Supervised Machine Learning: A Brief Primer.
Abstract Machine learning is increasingly used in mental health research and has the potential to advance our understanding of how to characterize, predict, and treat mental disorders and associated adverse health outcomes (e.g., suicidal behavior). Machine learning offers new tools to overcome challenges for which traditional statistical methods are not well-suited. This paper provides an overview of machine learning with a specific focus on supervised learning (i.e., methods that are designed to predict or classify an outcome of interest). Several common supervised learning methods are described, along with appl...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Jiang T, Gradus JL, Rosellini AJ Tags: Behav Ther Source Type: research

Effects of Presleep Cognitive Intrusions on Subjective Sleep and Next-Day Cognitive Performance in Insomnia.
Abstract Presleep cognitive intrusions about next-day activities, or proprioceptive and environmental stimuli, are thought to trigger insomnia in neurocognitive models. Recent research showed that intrusive cognitions at bedtime may interact with sleep in influencing next-day emotional functioning; their effects on cognitive functioning, however, is largely unknown. We tested the effects of presleep cognitive intrusions on subjective sleep and next-day cognitive performance in 80 participants, either with chronic insomnia or good sleepers. Presleep intrusions were inspected using a validated questionnaire and slee...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Ballesio A, Ghezzi V, Vacca M, Ottaviani C, Lombardo C Tags: Behav Ther Source Type: research

Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads.
Alleviate PTSD Abstract Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is efficacious in improving PTSD symptoms and relationship adjustment among couples with PTSD. However, there is a need for more efficient delivery formats to maximize engagement and retention and to achieve faster outcomes in multiple domains. This nonrandomized trial was designed to pilot an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered over a single weekend for 24 couples that included an active-duty service member or vet...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Fredman SJ, Macdonald A, Monson CM, Dondanville KA, Blount TH, Hall-Clark BN, Fina BA, Mintz J, Litz BT, Young-McCaughan S, Hancock AK, Rhoades GK, Yarvis JS, Resick PA, Roache JD, Le Y, Wachen JS, Niles BL, McGeary CA, Keane TM, Peterson AL, Consortium t Tags: Behav Ther Source Type: research

An Ecological Momentary Assessment Study Investigating the Function of Hoarding.
This study examined the function of hoarding behaviors and the relations between hoarding and a series of cognitive and affective processes in the moment using ecological momentary assessment. A matched-groups design was used to compare college students with higher hoarding symptoms (n = 31) and matched controls (n = 29). The two groups did not differ in what function they reported acquiring served, and positive automatic reinforcement was the most commonly reported function in both groups. Engaging in hoarding-relevant behaviors did not predict change in positive or negative affect when controlling for previous af...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Krafft J, Ong CW, Cruz RA, Twohig MP, Levin ME Tags: Behav Ther Source Type: research

Emotion Beliefs, Emotion Regulation, and Emotional Experiences in Daily Life.
Abstract One potential factor that could influence how individuals with at least moderate symptoms of depression cope with upsetting events in their daily lives is the beliefs that these individuals hold about whether emotions are malleable or fixed. The current study adopted an experience sampling approach to examine how the beliefs about emotion's malleability related to daily positive and negative affect and daily emotion regulation efforts among individuals with at least moderate symptoms of depression (N = 84). Results demonstrated that individuals having at least moderate symptoms of depression who held ...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Kneeland ET, Goodman FR, Dovidio JF Tags: Behav Ther Source Type: research

Do Cognitive Therapy Skills Neutralize Lifetime Stress to Improve Treatment Outcomes in Recurrent Depression?
Abstract Cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but not all patients respond. Past research suggests that stressful life events (SLE; e.g., childhood maltreatment, emotional and physical abuse, relationship discord, physical illness) sometimes reduce the efficacy of depression treatment, whereas greater acquisition and use of CT skills may improve patient outcomes. In a sample of 276 outpatient participants with recurrent MDD, we tested the hypothesis that patients with more SLE benefit more from CT skills in attaining response and remaining free of relapse/recurren...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Vittengl JR, Stutzman S, Atluru A, Jarrett RB Tags: Behav Ther Source Type: research

Sudden Gains in Internet-Based Cognitive Behavior Therapy for Body Dysmorphic Disorder.
la Cruz L Abstract Sudden gains have been associated with better short- and long-term treatment outcomes in a number of psychiatric disorders. However, no studies to date have evaluated sudden gains in body dysmorphic disorder (BDD). We used data from a previous randomized controlled trial evaluating the efficacy of an Internet-based cognitive-behavior treatment (CBT) for BDD. The sample consisted of 47 adults diagnosed with BDD. We compared the treatment outcomes of sudden gainers vs. gradual gainers (i.e., treatment responders with no sudden gains) and non-sudden gainers (i.e., gradual gainers plus nonresponders...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Bjureberg J, Enander J, Andersson E, Ivanov VZ, Rück C, Fernández de la Cruz L Tags: Behav Ther Source Type: research

A Multimethod Analysis of Incompleteness and Visual "Not Just Right" Experiences in Body Dysmorphic Disorder.
A Multimethod Analysis of Incompleteness and Visual "Not Just Right" Experiences in Body Dysmorphic Disorder. Behav Ther. 2020 Sep;51(5):764-773 Authors: Summers BJ, Wilver NL, Garratt GH, Cougle JR Abstract Individuals with body dysmorphic disorder (BDD) often report engaging in repetitive behaviors aimed at reducing feelings of imperfection anchored to their appearance. "Not just right" experiences (NJREs) and incompleteness (INC) are constructs related to perfectionism that have traditionally been studied in obsessive-compulsive disorder, though recent research has also linked t...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Summers BJ, Wilver NL, Garratt GH, Cougle JR Tags: Behav Ther Source Type: research

Predictors of Dropout in Cognitive Processing Therapy for PTSD: An Examination of Trauma Narrative Content.
We examined predictors of dropout in cognitive processing therapy (CPT) by coding the content of trauma narratives written in early sessions of CPT. Data are from a randomized controlled noninferiority trial of CPT and written exposure therapy (WET) in which CPT showed significantly higher dropout rates than WET (39.7% CPT vs. 6.4% WET). Participants were 51 adults with a primary diagnosis of PTSD who were receiving CPT and completed at least one of three narratives in the early sessions of CPT. Sixteen (31%) in this subsample were classified as dropouts and 35 as completers. An additional 9 participants dropped out but co...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Alpert E, Hayes AM, Barnes JB, Sloan DM Tags: Behav Ther Source Type: research

Low Parental Warmth and High Youth Impairment: A Recipe for Perceived Burdensomeness?
Abstract Theory and research document the role of perceived burdensomeness in the development of suicide ideation, including in youth. There is a critical need to identify and evaluate variables that foster perceived burdensomeness in youth, with an eye toward advancing etiological models and informing prevention approaches for at-risk youth who are not yet actively suicidal. The current study examined and replicated a conceptual model wherein the association between low parental warmth and burdensomeness is moderated by youth impairment. Participants were 75 and 150 clinic referred youths in Study 1 and Study 2, ...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Buitron V, Vaclavik D, Hill RM, Bose D, Pettit JW Tags: Behav Ther Source Type: research

The Validation of a Provider-Reported Fidelity Measure for the Transdiagnostic Sleep and Circadian Intervention in a Community Mental Health Setting.
Abstract Monitoring treatment fidelity is essential to check if patients receive adequate doses of treatment and to enhance our theoretical understanding of how psychosocial treatments work. Developing valid and efficient measures to assess fidelity is a priority for dissemination and implementation efforts. The present study reports on the psychometric properties of the Provider-Rated TranS-C Checklist-a provider-reported fidelity measure for the Transdiagnostic Sleep and Circadian Intervention (TranS-C). Adults with severe mental illness (SMI; N = 101) seeking treatment in a community mental health setting recei...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Gumport NB, Yu SH, Mullin AC, Mirzadegan IA, Harvey AG Tags: Behav Ther Source Type: research

Reward Processing and Decision-Making in Posttraumatic Stress Disorder.
Abstract Theory suggests that, in those with posttraumatic stress disorder (PTSD), positive emotion is likely dampened due to reexperiencing of trauma-related stimuli. Prior research has extended positive emotion experiencing to reward processing research but has not yet examined how trauma cues affect reward processing (i.e., the anticipation of and satisfaction with reward) and decision-making in individuals with PTSD. We compared 24 individuals diagnosed with PTSD to 29 trauma-exposed controls in passive and decision-making phases of a wheel-of-fortune task, following both neutral and trauma inductions. Three t...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: May CL, Wisco BE Tags: Behav Ther Source Type: research

Reward Responsiveness and Ruminative Styles Interact to Predict Inflammation and Mood Symptomatology.
Abstract Abnormal reward responsiveness and rumination each are associated with elevated inflammation and mood symptoms. Ruminating on positive and negative affect, or dampening positive affect, may amplify, or buffer, the associations of reward hyper/hyposensitivity with inflammation and mood symptoms. Young adults (N = 109) with high or moderate reward sensitivity completed reward responsiveness and ruminative style measures at the initial visit of a longitudinal study of mood symptoms, a blood draw to assess inflammatory biomarkers, and mood symptom measures at the study visits before and after the day of the b...
Source: Behavior Therapy - August 18, 2020 Category: Psychiatry & Psychology Authors: Moriarity DP, Ng T, Titone MK, Chat IK, Nusslock R, Miller GE, Alloy LB Tags: Behav Ther Source Type: research

Introduction to the Special Issue: The Impact and Treatment of Sleep Disturbance.
Abstract There is now widespread recognition that sleep disturbance is more than an epiphenomenon of psychopathology. Research on established evidence-based treatments for sleep disturbance have matured to focus on predictors and more flexible implementation modalities. Sleep disturbance overlaps and interacts with comorbid psychological disorders though a complex transdiagnostic process that impacts the development, maintenance, and treatment of psychological disorders. This special issue highlights a range of cutting-edge research on the management of common sleep disturbance and the interaction of sleep disturb...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: McLean CP Tags: Behav Ther Source Type: research

Predictors of Cognitive Behavioral Therapy for Insomnia (CBTi) Outcomes in Active-Duty U.S. Army Personnel.
Abstract Cognitive behavioral therapy for insomnia (CBTi) is well established as the first-line treatment for the management of chronic insomnia. Identifying predictors of response to CBTi should enable the field to efficiently utilize resources to treat those who are likely to respond and to personalize treatment approaches to optimize outcomes for those who are less likely to respond to traditional CBTi. Although a range of studies have been conducted, no clear pattern of predictors of response to CBTi has emerged. The purpose of this study was to examine the impact and relative importance of a comprehensive gro...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Pruiksma KE, Hale WJ, Mintz J, Peterson AL, Young-McCaughan S, Wilkerson A, Nicholson K, Dondanville KA, Fina BA, Borah EV, Roache JD, Litz BT, Bryan CJ, Taylor DJ, STRONG STAR Consortium Tags: Behav Ther Source Type: research

Brief Behavioral Treatment for Insomnia vs. Cognitive Behavioral Therapy for Insomnia: Results of a Randomized Noninferiority Clinical Trial Among Veterans.
Abstract The goal of this study was to compare a brief behavioral treatment for insomnia (BBTI), which has fewer sessions (4), shorter duration (
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Bramoweth AD, Lederer LG, Youk AO, Germain A, Chinman MJ Tags: Behav Ther Source Type: research

Effectiveness of an mHealth Intervention for Infant Sleep Disturbances.
This study assessed the real-world effectiveness of an mHealth behavioral sleep intervention (Customized Sleep Profile; CSP). Caregivers (83.9% mothers) of 404 infants (age 6 to 11.9 m, M = 8.32 m, 51.2% male) used the CSP (free and publicly available behavioral sleep intervention delivered via smartphone application, Johnson's® Bedtime® Baby Sleep App). Caregivers completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R) at baseline and again 4 to 28 days later. Changes in sleep patterns were analyzed, based on sleep problem status (problem versus no problem sleepers; PS; NPS). Sleep onset latency improved i...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Leichman ES, Gould RA, Williamson AA, Walters RM, Mindell JA Tags: Behav Ther Source Type: research

Delayed Bedtimes Are Associated With More Severe Obsessive-Compulsive Symptoms in Intensive Residential Treatment.
This study examined self-reported sleep behaviors in individuals taking part in an intensive treatment for OCD and the relations between these and OCD symptoms (both at admission to and discharge from the treatment program). Replicating previous findings in less severe populations, delayed sleep phases were relatively common in this group and later bedtimes were associated with more severe OCD symptoms at admission. Sleep onset latency and sleep duration were not associated with OCD symptom severity at admission. Later bedtimes were not associated with self-reported depression or worry symptom severity. There was no eviden...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Nota JA, Potluri S, Kelley KN, Elias JA, Krompinger JW Tags: Behav Ther Source Type: research

An Integrated Sleep and Reward Processing Model of Major Depressive Disorder.
Abstract Major depressive disorder with comorbid sleep disturbance has been associated with negative outcomes, including lower rates of treatment response and a greater likelihood of depressive relapse compared to those without sleep disturbance. However, little, if any, research has been conducted to understand why such negative treatment outcomes occur when sleep disturbance is present. In this conceptual review, we argue that the relationship of sleep disturbance and negative treatment outcomes may be mediated by alterations in neural reward processing in individuals with blunted trait-level reward responsivity...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Boland EM, Goldschmied JR, Wakschal E, Nusslock R, Gehrman PR Tags: Behav Ther Source Type: research

The Role of Professional Training Experiences and Manualized Programs in ABA Providers' Use of Parent Training With Children With Autism.
Abstract Parent training, in which providers teach parents intervention strategies to promote their children's skill acquisition and/or behavior management, is considered a best practice in the treatment for children with autism spectrum disorder (ASD) and yet is underutilized in community settings. The present study examined the role of training experiences and manual use in promoting the use of parent training by community providers who serve children with ASD. Applied behavior analysis (ABA) providers (N = 1,089) from across the United States completed self-report questionnaires online. The total number of ...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Ingersoll B, Straiton D, Caquias NR Tags: Behav Ther Source Type: research

Group Intervention for Adolescent Anxiety and Depression: Outcomes of a Randomized Trial with Adolescents in Kenya.
Abstract Youth mental health interventions in low-resource communities may benefit from including empirically supported elements, using stigma-free content, and using trained lay-providers. We developed and evaluated such an intervention, targeting adolescent depression and anxiety in Kenya, where mental health care is limited by social stigma and a paucity of providers. Kenyan adolescents (N = 51, ages 14-17, 60.78% female) from a school in an urban slum in Nairobi with self-reported moderate-to-severe symptoms of depression or anxiety were randomized to the 4-week "Shamiri" ("thrive") gro...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Osborn TL, Wasil AR, Venturo-Conerly KE, Schleider JL, Weisz JR Tags: Behav Ther Source Type: research

Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial.
Abstract Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postinterventi...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Fonseca A, Alves S, Monteiro F, Gorayeb R, Canavarro MC Tags: Behav Ther Source Type: research

Effects of "Dirty" Information on Disgust Responding to an Unknown Animal in Children: The Moderating Role of Maternal Disgust Proneness.
Effects of "Dirty" Information on Disgust Responding to an Unknown Animal in Children: The Moderating Role of Maternal Disgust Proneness. Behav Ther. 2020 Jul;51(4):634-645 Authors: Olatunji BO, Viar-Paxton M Abstract Although research has shown that disgust facilitates avoidance of small animals among adults, much less is known about disgust appraisals of small animals in children as well as the predictors of such appraisals. To address this gap, children (ages 5-13) were exposed to dirt-related and cleanliness-related information about unknown animals. The extent to which these types of in...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Olatunji BO, Viar-Paxton M Tags: Behav Ther Source Type: research

Can Acceptance, Mindfulness, and Self-Compassion Be Learned by Smartphone Apps? A Systematic and Meta-Analytic Review of Randomized Controlled Trials.
Abstract The potential health benefits of acceptance, mindfulness, and self-compassion are well-documented. However, interventions that teach these principles typically rely on face-to-face delivery, which can limit their dissemination. Delivering these interventions through smartphone apps could help overcome this. This meta-analysis examined whether principles of acceptance, mindfulness, and self-compassion can be learned through smartphone apps. Twenty-seven randomized controlled trials were included. Smartphone apps that included acceptance and/or mindfulness components resulted in significantly higher levels ...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Linardon J Tags: Behav Ther Source Type: research

Development and Open Trial of a Psychosocial Intervention for Young Children With Chronic Tics: The CBIT-JR Study.
Abstract The Comprehensive Behavioral Intervention for Tic Disorders (CBIT) has demonstrated efficacy in large randomized controlled trials for children (≥9 yrs), adolescents and adults with Tourette Syndrome and Chronic Tic Disorders. Given the early age of onset for tic disorders, a large portion of affected individuals with chronic tic disorders are less than 9 years of age and appropriate developmental adaptations of behavioral treatment have not yet been tested. The goal of this study was to adapt and evaluate the acceptability and utility of a family-based adaptation of CBIT for children under 9 yea...
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Bennett SM, Capriotti M, Bauer C, Chang S, Keller AE, Walkup J, Woods D, Piacentini J Tags: Behav Ther Source Type: research

Corrigendum to 'The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability' [Behavior Therapy 51(2) (2020) 294-309].
PMID: 32586438 [PubMed - in process] (Source: Behavior Therapy)
Source: Behavior Therapy - June 28, 2020 Category: Psychiatry & Psychology Authors: Wakschlag LS, Krogh-Jespersen S, Estabrook R, Hlutkowsky CO, Anderson EL, Burns J, Briggs-Gowan MJ, Petitclerc A, Perlman SB Tags: Behav Ther Source Type: research

Associations Between Social Anxiety and Affective and Empathic Forecasts: A Replication and Extension in a Mechanical Turk Sample.
Abstract People often overestimate the intensity and duration of their future emotions, referred to as an impact bias. Impact biases have been documented in predictions people make about their own emotions, as well as the others' emotions (i.e., affective and empathic forecasting, respectively). Recent studies have shown that negative impact biases may be stronger, and positive impact biases may be attenuated, in individuals with symptoms of social anxiety. The current study sought to replicate and extend these findings in a Mechanical Turk (MTurk) sample. MTurk is a particularly interesting online platform for su...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Arditte Hall KA, Coleman K, Timpano KR Tags: Behav Ther Source Type: research

Affective Styles in Panic Disorder and Specific Phobia: Changes Through Cognitive Behavior Therapy and Prediction of Remission.
f J Abstract Affective styles appear to be relevant to the development of psychopathology, especially anxiety disorders. The aim of the current study was to investigate changes in affective styles in patients with panic disorder and specific phobia, as a result of undergoing cognitive-behavioral therapy, and to identify a possible link between certain affective styles and remission. The sample consisted of outpatients (N = 101) suffering from panic disorder, specific phobia, or agoraphobia who completed the Affective Style Questionnaire (ASQ) before and after therapy, as well as at a 6-month follow-up assessment. ...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Totzeck C, Teismann T, Hofmann SG, von Brachel R, Zhang XC, Wannemüller A, Pflug V, Margraf J Tags: Behav Ther Source Type: research

Weekly Changes in Blame and PTSD Among Active-Duty Military Personnel Receiving Cognitive Processing Therapy.
Abstract Both negative posttraumatic cognitions and posttraumatic stress disorder (PTSD) symptoms decrease over the course of cognitive-behavior therapy for PTSD; however, further research is needed to determine whether cognitive change precedes and predicts symptom change. The present study examined whether weekly changes in blame predicted subsequent changes in PTSD symptoms over the course of cognitive processing therapy (CPT). Participants consisted of 321 active duty U.S. Army soldiers with PTSD who received CPT in one of two clinical trials. Symptoms of PTSD and blame were assessed at baseline and weekly thr...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Dillon KH, Hale WJ, LoSavio ST, Wachen JS, Pruiksma KE, Yarvis JS, Mintz J, Litz BT, Peterson AL, Resick PA, STRONG STAR Consortium Tags: Behav Ther Source Type: research

Emotion Regulation Difficulties During and After Partial Hospitalization Treatment Across Eating Disorders.
Abstract Emotion regulation deficits are associated with eating disorder (ED) symptoms, regardless of eating disorder diagnosis. Thus, recent treatment approaches for EDs, such as dialectical behavior therapy (DBT), have focused on teaching patients skills to better regulate emotions. The present study examined changes in emotion regulation among adult patients with EDs during DBT-oriented partial hospital treatment, and at follow-up (M[SD] = 309.58[144.59] days from discharge). Exploratory analyses examined associations between changes in emotion regulation and ED symptoms. Patients with anorexia nervosa, restric...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Brown TA, Cusack A, Berner LA, Anderson LK, Nakamura T, Gomez L, Trim J, Chen JY, Kaye WH Tags: Behav Ther Source Type: research

Exposing Worry's Deceit: Percentage of Untrue Worries in Generalized Anxiety Disorder Treatment.
Abstract Theories of cognitive therapy have long proposed that those with generalized anxiety disorder (GAD) have inaccurate expectations. By challenging them with objective evidence, symptoms are thought to decrease. To test these premises, this study used ecological momentary assessment (EMA) during the Worry Outcome Journal (WOJ) treatment to determine the percentage of GAD worries that did not come true. We then analyzed the association between participants' untrue worry percentages and GAD symptom change across treatment. Twenty-nine participants with GAD recorded worries when prompted for 10 days, reviewed t...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: LaFreniere LS, Newman MG Tags: Behav Ther Source Type: research

Congruence of Patient Takeaways and Homework Assignment Content Predicts Homework Compliance in Psychotherapy.
Abstract Homework is generally considered an essential part of psychotherapy. The present study tested the hypothesis that patients were more likely to complete homework assignments when the content of the assignments was more congruent with content the patient reported wanting to remember from the session (patient takeaways). The study relied on data collected in 541 sessions of individual naturalistic cognitive-behavioral therapy provided to 41 patients in a private practice setting and who completed a feedback form in each session that recorded the content of the homework assignments for the session, patient ta...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Jensen A, Fee C, Miles AL, Beckner VL, Owen D, Persons JB Tags: Behav Ther Source Type: research

Beyond the Constraints of an RCT: Naturalistic Treatment Outcomes for Anxiety-Related Disorders.
Abstract Despite considerable data from randomized controlled trials supporting use of behavioral therapies for anxiety disorders and anxiety-related disorders, there is a relative scarcity of data demonstrating that such findings are generalizable to patients in nonresearch settings, and a lack of standardized repeated outcome measurement in such settings. Using one of the largest examinations of naturalistic outcomes of behavioral therapies in treatment-seeking patients (N = 489), we examined the clinical characteristics and treatment outcomes of patients seeking treatment for anxiety and anxiety-related disorde...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Asnaani A, Benhamou K, Kaczkurkin AN, Turk-Karan E, Foa EB Tags: Behav Ther Source Type: research

Bidirectional Relationships Between Posttraumatic Stress Disorder and Social Functioning During Cognitive Processing Therapy.
This study investigated temporal relationships between posttraumatic stress symptoms and two indicators of social functioning during cognitive processing therapy. Participants were 176 patients (51.5% female, M age = 39.46 [SD = 11.51], 89.1% White, 42.6% active duty military/veteran) who participated in at least two assessment time points during a trial of cognitive processing therapy. Posttraumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-IV) and interpersonal relationship and social role functioning problems (Outcome Questionnaire-45) were assessed prior to each of 12 sessions. Multivariate multilevel lag...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Lord KA, Suvak MK, Holmes S, Shields N, Lane JEM, Sijercic I, Wagner AC, Stirman SW, Monson CM Tags: Behav Ther Source Type: research

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: An Initial Cluster Randomized Wait-List-Controlled Trial.
A, Chorot P Abstract Anxiety and depression are common debilitating conditions that show high comorbidity rates in adolescence. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich-May et al., 2018) is one of the few existing resources aimed at applying transdiagnostic treatment principles across the core dysfunctions implicated in the development of both anxiety and depression using a single protocol. This is the first known controlled study to examine the efficacy of the UP-A adapted as a nine-session universal preventive intervention program delivered in a s...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: García-Escalera J, Valiente RM, Sandín B, Ehrenreich-May J, Prieto A, Chorot P Tags: Behav Ther Source Type: research

A Test of the Habit-Goal Framework of Depressive Rumination and Its Relevance to Cognitive Reactivity.
ute;ttir TD, Snorrason I Abstract The aim of the present study was to test predictions derived from the habit-goal framework of depressive rumination and investigate its relevance to cognitive reactivity-another well-known vulnerability factor to depression. Formerly depressed (FD; n=20) and never depressed (ND; n=22) participants completed self-report measures of rumination, cognitive reactivity, and habitual characteristics of rumination (e.g., lack of awareness, control, intent). A standard mood-induction task was also used to measure cognitive reactivity and an outcome-devaluation task to measure general habit...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Ólafsson RP, Guðmundsdóttir SJ, Björnsdóttir TD, Snorrason I Tags: Behav Ther Source Type: research

A Neuropsychological Investigation of Perfectionism.
Abstract Perfectionism entails a burdensome preoccupation with one's self-evaluation in the context of performance outcomes. Although perfectionism has been subject to extensive research, scant literature on its effect on cognitive functioning is available, let alone in nonclinical populations. The aim of the present study is to utilize a comprehensive neuropsychological battery to assess cognitive functions among college students with high and low levels of perfectionism. Participants were 98 college students who were screened for clinical status, completed a neuropsychological battery, and assessed for perfectio...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Robinson A, Abramovitch A Tags: Behav Ther Source Type: research

Integrated Cognitive-Behavioral Therapy for Social Anxiety and HIV/STI Prevention for Gay and Bisexual Men: A Pilot Intervention Trial.
Abstract Given the alarmingly high HIV and sexually transmitted infection (STI) incidence among gay and bisexual men (GBM) worldwide, there is a critical need for HIV prevention interventions specifically for GBM. Social anxiety, or anxiety about being evaluated in interpersonal situations, is a risk factor for condomless anal sex (CAS) among GBM (e.g., Hart & Heimberg, 2005; Hart, James, Purcell, & Farber, 2008). Social anxiety may also increase substance use in sexual situations, which is another risk factor for HIV/STIs in this risk group (Semple, Strathdee, Zians, McQuaid, & Patterson, 2011). The g...
Source: Behavior Therapy - May 1, 2020 Category: Psychiatry & Psychology Authors: Hart TA, Noor SW, Vernon JRG, Antony MM, Gardner S, O'Cleirigh C Tags: Behav Ther Source Type: research

Advances in the Conceptualization, Assessment, and Treatment of Pediatric Irritability.
Abstract Pediatric irritability is a functionally impairing transdiagnostic symptom underlying a substantial proportion of child mental health referrals. The past 20 years have witnessed a striking uptick in empirical work focused on pediatric irritability, with increasing recognition of its role across multiple internalizing and externalizing disorders. That said, it has only been in recent years that research has begun to make advances in understanding the natural course and neurobiological underpinnings of irritability across development; research directly informing effective clinical management of pediatric ...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Roy AK, Comer JS Tags: Behav Ther Source Type: research

Anxious-Irritable Children: A Distinct Subtype of Childhood Anxiety?
In this study, our aims were to confirm the preponderance of irritability in clinically anxious children and compare clinically anxious children with irritability to those without irritability across sociodemographic, clinical, psychosocial, and family domains. Participants were 230 children with anxiety disorders (ages 6-14 years) and their mothers, and 91 healthy controls (ages 6-17 years) and their mothers. Of the clinically anxious children, 121 were anxious and irritable; 109 were anxious but not irritable. Irritability levels were significantly higher in the clinically anxious children compared with the healthy contr...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Shimshoni Y, Lebowitz ER, Brotman MA, Pine DS, Leibenluft E, Silverman WK Tags: Behav Ther Source Type: research

Irritability and Limited Prosocial Emotions/Callous-Unemotional Traits in Elementary-School-Age Children.
This study examined whether irritability, LPE/CU, or their combination explained significant variance in measures of internalizing or externalizing psychopathology, aggression, peer problems, impairment, or parenting. Participants were 219 elementary-school-age children, including 178 with attention-deficit/hyperactivity disorder, oppositional defiant disorder, and/or conduct disorder and 41 typically developing children. Results of analyses showed that irritability and LPE/CU had significant and sometimes unique associations with measures of child behavior, impairment, and parenting. There was also evidence that the inter...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Waschbusch DA, Baweja R, Babinski DE, Mayes SD, Waxmonsky JG Tags: Behav Ther Source Type: research

Exploring Longitudinal Mechanisms of Irritability in Children: Implications for Cognitive-Behavioral Intervention.
Abstract Severe irritability is a common and clinically important problem longitudinally associated with internalizing and externalizing problems in children. To better understand these mechanisms and to inform treatment research, we tested cognitive-behavioral processes as candidate mediators in the paths from irritability to later problems. Methods: A school sample (N = 238, 48% female, ages 8-10) was assessed at ~6-month intervals in fall (T1) and spring (T2) of third to fourth grade, and again the following fall (T3). Measures assessed irritability (T1/predictor); anger and sadness coping, intolerance of uncer...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Evans SC, Blossom JB, Fite PJ Tags: Behav Ther Source Type: research

Children's Facial Muscular Movements and Risk for Early Psychopathology: Assessing Clinical Utility.
Abstract Standardized developmentally based assessment systems have transformed the capacity to identify transdiagnostic behavioral markers of mental disorder risk in early childhood, notably, clinically significant irritability and externalizing behaviors. However, behavior-based instruments that both differentiate risk for persistent psychopathology from normative misbehavior, and are feasible for community clinicians to implement, are in nascent phases of development. Young children's facial expressions during frustration challenges may form the basis for novel assessments tools that are flexible, quick, and ea...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Grabell AS, Jones HM, Wilett AE, Bemis LM, Wakschlag LS, Perlman SB Tags: Behav Ther Source Type: research

The Validity of a Frustration Paradigm to Assess the Effect of Frustration on Cognitive Control in School-Age Children.
Abstract Irritability refers to a proneness for anger, and is a symptom of internalizing and externalizing psychopathology. Since irritability is associated with significant cross-sectional and longitudinal impairments, research on the behavioral and neural correlates of pediatric irritability in populations at risk for significant irritability is of paramount importance. Irritability can be assessed in the laboratory using behavioral paradigms that elicit frustration. Few behavioral frustration paradigms have been designed to measure the effects of frustration on cognitive control. Therefore, the goal of the pres...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Seymour KE, Rosch KS, Tiedemann A, Mostofsky SH Tags: Behav Ther Source Type: research

The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability.
Abstract Irritability is impairing in youth and is the core feature of disruptive mood dysregulation disorder (DMDD). Currently, there are no established clinician-rated instruments to assess irritability in pediatric research and clinical settings. Clinician-rated measures ensure consistency of assessment across patients and are important specifically for treatment research. Here, we present data on the psychometric properties of the Clinician Affective Reactivity Index (CL-ARI), the first semistructured interview focused on pediatric irritability. The CL-ARI was administered to a transdiagnostic sample of 98 you...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Haller SP, Kircanski K, Stringaris A, Clayton M, Bui H, Agorsor C, Cardenas SI, Towbin KE, Pine DS, Leibenluft E, Brotman MA Tags: Behav Ther Source Type: research

The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability.
Abstract Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritable mood and tantrums from indicators of concern, beginning in infancy. However, developmentally sensitive assessments of irritability-related impairment are lacking. We introduce the Early Childhood Irritability-Related Impairment Interview (E-CRI), which assesse...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Wakschlag LS, Krogh-Jespersen S, Estabrook R, Hlutkowsky CO, Anderson EL, Burns J, Briggs-Gowan MJ, Petitclerc A, Perlman SB Tags: Behav Ther Source Type: research

The Internal Structure of the Aberrant Behavior Checklist Irritability Subscale: Implications for Studies of Irritability in Treatment-Seeking Youth With Autism Spectrum Disorders.
Abstract Given the prominence of the Aberrant Behavior Checklist (ABC), Irritability Subscale (ABC-I), in treatment outcome studies, we conducted a critical examination of its internal consistency and relationship to other measures of irritability in 758 psychiatrically hospitalized youth with autism spectrum disorder. In exploratory and confirmation samples, we conducted factor and bifactor analyses to describe the internal structure of the ABC-I. Our results suggest that the ABC-I roughly represents a unidimensional construct of irritability, as indicated by a general factor in bifactor analysis. In addition to ...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Stoddard J, Zik J, Mazefsky CA, DeChant B, Gabriels R Tags: Behav Ther Source Type: research

Exposure-Based Cognitive-Behavioral Therapy for Disruptive Mood Dysregulation Disorder: An Evidence-Based Case Study.
Abstract Severe, chronic irritability is one of the most frequently reported problems in youth referred for psychiatric care. Irritability predicts adult depressive and anxiety disorders, and long-term impairment. Reflecting this pressing public health need, severe, chronic, and impairing irritability is now codified by the DSM-5 diagnosis of disruptive mood dysregulation disorder (DMDD). Since DMDD has only recently been added as its own nosological class, efficacious treatments that specifically target severe irritability as it presents in DMDD are still being developed. In a recent pilot study, we described the...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Linke J, Kircanski K, Brooks J, Perhamus G, Gold AL, Brotman MA Tags: Behav Ther Source Type: research

Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability.
Abstract Recent work has drawn attention to the previously underrecognized role that irritability plays in childhood psychopathology. Despite increased recognition of the clinical importance of pediatric irritability as a transdiagnostic symptom dimension, there is a lack of evidence-based treatments for this population that simultaneously and equitably addresses both child and contextual (e.g., parental) factors implicated in the development and maintenance of associated emotional and behavioral difficulties. In the current pilot study, we adapted the Unified Protocol for Transdiagnostic Treatment of Emotional Di...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Hawks JL, Kennedy SM, Holzman JBW, Ehrenreich-May J Tags: Behav Ther Source Type: research

Irritability as a Transdiagnostic Vulnerability Trait:Current Issues and Future Directions.
Abstract In recent years, irritability has received increasing attention among mental health professionals given its transdiagnostic associations with diverse forms of psychopathology. In contrast to other emotional states and traits, however, literature addressing associations between irritability and related temperament and personality constructs is limited. In addition, those who study irritability have diverse perspectives on its neurobiological substrates. In this comment, we situate irritability in the literatures on child temperament and adult personality, and describe a model in which irritability derives ...
Source: Behavior Therapy - March 1, 2020 Category: Psychiatry & Psychology Authors: Beauchaine TP, Tackett JL Tags: Behav Ther Source Type: research