Dispositional cognitive reappraisal, an emotion regulation skill that involves reframing thoughts about a situation to improve emotional responses, may be an important factor in predicting response to cognitive restructuring. This study examines whether dispositional cognitive reappraisal skills are associated with the efficacy of a lab-based cognitive restructuring manipulation in reducing physiological conditioned fear responses. Psychiatrically healthy participants (n = 107) completed fear acquisition on Day 1, followed by a cognitive restructuring manipulation or control task on Day 2 and a test of physiological fear responses and the Emotion Regulation Questionnaire on Day 3. A significant interaction between manipulation and dispositional cognitive reappraisal skills was observed (p < .05). Specifically, among participants who completed the lab-based cognitive restructuring manipulation, participants with low reappraisal skills showed greater decreases in conditioned fear responses than participants with high reappraisal skills. Further research is needed to replicate these findings and determine whether they would extend to clinical populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Fear conditioning research can provide insight into how individuals with clinically relevant traits learn to distinguish between threatening and safe stimuli. Prior studies have found higher anxiety symptoms to be associated with increased physiological fear responses to conditioned safety stimuli (CS-) and greater intolerance of uncertainty (IU) to be associated with increased responses to conditioned threat stimuli (CS+). Yet, relationships remain unclear in the general population, particularly during acquisition, and these effects have not been explored using category fear conditioning. Unselected adults underwent category conditioning in which one category (e.g., trial unique fish; CS+) was associated with shock, and another (e.g., trial unique birds; CS-) was not. Participants rated the pleasantness of each stimulus (n = 213) and skin conductance responses (SCR; n = 171) were recorded. Additionally, participants completed the Depression, Anxiety, Stress Scale (DASS-21) and the Intolerance of Uncertainty Scale (IU). There was a significant CS type x DASS anxiety interaction for SCR data when covarying for IU during acquisition (p=.012), driven by individuals with higher anxiety demonstrating higher SCRs to the CS- (p=.019). IU did not predict SCRs or pleasantness ratings during acquisition. Our results suggest that even in an unselected sample, individuals with higher anxiety symptoms may generalize physiological fear responses from a threatening category to a safe category or have difficulty inhibiting physiological fear responses to a safe category, while leaving self-report pleasantness ratings unaffected. It appears that intolerance of uncertainty does not influence self-report or physiologic measures during acquisition in this category conditioning paradigm.

Background: Combining data-driven natural language processing techniques with traditional methods using predefined word lists may offer greater insights into the connections between language patterns and depression and anxiety symptoms, particularly within specific stressful contexts. Methods: Between 2020 and 2021, 1106 participants wrote narrative responses describing their experiences during the COVID-19 pandemic and completed the Depression Anxiety Stress Scale-21 (DASS). We investigated language patterns associated with DASS symptoms using established categories from Linguistic Inquiry and Word Count (LIWC) and sentiment analysis, as well as exploratory natural language processing techniques. Finally, we constructed machine learning regression models in order to assess how much of the variance in DASS symptoms is related to language use. Results: We found significant positive bivariate correlations between total DASS symptoms and hypothesized LIWC categories: first-person singular pronouns, absolute language, and negative emotion words. These results remained largely similar when using negative sentiment scores and when statistically controlling for gender, age, and education. Exploratory n-gram analyses also revealed new individual words and phrases correlated with total DASS symptoms. Lastly, our regression models demonstrated a significant association between language use and total DASS symptoms (R2 = 0.36-0.62). Conclusions: The current study is one of the first to examine associations between language use and DASS symptoms during the pandemic using both traditional and data-driven techniques. These results replicate and extend prior findings regarding negative emotion and absolute language and identify unique correlates of DASS symptoms during pandemic-related stress, contributing to the literature on language and mental health more broadly.

Fear extinction is foundational to exposure therapy; therefore, the study of strategies to optimize fear extinction is relevant for clinical practice. This article provides a critical review of translational research on pharmacological enhancement of fear extinction, concentrating mostly on d -cycloserine, the agent with the most extensive evidence base across levels of analyses. Despite early promise, results across preclinical, human laboratory, and clinical trials have been mixed. We identify factors that may account for these inconsistent findings, including differences in study design, selection of subjects, sample size, and measurement approaches. We emphasize the need for a rigorous mechanistic research agenda that both assesses extinction processes—acquisition, consolidation, and retrieval—as distinct mechanistic targets and examines the relation between changes in these fear extinction processes and clinical outcomes. Finally, we discuss opportunities to advance translational research in this area by leveraging extant collaborative infrastructures to improve the quality, the efficiency, and ultimately the availability of effective clinical strategies.

Although negative autobiographical memories play a defined etiological role for trauma-related disorders, it is less clear what role they play in other anxiety-related disorders. Understanding the prevalence of negative autobiographical memories that are conceptually related to a patient’s symptoms (i.e., symptom-relevant negative autobiographical memories; SNAMs) in anxiety-related disorders may help inform the development of novel memory-based interventions. The current scoping review examined the prevalence of SNAMs in anxiety disorders and obsessive-compulsive disorder, including SNAMs that were reported to have occurred around symptom onset (i.e., Symptom Onset SNAMs) and SNAMs that were reported to have occurred at any time (i.e., Lifetime SNAMs). Lifetime SNAMs also included a subcategory of SNAMs associated with intrusive imagery. The relationship of the presence of SNAMs to symptom onset, disorder status, and symptom severity was also examined. A systematic search identified 39 relevant articles. The prevalence of Symptom Onset SNAMs assessed by the Phobic Origins Questionnaire, interviews, and the Origins Questionnaire ranged from 30-89% (IQR = 50-68.5%; samples = 23), 23-61% (IQR = 30-49%; samples = 11), and 17-37% (samples = 6), respectively. The prevalence of Lifetime SNAMs ranged from 89-100% (samples = 6) and Intrusive Imagery-Related Lifetime SNAMs ranged from 38-100% (IQR = 60.5-79%; samples = 12). Five of 14 studies observed a significantly higher rate of SNAMs in patient relative to control samples. Findings are discussed with regard to limitations of the current evidence and future research that can inform the value of targeting SNAMs in treatment.

Background: Recurrent symptom-relevant negative autobiographical memories are common in patients with emotional disorders such as anxiety and depression, even among those without a trauma-related diagnosis. Recurrent negative autobiographical memories may also contribute to distress in non-clinical populations. Methods: To examine the prevalence of recurrent negative autobiographical memories and associated psychological features, we recruited a student sample (n = 101) and a treatment-seeking sample of patients with emotional disorders (n = 123). We hypothesized that recurrent negative autobiographical memories would be associated with higher levels of psychological symptoms and rumination. We also conducted exploratory analyses of participants’ most bothersome memory. Results: In each sample, individuals who endorsed recurrent negative autobiographical memories had significantly higher depression, anxiety, and stress symptoms as well as greater rumination. In the treatment-seeking sample, where memories also had to be identified by patients as symptom-relevant, those who endorsed memories also had significantly higher clinician-rated symptom severity for their primary diagnosis. The majority of participants in each sample endorsed moderate or greater re-experiencing (sample 1: 79%, sample 2: 66%) and avoidance symptoms (sample 1: 78%, sample 2: 58%) related to their most bothersome memory. Conclusion: Recurrent negative autobiographical memories relate to mental health symptoms in both clinical and non-clinical samples. Further research should explore whether targeting such memories reduces distress or improves wellbeing in these populations.

Despite considerable cognitive neuroscience research demonstrating that emotions can influence the encoding and consolidation of memory, research has failed to demonstrate a relationship between self-reported ratings of emotions collected soon after a traumatic event and memory for the event over time. This secondary analysis of data from a multi-site longitudinal study of memories of the 9/11/2001 terrorist attacks, asked the question of whether emotional language use could predict memory over time. In the two weeks following the 9/11 attacks, participants (N = 691; mean age 36.8; 72% identifying as male; 76% identifying as white) wrote narratives about how they learned of the attacks and the impact of the attacks on them. Language features of these narratives were extracted using the Linguistic Inquiry Word Count program and used to predict three types of memory: (1) event memory accuracy, (2) flashbulb memory consistency, and (3) emotion memory consistency. These outcomes were assessed at the time of writing, one, three, and 10 years after the 9/11 attacks. Results of linear mixed-effects models indicate that greater use of negative emotion words in narratives predicts better event memory accuracy three and 10 years after the attacks and worse flashbulb memory consistency 10 years after the attacks. However, emotion word use did not predict emotion memory consistency across time. We also examine whether other exploratory linguistic predictors are associated with memory over time. These findings suggest that assessing language usage may serve as a potential early indicator of memory over time.

Consistent evidence suggests that exercise leads to improvements in subjective sleep quality and also objective sleep metrics in non-psychiatric adult populations. However, the degree to which exercise provides sleep benefits for adults with psychiatric disorders is less known, despite the potential benefits given that sleep disturbance is prevalent in these populations. In this narrative review, we synthesize results of randomized controlled trials examining the influence of aerobic and/or resistance exercise interventions on sleep outcomes in adult psychiatric populations. We specifically focus on populations with elevated symptoms or diagnoses of depression, anxiety, or posttraumatic stress disorder. A systematic search through June 2024 yielded 26 relevant trials. Overall, most trials reported improvement of subjective sleep quality after aerobic and/or resistance exercise programs in samples with depression. Similar effects were observed for posttraumatic stress; however, larger trials are needed. Further research is needed to examine the impact of exercise on sleep in anxiety populations as only one trial with mixed results was identified. Results were more equivocal for the subpopulation of adult women with perinatal or postpartum depression, demonstrating the importance of understanding exercise effects on sleep in specific subpopulations. Few studies examined objective sleep outcomes, impact of acute exercise on next day sleep, or the interplay between exercise, sleep, and psychiatric symptom changes, all important areas of future research. Other implications and future directions are discussed, including potential moderators and mechanisms of action that warrant further study to better understand how exercise interventions may optimally target sleep in psychiatric populations.

When recalling autobiographical events, people retrieve not only the event details, but also the feelings they experienced. Past work with different measures of memories for feelings remain inconclusive, suggesting that people are either highly consistent or inconsistent with remembering feelings. The current study examined whether people are able to consistently recall the intensity of previous feelings associated with consequential and negatively valenced emotional events, i.e., the 9/11 attack (N = 769) and Covid-19 pandemic (N = 726). By comparing the initial and recalled intensities of negative feelings, we found that people systematically recall more intense negative feelings than they initially reported – overestimating the intensity of past negative emotional experience. The Covid-19 dataset further showed that people whose emotional well-being improved more demonstrate smaller biases in remembered feelings. Across both datasets, the remembered intensity of feelings correlated with initial feelings and were also influenced by current feelings, although the impact of the current feelings was stronger in the Covid-19 dataset than the 9/11 dataset. Our results suggest that when recalling negative autobiographical events, people tend to overestimate the intensity of experienced negative emotional experience with the degree of bias influenced by current feelings and well-being.

Laboratory procedures have been used for decades as analogues for clinical processes with the goal of improving our understanding of psychological treatments for emotional disorders and identifying strategies to make treatments more effective. This research has often focused on translation from the laboratory to the clinic. Although this approach has notable successes, it has not been seamless. There are many examples of strategies that work in the laboratory that fail to lead to improved outcomes when applied clinically. One possible reason for this gap between experimental and clinical research is a failure to focus on translation from the clinic to the laboratory. Here, we discuss potential benefits of translation from the clinic to the laboratory and provide examples of how this might be implemented. We first consider two well-established laboratory analogues (extinction and cognitive reappraisal), identify critical aspects of the related clinical procedures (exposure and cognitive restructuring) that are missing from these analogues, and propose variations to better capture the clinical process. Second, we discuss two clinical procedures that have more recently been brought into the laboratory (eye-movement desensitization and reprocessing and imagery rescripting). We conclude by highlighting potential implications of this proposed shift in focus for translational research.

Fear conditioning paradigms are frequently used in the translational study of anxiety and fear-related disorders. Accordingly, it is important to understand whether the measurement of fear conditioning responses is systematically influenced by an individual's race. Studies have found increased pain sensitivity and smaller physiological startle responses in Asian individuals, compared to White individuals; to our knowledge, no studies have evaluated whether skin conductance response (SCR) outcomes differ between Asian and White individuals. In a series of secondary data analyses, we investigated potential differences in skin conductance level (SCL), orienting SCR, unconditioned SCR, SCR to CS+ and CS-, differential SCR, and differential SCR non-responder status. In sample 1, Asian participants (n = 97) demonstrated a significantly smaller mean differential SCR compared to White participants (n = 86). No other between group differences were observed. In sample 2, there was no difference in mean differential SCR between Asian (n = 52) and White (n = 62) participants, although more Asian participants failed to show adequate skin conductance levels for study entry. To our knowledge, this is the first study to evaluate differences between Asian and White samples using skin conductance outcomes in a fear conditioning paradigm. We detected only subtle evidence for SCR differences between Asian and White samples, unlikely to reach significance outside large studies.

Posttraumatic stress disorder can be viewed as a disorder of fear dysregulation. An abundance of research suggests that the prefrontal cortex is central to fear processing—that is, how fears are acquired and strategies to regulate or diminish fear responses. The current review covers foundational research on threat or fear acquisition and extinction in nonhuman animals, healthy humans, and patients with posttraumatic stress disorder, through the lens of the involvement of the prefrontal cortex in these processes. Research harnessing advances in technology to further probe the role of the prefrontal cortex in these processes, such as the use of optogenetics in rodents and brain stimulation in humans, will be highlighted, as well other fear regulation approaches that are relevant to the treatment of posttraumatic stress disorder and involve the prefrontal cortex, namely cognitive regulation and avoidance/active coping. Despite the large body of translational research, many questions remain unanswered and posttraumatic stress disorder remains difficult to treat. We conclude by outlining future research directions related to the role of the prefrontal cortex in fear processing and implications for the treatment of posttraumatic stress disorder.

Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use) across 28 studies (1,998 participants). AS targeted interventions, compared to control conditions, evidenced a significant moderate effect size for alleviating AS from pre- to post-treatment (d = 0.54) and approached a large effect size from pre-treatment to short-term follow-up (d = 0.78). The effect size for long-term follow-up did not reach significance (d = 0.29). For clinical/behavioral outcomes, AS interventions demonstrated significant small-to-moderate effect sizes for the three timepoints examined (d's = 0.20-0.41). Our findings help validate AS as a modifiable mechanistic target for prevention efforts.

Laboratory procedures have been used for decades as analogues for clinical processes with the goal of improving our understanding of psychological treatments and identifying strategies to make treatments more effective. The focus of this area of research has often been translation from the laboratory to the clinic. This process, however, has not been seamless; strategies that work in the laboratory do not always result in improved outcomes when applied clinically. One possible reason for this gap between experimental and clinical research is the failure to focus on translation from the clinic to the laboratory. In the current review, we will first discuss two well-established laboratory analogues (extinction and cognitive reappraisal), identify critical aspects of the related clinical procedures (exposure and cognitive restructuring) that we believe are missing from these analogues, and propose modifications to these analogues to better capture the clinical process. Second, we will further highlight the benefit of translation from the clinic to the laboratory by discussing two clinical procedures that have more recently been brought into the laboratory for examination (eye movement desensitization and reprocessing and imagery rescripting), discuss how we might improve translation from the clinic to the laboratory and future directions for this research.

Objective: We examined the association between sleep quality and academic performance by attending to university students' self-defined goals to increase studying behaviors over a four-week period. Methods: We evaluated this association in 100 undergraduates, who self-elected to change their studying behaviors and were randomly assigned to one of three interventions (action planning, dissonance-based, or reflection). Results: We found a negative association between the Pittsburgh Sleep Quality Index (PSQI) at baseline and subsequent studying time over the next four weeks, reflecting a small to medium effect size (partial r=.21). Depressive symptoms did not mediate the predictive influence of sleep quality on studying behavior. Intervention type did not influence the association between sleep quality and studying time. Conclusions: The predictive significance of sleep quality, in the context of the failure of effects for the randomized interventions, underscores the potential for intervening with sleep as part of efforts to improve academic behaviors. (c) 2019 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Posttraumatic stress disorder (PTSD) is known to persist, eliciting early medical co-morbidity, and accelerated aging. Although PTSD diagnosis has been found to be associated with smaller volume in multiple brain regions, posttraumatic stress (PTS) symptoms and their associations with brain morphometry are rarely assessed over long periods of time. We predicted that persistent PTS symptoms across ~24 years would be inversely associated with hippocampal, amygdala, anterior cingulate volumes, and hippocampal occupancy (HOC = hippocampal volume/[hippocampal volume + inferior lateral ventricle volume]) in late middle age. Exploratory analyses examined prefrontal regions. We assessed PTS symptoms in 247 men at average ages 38 (time 1) and 62 (time 2). All were trauma-exposed prior to time 1. Brain volumes were assessed at time 2 using 3 T structural magnetic resonance imaging. Symptoms were correlated over time (r = 0.46 p < .0001). Higher PTS symptoms averaged over time and symptoms at time 1 were both associated with lower hippocampal, amygdala, rostral middle frontal gyrus (MFG), and medial orbitofrontal cortex (OFC) volumes, and a lower HOC ratio at time 2. Increased PTS symptomatology from time 1 to time 2 was associated with smaller hippocampal volume. Results for hippocampal, rostral MFG and medial OFC remained significant after omitting individuals above the threshold for PTSD diagnosis. Even at sub-diagnostic threshold levels, PTS symptoms were present decades after trauma exposure in parallel with highly correlated structural deficits in brain regions regulating stress responsivity and adaptation.

Objective To evaluate the relationships between perceived stigma and duration of untreated psychosis (DUP), demographic characteristics, and clinical and psychosocial functioning in persons with a first episode of psychosis (FEP). Method A total of 399 participants with FEP presenting for treatment at 34 sites in 21 states throughout the United States were evaluated using standardized instruments to assess diagnosis, symptoms, psychosocial functioning, perceived stigma, wellbeing, and subjective recovery. Results Perceived stigma was correlated with a range of demographic and clinical variables, including DUP, symptoms, psychosocial functioning, and subjective experience. After controlling for symptom severity, perceived stigma was related to longer DUP, schizoaffective disorder diagnosis, more severe depression, and lower wellbeing and recovery. The associations between stigma and depression, wellbeing, and recovery were stronger in individuals with long than short DUP, suggesting the effects of stigma on psychological functioning may be cumulative over the period of untreated psychosis. Conclusion The findings suggest that independent of symptom severity, perceived stigma may contribute to delay in seeking treatment for FEP, and this delay may amplify the deleterious effects of stigma on psychological functioning. The results point to the importance of reducing DUP and validating interventions targeting the psychological effects of stigma in people with FEP.

Background Animal models and human studies have identified the potential of modafinil as a cognitive enhancing agent, independent of its effects on promoting wakefulness in sleep-deprived samples. Given that single-dose applications of other putative memory enhancers (eg, d-cycloserine, yohimbine, and methylene blue) have shown success in enhancing clinical outcomes for anxiety-related disorders, we conducted a meta-analytic review examining the potential for single-dose effects for modafinil on cognitive functioning in non-sleep-deprived adults. Methods A total of 19 placebo-controlled trials that examined the effects of single-dose modafinil versus placebo on the cognitive domains of attention, executive functioning, memory, or processing speed were identified, allowing for the calculation of 67 cognitive domain-specific effect sizes. Results The overall positive effect of modafinil over placebo across all cognitive domains was small and significant (g = 0.10; 95% confidence interval, 0.05-0.15; P < 0.001). No significant differences between cognitive domains were found. Likewise, no significant moderation was found for modafinil dose (100 mg vs 200 mg) or for the populations studied (psychiatric vs nonpsychiatric). Conclusions In conclusion, the available evidence indicates only limited potential for modafinil to act as a cognitive enhancer outside sleep-deprived populations.