New Research From Clinical Psychological Science

Electrodermal Activity and Heart Rate Variability During Exposure Fear Scripts Predict Trait-Level and Momentary Social Anxiety and Eating-Disorder Symptoms in an Analogue Sample 
Caroline Christian, Elizabeth Cash, Dan A. Cohen, Christopher M. Trombley, and Cheri A. Levinson  

Eating disorders (EDs) and social anxiety disorder (SAD), characterized by high levels of fear, are treated with exposure therapy (i.e., exposing the patient to the source of their fear). To test how physiological markers of fear can signal how exposure influences symptoms, Christian and colleagues measured heart rate variability, heart rate, and electrodermal activity (EDA) using wearable sensor technology while participants listened to ED fear, SAD fear, and neutral scripts. Results indicated that the most salient predictor of ED and SAD symptoms was EDA when patients listened to the neutral script. This research highlights the utility of wearable sensor technology as a complement to exposure therapy.  

Psychological Distress Across Adulthood: Equating Scales in Three British Birth Cohorts 
Hannah E. Jongsma et al.

To examine psychological distress across adulthood and cross-cohort trends, Jongsma and colleagues used data from the psychological-distress measures administered in the 1946, 1958, and 1970 British birth cohorts. The researchers equated the scales (i.e., created a common score for the different measures used) using information from an independently recruited calibration sample and different methods. Results indicated an inverse U shape of distress across adulthood. However, different measures and methods appeared to introduce differences in point estimates, particularly for comparisons between cohorts, preventing clear conclusions regarding between-cohorts trends. Further analyses suggested that, to equate the scales, the method of multiple imputation yielded more accurate estimates than equipercentile linking.   

Personality (Dys)Function and General Instability
Whitney R. Ringwald, Michael N. Hallquist, Alexandre Y. Dombrovski, and Aidan G. C. Wright 

Humans generally adapt to the environment while maintaining psychological equilibrium. Systems theories of personality hold that generalized processes control a person’s stability by regulating how strongly they react to various situations. Research has suggested that people have higher order traits of general personality function (stability) and dysfunction (general personality pathology, or GPP). Ringwald and colleagues examined how general personality functioning manifests in everyday life across individuals drawn from community and clinical samples. Consistent with systems theories, they found that (a) there is a general factor that reflects reactivity across major domains of functioning, and (b) reactivity is strongly associated with stability and GPP.   

Mental-Health Trajectories of U.S. Parents With Young Children During the COVID-19 Pandemic: A Universal Introduction of Risk
Maureen Zalewski, Sihong Liu, Megan Gunnar, Liliana J. Lengua, and Philip A Fisher

Zalewski and colleagues sought to identify parental mental-health trajectories predicted by pre-COVID-19 cumulative risk and COVID-19-specific risk factors. From April to November 2020, they tested a sample of 3,085 parents across the United States who had one or more children age 5 or younger. Results indicated that the Pre–COVID-19 cumulative risk as well as the COVID-19-specific risks of financial strain, decreased employment, and increased family conflict were salient risk factors predicting poor mental-health trajectories. These findings have public-health implications because prolonged exposure to mental-health symptoms in parents constitutes a risk factor for child development.  

Resting-State Functional Connectivity Differences Following Experimental Manipulation of the Orbitofrontal Cortex in Two Directions via Theta-Burst Stimulation
Rebecca B. Price et al.

Price and colleagues assigned individuals with compulsive behavior (CB) disorders to receive neuromodulation targeting the left orbitofrontal cortex (OFC; a brain area associated with CBs) followed by computer-based behavioral “habit-override” training. Neuromodulation was applied via intermittent theta-burst stimulation (iTBS) or continuous TBS (cTBS). Relative to cTBS, iTBS increased the resting-state functional connectivity (RSFC) between right OFC and other brain regions, both within and beyond regions known for their role in CB. The RSFC connectivity effects were correlated with subjective difficulty during habit-override training. These findings help reveal neural network-level impacts of neuromodulation and can inform the development of interventions.  

Adults’ Memory for a Maltreatment-Related Childhood Experience: Interview Protocols
Deborah Goldfarb et al.

How can accurate memories of childhood events be obtained? Goldfarb and colleagues examined the accuracy of three types of interview protocols: a standard forensic interview, a cognitive interview with mental reinstatement (asking witnesses to mentally recreate the target event), and a cognitive interview with mental- and physical-context reinstatement (using photos or videos to help the reinstatement). They tested adults who had experienced a documented medical examination related to child maltreatment when they were 3 to 16 years old, 20 years prior to the interview. Regardless of reinstatement, the cognitive interview increased the accuracy of their memories. Younger age at maltreatment was associated with less complete but equally accurate memories, and a greater number of posttraumatic-stress-disorder symptoms in adulthood predicted incorrect answers to misleading questions.   

How to Change Negative Outcome Expectations in Psychotherapy? The Role of the Therapist’s Warmth and Competence
Anna Seewald and Winfried Rief 

A therapist’s warmth and competence might overcome a patient’s negative outcome expectations for psychological treatments and thus lead to favorable treatment outcomes, this research suggests. Seewald and Rief investigated how a therapist’s interpersonal behavior can optimize the modification of negative outcome expectations. After inducing negative expectations in an online experiment, they presented different videos of therapist-patient interactions to violate those expectations. In the videos, the researchers kept the information constant but manipulated the therapist’s warmth and competence. Results indicated that the therapist being both warm and competent led to the most positive outcome expectations.  

The Development and Internal Evaluation of a Predictive Model to Identify for Whom Mindfulness-Based Cognitive Therapy Offers Superior Relapse Prevention for Recurrent Depression Versus Maintenance Antidepressant Medication  
Zachary D. Cohen et al.

Cohen and colleagues developed clinical prediction models to investigate how adults with recurrent depression choose between continuing with antidepressant medication (ADM) maintenance or switching to mindfulness-based cognitive therapy (MBCT). Using previously published data, they constructed prognostic models that combined demographic, clinical, and psychological factors to predict relapse at 24 months under ADM or MBCT. Individuals with the poorest ADM prognoses who switched to MBCT had better outcomes compared with individuals who maintained ADM (48% vs. 70% relapse, respectively). For individuals with moderate to good ADM prognoses, both treatments resulted in a similar likelihood of relapse.   

Role of Triarchic Traits in Relations of Early Resting Heart Rate With Antisocial Behavior and Broad Psychopathology Dimensions in Later Life
Bridget M. Bertoldi et al.

This research suggests that disinhibition and boldness play a role in the association between early heart rate and antisocial behavior and other clinical problems later in life. Bertoldi and colleagues used data from a longitudinal study of antisocial behavior risk and found that low resting heart rate in childhood was related to adult antisocial behavior, thanks largely to a covariance between antisocial behavior and traits of disinhibition and boldness. In addition, low childhood heart rate was related to greater externalizing problems (e.g., substance abuse) and fewer internalizing problems in adulthood (e.g., depression); disinhibition accounted for the former association, and boldness accounted for the latter. 

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