Rumination, but not mood, predicts prospective memory performance: novel insights from a derived measure of trait rumination

Prospective memory (PM) is the accurate execution of an intention in the future. PM may be negatively impacted by negative affect, but the underlying mechanisms remain unclear. Rumination may increase the frequency of task-irrelevant thoughts, which deplete attentional capacity and reduce performance. To date, no studies have examined state and trait rumination on an online measure of PM. The present study examined the effects of state and trait rumination on an event-based, focal PM task embedded within a one-back task over multiple sessions. 95 non-depressed adults (18-53 years) completed measures of state/trait rumination, mood, and PM on at least two occasions. Using multi-level modelling, we found that a derived measure of trait rumination, but not an established trait rumination survey, nor negative mood, predicted poorer PM accuracy. These novel findings demonstrate that trait rumination may partially underlie the association between negative affect & PM in a non-clinical sample, and highlight the potential of online methods to study PM.

A prospective longitudinal study of depression, perceived stress, and perceived control in resettled Syrian refugees' mental health and psychosocial adaptation

This prospective study examined the psychosocial adaptation of a community sample of newly resettled Syrian refugees in Canada (N = 235). Specifically, depressive symptoms, perceived stress, and perceived control were collected in Arabic at baseline and 1-year follow-up. Two theory-informed, cross-lagged panel models demonstrated that higher baseline depressive symptoms predicted lower perceived self-efficacy and lower perceived control at 1-year follow-up. Similarly, baseline depressive symptoms were concurrently correlated with higher perceived helplessness, lower perceived self-efficacy, and lower perceived control. Secondary regression analyses further demonstrated that baseline depressive symptoms predicted lower perceived social support and higher anxiety symptoms, though neither were assessed at baseline. Empirical results identify a potentially broad, precipitating, and persistent effect of depressive symptoms on Syrian refugees' psychosocial resources and adaptation post-migration, which is consistent with both the transactional model of stress and coping and the self-efficacy theory of depression, respectively. Clinically, the study results highlight the importance of early screening for depressive symptoms among refugee newcomers within a culturally and trauma-informed, integrated health setting. Furthermore, this study underscores the value and need for theoretically guided longitudinal studies to advance future research on refugee mental health and psychosocial adaptation.

Monthly correlates of longitudinal child mental health during the COVID-19 pandemic according to children and caregivers

Multiple reviews identify the broad, pervasive initial impact of the global COVID-19 pandemic on the mental health of children, who may be particularly vulnerable to long-term psychiatric sequelae of the ongoing pandemic. However, limited longitudinal research examines persistence of, or change in, children's distress or psychiatric symptomatology. From June 2020 through December 2021, we enrolled two cohorts of families of children aged 8-13 from Southwestern Ontario into a staggered baseline, longitudinal design that leveraged multi-informant report (N = 317 families). In each family, one child and one parent/guardian completed a baseline assessment, 6 monthly follow-up assessments, and one final follow-up assessment 9 months post-baseline. At each assessment, the child and parent/guardian completed the CoRonavIruS health Impact Survey and measures of child anxiety, depressive, irritability, and posttraumatic stress syndromes. Children's mental health, indexed by the severity of multiple syndromes, fluctuated over the study period. Elevated local monthly COVID-19 prevalence, hospitalization, and death rates were associated with monthly elevations in children's reported worry about contracting COVID-19 and stress related to stay-at-home orders. In turn, both elevated monthly worry about contracting COVID-19 and stress related to stay-at-home orders were associated with monthly elevations in child- and parent-/guardian-report of children's emotional distress and psychiatric syndromes. This study illustrates the importance of, and informs the potential design of, longitudinal research to track the mental health of children, who may be particularly vulnerable to broad psychosocial sequelae of health crises such as the COVID-19 pandemic.

Symptoms of borderline personality and related pathologies behave as temporal and contemporaneous networks

In contrast to latent variable models suggesting a common etiology, network theory proposes that symptoms of psychopathology co-occur because of direct, dynamic associations among them. We examined how symptoms associated with borderline personality disorder, depression, and anxiety mutually reinforce one another over time, forming a network. We further identified symptoms that drove the network by exerting the most influence on other symptoms. Participants were 37 undergraduate students aged 18 to 26. Following baseline assessment, participants were prompted to answer a Qualtrics-based survey of current symptoms of BPD, depression, and anxiety twice daily for 40 days. Multilevel time-series network analyses were conducted with (a) BPD symptoms alone and (b) BPD, depressive and anxiety symptoms. In the network of BPD symptoms, momentary interpersonal difficulties predicted later dissociation, which predicted later affective fluctuation at the within-person level. Dissociation exerted the strongest influence on the overall symptom network. When depressive and anxiety symptoms were included, the networks identified several cross-disorder connections, such as anhedonia and feeling tense, which highlight potential pathways that describe the comorbidity of BPD with anxiety and depressive syndromes. Overall, cognitive symptoms and dissociation were identified as the most influential symptoms across the networks. This study indicates that BPD, depression, and anxiety symptoms may mutually reinforce one another concurrently and over time. Cognitive symptoms exert the highest influence on the cross-disorder networks, such that they influence BPD, depressive, and anxiety symptoms. Our results support the need of targeting cognitions in the treatment of comorbid BPD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-critical perfectionism, dependency and entropy during cognitive behavioural therapy for depression

OBJECTIVES

This study examined whether 'personality vulnerability' (i.e., self-critical perfectionism or dependency) predicts the trajectory of change, as well as variability and instability (i.e., entropy) of symptoms, during cognitive behaviour therapy (CBT) for depression.

DESIGN

Study participants were outpatients (N = 312) experiencing a primary mood disorder. Participants received CBT for depression group sessions over 15 weeks. Self-report measures of self-critical perfectionism, dependency, and depression were collected longitudinally.

METHODS

A latent growth mixture modelling (LGMM) statistical approach was used to evaluate the presence of latent classes of individuals based on their longitudinal pattern of symptom change during CBT and to evaluate whether baseline self-critical perfectionism or dependency predicts class membership. A Latent Acceleration Score (LAS) model evaluated whether perfectionism or dependency led to variability in depression symptom change (e.g., velocity) by considering changes in velocity (e.g., acceleration and/or deceleration).

RESULTS

LGMM indicated the presence of two latent classes that represent symptom improvement (N = 239) or minimal symptom improvement over time (N = 73). Elevated baseline self-critical perfectionism, but not dependency, predicted a greater likelihood of membership in the class of participants who demonstrated minimal symptom improvement over time. The second analysis examined whether baseline self-critical perfectionism also predicts depression symptom variability and instability. The LAS perfectionism model demonstrated that perfectionism accelerates depression symptom change during the first seven sessions of treatment, then has a decelerating effect on depression symptom change.

CONCLUSIONS

Results indicated that higher baseline self-critical perfectionism predicted higher variability and instability in depression symptoms and variability in acceleration and deceleration, over the course of treatment.

Alternative model of personality disorders traits predict residential addictions treatment completion

BACKGROUND

Among people receiving residential treatment for a substance use disorder (SUD), premature treatment termination predicts poor post-treatment outcomes. We examined the utility of the alternative model for personality disorders (AMPD) for predicting premature residential SUD treatment termination, including interactions with age and gender.

METHODS

Participants (N = 374) were receiving residential treatment for SUD and enrolled in a clinical trial with two conditions: Skills for Improving Distress Intolerance (SIDI) and Supportive Counseling (NCT01741415). Participants were assessed at intake on AMPD traits using the Personality Inventory for DSM-5 (PID-5) and tracked longitudinally. After establishing gender and age measurement invariance, we used competing risk models to predict treatment completion versus premature termination using interactions of PID-5 scores with age and gender.

FINDINGS

Disinhibition and Negative Emotionality domains and facets predicted premature treatment termination, particularly among younger, male participants. There were positive effects of SIDI on treatment completion for participants with high levels of domain and facet Negative Emotionality. A small proportion (≈ 12 %) of the PID-5 items showed differential item functioning by age or gender; however, the aggregate impact on test-level total scores was negligible.

CONCLUSIONS

Participants (particularly young men) displaying poor self-control and emotional regulation are at risk for premature termination. These findings, together with minimal aggregate differential item functioning at the scale level, suggest that the PID-5 is a practically useful, construct-valid, non-proprietary measure, aspects of which can be used for screening in residential SUD treatment. Furthermore, among those with high negative emotionality, SIDI may be effective in preventing premature treatment termination.

Pediatric anxiety associated with altered facial emotion recognition

Multiple psychiatric disorders are associated with difficulties in facial emotion recognition. However, generalized anxiety disorder may be associated with more accurate recognition of others' emotional expressions, particularly expressions of happiness and fear, which index safety and threat. Children aged 9-14 from a community sample (N = 601) completed a facial emotion labeling task. Children's symptoms of depressive and anxiety syndromes were assessed by self- and parent-report. Elevated symptoms of generalized anxiety disorder were associated with more accurate facial emotion recognition (β = 0.16, p = 0.007), specifically recognition of happiness (β = 0.17, p = 0.002) and fear (β = 0.15, p = 0.006). Elevated depressive symptoms were associated with less accurate facial emotion recognition (β = -0.12, p = 0.018), specifically happiness (β = -0.15, p = 0.002). Elevated symptoms of separation anxiety disorder were also associated with less accurate facial emotion recognition (β = -0.16, p = 0.003), specifically happiness (β = -0.15, p = 0.006) and fear (β = -0.15, p = 0.005), which highlights the importance of distinguishing between anxiety syndromes. Results held when adjusting for child age and sex. Evidence that symptoms of generalized anxiety disorder are associated with more accurate recognition of happiness and fear is consistent with theories of heightened social vigilance and support a transdiagnostic role of facial emotion recognition that may inform the psychosocial development of youth with anxiety and depressive symptoms.

Children's Mental Health in Southwestern Ontario during Summer 2020 of the COVID-19 Pandemic

OBJECTIVE

COVID-19 presents an unprecedented global crisis. Research is critically needed to identify the impact of the pandemic on children's mental health including psychosocial factors that predict resilience, recovery, and persistent distress. The present study collected data in June-July 2020 to describe children's mental health during the initial phase of the pandemic, including the magnitude and nature of psychiatric and psychological distress in children, and to evaluate social support as a putative psychosocial moderator of children's increased distress.

METHOD

Children and parents from 190 families of children aged 8 to 13 from the Windsor-Essex region of Southwestern Ontario reported (i) retrospectively on children's well-being (e.g., worry, happiness) immediately prior to the pandemic and (ii) on children's current well-being; irritability; social support; and anxiety, depressive, and posttraumatic stress symptoms at the baseline assessment of an ongoing longitudinal study of the COVID-19 pandemic.

RESULTS

Children and parents reported worsened well-being and psychological distress during the pandemic compared to retrospective report of pre-pandemic well-being. Child-perceived social support from family and friends was associated with lower symptom severity and attenuated increase in psychological distress.

CONCLUSIONS

Study findings suggest possible broad psychological impacts of the COVID-19 pandemic and are consistent with prior research that indicates a protective role of social support to mitigate the negative psychological impact of the pandemic. These findings may inform clinical assessments and highlight the need for public resources to safeguard children's mental health.

Intraindividual association of PTSD symptoms with binge drinking among trauma-exposed students

People, particularly undergraduate students, who report elevated symptoms of posttraumatic stress disorder (PTSD) are at elevated risk of binge drinking. The present study used ecological momentary assessment to (a) evaluate whether PTSD severity, specifically, or psychological distress, generally, are associated with binge drinking and (b) examine the self-medication and susceptibility models of the comorbidity of PTSD with binge drinking while accounting for shared liability (i.e., the between-person association of PTSD symptom severity with binge drinking). Within a larger study of undergraduate student mental health, for 14 days, students who reported a potentially traumatic experience (N = 276) reported nightly on use of alcohol and psychoactive substances and thrice daily on current affect, internalizing symptoms, and PTSD symptoms. Daily binge drinking, per the NIAAA definition, was analyzed using multivariate mixed effects, multilevel logistic regression. Results support the self-medication model; participants were more likely to binge drink on days marked by elevated PTSD symptoms, OR = 2.82, p < .01. Binge drinking was also more likely on weekends, OR = 4.21, p < .0001, and days marked by elevated daily positive affect, OR = 1.60, p < .001. Binge drinking was not associated with concurrent depressive or general anxiety symptoms (p > .30). PTSD symptoms were not associated with use of cannabis or other substances (p > .06). Regarding the susceptibility model, following a binge drinking episode, participants reported elevated depressive symptoms, B = 0.34, p = .04, but no change in affect, PTSD symptoms, or general anxiety symptoms (p > .16). Results suggest that, beyond understanding who is at risk for binge drinking, fluctuations in PTSD severity clarify when students engage in binge drinking. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotional and interpersonal mechanisms in community SSRI treatment of social anxiety disorder

BACKGROUND

Affective and interpersonal behavioural patterns characteristic of social anxiety disorder show improvement during treatment with serotonin agonists (e.g., selective serotonin reuptake inhibitors), commonly used in the treatment of social anxiety disorder. The present study sought to establish whether, during community psychopharmacological treatment of social anxiety disorder, changes in positive or negative affect and agreeable or quarrelsome behaviour mediate improvement in social anxiety symptom severity or follow from it.

METHODS

Adults diagnosed with social anxiety disorder (n = 48) recorded their interpersonal behaviour and affect naturalistically in an event-contingent recording procedure for 1-week periods before and during the first 4 months of treatment with paroxetine. Participants and treating psychiatrists assessed the severity of social anxiety symptoms monthly. A multivariate latent change score framework examined temporally lagged associations of change in affect and interpersonal behaviour with change in social anxiety symptom severity.

RESULTS

Elevated agreeable behaviour and positive affect predicted greater subsequent reduction in social anxiety symptom severity over the following month of treatment. Elevated negative affect, but not quarrelsome behaviour, predicted less subsequent reduction in symptom severity.

LIMITATIONS

Limitations included limited assessment of extreme behaviour (e.g., violence) that may have precluded examining the efficacy of paroxetine because of the lack of a placebo control group.

CONCLUSION

The present study suggests that interpersonal behaviour and affect may be putative mechanisms of action for serotonergic treatment of social anxiety disorder. Prosocial behaviour and positive affect increase during serotonergic treatment of social anxiety disorder. Specifically, modulating agreeable behaviour, positive affect and negative affect in individuals' daily lives may partially explain and refine clinical intervention.

Model Fit Estimation for Multilevel Structural Equation Models

Structural equation modeling (SEM) provides an extensive toolbox to analyze the multivariate interrelations of directly observed variables and latent constructs. Multilevel SEM integrates mixed effects to examine the covariances between observed and latent variables across many levels of analysis. However, while it is necessary to consider model fit, traditional indices are largely insufficient to analyze model fit at each level of analysis. The present paper reviews i) the partially-saturated model fit approach first suggested by Ryu and West (2009) and ii) an alternative model parameterization that removes the multilevel data structure. We next describe the implementation of an algorithm to compute partially-saturated model fit for 2-level structural equation models in the open source SEM package, OpenMx, including verification in a simulation study. Finally, an example empirical application evaluates leading theories on the structure of affect from ecological momentary assessment data collected thrice daily for two weeks from 345 participants.

Genetic and Environmental Predictors of Adolescent PTSD Symptom Trajectories Following a Natural Disaster

: Genes, environmental factors, and their interplay affect posttrauma symptoms. Although environmental predictors of the longitudinal course of posttraumatic stress disorder (PTSD) symptoms are documented, there remains a need to incorporate genetic risk into these models, especially in youth who are underrepresented in genetic studies. In an epidemiologic sample tornado-exposed adolescents (n = 707, 51% female, Mage = 14.54 years), trajectories of PTSD symptoms were examined at baseline and at 4-months and 12-months following baseline. This study aimed to determine if rare genetic variation in genes previously found in the sample to be related to PTSD diagnosis at baseline (MPHOSPH9, LGALS13, SLC2A2), environmental factors (disaster severity, social support), or their interplay were associated with symptom trajectories. A series of mixed effects models were conducted. Symptoms decreased over the three time points. Elevated tornado severity was associated with elevated baseline symptoms. Elevated recreational support was associated with lower baseline symptoms and attenuated improvement over time. Greater LGLAS13 variants attenuated symptom improvement over time. An interaction between MPHOSPH9 variants and tornado severity was associated with elevated baseline symptoms, but not change over time. Findings suggest the importance of rare genetic variation and environmental factors on the longitudinal course of PTSD symptoms following natural disaster trauma exposure.

Genetic underpinnings of callous-unemotional traits and emotion recognition in children, adolescents, and emerging adults

BACKGROUND

Callous-Unemotional (CU) and psychopathic traits are consistently associated with impaired recognition of others' emotions, specifically fear and sadness. However, no studies have examined whether the association between CU traits and emotion recognition deficits is due primarily to genetic or environmental factors.

METHODS

The current study used data from 607 Caucasian twin pairs (N = 1,214 twins) to examine the phenotypic and genetic relationship between the Inventory of Callous-Unemotional Traits (ICU) and facial emotion recognition assessed via the laboratory-based Facial Expression Labeling Task (FELT).

RESULTS

The uncaring/callous dimension of the ICU was significantly associated with impaired recognition of happiness, sadness, fear, surprise, and disgust. The unemotional ICU dimension was significantly associated with improved recognition of surprise and disgust. Total ICU score was significantly associated with impaired recognition of sadness. Significant genetic correlations were found for uncaring/callous traits and distress cue recognition (i.e. fear and sadness). The observed relationship between uncaring/callous traits and deficits in distress cue recognition was accounted for entirely by shared genetic influences.

CONCLUSIONS

The results of the current study replicate previous findings demonstrating impaired emotion recognition among youth with elevated CU traits. We extend these findings by replicating them in an epidemiological sample not selected or enriched for pathological levels of CU traits. Furthermore, the current study is the first to investigate the genetic and environmental etiology of CU traits and emotion recognition, and results suggest genetic influences underlie the specific relationship between uncaring/callous traits and distress cue (fear/sadness) recognition in others.

Differential Associations of Distress Tolerance and Anxiety Sensitivity With Adolescent Internalizing Psychopathology

Distress tolerance and anxiety sensitivity may differentiate among internalizing disorders, though few studies have examined differential associations of distress tolerance and anxiety sensitivity with depression and anxiety symptoms while adjusting for their intercorrelation. In an adolescent genetic epidemiological sample (ages 15-21), the present study (N = 848, 56.97% female) examined concurrent associations of distress tolerance and anxiety sensitivity with internalizing psychopathology (i.e., symptoms of depression, anxiety, and general stress) at baseline and prospective, predictive associations of baseline distress tolerance and anxiety sensitivity with internalizing psychopathology at 2-year follow-up. In addition, the present study assessed distress tolerance with two laboratory-based tasks, a carbon dioxide challenge and the mirror-tracing task, to distinguish between tolerance of physiological and cognitive distress, respectively. Elevated anxiety sensitivity was broadly associated with elevated symptoms of internalizing psychopathology at baseline and prospectively predicted elevated depression, anxiety, and stress symptoms at 2-year follow-up. Higher tolerance of cognitive distress was associated with lower concurrent anxiety symptoms but not with anxiety symptoms at follow-up. The present results clarify previously mixed findings; during adolescence, anxiety sensitivity showed broad concurrent and prospective associations with internalizing disorder risk whereas distress tolerance, specifically regarding cognitive distress, was associated with only elevated concurrent anxiety symptoms.

Age of alcohol use initiation and psychiatric symptoms among young adult trauma survivors

Alcohol use disorder (AUD) evidences high rates of comorbidity with a range of psychiatric disorders, particularly within high-risk populations, such as individuals exposed to physical or sexual violence. Increasing efforts are focused on understanding the role of early alcohol use (e.g., during adolescence) on emotional and psychiatric functioning over time, as well as sex differences in these associations. The aim of the current study was to evaluate patterns of association between age of initiation of regular alcohol use and posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms as a function of sex. Participants were 269 college students with a history of interpersonal trauma and alcohol use who completed a battery of questionnaires regarding alcohol use and emotional health. Neither bivariate correlations nor results from structural equation models covarying for key factors showed a relationship between age of alcohol use initiation and current psychiatric symptoms among men (n = 63). Results of a structural equation model supported an association between earlier age of alcohol use initiation and greater levels of current PTSD (β = -0.14), anxiety (β = -0.15), and depression symptoms (β = -0.16) in the female sub-sample (n = 202), after controlling for covariates, as well as intercorrelations among criterion variables. Statistical support for sex as a moderator of these associations was not detected. The current study provides preliminary evidence for potential sex differences in the role of early alcohol use in the development of psychiatric symptoms and highlights the need for systematic longitudinal research.

Examination of Racial Differences in a Posttraumatic Stress Disorder Group Therapy Program for Veterans

Posttraumatic stress disorder (PTSD) is one of the most prevalent mental health diagnoses for veterans. Group therapy can be an effective and efficient means of treating PTSD, yet the literature exploring treatment outcomes for racial minorities is mixed and limited. The present study was an evaluation across racial groups of the PTSD Recovery Program, a manualized group therapy implemented at a Veterans Affairs hospital. Data were collected from male veterans (N = 450) who identified as non-Hispanic White or non-Hispanic African American and participated in a 10-week, combat-related, group therapy program between 2010 and 2014. Participants completed the Posttraumatic Stress Disorder Checklist-Military version (PCL-M) measure at pre-treatment and post-treatment. The Program led to a statistically significant reduction in PCL-M scores (Cohen's d = .64). Symptom reduction occurred regardless of race, with no racial differences in improvement. Racial and ethnic composition of groups was not related to outcomes. The Program was effective regardless of veteran group or provider. Results imply that the PTSD Recovery Program is an effective first-line option to treating non-Hispanic White and non-Hispanic African American veterans with PTSD. Future research should continue to explore the associations between group characteristics and treatment outcomes.

A Developmental Twin Study of Emotion Recognition and Its Negative Affective Clinical Correlates

OBJECTIVE

Youth with psychiatric disorders distinguished by irritability, including depression and associated trait neuroticism, show deficits in the ability to recognize facial expressions of emotion, particularly happiness. However, the contribution of genetic and environmental factors to this ability remains unknown. The present study examined this trait in twins to assess the genetic and environmental influences on face-emotion recognition abilities and their association with irritability, neuroticism, and depression.

METHOD

Child and adolescent twins (N = 957 from 496 families) 9 to 17 years old rated their irritability (on the Affective Reactivity Index), neuroticism (on the Junior Eysenck Personality Questionnaire), and depression (on the Short Mood and Feelings Questionnaire) and completed a face-emotion labeling task. Faces depicting anger, disgust, fear, happiness, sadness, and surprise were morphed with a neutral face, yielding 10 levels of increasing emotional expressivity. Biometrical twin analyses evaluated contributions of genetic and environmental factors to the etiology of face-emotion recognition and its association with irritability, neuroticism, and depression.

RESULTS

Recognition of each emotion was heritable; common and specific sets of genetic factors influenced all emotions and individual emotions, respectively. Irritability, neuroticism, and depression were modestly and negatively correlated with emotion recognition, particularly the recognition of happiness. For irritability and neuroticism, this correlation appeared largely due to genetic factors.

CONCLUSION

This study maps genetic and environmental contributions to face-emotion recognition and its association with irritability, neuroticism, and depression. Findings implicate common genetic factors in deficits regarding the recognition of happiness associated with irritability and neuroticism in childhood and adolescence.

Affect, interpersonal behaviour and interpersonal perception during open-label, uncontrolled paroxetine treatment of people with social anxiety disorder: a pilot study

BACKGROUND

Laboratory-based research with community samples has suggested changes in affective, behavioural and cognitive processes as possible explanations for the effects of serotonergic medications. Examining the effects of serotonergic medications using an ecological momentary measure (such as event-contingent recording) in the daily lives of people with social anxiety disorder would contribute to establishing the effects of these medications on affect, behaviour and one form of cognition: perception of others’ behaviour.

METHODS

The present study assessed changes in affect, interpersonal behaviour and perception of others’ behaviour in adults with social anxiety disorder using ecological momentary assessment at baseline and over 4 months of a single-arm, uncontrolled, open-label trial of treatment with the selective serotonin reuptake inhibitor paroxetine.

RESULTS

Anxiety and concurrent depressive symptoms decreased. Participants also reported increased positive and decreased negative affect; increased agreeable and decreased quarrelsome behaviour; increased dominant and decreased submissive behaviour; and increased perception that others behaved agreeably toward them. Moreover, participants demonstrated reduced intraindividual variability in affect, interpersonal behaviour and perception of others’ behaviour.

LIMITATIONS

Limitations included the lack of a placebo group, the inability to identify the temporal order of changes and the restricted assessment of extreme behaviour.

CONCLUSION

The results of the present study demonstrate changes during pharmacotherapy in the manifestation of affect, interpersonal behaviour and interpersonal perception in the daily lives of people with social anxiety disorder. Given the importance of interpersonal processes to social anxiety disorder, these results may guide future research seeking to clarify mechanisms of action for serotonergic medications.

A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes

Childhood irritability exhibits significant theoretical and empirical associations with depression and anxiety syndromes. The current study used the twin design to parse genetic and environmental contributions to these relationships. Children ages 9-14 from 374 twin pairs were assessed for irritability and symptoms of depression, generalized anxiety, panic, social phobia, and separation anxiety using dimensional self-report instruments. Multivariate structural equation modeling decomposed the correlations between these syndromes into genetic and environmental components to examine shared and specific risk domains. Irritability had significant associations with each internalizing symptom domain. Genetic contributions to irritability are moderately correlated with genetic risk for symptoms of depression, generalized anxiety, and separation anxiety with weaker overlap with the other anxiety syndromes. Familial and specific environmental risk factors explained covariation among syndromes and indicated potential syndrome-specific risk. There is substantial overlap among the genetic and environmental factors that influence individual differences in irritability and those that increase liability for depression and anxiety symptoms in children. These findings deepen the current understanding of childhood internalizing risk factors and provide important implications for syndrome prediction and susceptibility gene discovery efforts.

Social support, negative social exchange, and response to case formulation-based cognitive behavior therapy

We investigated associations between pretreatment social support, negative social exchange, and slope of weekly symptom change for depression, anxiety, and stress over the course of ideographic, case formulation-based, cognitive behavior therapy. Participants were 74 adults treated in a private practice setting. We used self-report measures to assess social support and negative social exchange at intake and to assess symptoms on a weekly basis. At pretreatment, a higher level of social support was associated with lower levels of depression, and a higher level of negative social exchanges was associated with higher levels of depression and stress. Pretreatment social support was not significantly associated with slope of symptom change. However, a higher level of pretreatment negative social exchanges was associated with steeper slope of change in symptoms of depression and stress during treatment. These findings suggest that the association between pretreatment negative social exchanges and subsequent symptoms may be stronger than that of social support and subsequent symptoms. Additionally, we discuss the possibility that having data on negative social exchanges at the start of treatment may benefit the outcome of ideographic, case formulation-based, cognitive behavior therapy.

Moderation of improvement in self-efficacy following group psychotherapy for PTSD

Posttraumatic stress disorder (PTSD) is a primary mental health concern of veterans. In clinical settings, efforts to improve broad facets beyond symptom amelioration and consideration of moderators of treatment effectiveness in this population are needed for continued improvement in care. General self-efficacy (GSE) has been indicated as a useful treatment target because of its association with positive outcomes such as increased positive health behaviors. Both race and educational attainment represent potential moderators of treatment response that are relevant for a veteran PTSD population. This study aimed to determine whether a PTSD Recovery Group Therapy Program resulted in improvement in GSE and whether racial and educational differences moderated GSE outcomes. Archival data were examined from male veterans (N = 450) receiving mental health services at a Veterans Affairs medical center using multilevel modeling to examine change in GSE over the course of treatment as well as moderation of change in GSE as a function of race and educational attainment. After completion of group therapy, results indicated there was significant improvement in GSE, with significantly different improvement based on education. Higher levels of education were associated with greater increases in GSE after treatment. Improvement in GSE did not differ by participant race. In clinical settings, efforts to increase GSE and attending to moderators such as educational attainment may be useful for improving PTSD treatment approaches. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population

Individual differences in cognitive processes and coping behaviors play a role in the development and maintenance of posttraumatic stress disorder (PTSD). Given the large numbers of combat-exposed service members returning from the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) conflicts, exploring individual differences in cognitive-affective processes is important for informing our understanding of PTSD etiology and early intervention in military samples. The present study examined the unique main and interactive effects of negative posttrauma cognitions (i.e., negative beliefs about self [NS], the world [NW], and self-blame [SB]) and coping strategies (i.e., positive behavioral, positive cognitive, avoidant coping, and social and emotional coping) on PTSD diagnosis within 155 (M_age = 30.7, SD = 4.48) OEF/OIF/OND combat trauma-exposed veterans recruited from an ongoing study examining the effects of combat trauma and stress reactivity. In the final, stepwise logistic regression analysis, avoidant coping, but no other coping strategy, was significantly positively related to PTSD diagnosis in the initial step. Higher levels of NS, but not NW, were significantly associated with having a PTSD diagnosis, while SB was associated with decreased likelihood of PTSD, above and beyond coping strategies. A significant interaction effect was found between NS and positive cognitive coping, such that greater positive cognitive coping weakened the relationship between NS and PTSD. Examining and addressing coping behaviors and negative thoughts of self jointly may benefit assessment and intervention approaches in a combat-trauma population.

Adaptive Equilibrium Regulation: Modeling Individual Dynamics on Multiple Timescales

Damped Linear Oscillators estimated by 2nd-order Latent Differential Equation have assumed a constant equilibrium and one oscillatory component. Lower-frequency oscillations may come from seasonal background processes, which non-randomly contribute to deviation from equilibrium at each occasion and confound estimation of dynamics over shorter timescales. Boker (2015) proposed a model of individual change on multiple timescales, but implementation, simulation, and applications to data have not been demonstrated. This study implemented a generalization of the proposed model; examined robustness to varied timescale ratios, measurement error, and occasions-per-person in simulated data; and tested for dynamics at multiple timescales in experience sampling affect data. Results show small standard errors and low bias to dynamic estimates at timescale ratios greater than 3:1. Below 3:1, estimate error was sensitive to noise and total occasions; rates of non-convergence increased. For affect data, model comparisons showed statistically significant dynamics at both timescales for both participants.

Genetic and Environmental Contributions of Negative Valence Systems to Internalizing Pathways

The genetic and environmental contributions of negative valence systems (NVS) to internalizing pathways study (also referred to as the Adolescent and Young Adult Twin Study) was designed to examine varying constructs of the NVS as they relate to the development of internalizing disorders from a genetically informed perspective. The goal of this study was to evaluate genetic and environmental contributions to potential psychiatric endophenotypes that contribute to internalizing psychopathology by studying adolescent and young adult twins longitudinally over a 2-year period. This report details the sample characteristics, study design, and methodology of this study. The first wave of data collection (i.e., time 1) is complete; the 2-year follow-up (i.e., time 2) is currently underway. A total of 430 twin pairs (N = 860 individual twins; 166 monozygotic pairs; 57.2% female) and 422 parents or legal guardians participated at time 1. Twin participants completed self-report surveys and participated in experimental paradigms to assess processes within the NVS. Additionally, parents completed surveys to report on themselves and their twin children. Findings from this study will help clarify the genetic and environmental influences of the NVS and their association with internalizing risk. The goal of this line of research is to develop methods for early internalizing disorder risk detection.

A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood

Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.

Test-retest reliability of the facial expression labeling task

Recognizing others' emotional expressions is vital for socioemotional development; impairments in this ability occur in several psychiatric disorders. Further study is needed to map the development of this ability and to evaluate its components as potential transdiagnostic endophenotypes. Before doing so, however, research is required to substantiate the test-retest reliability of scores of the face emotion identification tasks linked to developmental psychopathology. The current study estimated test-retest reliability of scores of one such task, the facial expression labeling task (FELT) among a sample of twin children (N = 157; ages 9-14). Participants completed the FELT at two visits two to five weeks apart. Participants discerned the emotion presented of faces depicting six emotions (i.e., happiness, anger, sadness, fear, surprise, and disgust) morphed with a neutral face to provide 10 levels of increasing emotional expressivity. The present study found strong test-retest reliability (Pearson r) of the FELT scores across all emotions. Results suggested that data from this task may be effectively analyzed using a latent growth curve model to estimate overall ability (i.e., intercept; r's = 0.76-0.85) and improvement as emotions become clearer (i.e., linear slope; r's = 0.69-0.83). Evidence of high test-retest reliability of this task's scores informs future developmental research and the potential identification of transdiagnostic endophenotypes for child psychopathology. (PsycINFO Database Record

Clinical Correlates of Carbon Dioxide Hypersensitivity in Children

OBJECTIVE

Hypersensitivity to carbon dioxide (CO₂)-enriched air may be a promising risk marker for anxiety disorders. Among adult and adolescent samples, heterogeneity in distress response to the CO₂ challenge task indexes 3 underlying classes of individuals, which distinguish between sustained and acute threat response as markers for internalizing disorders, broadly, and anxiety disorders, specifically. The present study examines latent classes in children's response to the CO₂ challenge task to clarify the association of CO₂ hypersensitivity with anxiety and internalizing symptomatology in childhood.

METHOD

Healthy children from a community twin sample (N = 538; age 9-13 years) rated anxious distress every 2 minutes while breathing air enriched to 7.5% CO₂ for 8 minutes. Latent growth mixture modeling evaluated potential classes of individuals with characteristic trajectories of distress during the task to clarify the association with internalizing disorder symptoms and related traits (e.g., anxiety sensitivity, irritability).

RESULTS

Although all participants reported increased distress during the task, interindividual heterogeneity in distress indexed 3 underlying classes: a consistently low class ("low"), a consistently high class ("high"), and participants who demonstrated markedly increased acute distress ("acute"). Compared to the low class, the high class reported greater internalizing psychopathology, whereas membership in the acute class was associated with experiencing a panic-like event during the task.

CONCLUSION

As in older individuals, 3 distinct trajectories emerged to capture interindividual heterogeneity in children's distress during the CO₂ challenge task. These classes were distinguished by clinical validators that reinforce the association of CO₂ hypersensitivity and internalizing disorder phenotypes in children.

Clarifying the role of neuroticism in suicidal ideation and suicide attempt among women with major depressive disorder

BACKGROUND

Prior research consistently demonstrates that neuroticism increases risk for suicidal ideation, but the association between neuroticism and suicidal behavior has been inconsistent. Whereas neuroticism is recommended as an endophenotype for suicidality, the association of neuroticism with attempted suicide warrants clarification. In particular, prior research has not distinguished between correlates of attempted suicide, correlates of suicidal ideation, and correlates of comorbid psychopathology.

METHODS

The present study used the CONVERGE study, a sample of 5864 women with major depressive disorder (MD) and 5783 women without MD throughout China. Diagnoses, suicidal ideation, and attempted suicide were assessed with the Composite International Diagnostic Interview (CIDI). Neuroticism was assessed with the neuroticism portion of the Eysenck Personality Questionnaire.

RESULTS

Results replicate prior findings on the correlates of suicidal ideation, particularly elevated neuroticism among individuals who report prior suicidal ideation. Moreover, as compared with individuals who reported having experienced only suicidal ideation, neuroticism was associated with decreased likelihood of having attempted suicide.

CONCLUSIONS

The association of neuroticism with suicidality is more complicated than has been previously described. Whereas neuroticism increases risk for suicidal ideation, neuroticism may decrease risk for a suicide attempt among individuals with suicidal ideation. These results have implications for the assessment of risk for a suicide attempt among individuals who report suicidal ideation and addresses prior discordant findings by clarifying the association between neuroticism and attempted suicide.

Clinical characteristics of latent classes of CO2 hypersensitivity in adolescents and young adults

Although breathing CO₂-enriched air reliably increases anxiety, there is debate concerning the nature and specificity of CO₂ hypersensitivity to panic risk and panic disorder versus anxiety disorders and related traits broadly, particularly among adolescents and emerging adults. The present study sought to clarify the association of CO₂ hypersensitivity with internalizing conditions and symptoms among adolescents and young adults. Participants (N = 628) self-reported anxiety levels every 2 min while breathing air enriched to 7.5% CO₂ for 8 min. Growth mixture models were used to examine the structure of anxiety trajectories during the task and the association of each trajectory with dimensional and diagnostic assessments of internalizing disorders. Three distinct trajectories emerged: overall low (low), overall high (high), and acutely increased anxiety (acute). Compared to the low class, the acute class reported elevated neuroticism, anxiety sensitivity, and stress whereas the high class reported elevated anxiety symptoms, depression symptoms, neuroticism, anxiety sensitivity, and increased likelihood of an anxiety disorder diagnosis. Moreover, the acute and high classes reported experiencing a panic-like event at a higher rate than the low class while participants in the high class terminated the task prematurely at a higher rate. The present study clarifies the nature of response to CO₂ challenge. Three distinct response profiles emerged, which clarifies the manifestation of CO₂ hypersensitivity in anxiety disorders with strong, though not unique, associations with panic-relevant traits.

Depression symptoms moderate the association between emotion and communal behavior

Depression is associated with emotion regulation deficits which manifest as elevated negative affect and greater continuation of negative affect over time. The present study examined a possible emotion regulatory deficit, whether depression symptoms attenuate the association between communal (i.e., agreeable, quarrelsome) behavior and affect. A community sample reported on depression and anxiety symptoms before recording their affect and behavior following naturally occurring interpersonal interactions over 21 days. Participants' behaviors were measured using items selected to represent the Interpersonal Circumplex Model of behavior. Results indicated an association between affect and communal behavior, which was stronger for negative than positive affect. Depression symptoms moderated this association; elevated depression symptoms were associated with decreased association of affect and interpersonal behavior. Comorbid anxiety symptoms did not moderate this association. Results suggest that elevated depression symptoms are associated with a diminished ability to adapt communal behavior to emotion cues. Given prior evidence of elevated overall quarrelsome behavior among individuals with elevated depression symptoms, this may demonstrate an interpersonal mechanism by which emotion regulation deficits impact the generation of interpersonal problems. (PsycINFO Database Record

Likelihood-based confidence intervals for a parameter with an upper or lower bound

The precision of estimates in many statistical models can be expressed by a confidence interval (CI). CIs based on standard errors (SE) are common in practice, but likelihood-based CIs are worth consideration. In comparison to SEs, likelihood-based CIs are typically more difficult to estimate, but are more robust to model (re)parameterization. In latent variable models, some parameters may take on values outside of their interpretable range. Therefore, it is desirable to place a bound to keep the parameter interpretable. For likelihood-based CI, a correction is needed when a parameter is bounded. The correction is known (Wu & Neale, 2012), but is difficult to implement in practice. A novel automatic implementation that is simple for an applied researcher to use is introduced. A simulation study demonstrates the accuracy of the correction using a latent growth curve model and the method is illustrated with a multilevel confirmatory factor analysis.

Panic symptom clusters differentially predict suicide ideation and attempt

Increasingly strong evidence links anxiety disorders in general and panic attacks in particular to suicidality. The underlying causes and specifics of this relation, however, remain unclear. The present article sought to begin addressing this question by clarifying the association between panic symptoms and suicidality. Data were sampled from the NESARC epidemiological data set from the US and analyzed as four independently, randomly selected subsets of 1000 individuals using structural equation modeling analyses and replicating results across samples. Evidence is presented for four symptom clusters (cognitive symptoms, respiratory distress, symptoms of alpha and beta adrenergic activation) and the differential association of each with suicidal ideation and attempts. Symptoms of alpha adrenergic activation predicted prior suicide attempt whereas cognitive symptoms predicted prior suicidal ideation. These findings were independent of comorbid major depressive disorder. It is suggested that assessment of suicide risk in the community includes the presentation of cognitive symptoms and symptoms related to alpha adrenergic activation.

Naturalistic interpersonal behavior patterns differentiate depression and anxiety symptoms in the community

Symptoms of depression and anxiety are associated with interpersonal problems that, in turn, exacerbate and maintain these symptoms. The purpose of the present study was to identify patterns of interpersonal behavior characteristic of each syndrome, particularly whether intraindividual variability in interpersonal behavior differentiates between anxiety and depression symptoms. After reporting on depression and anxiety symptoms, community participants recorded their behavior following interpersonal interactions over 21 days. Participants' interpersonal behavior at each event was measured using behavior dimensions from the interpersonal circumplex: dominant, submissive, agreeable, and quarrelsome. Mean levels of behavior and intraindividual variability were computed over events and then regressed on depression and anxiety symptoms using structural equation modeling. Elevations in reported depression and anxiety symptoms were both associated with elevated mean-level quarrelsome and submissive behavior. Independent of mean-level behavior and concurrent depression symptoms, elevated anxiety symptoms were associated with elevated variability in agreeable, dominant, and submissive behavior and with elevated variability in type of interpersonal behavior (i.e., spin). Depression symptoms were unrelated to variability in interpersonal behavior. Results demonstrate that variability in behavior distinguishes anxiety from depression symptoms.