects of AE interacted with simultaneous within-person emotional bond. Given strong emotional bond, AE positively predicted coping, whereas given weak emotional bond, AE negatively predicted coping. Further, cross-level interactions of between-person AE and within-person agreement on collaboration and resource activation indicated that these positively predicted coping only in dyads with high between-person AE. CONCLUSION AE may enhance coping when complemented with strong emotional bond. Further, within-person effects of agreement on collaboration and resource activation seem to rely on a certain degree of between-person AE. Results are discussed in relation to current findings on emotional processing in CBT.
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Affiliation(s)
- Nicolas Wrede
- Institute of Psychology, Department of Counseling and Clinical Intervention, Friedrich-Schiller-University Jena, Jena, Germany
| | - Nils F Töpfer
- Institute of Psychology, Department of Counseling and Clinical Intervention, Friedrich-Schiller-University Jena, Jena, Germany
| | - Gabriele Wilz
- Institute of Psychology, Department of Counseling and Clinical Intervention, Friedrich-Schiller-University Jena, Jena, Germany
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Kramer AC, Neubauer AB, Schmiedek F. The Effectiveness of A Slow-Paced Diaphragmatic Breathing Exercise in Children's Daily Life: A Micro-Randomized Trial. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:797-810. [PMID: 35704507 DOI: 10.1080/15374416.2022.2084743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Breathing exercises have been proposed as an effective intervention to improve subjective well-being and manage anxiety symptoms. As they are comparatively easy to learn and to implement, breathing exercises may be particularly beneficial for children. Although breathing exercises are ultimately supposed to provide salutary effects in individuals' everyday lives, immediate effects of breathing exercises in naturalistic contexts have received limited empirical attention. The purpose of this study was to examine immediate effects of slow-paced diaphragmatic breathing on negative affect as well as on relaxation in an ecologically valid setting. To that end, we conducted a micro-randomized trial in children's daily life. METHOD On each of 15 days, children (N = 171, aged 9-13 years, 54% female) were randomized to different conditions: performing a video-guided slow-paced diaphragmatic breathing exercise (experimental condition), watching a different video (active control condition), or a passive control condition. RESULTS The breathing exercise had no immediate effects on negative affect or relaxation compared to both control conditions. However, in situations when children reported higher levels of worries than usual, relaxation was higher when children performed the breathing exercise compared to the passive control condition. Compared to the active control condition, the breathing exercise did not result in higher levels of relaxation in situations when children worried more than normally. CONCLUSIONS Findings highlight that context-specific factors can modulate the effectiveness of breathing exercises and should be taken into account to tailor interventions to individuals' needs.
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Affiliation(s)
- Andrea C Kramer
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education
- Center for Individual Development and Adaptive Education of Children at Risk (IDeA)
| | - Andreas B Neubauer
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education
- Center for Individual Development and Adaptive Education of Children at Risk (IDeA)
| | - Florian Schmiedek
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education
- Center for Individual Development and Adaptive Education of Children at Risk (IDeA)
- Department of Psychology and Sport Sciences, Goethe University Frankfurt
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Rights JD, Sterba SK. On the Common but Problematic Specification of Conflated Random Slopes in Multilevel Models. MULTIVARIATE BEHAVIORAL RESEARCH 2023; 58:1106-1133. [PMID: 37038722 DOI: 10.1080/00273171.2023.2174490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
For multilevel models (MLMs) with fixed slopes, it has been widely recognized that a level-1 variable can have distinct between-cluster and within-cluster fixed effects, and that failing to disaggregate these effects yields a conflated, uninterpretable fixed effect. For MLMs with random slopes, however, we clarify that two different types of slope conflation can occur: that of the fixed component (termed fixed conflation) and that of the random component (termed random conflation). The latter is rarely recognized and not well understood. Here we explain that a model commonly used to disaggregate the fixed component-the contextual effect model with random slopes-troublingly still yields a conflated random component. Negative consequences of such random conflation have not been demonstrated. Here we show that they include erroneous interpretation and inferences about the substantively important extent of between-cluster differences in slopes, including either underestimating or overestimating such slope heterogeneity. Furthermore, we show that this random conflation can yield inappropriate standard errors for fixed effects. To aid researchers in practice, we delineate which types of random slope specifications yield an unconflated random component. We demonstrate the advantages of these unconflated models in terms of estimating and testing random slope variance (i.e., improved power, Type I error, and bias) and in terms of standard error estimation for fixed effects (i.e., more accurate standard errors), and make recommendations for which specifications to use for particular research purposes.
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Wyatt KP, Eberle JW, Ruork AK, Neacsiu AD. Mechanisms of change in treatments for transdiagnostic emotion dysregulation: The roles of skills use, perceived control and mindfulness. Clin Psychol Psychother 2023; 30:1380-1392. [PMID: 37408301 DOI: 10.1002/cpp.2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/06/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
Emotion dysregulation (ED) is a key target for change among empirically supported treatments for emotional disorders, including dialectical behaviour therapy skills training (DBT-ST), yet how treatments improve ED is poorly understood. Using data from a randomised trial of DBT-ST versus supportive group therapy for transdiagnostic ED, we tested whether three mechanistic variables-behavioural skills use, mindfulness, and perceived control-explain variability in ED within people over time. We additionally explored the mediating roles of these variables between conditions. Adults with transdiagnostic ED (N = 44) participated in weekly groups for 4 months, with assessments at pre-, mid- and post-treatment and at 2-month follow-up. As hypothesised, multilevel models disaggregating within- and between-person effects indicated that skills use, mindfulness, and perceived control each had significant total and unique within-person associations with ED at concurrent time points, net the effect of time. Unexpectedly, these within-person relations were not significant for mechanistic variables predicting ED 2 months later. Further, unique between-person variability in skills use, mindfulness, and perceived control did not significantly mediate the relationship between condition and ED improvements. The present study is an important step in clarifying ED mechanisms of change, both within and between persons.
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Affiliation(s)
- Kristin P Wyatt
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Arise Psychological Wellness and Consulting, PLLC, Carrboro, North Carolina, USA
| | - Jeremy W Eberle
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Allison K Ruork
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Andrada D Neacsiu
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
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Patel A, Daros AR, Irwin SH, Lau P, Hope IM, Perkovic SJM, Laposa JM, Husain MI, Levitan RD, Kloiber S, Quilty LC. Associations between rumination, depression, and distress tolerance during CBT treatment for depression in a tertiary care setting. J Affect Disord 2023; 339:74-81. [PMID: 37392943 DOI: 10.1016/j.jad.2023.06.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Rumination is strongly associated with depressive symptom severity and course. However, changes in rumination during outpatient cognitive behavioral therapy (CBT), and their links to baseline features such as distress tolerance and clinical outcomes, have received limited attention. METHODS 278 outpatients with depression received group or individual CBT. Measures of rumination, distress tolerance, and depression symptom severity were assessed at baseline and periodically during treatment. Mixed effect and regression-based models evaluated changes over time, and associations between rumination, distress tolerance and depression severity. RESULTS Depression and rumination decreased throughout acute treatment. Rumination reduction was concurrently associated with depressive symptom reduction. Lower levels of rumination at each time point prospectively predicted lower depressive symptoms at the next time point. Distress tolerance measured at baseline was positively associated with depression symptom severity; the indirect effect on post-treatment depression symptoms via rumination measured mid-treatment was nonsignificant when rumination at baseline was accounted for. Changes in and associations between depression and rumination were replicated in sensitivity analyses; although changes in depression and rumination were smaller in magnitude in patients receiving treatment during COVID-19. LIMITATIONS Additional assessment points would permit a more nuanced assessment of the role rumination may play in mediating the associations between distress tolerance and depression severity. Additional investigation of treatments in community settings may also further our understanding of variability in rumination during depression treatment. CONCLUSIONS The current study provides unique real-world support for variability in rumination as a key indicator of change over the course of CBT for depression.
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Affiliation(s)
- Alina Patel
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | | | | | - Parky Lau
- Toronto Metropolitan University, Canada
| | - Ingrid M Hope
- Campbell Family Mental Health Research Institute, CAMH, Canada
| | | | - Judith M Laposa
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - M Ishrat Husain
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - Robert D Levitan
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - Stefan Kloiber
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada.
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Blaxton JM, Whitehead BR, Bergeman CS. Age Differences Among Different Sources of Stressor Related Negative Affect. Int J Aging Hum Dev 2023; 97:289-305. [PMID: 35786015 DOI: 10.1177/00914150221112282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examine age differences in the relationship between negative affect (NA) and different indicators of daily stress (interpersonal, health, and financial stressors and perceived stress). Participants completed 56 days of daily diary surveys from Wave 1 of the Notre Dame Study of Health & Well-being. Multi-level modeling allowed us to assess the within-person relationships between daily stress and NA and the cross-level interactions between these daily relationships and cross-sectional age. Each type of stress additively related to daily NA. Older age related to an exacerbated relationship between daily interpersonal stressors and NA, but a weaker relationship between daily perceived stress and NA. Interventions focused on enhancing daily well-being can encourage older adults to ensure they do not have overpacked schedules in regards to social relationships, and encourage midlife and younger adults to engage in activities that disrupt the link between perceived stress and NA.
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Affiliation(s)
- Jessica M Blaxton
- Psychology Department, Metropolitan State University, St. Paul, MN, USA
| | | | - C S Bergeman
- Psychology Department, University of Notre Dame, Notre Dame, IN, USA
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37
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Daros AR, Wardell JD, Quilty LC. Multilevel associations of emotion regulation strategy use during psychotherapy for depression: A longitudinal study. J Affect Disord 2023; 338:107-118. [PMID: 37290525 DOI: 10.1016/j.jad.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/24/2023] [Accepted: 06/04/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with depression select avoidant emotion regulation (ER) strategies more often than engagement strategies. While psychotherapy improves ER strategies, examining the week-to-week changes in ER and their relationship to clinical outcomes is warranted to understand how these interventions work. This study examined the changes in six ER strategies and depressive symptoms during virtual psychotherapy. METHODS Treatment-seeking adults (N = 56) with moderate depression severity completed a baseline diagnostic interview and questionnaires and were followed for up to 3 months as they completed virtual psychotherapy in an unrestricted format (e.g., individual) and orientation (e.g., cognitive-behavioral therapy; CBT). Participants completed weekly assessments of depression and six ER strategies along with assessments of CBT skills and participant-rated CBT components for each psychotherapy session. Multilevel modeling was used to examine associations between within-person changes in ER strategy use and weekly depression scores, controlling for between-person effects and time. RESULTS Depressive symptoms, rumination, and experiential avoidance decreased non-linearly over time while cognitive reappraisal and acceptance increased non-linearly. Controlling for CBT skills, within-person increases in acceptance and cognitive reappraisal, as well as within-person decreases in experiential avoidance, were associated with fewer depressive symptoms over time. People who reported greater CBT components in their sessions also reported fewer depressive symptoms over time. LIMITATIONS The study was unable to make more causal inferences or standardize the type, baseline, or length of psychotherapy received. CONCLUSIONS Improvements in ER strategies were associated with depression symptom reduction during psychotherapy. Future research to elucidate ER strategies as mediators of treatment response is warranted.
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Affiliation(s)
- Alexander R Daros
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychology, York University, Canada.
| | - Jeffrey D Wardell
- Department of Psychology, York University, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada
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Semcho SA, Southward MW, Stumpp NE, Smith MM, Fruhbauerova M, Sauer-Zavala S. Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol. Psychother Res 2023:1-14. [PMID: 37703649 DOI: 10.1080/10503307.2023.2254467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023] Open
Abstract
ABSTRACTThe Unified Protocol (UP) theoretically leads to reductions in emotional disorder symptoms by reducing aversive reactions to emotions. However, aversive reactions can take many forms (e.g., non-acceptance, behavioral avoidance). We examined if (1) multiple aspects of aversive reactivity predicted session-to-session changes in anxiety and depression in the UP, (2) these aspects reflected a single latent construct, and (3) changes in this latent construct predicted changes in anxiety and depression. Participants (N = 70, Mage = 33.74, 67.1% female, 74.3% white) completed six sessions of UP modules and measures of aversive reactivity, anxiety, and depression before each session. We used hierarchical linear modeling and random-intercept cross-lagged panel models to test aspects of aversive reactivity and a latent factor of aversive reactivity, respectively, as predictors of session-to-session changes in anxiety and depression. Within-person improvements in four of five aspects of aversive reactivity predicted decreases in anxiety, and improvements in two aspects predicted decreases in depression. However, within-person improvements in latent aversive reactivity predicted decreases in anxiety at five sessions and in depression across all sessions. These results add to the growing literature highlighting the role of aversive reactivity as a potential transdiagnostic process involved in improvements in emotional disorder symptoms during treatment.
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Schmidt LI, Neubauer AB, Stoffel M, Ditzen B, Schirmaier J, Farrenkopf C, Sieverding M. Effects of mental contrasting on sleep and associations with stress: A randomized controlled trial. J Health Psychol 2023; 28:1057-1071. [PMID: 36922707 PMCID: PMC10492430 DOI: 10.1177/13591053231159168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Mental contrasting with implementation intentions (MCII) has been successfully applied to improve health-related behaviors (e.g. exercise). We explored its effectiveness to improve sleep outcomes beyond effects of sleep hygiene (SH) information, and investigated associations with stress. Eighty university employees (mean age: 29.6, SD = 4.5) were randomized to either a MCII + SH or a SH-only condition. During a baseline-week and a post-intervention week, sleep duration (Fitbit Alta and self-report), sleep quality, and stress were assessed daily and saliva was collected to assess the cortisol awakening response (CAR). In total, self-reported sleep quality and duration increased, but there was no meaningful condition*week interaction for sleep parameters or CAR. Higher average stress was associated with shorter sleep duration and lower sleep quality. Within-person, days with higher stress were followed by nights with lower sleep quality. Despite overall improvements, effects of MCII were not confirmed. MCII might be less effective to improve behaviors which are less controllable.
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Affiliation(s)
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Germany
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Schricker IF, Nayman S, Reinhard I, Kuehner C. Reactivity toward daily events: Intraindividual variability and change in recurrent depression - A measurement burst study. Behav Res Ther 2023; 168:104383. [PMID: 37586185 DOI: 10.1016/j.brat.2023.104383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/29/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
In Major Depressive Disorder, first evidence shows heightened mood-reactivity toward daily events. Related longitudinal studies in remitted patients with recurrent major depression are lacking. Long-term changes in such short-term within-person associations can be analysed via measurement burst designs. Two bursts, separated by approximately 4.4 years, consisted of a baseline session and an Ambulatory Assessment (burst-1: 3 days, burst-2: 5 days). Via smartphone, 54 initially remitted patients with recurrent major depression indicated their negative and positive affect, rumination, self-acceptance, and the occurrence of negative and positive daily events ten times and collected saliva cortisol samples five times per day. In bursts with higher depression levels, patients showed blunted negative affect- and cortisol-reactivity and stronger decreases in positive affect and self-acceptance toward negative daily events, as well as stronger increases in self-acceptance following positive daily events. However, patients with higher depression levels demonstrated stronger ruminative stress-reactivity within bursts. Furthermore, patients with higher depression levels showed an increase of affective stress-reactivity over bursts, such that negative affect more strongly increased and positive affect more strongly decreased following negative daily events over bursts. Following positive daily events, patients with higher depression levels showed stronger decreases in negative affect within bursts and a decrease of self-acceptance-reactivity over bursts. To conclude, measurement burst designs enable to examine intraindividual variability and change of micro-level processes, and possible moderators thereof, potentially providing prognostic information for the course of recurrent major depression.
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Affiliation(s)
- Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
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Fairlie AM, Calhoun BH, Graupensperger S, Patrick ME, Lee CM. Daily-level simultaneous alcohol and marijuana use and its associations with alcohol use, marijuana use, and negative consequences in a young adult community sample. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1690-1701. [PMID: 38051139 DOI: 10.1111/acer.15145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/29/2023] [Accepted: 06/25/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Simultaneous alcohol and marijuana (SAM) use has been associated with greater alcohol use and consequences at the daily level, but limited research has examined SAM use in relation to marijuana use and its consequences. This study tested daily associations between SAM use and four outcomes: alcohol use (number of drinks), marijuana use (hours high), negative alcohol consequences, and negative marijuana consequences. METHODS A community sample of young adults [ages 18-25, mean (SD) = 21.61 (2.17) years] with recent alcohol and SAM use was recruited (N = 409; 50.9% female; 48.2% non-Hispanic/Latinx White). Participants completed a baseline survey and six 2-week bursts of daily surveys (81.1% of morning surveys completed) and reported on substance use and negative substance-related consequences. Multilevel modeling was used to test the main aims and to explore each specific consequence. RESULTS Among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total negative alcohol-related consequences than non-SAM use days. Among days with any marijuana use, SAM use days were associated with more hours being high than non-SAM use days. Exploratory models showed that SAM use was related to five specific alcohol-related consequences and two specific marijuana-related consequences. CONCLUSIONS These findings build upon prior research by showing that SAM use days are linked to consuming more drinks, reporting more hours being high from marijuana, and experiencing more total alcohol-related consequences even after controlling for the number of drinks, the number of hours high, any tobacco/nicotine use, and any other substance use. SAM use was also associated with a greater likelihood of experiencing some specific consequences related to alcohol and marijuana. The findings underscore the need for additional research on SAM use and marijuana-related outcomes.
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Affiliation(s)
- Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Brian H Calhoun
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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Ruf A, Neubauer AB, Koch ED, Ebner-Priemer U, Reif A, Matura S. Microtemporal Dynamics of Dietary Intake, Physical Activity, and Impulsivity in Adult Attention-Deficit/Hyperactivity Disorder: Ecological Momentary Assessment Study Within Nutritional Psychiatry. JMIR Ment Health 2023; 10:e46550. [PMID: 37590053 PMCID: PMC10472180 DOI: 10.2196/46550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Increasing attention is being paid to lifestyle factors, such as nutrition and physical activity (PA), as potential complementary treatment options in attention-deficit/hyperactivity disorder (ADHD). Previous research indicates that sugar and saturated fat intake may be linked to increased impulsivity, a core symptom of ADHD, whereas protein intake and PA may be related to reduced impulsivity. However, most studies rely on cross-sectional data that lack microtemporal resolution and ecological validity, wherefore questions of microtemporal dynamics (eg, is the consumption of foods high in sugar associated with increased impulsivity within minutes or hours?) remain largely unanswered. Ecological momentary assessment (EMA) has the potential to bridge this gap. OBJECTIVE This study is the first to apply EMA to assess microtemporal associations among macronutrient intake, PA, and state impulsivity in the daily life of adults with and without ADHD. METHODS Over a 3-day period, participants reported state impulsivity 8 times per day (signal-contingent), recorded food and drink intake (event-contingent), and wore an accelerometer. Multilevel 2-part models were used to study the association among macronutrient intake, PA, and the probability to be impulsive as well as the intensity of impulsivity (ADHD: n=36; control: n=137). RESULTS No association between macronutrient intake and state impulsivity was found. PA was not related to the intensity of impulsivity but to a higher probability to be impulsive (ADHD: β=-.09, 95% CI -0.14 to -0.04; control: β=-.03, 95% CI -0.05 to -0.01). No evidence was found that the combined intake of saturated fat and sugar amplified the increase in state impulsivity and that PA alleviated the positive association between sugar or fat intake and state impulsivity. CONCLUSIONS Important methodological considerations are discussed that can contribute to the optimization of future EMA protocols. EMA research in the emerging field of nutritional psychiatry is still in its infancy; however, EMA is a highly promising and innovative approach as it offers insights into the microtemporal dynamics of psychiatric symptomology, dietary intake, and PA in daily life.
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Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
| | - Elena D Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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Chad-Friedman E, Galano MM, Lemay EP, Olino TM, Klein DN, Dougherty LR. Parsing between- and within-person effects: Longitudinal associations between irritability and internalizing and externalizing problems from early childhood through adolescence. Dev Psychopathol 2023; 35:1371-1381. [PMID: 34955108 PMCID: PMC9234095 DOI: 10.1017/s0954579421001267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This report examines between- and within-person associations between youth irritability and concurrent and prospective internalizing and externalizing symptoms from early childhood through adolescence. Distinguishing between- and within-person longitudinal associations may yield distinct, clinically relevant information about pathways to multifinality from childhood irritability. METHODS Children's irritability and co-occurring symptoms were assessed across five waves between ages 3 and 15 years using the mother-reported Child Behavior Checklist (N = 605, 46% female). Parental history of depressive disorders was assessed with a clinical interview. RESULTS Results demonstrated that between- and within-person irritability were uniquely associated with concurrent depressive, anxiety, and defiance symptoms, but not ADHD. Prior wave within-person irritability also predicted next wave depressive, anxiety, and defiance symptoms, controlling for prior symptoms; these prospective associations were bidirectional. Child sex and parental depressive disorders moderated associations. DISCUSSIONS Findings identify pathways from within- and between-person irritability to later internalizing and externalizing psychopathology. Results demonstrate the importance of parsing within- and between-person effects to understand nuanced relations among symptoms over childhood.
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MacNeil S, Renaud J, Gouin JP. Respiratory sinus arrhythmia, negative social interactions, and fluctuations in unmet interpersonal needs: A daily diary study. Suicide Life Threat Behav 2023; 53:597-612. [PMID: 37208985 DOI: 10.1111/sltb.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 04/04/2023] [Accepted: 04/22/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION This study examined daily fluctuations in the unmet interpersonal needs of thwarted belongingness and perceived burdensomeness in response to daily negative social interactions, as well as the moderating role of respiratory sinus arrhythmia (RSA) across adolescents at lower and higher risk for suicidal ideation. METHODS Fifty five adolescents with major depressive disorder (MDD, i.e., higher-risk group) and without MDD (i.e., lower-risk group) completed measures of resting RSA, and daily measures of negative social interactions, perceived burdensomeness, and loneliness, as a proxy for thwarted belongingness, for 10 consecutive days. Within-person analyses examined the association between daily negative social interactions and unmet interpersonal needs, and the moderating roles of RSA and higher-risk group status. Between-person analyses also examined the association between RSA and unmet interpersonal needs across groups. RESULTS At the within-person level, participants reported more unmet interpersonal needs on days when they reported more negative social interactions. At the between-person level, higher RSA was associated with decreased loneliness in both groups, and decreased burdensomeness among the higher-risk group. CONCLUSIONS Negative social interactions are associated with daily unmet interpersonal needs. Higher RSA may serve as a protective factor mitigating risk for unmet interpersonal needs, particularly burdensomeness, among adolescents at higher risk for suicidal ideation.
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Affiliation(s)
- Sasha MacNeil
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Graupensperger S, Calhoun BH, Fleming CN, Patrick ME, Lee CM. Longitudinal examination of high-risk drinking contexts: Daytime drinking, pregaming, and drinking games linked to high-risk alcohol use and negative consequences in young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1364-1376. [PMID: 37128660 PMCID: PMC10760786 DOI: 10.1111/acer.15095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND The contexts in which young adults drink alcohol play a salient role in alcohol-related outcomes and negative consequences at an event-level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre-partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within-person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow-up timepoint, controlling for baseline AUDIT scores. METHOD A community sample of 759 young adults (Mage = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30-month follow-up. Multilevel models estimated within- and between-person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol-related outcomes (weekly consumption, consequences, SAM use). A single-level negative binomial regression tested associations between drinking context frequency averages across a two-year period and changes in AUDIT scores from baseline to a follow-up 2.5 years later. RESULTS Over 75% of the sample of non-abstaining young adults reported drinking in each of the three contexts at least once during the 24-month period. Within-persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30-month follow-up, suggesting that there are potential long-term risks of drinking in these contexts. CONCLUSIONS Findings suggest that daytime drinking, pregaming, and playing drinking games are high-risk contexts in terms of month-to-month and long-term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms.
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Affiliation(s)
| | - Brian H. Calhoun
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Charles N. Fleming
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Christine M. Lee
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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Boer M, Cosma A, Twenge JM, Inchley J, Jeriček Klanšček H, Stevens GWJM. National-Level Schoolwork Pressure, Family Structure, Internet Use, and Obesity as Drivers of Time Trends in Adolescent Psychological Complaints Between 2002 and 2018. J Youth Adolesc 2023:10.1007/s10964-023-01800-y. [PMID: 37349663 PMCID: PMC10371956 DOI: 10.1007/s10964-023-01800-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023]
Abstract
Little is known about societal processes that contribute to changes in adolescent mental health problems. This study aims to fill this gap using data from the Health Behavior in School-aged Children study between 2002 and 2018 (ncountries = 43, nindividuals = 680,269, Mage = 14.52 (SD = 1.06), 51.04% female), supplemented with other international data. National-level psychological complaints increased more strongly among girls than boys. National-level schoolwork pressure, single-parent households, time spent on internet, and obesity were generally rising. In both boys' and girls' samples, increases in national-level schoolwork pressure, obesity, and time spent on internet use were independently associated with increases national-level psychological complaints. However, national-level obesity and psychological complaints were more strongly related among girls than boys. Results highlight the potential impact of societal-level processes on adolescent mental health problems.
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Affiliation(s)
- M Boer
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands.
| | - A Cosma
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - J M Twenge
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - J Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - G W J M Stevens
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
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Nilsen SA, Stormark KM, Heradstveit O, Breivik K. Trends in physical health complaints among adolescents from 2014 - 2019: Considering screen time, social media use, and physical activity. SSM Popul Health 2023; 22:101394. [PMID: 37114241 PMCID: PMC10126924 DOI: 10.1016/j.ssmph.2023.101394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/10/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
The rising rates of physical and mental health complaints among adolescents observed in many countries have coincided with an increased time spent on screen-based devices, including social media use. We sought to document recent trends in physical health complaints (PHC) and whether co-occurring trends in screen time, social media use, and physical activity may account for these trends. To achieve these aims, we used data from the nationwide Ungdata surveys conducted annually at the municipality level in Norway, comprising 419,934 adolescents aged 13-18 from six survey years (2014-2019). Six items assessed PHC, including neck and shoulder pain, headache, and abdominal pain, during the past month. To account for the nesting structure of Ungdata, and to exploit the variation within and between municipalities, we used multilevel analyses with adolescents nested in municipality-years (n = 669), nested in municipalities (n = 345). We found a small to moderate linear increase in number of PHC among boys and girls from 2014 to 2019. Screen time and social media use moderately attenuated the trend for girls, and to a lesser extent for boys. Screen time and social media use were further positively associated with PHC across the between and within-municipality levels, and social media use was more strongly associated with PHC for girls than boys across all levels of analysis. A similar pattern emerged when considering each symptom individually. The results suggest that the prevalence of PHC rose in tandem with a group-level shift towards higher screen time and social media use. Moreover, the results indicate that higher screen time and social media use may have led to changes in the youth culture with potential consequences for adolescents' well-being.
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Affiliation(s)
- Sondre Aasen Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
- Corresponding author. Norwegian Research Centre, Regional Centre for Child and Youth Mental Health and Child Welfare, Postbox 22, Nygårdstangen, 5838, Bergen, Norway.
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
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Walukevich-Dienst K, Piccirillo ML, Calhoun BH, Bedard-Gilligan M, Larimer ME, Patrick ME, Lee CM. Daily-level relationships between negative affect, negative emotion differentiation, and cannabis behaviors among a high-risk sample of young adults. J Affect Disord 2023; 335:392-400. [PMID: 37211055 DOI: 10.1016/j.jad.2023.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/23/2023]
Abstract
Prior research suggests that higher trait negative emotion differentiation (NED; one's ability to make subtle distinctions between different negative emotional states) is associated with consuming less alcohol when experiencing high negative affect (NA) in daily life. Yet, whether these findings extend to cannabis use behaviors is unclear. The present study used intensive daily data to test whether NED moderated the relationship between NA and cannabis behaviors. A community sample of 409 young adults who used alcohol and cannabis completed a baseline survey and five 2-week bursts of online surveys across two years. Multilevel models tested cross-level interactions between trait NED (person-level) and daily NA (daily-level) predicting cannabis use, hours high, negative consequences, craving, and coping motives. In contrast to expectations, on days with higher reported NA, people with higher NED (compared to those with lower NED) had a greater likelihood of experiencing any cannabis craving, experienced more intense craving, and reported higher cannabis coping motives. NED x NA interaction was not significant for likelihood of cannabis use, hours high, or negative consequences. Post-hoc descriptive analyses suggest notable person-specific heterogeneity in these findings. Individuals with higher ability to differentiate between negative emotions reported higher coping motives and craving when experiencing higher NA. However, these associations were variable for individuals within the sample. It may be that high NED individuals crave and purposefully use cannabis to reduce NA states. Findings are inconsistent with the alcohol literature and have important implications for intervention efforts aimed at reducing coping-motivated cannabis use among young adults.
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Affiliation(s)
- Katherine Walukevich-Dienst
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
| | - Marilyn L Piccirillo
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA 98195-7238, USA
| | - Brian H Calhoun
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA 98195-7238, USA
| | - Michele Bedard-Gilligan
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA 98195-7238, USA
| | - Mary E Larimer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA 98195-7238, USA
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, P.O. Box 1248, 426 Thompson St., Ann Arbor, MI 48106-1248, USA
| | - Christine M Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA 98195-7238, USA
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Calhoun BH, Graupensperger S, Fairlie AM, Walukevich-Dienst K, Patrick ME, Lee CM. "Wake-and-bake" cannabis use: Predictors and cannabis-related outcomes of use shortly after waking. Drug Alcohol Depend 2023; 248:109937. [PMID: 37236059 DOI: 10.1016/j.drugalcdep.2023.109937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Given recent historical increases in young adults frequent cannabis use and changes in cannabis policies throughout the United States, there is a need to examine high-risk patterns of use. This paper examined predictors and cannabis-related outcomes of "wake-and-bake" cannabis use, operationalized as use within 30min of waking. METHODS Participants were 409 young adults (Mage=21.61 years, 50.8% female) enrolled in a longitudinal study on simultaneous alcohol and cannabis use (i.e., using alcohol and cannabis at the same time such that their effects overlap). Eligibility criteria included reporting alcohol use 3+ times and simultaneous alcohol and cannabis use 1+ times in the past month. Participants completed twice-daily surveys for six 14-day bursts across two calendar years. Aims were tested using multilevel models. RESULTS Analyses were limited to cannabis use days (9406 days; 33.3% of all sampled days), and thereby to participants who reported using cannabis (384 participants; 93.9% of the sample). Wake-and-bake use was reported on 11.2% of cannabis use days and at least once by 35.4% of participants who used cannabis. On wake-and-bake use days, participants were high for more hours and had greater odds of driving under the influence of cannabis, but did not experience more negative consequences, relative to non-wake-and-bake cannabis use days. Participants who reported more cannabis use disorder symptoms and those reporting higher average social anxiety motives for cannabis use reported more frequent wake-and-bake use. CONCLUSIONS Wake-and-bake cannabis use may be a useful marker of high-risk cannabis use, including driving under the influence of cannabis.
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Affiliation(s)
- Brian H Calhoun
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA, 98195-7238, USA.
| | - Scott Graupensperger
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA, 98195-7238, USA
| | - Anne M Fairlie
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA, 98195-7238, USA
| | - Katherine Walukevich-Dienst
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA, 98195-7238, USA
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, P.O. Box 1248, 426 Thompson St, Ann Arbor, MI, 48106-1248, USA
| | - Christine M Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 357238, Seattle, WA, 98195-7238, USA
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Brotto LA, Zdaniuk B, Chivers ML, Jabs F, Grabovac AD, Lalumière ML. Mindfulness and Sex Education for Sexual Interest/Arousal Disorder: Mediators and Moderators of Treatment Outcome. JOURNAL OF SEX RESEARCH 2023; 60:508-521. [PMID: 36178481 DOI: 10.1080/00224499.2022.2126815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual Interest/Arousal Disorder (SIAD) is a common sexual dysfunction in women. Both mindfulness-based cognitive therapy (MBCT) plus psychoeducation and sex therapy, education, and support (STEP; which contains the same educational information as in the MBCT arm but also integrates supportive-expressive therapy), are effective. We tested mediators and moderators of improvements. Each treatment arm consisted of eight sessions delivered weekly, and participants completed measures online pre-treatment, immediately post-treatment, and at 6- and 12-month post-treatment. Depression, self-reported interoceptive awareness, self-compassion, self-criticism, and mindfulness were examined as mediators, and expectations for improvement as a moderator. Of 148 cisgender women who consented, 70 were randomized to the MBCT plus psychoeducation group (mean age 39.3 ± 13.2 yrs) and 78 to the STEP group (mean age 37.9 ± 12.2 yrs). Decreases in depression mediated decreases in sexual distress in the MBCT plus psychoeducation group only. Improvements in interoceptive awareness mediated changes in both sexual desire and arousal, and sexual distress, and to a greater degree after MBCT plus psychoeducation. Changes in self-compassion mediated changes in sexual desire and arousal only for the MBCT plus psychoeducation group and mediated changes in sexual distress in both groups. Reductions in self-criticism mediated improvements in sexual distress to a greater extent after MBCT plus psychoeducation. Changes in mindfulness predicted changes in desire and arousal, and distress only in the MBCT plus psychoeducation group. Expectations for improvement did not moderate any outcomes. The findings have implications for understanding common and potentially distinct pathways by which MBCT plus psychoeducation and supportive sex education improve symptoms of SIAD.
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Affiliation(s)
- Lori A Brotto
- Department of Obstetrics and Gynecology, University of British Columbia
| | - Bozena Zdaniuk
- Department of Obstetrics and Gynecology, University of British Columbia
| | | | - Faith Jabs
- Department of Obstetrics and Gynecology, University of British Columbia
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