Is a brief mindfulness ecological momentary intervention more efficacious than a self-monitoring app for social anxiety disorder? A randomized controlled trial

Despite their proliferation, limited knowledge exists regarding possible benefits of brief mindfulness ecological momentary interventions (MEMIs) for social anxiety disorder (SAD). Propositions that MEMIs could alleviate SAD symptoms and related clinical outcomes remain untested. This trial evaluated a 14-day MEMI for SAD. Participants with self-reported SAD were randomized to MEMI (n = 96) or self-monitoring app (SM; n = 95). Whereas MEMI instructed mindfulness exercises, SM prompted only self-monitoring five times daily for 14 days. Participants completed state-level self-reports of depression, anxiety, and mindfulness pre-post-mindfulness practice and SAD symptoms, worry, depression severity, repetitive negative thinking, and trait mindfulness at pre-randomization, post-intervention, and 1-month follow-up (1MFU). Hierarchical linear modeling was conducted. The MEMI yielded statistically significantly larger improvements in momentary depression, anxiety, and mindfulness (Cohen's d = -0.10-0.11). Although no between-group effects emerged in alleviating SAD fear and avoidance, excessive worry, depression severity, repetitive negative thinking, and trait mindfulness (-0.13-0.15), within-group effects were significantly small-to-large from pre-post and pre-1MFU (-4.62-0.67). A significant reduction in depression severity occurred in MEMI (-0.63--0.60) but not SM (-0.31--0.29). Brief MEMI and SM yielded nondifferent sustained effects on SAD, comorbid symptoms, and risk factors, highlighting its potential value within stepped-care delivery settings.

The influence of socio-economic status on child temperament and psychological symptom profiles

The influence of socio-economic status (SES) on child temperament and psychological symptoms was examined using a nationally representative sample in Singapore. Data were available for 2169 children from 1987 families. Caregivers' reports were obtained on children aged 4-6. SES was operationalized as an aggregation of household income per capita, parental education level and housing type. Compared to their counterparts from higher SES families, children from low-SES families tended to exhibit (a) higher negative affectivity but lower effortful control, and (b) higher internalizing and externalizing symptoms. In addition, children with a 'resilient' temperamental profile (i.e. low negative affectivity and high effortful control) were more likely to come from families with much higher SES, relative to children with other profiles. Children with high internalizing symptoms tended to come from low-SES backgrounds, regardless of their externalizing symptoms. Among children with low internalizing symptoms, those with high externalizing symptoms came from lower SES backgrounds compared to those with low externalizing symptoms. Parental warmth and distress mediated the association between SES and child temperament and symptom profiles, with the exception of distress in the SES-temperament link. These findings supported the family stress model and highlighted the novel perspective of SES's influence on configurations of child temperament and symptom characteristics.

Longitudinal associations between academic competence-building and depression symptoms in early adolescence

The longitudinal associations between academic competence-building and depression symptoms were investigated among 741 early adolescents in Singapore. Extending from past studies on academic achievement and depression, the current research tested two competing hypotheses - the academic incompetence hypothesis versus the adjustment erosion hypothesis using a 3-wave longitudinal study over an academic year. The former hypothesis suggests that prior deficits in academic competence-building lead to subsequent depression symptoms, whereas the latter posits that previous depression leads to subsequent deficits in competence-building. Longitudinal associations between a higher-order competence-building factor (operationalized using multiple constituent motivational variables) and depression were examined using a random intercept cross-lagged panel model. Results indicated that within-individual decreases in competence-building prospectively predicted subsequent within-individual increases in depression symptoms, but the opposite effect was not observed. Within-individual fluctuations in competence-building also predicted end-of-year grades and teacher-reported adjustment problems. Overall, the current findings were consistent with the academic incompetence hypothesis, suggesting that interventions aimed at sustaining academic competence-building could offer protection against the worsening of depression. These results clarified the within-individual developmental dynamics between academic competence-building and depression symptoms in adolescents over time.

Validating the biosocial model of borderline personality disorder: Findings from a longitudinal study

This longitudinal study aimed to validate the biosocial theory of borderline personality disorder (BPD) by examining the transactional relationship between individual vulnerabilities and parental invalidation, and their links to BPD symptoms. We recruited a sample of 332 adolescents (mean age = 14.18 years; 58.3% female) residing in Singapore and administered self-report measures across three time-points (six months apart). Results from our path analytic model indicated that parental invalidation, impulsivity, and emotional vulnerability exhibited unique predictive associations with emotion dysregulation six months later. There was also a reciprocal prospective relationship between emotion regulation difficulties and BPD symptoms. Using random-intercepts cross-lagged panel models, we found partial evidence for a within-individual reciprocal relationship between parental invalidation and emotional vulnerability, and a unidirectional relationship of within-individual changes in impulsivity positively predicting changes in parental invalidation six months later. Overall, the study provided partial empirical support for the biosocial model in a Singaporean context.

Emotion dysregulation and symptoms of anxiety and depression in early adolescence: Bidirectional longitudinal associations and the antecedent role of parent-child attachment

Difficulties in emotion regulation have been consistently associated with various psychological difficulties, including anxiety and depression; however, less is known about the directionality of this relationship, particularly in adolescents. In addition, early parent-child attachment quality has been closely linked to the development of emotion regulation. Previous studies have proposed an overarching model in attempt to describe the developmental trajectory of anxiety and depression from early attachment, albeit with several limitations that are discussed in this paper. This study adds to this field of research by investigating the longitudinal associations between emotion dysregulation (ED) and symptoms of anxiety and depression among 534 early adolescents in Singapore over three timepoints in a school year, and the antecedent role of attachment quality on individual differences on these variables. Bidirectional influences were found between ED and anxiety and depression symptoms, respectively, between T1 and T2, but not T2 and T3, at the between- and within-individual levels of analysis. Additionally, attachment anxiety and avoidance were both significantly predictive of individual differences in ED and for both psychological symptoms. The current findings provide preliminary evidence of a mutually reinforcing relationship between ED and symptoms of anxiety and depression in early adolescence, where attachment quality serves as a developmental antecedent that sets these longitudinal associations in motion.

Parental invalidation and its associations with borderline personality disorder symptoms: A multivariate meta-analysis

Childhood invalidation has been postulated to be implicated in the development of borderline personality disorder (BPD), according to the biosocial model. Despite its significance, most systematic reviews and meta-analyses have focused on examining the associations between extreme forms of invalidation, such as sexual abuse, and BPD. Nonetheless, individuals could experience mild-to-severe levels of parental invalidation, with or without abuse. This study examined the relationship between parental invalidation as an overall construct and BPD symptoms, synthesized across 21 studies (total N = 7,198). As most reviewed studies utilized retrospective self-report measures, the effect sizes derived pertained largely to the association between reported childhood parental invalidation and BPD symptoms. We conducted a multivariate meta-analysis to account for the dependence of multiple effect sizes obtained from a single study and to maintain precision in obtained effect sizes. Maternal, paternal, and overall parental invalidation were positively associated with BPD symptoms, with small-to-moderate effect sizes of .26, .23, and .25, respectively. The mean effect size of maternal invalidation was greater than that of paternal invalidation. We also investigated if the parental invalidation-BPD associations were moderated by child gender, age, and culture (degree of individualism). Only overall parental invalidation and BPD symptoms association was moderated by child's gender, with larger effect sizes found for samples with a greater proportion of males. Age and culture did not moderate the parental invalidation-BPD association. Risk of publication bias was low. Our findings provide support for the invalidating childhood environment component of the biosocial model. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Primer on Meta-Analytic Structural Equation Modeling: the Case of Depression

In this paper, we show how the methods of systematic reviewing and meta-analysis can be used in conjunction with structural equation modeling to summarize the results of studies in a way that will facilitate the theory development and testing needed to advance prevention science. We begin with a high-level overview of the considerations that researchers need to address when using meta-analytic structural equation modeling (MASEM) and then discuss a research project that brings together theoretically important cognitive constructs related to depression to (a) show how these constructs are related, (b) test the direct and indirect effects of dysfunctional attitudes on depression, and (c) test the effects of study-level moderating variables. Our results suggest that the indirect effect of dysfunctional attitudes (via negative automatic thinking) on depression is two and a half times larger than the direct effect of dysfunctional attitudes on depression. Of the three study-level moderators tested, only sample recruitment method (clinical vs general vs mixed) yielded different patterns of results. The primary difference observed was that the dysfunctional attitudes → automatic thoughts path was less strong for clinical samples than it was for general and mixed samples. These results illustrate how MASEM can be used to compare theoretically derived models and predictions resulting in a richer understanding of both the empirical results and the theories underlying them.

Pathological personality, situations, and their joint influences on daily emotional symptoms

OBJECTIVE

The present research aims to advance current understanding on how individuals with pathological personality traits construe their day-to-day situational experiences.

METHOD

College students (N = 231) completed a measure of personality pathology, followed by six assessments of everyday situations and anxiety/depression symptoms over two weeks.

RESULTS

Multilevel analyses indicated that personality pathology was meaningfully associated with situational experiences. Major findings suggested that situations that entailed aggravations and interpersonal confrontations were associated with negative affectivity, antagonism, and psychoticism. Detached individuals were less likely to experience pleasant and social situations. Exploratory analyses suggested an amplification effect where individuals high on personality pathology were more anxious or depressed when they perceived certain situational features, compared to their low trait counterparts. However, such cross-level interactions constituted a small minority; most personality traits and situations exerted additive effects on symptoms.

CONCLUSION

Situational experiences appear to be driven in part by personality pathology. The exacerbation of daily negative symptoms can be attributed to the joint (largely additive) influence of the trigger situations and pathological personality traits.

Personality traits and health‐risk behaviours in university students

Relations between personality and health‐risk behaviours in university undergraduates were examined using multiple measures of personality across multiple samples (N = 1151). Big Five personality variables, at both factor and facet levels, were used to predict three specific health‐risk behaviours: (a) tobacco consumption, (b) alcohol consumption and (c) speeding in an automobile. Our findings showed that low Conscientiousness and low Agreeableness were uniformly associated with this cluster of potentially health damaging behaviours. Extraversion was additionally associated with alcohol use. Interaction effects were found between Conscientiousness and Agreeableness on smoking and (for men only) on drinking. Other personality variables not centrally related to the Big Five, such as Risk‐Taking (high) and Integrity (low), were also implicated in the present health‐risk behaviours. Copyright © 2009 John Wiley & Sons, Ltd.

Subjective status and perceived legitimacy across countries

The relationships between subjective status and perceived legitimacy are important for understanding the extent to which people with low status are complicit in their oppression. We use novel data from 66 samples and 30 countries (N = 12,788) and find that people with higher status see the social system as more legitimate than those with lower status, but there is variation across people and countries. The association between subjective status and perceived legitimacy was never negative at any levels of eight moderator variables, although the positive association was sometimes reduced. Although not always consistent with hypotheses, group identification, self-esteem, and beliefs in social mobility were all associated with perceived legitimacy among people who have low subjective status. These findings enrich our understanding of the relationship between social status and legitimacy.

Evaluating Structural Models of Cognitive Vulnerabilities: Transdiagnostic and Specific Pathways to Internalizing Symptoms

The structure of cognitive vulnerabilities to anxiety and depression was examined via a hierarchical approach to examine the usefulness of a bifactor model for identifying a broad transdiagnostic (i.e., common core) factor versus disorder-specific variables (i.e., unique dimensions) in predicting internalizing psychopathology. Several models (i.e., single factor, correlated factor, single hierarchical, and bifactor models) were evaluated in undergraduate (n = 351) and adolescent (n = 385) samples. Across both samples, the bifactor model exhibited comparable good fit as the correlated and single hierarchical models. This model comprised a core transdiagnostic vulnerability factor and six specific factors (i.e., negative cognitive style, dysfunctional attitudes, ruminative style, intolerance of uncertainty, anxiety sensitivity, and fear of negative evaluation). Although the transdiagnostic factor predicted a general internalizing symptom factor, unique fear-related specific-level associations between individual vulnerability and symptom remained significant. Moreover, the transdiagnostic vulnerability factor predicted internalizing symptoms, even after controlling for personality and gender. These findings highlight the importance of advancing an integrative etiologic model of internalizing psychopathology.

Cross-Cultural and Gender Invariance of Transdiagnostic Processes in the United States and Singapore

The Research Domain Criteria define cognitive and emotional processes (e.g., rumination, intolerance of uncertainty, anxiety sensitivity, emotion dysregulation) as key transdiagnostic elements of psychopathology. However, there is currently a dearth of construct equivalence studies on measures of these processes. We thus aimed to validate the latent structures of five transdiagnostic constructs using established and newer measures: two-factor Rumination-Reflection Questionnaire, six-factor Perseverative Cognitions Questionnaire, two-factor Intolerance of Uncertainty Scale, three-factor Anxiety Sensitivity Index-3, two-factor Cognitive and Behavioral Processes Questionnaire (CBPQ). Measurement equivalence was examined across 292 American and 144 Singaporean undergraduates. Cross-cultural confirmatory factor analyses revealed strict invariance for all measures, with interfactor association differences on the Perseverative Cognitions Questionnaire and CBPQ. Across gender, full invariance was found on all measures except the CBPQ. Theoretical and clinical implications are discussed.

Construct Validity of the McLean Screening Instrument for Borderline Personality Disorder in Two Singaporean Samples

This study examined the construct validity of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) in a consecutive sample of adult psychiatric patients (n = 128) and a separate sample of undergraduate students (n = 289) in Singapore. Participants were administered the MSI-BPD and other measures assessing related symptoms of BPD. Patients were also administered a semistructured interview by interviewers blind to their MSI-BPD scores. Confirmatory factor analyses revealed a unique three-factor solution, consisting of affect dysregulation, self-disturbances, and behavioral and interpersonal dysregulation. In both samples, the MSI-BPD demonstrated good internal consistency and convergent validity. The measure also showed good discriminant validity and predictive accuracy (AUC = .82), with an optimal cut-off score of 7.5. Overall, the findings suggest that BPD is a valid and coherent clinical construct in Singapore, and point to the need to further clarify the presentation and etiology of BPD in this cultural context.

Associations Between the DSM-5 Section III Trait Model and Impairments in Functioning in Singaporean College Students

The Alternative Model for Personality Disorders (AMPD) in Section III of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, recommends the joint consideration of personality disorder severity (i.e., dysfunction) and style (i.e., trait profile) in personality disorder diagnosis. The current study examined the association between maladaptive personality dysfunction and traits using a Singaporean student sample (N = 360). A subsample (n = 151) had informant ratings of personality traits on target participants. Results indicated that dysfunctions and traits were substantially correlated, calling into question their distinctiveness. However, the overlap was less pronounced when informant ratings were used. Consistent with prior research, the validity of the PID-5 trait model appeared to be supported, as observed in the meaningful differential relations with different impairment outcomes. These findings represent a preliminary yet critical test of the generalizability of the AMPD to a non-Western cultural group.

Becoming more or less mature? The decline of self-control in middle childhood

OBJECTIVE

This study examined the developmental change in self-control and its association with daily stressful events during middle childhood, as well as the factors that contribute to individual differences in the trajectory of self-control.

METHOD

A community sample of 302 Singaporean children (42% female, 69% Chinese) and their parents were recruited when the children were age 7. Follow-up assessments were made when the children were ages 8, 9, and 11. Developmental changes were examined using latent growth and autoregressive cross-lagged models.

RESULTS

Self-control showed a normative decline over time, and this trajectory was associated with an increase in daily stressful events. There was partial evidence for a reciprocal relationship between self-control and daily stressful events over time. Moreover, the child temperament dimension of effortful control (assessed at age 7) mitigated the decline in self-control, whereas low socioeconomic status predicted lower initial levels of self-control.

CONCLUSIONS

This study advances current understanding on the developmental change in self-control during middle childhood, as well as the factors that shape the direction and magnitude of this change.

The Looming Maladaptive Style Questionnaire: Measurement invariance and relations to anxiety and depression across 10 countries

The Looming Maladaptive Style Questionnaire (LMSQ) is a self-report measure designed to assess the looming cognitive style, a tendency to interpret threats as rapidly approaching and increasing in magnitude. To date, no systematic evaluation on the psychometric properties of the LMSQ across diverse cultural contexts has been done. In the present research, the measurement invariance of the LMSQ test scores was examined in 10 countries (N=4000). Confirmatory factor analysis suggested that a two-factor model (i.e., physical looming and social looming) fitted the data well across countries. Partial measurement invariance was established for the LMSQ scores across the countries whereas full measurement invariance was achieved across gender. Meta-analytic structural equation modeling was applied to examine the unique contributions of the two looming factors to anxiety and depression symptoms. Results indicated that the test scores underlying two looming factors were crucial and valid predictors of symptoms. The LMSQ shows promise as a measure with cross-cultural generalizability and opens new avenues for its use in diverse cultural settings.

Comparisons of Daily Behavior Across 21 Countries

While a large body of research has investigated cultural differences in behavior, this typical study assesses a single behavioral outcome, in a single context, compared across two countries. The current study compared a broad array of behaviors across 21 countries ( N = 5,522). Participants described their behavior at 7:00 p.m. the previous evening using the 68 items of the Riverside Behavioral Q-sort (RBQ). Correlations between average patterns of behavior in each country ranged from r = .69 to r = .97 and, in general, described a positive and relaxed activity. The most similar patterns were United States/Canada and least similar were Japan/United Arab Emirates (UAE). Similarities in behavior within countries were largest in Spain and smallest in the UAE. Further analyses correlated average RBQ item placements in each country with, among others, country-level value dimensions, personality traits, self-esteem levels, economic output, and population. Extroversion, openness, neuroticism, conscientiousness, self-esteem, happiness, and tolerant attitudes yielded more significant correlations than expected by chance.

RGD-conjugated iron oxide magnetic nanoparticles for magnetic resonance imaging contrast enhancement and hyperthermia

The purpose of this study was to develop a specific targeting magnetic nanoparticle probe for magnetic resonance imaging and therapy in the form of local hyperthermia. Carboxymethyl dextran-coated ultrasmall superparamagnetic iron oxide nanoparticles with carboxyl groups were coupled to cyclic arginine-glycine-aspartic peptides for integrin α(v)β₃ targeting. The particle size, magnetic properties, heating effect, and stability of the arginine-glycine-aspartic-ultrasmall superparamagnetic iron oxide were measured. The arginine-glycine-aspartic-ultrasmall superparamagnetic iron oxide demonstrates excellent stability and fast magneto-temperature response. Magnetic resonance imaging signal intensity of Bcap37 cells incubated with arginine-glycine-aspartic-ultrasmall superparamagnetic iron oxide was significantly decreased compared with that incubated with plain ultrasmall superparamagnetic iron oxide. The preferential uptake of arginine-glycine-aspartic-ultrasmall superparamagnetic iron oxide by target cells was further confirmed by Prussian blue staining and confocal laser scanning microscopy.

When Being Discrepant from One's Ideal or Ought Selves Hurts: The Moderating Role of Neuroticism

Self–discrepancy theory posits that people experience emotional consequences when they perceive discrepancies between their actual and possible selves. However, the extent to which people react emotionally to these self–discrepancies (i.e. ideal, ought and undesired) may be a function of individual differences in neuroticism. Across both experimental (Study 1; N = 155) and correlational designs (Study 2; N = 139) involving college students, the authors demonstrated that neuroticism moderated the discrepancy–emotion associations such that high–neuroticism individuals showed elevated depression and anxiety symptoms when their self–discrepancies were activated. The heightened symptoms were maintained over time. Negative repetitive thoughts (i.e. rumination and worry) were examined as potential mediating mechanisms between the discrepancy × neuroticism interaction and symptoms. Partial support was obtained in that rumination mediated between undesired discrepancy × neuroticism interaction and anxious/depressive symptoms. Implications and possible theoretical extensions for self–discrepancy theory are discussed. Copyright © 2012 John Wiley & Sons, Ltd.

The effects of social evaluation and looming threat on self-attentional biases and social anxiety

This paper examines how two proposed cognitive vulnerabilities of social anxiety, the fear of negative evaluation, and looming cognitive style may combine with socially demanding situations in predicting social anxiety symptoms and performance deficits. Fifty-two individuals previously identified as possessing these two cognitive vulnerabilities were randomly assigned to conditions in a 2 (high versus low social evaluation)x2 (high versus low temporal looming) experimental design. Significant interaction effects were found for: (a) residual change in anxiety symptoms from baseline level, and (b) performance on a speech task. Specifically, cognitively at-risk individuals exhibited the most increase in anxiety and the most performance deficits in the condition where social evaluation and temporal looming were high. In addition, a mediational effect of illusion of transparency (a form of self-attentional bias) between situational demands and residual change in anxiety was found. Implications arising from these results are discussed.

Worry and rumination: Differential associations with anxious and depressive symptoms and coping behavior

Worry and rumination are closely allied cognitive processes that impact on the experience of anxious and depressive symptoms. Using a prospective design, this study examined overlapping and distinct features of worry and rumination in relation to symptoms and coping behavior in a nonclinical sample of Singaporean college students. Worry and rumination were highly correlated, but they retained distinct components that predicted anxious and depressive symptoms differentially within and across time. Specifically, worry was uniquely associated with anxious and depressive symptoms whereas rumination was uniquely related to depression. In comparison to rumination, worry emerged as the dominant cognitive vulnerability factor that predicted increments in symptoms over time. With regards to coping behavior, low perceived coping effectiveness partially mediated the relation between worry and increases in anxiety and depression. Conversely, rumination uniquely predicted higher disengagement from problems, which resulted in further exacerbation of depressive mood. These results demonstrated not only the distinct features of worry and rumination on coping behavior, but also the different coping pathways by which they differentially impact on subsequent symptoms.