New Research From Clinical Psychological Science

Physical Distancing and Mental Health During the COVID-19 Pandemic: Factors Associated With Psychological Symptoms and Adherence to Pandemic Mitigation Strategies
Omid V. Ebrahimi, Asle Hoffart, and Sverre Urnes Johnson

During the COVID-19 pandemic, symptoms of depression and anxiety in Norwegian adults were 2 to 3 times higher than those measured in samples before the pandemic. Females, ethnic minorities, LGBT individuals, younger adults, unemployed individuals, and individuals with a previous psychiatric diagnosis reported more symptoms. Participants who felt more competent to deal with the pandemic felt fewer symptoms. Access to information about the pandemic was associated with reduced anxiety, and exercising, experiencing nature, and performing distracting activities were associated with reduced depression. Regarding adherence to mitigation protocols, older adults and women as well as those with altruistic attitudes or worry about the health of significant others reported the highest adherence.

Bivariate Latent-Change-Score Analysis of Peer Relations From Early Childhood to Adolescence: Leading or Lagging Indicators of Psychopathology
Brent I. Rappaport et al.

Poor peer relations during youth are connected with psychopathology. Understanding this connection is necessary for better public health. Rappaport and colleagues assessed peer relations and clinical symptoms in 306 children between 3 and 11 years old. They found that peer victimization/rejection was a leading indicator of depression from early childhood into preadolescence and that peer-directed aggression was a leading indicator of externalizing symptoms (i.e., oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder) in late childhood. Thus, poor peer relations can be risk factors for psychopathology, and it may be important to address this concern early in life.

Reevaluating the Alliance–Outcome Relationship in the Early Sessions of Cognitive Behavioral Therapy of Depression
Megan L. Whelen, Samuel T. Murphy, and Daniel R. Strunk

Whelen and colleagues investigated the relationship between the patient-therapist alliance and cognitive behavioral therapy (CBT) outcomes in depression. Using a model that estimates a reciprocal relation between therapeutical alliances and outcomes, they found only modest evidence that the alliance predicted subsequent improvement of symptoms. However, a more conservative version of the model indicated that this relationship may not be significant and that much of the impact of the patient-therapist alliance could be attributed to patient factors. These findings suggest that the patient-therapist alliance has a limited impact on improving CBT outcomes for patients with depression.

Machine Learning to Classify Suicidal Thoughts and Behaviors: Implementation Within the Common Data Elements Used by the Military Suicide Research Consortium
Andrew K. Littlefield et al.

Littlefield and colleagues compared the performance of three machine-learning approaches (elastic net, random forest, and stacked ensembles) with a traditional statistical approach (logistic regression) to classify suicide thoughts and behaviors. They used self-reported data, found in the Common Data Elements repository used by the U.S. Military Suicide Research Consortium, to inform the approaches. Results indicated that modern and traditional approaches classified suicide thoughts and behaviors equally well. These findings suggest that machine-learning approaches might not be more accurate at classifying suicide thoughts and behaviors than traditional statistical approaches.

Associations of Resting Heart Rate and Intelligence With General and Specific Psychopathology: A Prospective Population Study of 899,398 Swedish Men
Erik Pettersson et al.

In a sample of Swedish males, Pettersson and colleagues found an inverse relationship between correlated psychopathology factors (including psychiatric diagnoses, criminal convictions, and medical prescriptions) and general intelligence (IQ). However, a general factor model of psychopathology indicated that several of these associations could be attributed to general variance rather than variance associated with the specific factors. Resting heart rate (RHR) predicted higher internalizing but lower externalizing problems (e.g., depression and substance abuse, respectively). Thus, low IQ might be a risk factor for any form of psychopathology, and RHR might help to differentiate internalizing and externalizing psychopathological problems.

Increase in Suicidal Thinking During COVID-19
Rebecca G. Fortgang et al.

Suicidal thinking among adults, but not adolescents, appears to have increased during the COVID-19 pandemic, especially among adults with increased feelings of isolation. Fortgang and colleagues examined suicidal thinking and isolation in a sample of American individuals recently hospitalized for suicidal thinking or behaviors. Participants had already been enrolled in a 6-month smartphone-monitoring study; their data had been collected before and after the onset of the pandemic. Given that feelings of isolation predicted increased suicidal thinking even as social-distancing policies remain important to control the pandemic, there appears to be a need for digital outreach and treatment.

Recoiling From Threat: Anxiety Is Related to Heightened Suppression of Threat, Not Increased Attention to Threat
Emily S. Kappenman, Raphael Geddert, Jaclyn L. Farrens, John J. McDonald, and Greg Hajcak

Kappenman and colleagues measured brain event-related potentials (ERPs) to disentangle attentional selection and suppression of threatening images (e.g., weapons, snakes) and conditioned threats (colored shapes paired with electric shocks). In a sample of young adults, both threat types increased attentional selection, but only the conditioned threats elicited subsequent suppression. Trait anxiety was not related to attentional selection, but increased anxiety was associated with greater suppression of conditioned threats. These findings suggest that individuals with more anxiety, compared with those with less anxiety, do not pay more attention to threats but more often suppress those threats.

Physical Aggression Is Associated With More Effective Postdecisional Processing of Social Threat
Grace M. Brennan and Arielle Baskin-Sommers

Seventy-five incarcerated men with different physical-aggression scores identified the emotions in faces displaying anger (i.e., threat) and happiness (i.e., nonthreat) at low, moderate, or high levels of ambiguity. They then rated their confidence in their responses. Participants who scored higher on physical aggression were better at differentiating threatening and nonthreatening faces under moderate ambiguity than participants who scored lower on physical aggression. These participants also experienced steeper decreases in confidence after they wrongfully decided that threatening faces were nonthreatening, indicating more extensive postdecisional processing. These findings suggest that postdecisional processing might maintain threat-based social decisions in physical aggression.

Tobacco Smoking and the Association With First Incidence of Mood, Anxiety, and Substance Use Disorders: A 3-Year Prospective Population-Based Study
Karin Monshouwer, Margreet ten Have, Ron de Graaf, Matthijs Blankers, and Margriet van Laar

Monshouwer and colleagues used data from a study of 18- to 64-year-old smokers and nonsmokers to study the incidence of mood, anxiety, and substance use disorders among smokers. In a 3-year follow-up, participants who were smokers at baseline were more likely than nonsmokers to report experiencing the first incidence of any mood, anxiety, or substance use disorder. In a 6-year follow-up, the results were similar except for a weaker association between smoking and substance use disorders. However, the reported effects do not necessarily indicate a causal relationship between smoking and poorer mental health.