In the present study we examined loneliness among individuals with and without social anxiety disorder (SAD), contexts that may moderate the experience of loneliness, and the temporal relationship between loneliness and social anxiety. We examined 88 individuals (44 with SAD and 44 without SAD) and used experience sampling (ES) methods, comprising of real-time measurement of naturally occurring events and participants' emotional reactions to them during participants' daily lives over the course of 21 days. Hierarchical linear models indicated that individuals with SAD reported significantly more loneliness compared to individuals without SAD. We also found that characteristics of social situations (negativity, positivity, and meaningfulness) were all positively and significantly associated with loneliness among individuals with SAD. Thus, social situations that were experienced as more negative, more positive, and more meaningful all resulted in increased loneliness for individuals with SAD. We also found a significant Positivity × Meaningfulness interaction that indicated that the effect of positivity was attenuated when meaningfulness was high. Notably, none of these effects were found for individuals without SAD. Finally, we found that for individuals with SAD, both anxiety and loneliness predicted changes in each other and combined to form a deleterious cycle. However, evidence for such a cycle was not found for individuals without SAD. The role of loneliness in the psychopathology of SAD and its maintenance, as well as clinical implications are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Elevated neuroticism may confer vulnerability to the depressogenic effects of stressful life events (SLEs). However, the mechanisms underlying this susceptibility remain poorly understood. Accumulating evidence suggests that stress-related disruptions in neural reward processing might undergird links between stress and depression. Using data from the Saint Louis Personality and Aging Network (SPAN) study and Duke Neurogenetics Study (DNS), we examined whether neuroticism moderates links between stressful life events (SLE) and depression as well as SLEs and ventral striatum (VS) response to reward. In the longitudinal SPAN sample (n = 971 older adults), SLEs prospectively predicted future depressive symptoms, especially among those reporting elevated neuroticism, even after accounting for prior depressive symptoms and previous SLE exposure (NxSLE interaction: p = .016, ΔR² = 0.003). Cross-sectional analyses of the DNS, a young adult college sample with neuroimaging data, replicated this interaction (n = 1,343: NxSLE interaction: p = .019, ΔR² = 0.003) and provided evidence that neuroticism moderates the association between SLEs and reward-related VS response (n = 1,195, NxSLE: p = .017, ΔR² = 0.0048). Blunted left VS response to reward was associated with a lifetime depression diagnosis, r = -0.07, p = .02, but not current depressive symptoms, r = -0.003, p = .93. These data suggest that neuroticism may promote vulnerability to stress-related depression and that sensitivity to stress-related reductions in VS response may be a potential neural mechanism underlying vulnerability to clinically significant depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Over the past 2 decades Bayesian methods have been gaining popularity in many scientific disciplines. However, to this date, they are rarely part of formal graduate statistical training in clinical science. Although Bayesian methods can be an attractive alternative to classical methods for answering certain research questions, they involve a heavy "overhead" (e.g., advanced mathematical methods, complex computations), which pose significant barriers to researchers interested in adding Bayesian methods to their statistical toolbox. To increase the accessibility of Bayesian methods for psychopathology researchers, this article presents a gentle introduction of the Bayesian inference framework and a tutorial on implementation. We first provide a primer on the key concepts of Bayesian inference and major implementation considerations related to Bayesian estimation. We then demonstrate how to apply hierarchical Bayesian modeling (HBM) to experimental psychopathology data. Using a real dataset collected from two clinical groups (schizophrenia and bipolar disorder) and a healthy comparison sample on a psychophysical gaze perception task, we illustrate how to model individual responses and group differences with probability functions respectful of the presumed underlying data-generating process and the hierarchical nature of the data. We provide the code with explanations and the data used to generate and visualize the results to facilitate learning. Finally, we discuss interpretation of the results in terms of posterior probabilities and compare the results with those obtained using a traditional method. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Determining the long-term psychosis-related outcomes of late-teen individuals characterized initially by a nonpsychotic, schizotypic feature (elevated perceptual aberrations) can further our understanding of the developmental pathways leading to schizophrenia, nonaffective psychotic conditions, and psychotic symptoms later in adulthood. Using the well-known laboratory/psychometric high-risk approach, the present study investigated the associations between nonpsychotic perceptual aberrations measured at age 18, in individuals with no prior history of psychosis, and clinical psychotic symptom outcomes 17 years later in midlife (middle 30s). Clinical assessments for hallucinations and delusions were completed for 191 adults (95% of the original sample) in the follow-up study. Elevated perceptual aberrations at age 18 predicted increased levels of hallucinations, delusions, and total psychotic symptoms in midlife as well as psychotic illness. The associations between baseline perceptual aberrations and later psychotic symptoms were not accounted for by general nonspecific psychopathology factors such as anxiety or depression present at age 18. Early detection of subtle, nonpsychotic forms of perceptual disturbance may aid in identifying individuals at increased risk for nonaffective psychosis outcomes in adulthood. Perceptual aberrations may constitute a useful endophenotype for genetic, neurobiological, and cognitive neuroscience investigations of schizophrenia liability. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Even though memory performance is a commonly researched aspect of Obsessive-Compulsive Disorder (OCD), a coherent and unified explanation of the role of specific cognitive factors has remained elusive. To address this, the present meta-analysis examined the predictive validity of Harkin and Kessler’s (2011) Executive Function (E), Binding Complexity (B) and Memory Load (L) Classification System with regards to affected vs. unaffected memory performance in OCD. We employed a multi-level meta-analytic approach (Viechtbauer, 2010) to accommodate the interdependent nature of the EBL model and interdependency of effect sizes (305 effect sizes from 144 studies, including 4424 OCD patients). Results revealed that the EBL model predicted memory performance, i.e., as EBL demand increases, those with OCD performed progressively worse on memory tasks. Executive function was the driving mechanism behind the EBL’s impact on OCD memory performance and negated effect size differences between visual and verbal tasks in those with OCD. Comparisons of sub-task effect sizes were also generally in accord with the cognitive parameters of the EBL taxonomy. We conclude that standardised coding of tasks along individual cognitive dimensions and multi-level meta-analyses provides a new approach to examine multi-dimensional models of memory and cognitive performance in OCD and other disorders.
Accumulated empirical evidence suggests that death anxiety is strongly associated with multiple mental health conditions. Despite this, few studies have experimentally explored whether manipulating reminders of death could influence the symptoms of mental illnesses. The present, preregistered study used a mortality salience design to assess whether death reminders could increase anxious behavior (i.e., time spent scanning one's body, identification with images consistent with poorer health, and intention to visit a medical practitioner) among individuals with relevant disorders. A total of 128 treatment-seeking participants with either a body scanning disorder (i.e., panic disorder, illness anxiety, or somatic symptom disorder) or a nonscanning disorder (i.e., depression) were randomly allocated to either a mortality salience or control condition. Following this, participants were presented with a series of images of various body parts, which purportedly predicted particular life outcomes, and asked to check their own body and select the image that most closely matched their own. As hypothesized, the results revealed that mortality salience produced an overall increase in all three anxiety-related behaviors. Further, mortality salience selectively increased scanning duration and identification with images indicating poorer health for individuals with a scanning disorder. This effect only occurred when participants were told the body part predicted a health-relevant outcome. In contrast, mortality salience increased intention to visit a medical specialist regardless of one's disorder. The findings support theoretical predictions that death anxiety may have a causal role in multiple mental disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
This systematic review and meta-analysis updates evidence pertaining to response inhibition in obsessive-compulsive disorder (OCD) as measured by the stop-signal task (SST). We conducted a meta-analysis of the literature to compare response inhibition in patients with OCD and healthy controls, metaregressions to determine relative influences of age and sex on response inhibition performance, and a risk of bias assessment for included studies using the Newcastle-Ottawa Scale (NOS). Stop-signal reaction time (SSRT), which estimates the latency of the stopping process deficit, was significantly longer in OCD samples than in controls, reflecting inferior inhibitory control (Raw mean difference = 23.43 ms; p = <.001; 95% CI [17.42, 29.45]). We did not observe differences in mean reaction time (MRT) in OCD compared with controls (Raw mean difference = 2.51 ms; p = .755; 95% CI [-13.27, 18.30]). Reaction time variability (RTSD) was reported in one study only. Age impacted effect size of SSRT, indicating inferior performance in older OCD patients than younger ones. We did not observe a significant effect of sex on SSRT or MRT scores. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Hierarchical dimensional models of psychopathology derived for adult and child community populations offer more informative and efficient methods for assessing and treating symptoms of mental ill health than traditional diagnostic approaches. It is not yet clear how many dimensions should be included in models for youth with neurodevelopmental conditions. The aim of this study was to delineate the hierarchical dimensional structure of psychopathology in a transdiagnostic sample of children and adolescents with learning-related problems, and to test the concurrent predictive value of the model for clinically, socially, and educationally relevant outcomes. A sample of N = 403 participants from the Centre for Attention Learning and Memory (CALM) cohort were included. Hierarchical factor analysis delineated dimensions of psychopathology from ratings on the Conner's Parent Rating Short Form, the Revised Children's Anxiety and Depression Scale, and the Strengths and Difficulties Questionnaire. A hierarchical structure with a general p factor at the apex, broad internalizing and broad externalizing spectra below, and three more specific factors (specific internalizing, social maladjustment, and neurodevelopmental) emerged. The p factor predicted all concurrently measured social, clinical, and educational outcomes, but the other dimensions provided incremental predictive value. The neurodevelopmental dimension, which captured symptoms of inattention, hyperactivity, and executive function and emerged from the higher-order externalizing factor, was the strongest predictor of learning. This suggests that in struggling learners, cognitive and affective behaviors may interact to influence learning outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Experiencing eating disorder symptoms is associated with maladaptive outcomes and impairment in functioning. A paucity of research exists examining eating disorder symptoms among ethnic/racial minority women. Using a network analysis, we evaluated core symptoms of eating disorder psychopathology and the degree of association between eating disorder symptoms in a sample of ethnic/racial minority women. Participants were 296 Black, 261 Hispanic, and 261 Asian American women recruited across the United States to complete an online survey. Inclusionary criteria yielded a sample with high eating disorder psychopathology. The Network Comparison Test was used to identify differences in networks between groups and yielded no significant differences between the three ethnic/racial groups. Thus, one network analysis on the entire sample was conducted in the main analyses. However, separate group analyses are presented in the online supplemental materials. Consistent with the transdiagnostic theory of eating disorders, weight concerns (i.e., strong desire to lose weight and fear of weight gain) emerged as central symptoms. Discrepant from findings with predominantly White samples, purging emerged as a central symptom as well, while shape concerns did not. Interestingly, having to weigh oneself weekly, having a flat stomach, fasting, and compulsive exercising were on the periphery of the network. Findings are discussed in terms of clinical implications and comparative similarities and differences when addressing the existing literature. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Restrictive eating is common and associated with negative psychological outcomes across the life span and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N = 457), transdiagnostic adults (Study 2: N = 145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N = 45). Study 1 indicated the four-function model was a good fit for restricting (root mean square error of approximation [RMSEA] = .06, Tucker-Lewis index [TLI] = .88). This factor structure replicated in Study 2 (comparative fit index [CFI] = .97, RMSEA = .07, TLI = .97, standardized root mean square residual [SRMR] = .09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps < .05). In Study 1, social functions were associated with less social support (ps < .001). Across studies, automatic functions were associated with greater restriction ps < .05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Despite the clinical emphasis on processes happening within individuals, investigations into the psychological, structural connections between mental health symptoms have almost exclusively analyzed differences between people. These investigations have revealed important findings; however, they do not reveal the close connections among symptoms in an individuals' psychology. This study thus examined the psychological connections between symptoms directly, using borderline personality disorder (BPD) symptoms as an example. Participants (252; 74 with BPD) reported their momentary BPD symptoms five times daily, and 165 did so again 18 months later. In support of personalized medicine (Wright & Woods, 2020), individuals' BPD symptom structures differed considerably from each other and from the between-person structure. A novel technique revealed that differences were greater than expected by chance. Within-person structures tended to exhibit more symptom granularity (more factors and lower variance explained) and differing symptom meanings (patterns of loadings). For example, some individuals exhibited close connections between relationship turmoil and identity uncertainty, whereas other individuals exhibited close connections between relationship turmoil and impulsivity. Thus, conceptions of any given person's psychopathological processes using between-person structural findings will most likely be inaccurate. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Posttraumatic stress disorder (PTSD) is marked by alterations in emotional functioning, physiological reactivity, and attention. Neural reactivity to acoustic startle stimuli can be used to understand brain functions related to these alterations. Investigations of startle reactivity in PTSD have yielded inconsistent findings, which may reflect the heterogeneity of the disorder. Furthermore, little is known of how the common co-occurrence of mild traumatic brain injury (mTBI; i.e., concussion) may influence neural reactivity. We examined the event-related potentials (ERPs) of combat veterans (n = 102) to acoustic startle probes delivered during viewing of pleasant, neutral, unpleasant, and combat-related pictures. Interview-based assessments yielded dimensional characterizations of PTSD and mTBI. The P3 ERP response to startle probes was reduced during all affective relative to neutral pictures but failed to be associated with a PTSD diagnosis. However, two separable domains of PTSD symptomatology were associated with startle ERPs regardless of the picture conditions. Maladaptive avoidance was associated with smaller N1, P2, and P3 amplitudes, while intrusive reexperiencing was associated with larger P2 amplitudes. There were no main effects of mTBI. Findings suggest that level of symptomatology rather than a formal diagnosis of PTSD better explains alterations in neural reactivity after traumatic events, while mild brain injuries have little impact. Avoidance symptoms of PTSD may dampen neural functions that facilitate reorientation to threat while intrusive reexperiencing of traumatic events appears to heighten sensory reactivity. Considering specific aspects of symptomatology provides insight into the neural basis of trauma-related psychopathology and may help guide individualization of clinical interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Many individuals report drinking alcohol to cope or relieve negative affective states, but existing evidence is inconsistent regarding whether individuals experience negatively reinforcing effects after drinking to cope (DTC). We used ecological momentary assessment to examine the effects of DTC during daily-life drinking episodes in a sample of current drinkers (N = 110; 52 individuals with borderline personality disorder and 58 community individuals). Multilevel models were used to test whether momentary and episode-level endorsement of DTC-depression and DTC-anxiety motives would be related to increased subjective drinking-contingent relief and decreased depression and anxiety during drinking episodes. Momentary DTC-anxiety predicted greater subsequent drinking-contingent relief, and greater episode-level DTC-anxiety and DTC-depression predicted greater drinking-contingent relief during the episode. However, we did not find decreased depression and anxiety following endorsement of DTC-depression and DTC-anxiety. Instead, we found that greater episode-level DTC-depression was associated with increased depression. Thus, findings suggest that individuals' negative affective states may not improve during DTC despite endorsing drinking-contingent relief. This discrepancy warrants further attention because subjective relief likely reinforces DTC, whereas awareness of one's change (or lack of change) in affect may provide valuable counterevidence for whether alcohol use is an effective coping strategy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Capability-based models propose that people die by suicide because they want to, and they can. Despite the intuitive appeal of this hypothesis, longitudinal evidence testing its predictive validity has been limited. This study tested the predictive validity of the desire-capability hypothesis. A total of 1,020 self-injuring and/or suicidal adults were recruited worldwide online from suicide, self-injury, and mental health web forums. After baseline assessment, participants completed follow-up assessments at 3, 14, and 28 days after baseline. Participant retention was high (>90%) across all follow-up assessments. Analyses examined the effect of the statistical interaction between suicidal desire and indices of capability for suicide on future nonfatal suicide attempts. Main analyses focused on the fearlessness about death facet of capability for suicide; exploratory analyses examined preparations for suicide. Logistic regression was used to predict suicide attempt status at follow-up; zero-inflated negative binomial models were implemented to predict the frequency of nonfatal suicide attempts at follow-up. Results were consistent across models, finding very little evidence of the desire-capability interaction as a significant predictor of suicide attempt status or frequency at follow-up. We close with a discussion of the limitations of this study as well as the implications of our findings for future suicide science. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Emerging evidence suggests socioeconomic disadvantage may increase risk for eating disorders (EDs). However, there are very few studies on the association between disadvantage and EDs, and all have focused on individual-level risk factors (e.g., family income). Neighborhood disadvantage (i.e., elevated poverty and reduced resources in one's neighborhood) is associated with increased risk for anxiety/depression and poor physical health. To date, no studies have examined phenotypic associations between neighborhood disadvantage and disordered eating, or how any form of disadvantage may interact with genetic individual differences in risk for EDs. We examined phenotypic and etiologic associations between neighborhood disadvantage and disordered eating in 2,922 girls ages 8-17 from same-sex twin pairs recruited through the Michigan State University Twin Registry. Parents rated the twins on nine items assessing core disordered eating symptoms (e.g., weight preoccupation, binge eating), and neighborhood disadvantage was calculated from 17 indicators of contextual disadvantage (e.g., median home value, neighborhood unemployment). Puberty was measured using the Pubertal Development Scale to examine whether associations were consistent across development. At a phenotypic level, greater neighborhood disadvantage was associated with significantly greater disordered eating symptoms in girls at all stages of puberty (β = .07). Moreover, Genotype × Environment models showed that girls living in more disadvantaged neighborhoods exhibited stronger and earlier (i.e., during pre/early puberty) activation of genetic influences on disordered eating. Results highlight the critical importance of considering contextual disadvantage in research on etiology and risk for disordered eating, and the need for increased screening and treatment for EDs in disadvantaged youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Background. Adolescents’ emotion regulatory capacities may modulate the relationship between childhood maltreatment experiences and psychopathology. Affective inhibitory control constitutes an important part of emotion regulation and involves the ability to regulate automatic or prepotent responses to irrelevant and potentially distracting emotional information. Aims. The aim of the present study was to investigate the role of affective inhibitory control in the relationship between exposure to childhood psychological and physical abuse and internalizing problems in adolescence. Method. A nationally representative sample of adolescents (Mage/SD =14/.8) exposed to physical and psychological abuse (N = 1841; male = 964; female = 877) conducted an Emotional Go/No-go task. Participants were presented with angry facial expressions as emotional no-go stimuli in order to examine their ability to inhibit behavioral responses to threatening task-irrelevant stimuli. Results. Affective inhibitory control problems were uniquely related to internalizing problems in girls, but not in boys. Moreover, affective inhibitory control moderated the relationship between exposure to psychological abuse and internalizing problems in girls. We did not observe any relationship between inhibitory control and internalizing problems when neutral faces were presented as task-irrelevant information. Conclusion. Findings suggest that a reduced ability to inhibit threatening, but task-irrelevant, information is related to internalizing problems in adolescent girls exposed to physical and psychological abuse. This highlights the importance of affective inhibitory control as a potential moderating mechanism in individual risk for experiencing internalizing problems in abused adolescent girls.
There has been increasing recognition that classically defined psychiatric disorders cluster hierarchically. However, the degree to which this hierarchical taxonomy manifests in the distribution of one's daily affective experience is unknown. In 462 young adults, we assessed psychiatric symptoms across internalizing and externalizing disorders and then used cell-phone-based ecological momentary assessment (EMA) to assess the distribution (mean, standard deviation, skew, kurtosis) of one's positive and negative affect over 3-4 months. Psychiatric symptoms were modeled using a higher-order factor model that estimated internalizing and externalizing spectra as well as specific disorders. Individualized factor loadings were extracted, and path models assessed associations between spectra and syndromes, and daily affect. Internalizing and externalizing spectra displayed broad differences in the distribution of affective experiences, while within the internalizing spectrum, syndromes loading onto fear and distress subfactors were associated with distinct patterns of affective experiences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
The current study visualized attention-deficit/hyperactivity disorder (ADHD) symptom networks in a longitudinal sample of participants across childhood and adolescence with exploratory examination of age and gender effects. Eight hundred thirty-six children ages 7-13 years were followed annually for 8 years in total. Across parent and teacher report, results suggested "is easily distracted" and "difficulties sustaining attention" as central symptoms across three testing points (i.e., Year 1, Year 3, and Years 5-8 collapsed). "Difficulties following instructions" and "intrudes/interrupts" also emerged as parent-reported central symptoms. Assessment of network structure across the three testing points suggested global robustness of relations among ADHD symptoms from midchildhood into early adolescence. However, relations among symptoms that cause problems in school settings (i.e., being easily distracted) were stronger in teacher-reported than parent-reported networks. When aggregated into a sum score, central symptoms during Year 1 predicted total difficulties related to mental health problems 5 years later just as well as all 18 symptoms. Central symptoms of ADHD may be useful as screeners of future emotional and behavioral difficulties. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
