New Research From Clinical Psychological Science

Gray-Matter Morphometry of Internalizing-Symptom Dimensions During Adolescence
Harry R. Smolker, Hannah R. Snyder, Benjamin L. Hankin, and Marie T. Banich

Smolker and colleagues used structural MRI to identify the neuroanatomical correlates of four dimensions of internalizing psychopathology symptoms in adolescents: a common internalizing dimension capturing symptoms across internalizing disorders, a low-positive-affect-specific dimension, an anxious-arousal-specific dimension, and an anxious-apprehension-specific dimension. Results suggested that these dimensions are associated with neuroanatomy across much of the brain, including in the prefrontal and limbic regions and regions supporting visual processing. The results differed between males and females in regions that are sexually dimorphic in adulthood. These findings may shed light on neurodevelopmental processes that make adolescence a critical period for the trajectory of mental illness.

Affect-Dynamic Signatures of Psychosis Risk Across Multiple Time Scales and Contexts
Lilian Y. Li, Jason Schiffman, and Elizabeth A. Martin

Fluctuations of affect across time may predict psychosis risk early in the illness course. These markers can be time- and context-sensitive, facilitating the identification of developmental pathways to psychosis and informing risk-detection approaches. Li and colleagues examined the relation between affect dynamics in response to emotional materials (presented in the lab and social media) and two types of subthreshold symptoms of psychosis: positive symptoms (perceptual aberration and magical ideation) and negative symptoms (social anhedonia). They found a link between heightened frequency of affective fluctuations and positive symptoms, and a modest link between fewer fluctuations (i.e., heightened persistence of baseline states) and negative symptoms.

Covariate Selection for Estimating Individual Treatment Effects in Psychotherapy Research: A Simulation Study and Empirical Example
Robin Anno Wester, Julian Rubel, and Axel Mayer

Estimating individual treatment effects (ITEs) is crucial to personalized psychotherapy, but making these estimates accurately requires identifying all covariates that interact with treatment, which can be challenging. Wester and colleagues used a simulation to compare different covariate-selection strategies, along with their consequences on these estimations. The results suggested that no single covariate-selection strategy dominated across all factor-level combinations and performance measures. Instead, each covariate-selection strategy appeared to be best suited for specific problem settings. For example, domain-backward stepwise regression and backward stepwise regression using Bayesian information criterion were least biased in estimating variance of ITEs across the most conditions.

Optimal Well-Being After Psychopathology: Prevalence and Correlates
Andrew R. Devendorf, Ruba Rum, Todd B. Kashdan, and Jonathan Rottenberg

Devendorf and colleagues report the prevalence of optimal well-being (OWB) following recovery after psychopathology. Using a large Canadian sample (N = 23,491), they found that: (a) 9.8% of participants with a history of psychopathology achieved OWB; (b) participants with a history of substance use disorders (10.2%) and depression (7.1%) were the most likely to report OWB; and (c) participants with anxiety (5.7%), suicidal ideation (5.0%), bipolar I (3.3%), and bipolar II (3.2%) were less likely to report OWB. Moreover, having a history of just one disorder increased the odds of OWB relative to having a history of multiple disorders.

Systemic Challenges in Internship Training for Health-Service-Psychology: A Call to Action From Trainee Stakeholders
R. Palitsky et al.

In this article, 23 trainees across different sites and specializations use lessons learned from COVID-19 as a call to action in health-service-psychology (HSP) training. The training challenges they observed during COVID-19 made more salient systemic and philosophical issues that already existed. Historically, trainee voices have been absent from literature about clinical training, Palitsky and colleagues say. The authors describe long-standing dilemmas in HSP training that will continue to require resolution after the pandemic has subsided, and they recommend systems-level changes that would advance equity and sustainability in HSP training.

Does Objectively Measured Social-Media or Smartphone Use Predict Depression, Anxiety, or Social Isolation Among Young Adults?
Craig J. R. Sewall, Tina R. Goldstein, Aidan G. C. Wright, and Daniel Rosen

Sewall and colleagues examined the associations between three aspects of digital-technology use (duration and frequency of smartphone use, duration of social-media use) and three aspects of psychological distress (depression, anxiety, and social isolation) among a sample of young adults. They found that most relationships between digital-technology use and psychological distress were statistically nonsignificant, and all effects were very small and unlikely to register a meaningful impact on a person’s psychological distress. In post hoc subgroup analyses, the researchers found scant evidence for the usual claim that digital-technology use is more harmful to women and/or younger people.

Connectivity Patterns Evoked by Fearful Faces Demonstrate Reduced Flexibility Across a Shared Dimension of Adolescent Anxiety and Depression
Nicholas A. Hubbard et al.

Hubbard and colleagues used functional MRI to investigate the neurobiological processes underlying how people with anxiety and depression prioritize processing negative emotional information. Adolescents with or without symptoms of depression or anxiety were cued to attend to or ignore emotional faces. In participants with anxious and depressive symptoms, the connectivity patterns did not change much from conditions in which they needed to ignore fearful faces to conditions in which they needed to attend to them. The patterns changed when they were ignoring or attending to happy, sad, or neutral faces. These findings suggest a failure to flexibly adapt in the presence of negative emotional information, which may reflect a common neurobiological mechanism in anxiety and depression.

Maturing Out: Between- and Within-Persons Changes in Social-Network Drinking, Drinking Identity, and Hazardous Drinking Following College Graduation
Kristen P. Lindgren et al.

Lindgren and colleagues followed a sample of 422 college students reporting hazardous drinking (HD) from 6 months before graduation until 2 years after graduation. The researchers assessed their drinking, drinking identity (i.e., level of identification with drinking), and social networks online. Results indicated that each participant’s changes in drinking identity did not influence the relationship between their changes in social-network drinking and personal HD. However, there was some evidence that individuals’ changes in HD were followed by changes in drinking identity, which suggests that drinking identity may function as a marker instead of a mechanism of “natural” HD reduction during the transition out of college.

Effects of Alcohol Intoxication on Sexual Decision-Making Among Men Who Have Sex With Men: Alcohol’s Influences on Self-Control Processes
Stephen A. Maisto et al.

Maisto and colleagues tested mechanisms linking alcohol intoxication and condomless anal intercourse (CAI) in a sample of men who have sex with men. Participants drank water, a placebo, or alcohol. Afterward, they completed a working memory task (a task to measure implicit approach to and avoidance of CAI images versus condom images) and saw two video role-play vignettes of high-risk sexual scenarios. Alcohol increased CAI intentions via implicit approach biases toward CAI stimuli only when sexual arousal was elevated. Alcohol also increased CAI intentions via impairments in working memory but only when sexual arousal was low. The results about behavioral skills and risk exposure were mixed.

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