Showing papers in "Journal of Abnormal Psychology in 2005"
TL;DR: The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching class of emotional disorders, which can be decomposed into 3 subclasses.
Abstract: The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." There are now sufficient data to eliminate this rational system and replace it with an empirically based structure that reflects the actual similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching class of emotional disorders, which can be decomposed into 3 subclasses: the bipolar disorders (bipolar I, bipolar II, cyclothymia), the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), and the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia). The optimal placement of other syndromes (e.g., obsessive-compulsive disorder) needs to be clarified in future research.
1,288 citations
TL;DR: The results suggest that WM deficit in schizophrenia is modality independent and that encoding and/or early part of maintenance may be problematic.
Abstract: Working memory (WM) deficit is a cardinal cognitive symptom of schizophrenia, but the differences among the tasks and measures used to assess WM make it difficult to compare across studies. The authors conducted a meta-analytic review to address 3 major questions: (a) Do patients with schizophrenia show WM deficits across diverse methodology; (b) Is WM deficit supramodal; and (c) Does the WM deficit worsen with longer delays? The results indicate that significant WM deficit was present in schizophrenia patients in all modalities examined. Increasing delay beyond 1 s did not influence the performance difference between schizophrenia patients and healthy control participants in WM. These results suggest that WM deficit in schizophrenia is modality independent and that encoding and/or early part of maintenance may be problematic.
760 citations
TL;DR: Three broad, innate temperament dimensions differentiate through both biologically and environmentally based developmental processes into a hierarchical personality trait structure and, at their extremes, are risk factors for psychopathology, especially given adverse life experiences (stress).
Abstract: Personality and psychopathology long have been viewed as related domains, but the precise nature of their relations remains unclear. Through most of the 20th century, they were studied as separate fields; within psychopathology, clinical syndromes were separated from personality disorders in 1980. This division led to the revelation of substantial overlap among disorders both within and across axes and to the joint study of normal and abnormal personality. The author reviews these literatures and proposes an integrative framework to explain personality-psychopathology relations: Three broad, innate temperament dimensions--negative affectivity, positive affectivity, and disinhibition--differentiate through both biologically and environmentally based developmental processes into a hierarchical personality trait structure and, at their extremes, are risk factors (diatheses) for psychopathology, especially given adverse life experiences (stress).
696 citations
TL;DR: Considering the functions of SMB clarified the relations between SMB and other clinical constructs reported in previous studies such as suicide attempts, posttraumatic stress, and social concerns and has direct implications for the assessment and treatment ofSMB.
Abstract: Adolescent self-mutilative behavior (SMB) is a pervasive and dangerous problem, yet factors influencing the performance of SMB are not well understood. The authors examined the contextual features and behavioral functions of SMB in a sample of 89 adolescent psychiatric inpatients. SMB typically was performed impulsively, in the absence of physical pain, and without the use of alcohol or drugs. Moreover, analyses supported the construct validity of a functional model in which adolescents reported engaging in SMB for both automatic and social reinforcement. Considering the functions of SMB clarified the relations between SMB and other clinical constructs reported in previous studies such as suicide attempts, posttraumatic stress, and social concerns and has direct implications for the assessment and treatment of SMB.
682 citations
TL;DR: The authors conclude with a dimensional mental disorder classification that they suggest provides a useful model and suggest that future editions of the Diagnostic and Statistical Manual of Mental Disorders give more recognition to dimensional models of classification.
Abstract: The question of whether mental disorders are discrete clinical conditions or arbitrary distinctions along dimensions of functioning is a long-standing issue, but its importance is escalating with the growing recognition of the frustrations and limitations engendered by the categorical model. The authors provide an overview of some of the dilemmas of the categorical model, followed by a discussion of research that addresses whether mental disorders are accurately or optimally classified categorically or dimensionally. The authors' intention is to document the importance of this issue and to suggest that future editions of the Diagnostic and Statistical Manual of Mental Disorders give more recognition to dimensional models of classification. They conclude with a dimensional mental disorder classification that they suggest provides a useful model.
625 citations
TL;DR: Whether deficient inhibitory motor control is the core deficit of attention-deficit/hyperactivity disorder (ADHD) is discussed, and why it may be less crucial in children than in adults with ADHD.
Abstract: This review discusses whether deficient inhibitory motor control is the core deficit of attention-deficit/hyperactivity disorder (ADHD). Inhibitory motor control is commonly assessed using the stop-signal paradigm. Since the last meta-analysis that was performed, 33 new studies have appeared. The current meta-analysis revealed a significant difference between ADHD patients and matched controls in stop latency (stop-signal reaction time) in both children and adults. Basic reaction time was significantly longer in children with ADHD, but not in adults, and there was a significant interaction between the elongation of the latency to stop and to respond in adults, but not in children. Deficient inhibitory motor control may be less crucial in children than in adults with ADHD.
601 citations
TL;DR: Results cast doubt on the proposition that restrained eating is a primary cause of bulimic symptoms, emotional eating, and psychological distress seen in individuals who are trying to control their weight, and suggest that body dissatisfaction is the key factor.
Abstract: This study uses prospective data from a survey of 1,177 adolescent girls to examine whether emotional eating, binge eating, abnormal attitudes to eating and weight, low self-esteem, stress, and depression are associated with dietary restraint or body dissatisfaction. In analyses that included both restraint and body dissatisfaction as independent predictors, restraint was associated only with more negative attitudes to eating, whereas body dissatisfaction was significantly associated with all the adverse outcomes. These results cast doubt on the proposition that restrained eating is a primary cause of bulimic symptoms, emotional eating, and psychological distress seen in individuals who are trying to control their weight, and rather suggest that body dissatisfaction is the key factor.
582 citations
TL;DR: Testing 3 competing views of how depression alters emotional reactivity found positive attenuation (reduced positive), negative potentiation (increased negative), and emotion context insensitivity (ECI) views provide partial support.
Abstract: The present study tested 3 competing views of how depression alters emotional reactivity: positive attenuation (reduced positive), negative potentiation (increased negative), and emotion context insensi- tivity (ECI; reduced positive and negative).Normative and idiographic stimuli that elicited happy, sad, and neutral states were presented to currently depressed, formerly depressed, and healthy control individuals while experiential, behavioral, and autonomic responses were measured.Currently depressed individuals reported less sadness reactivity and less happiness experience across all conditions than did the other participants, and they exhibited a more dysphoric response to idiographic than to normative stimuli.Overall, data provide partial support for the positive attenuation and ECI views.Depression may produce mood-state-dependent changes in emotional reactivity that are most pronounced in emotion experience reports. Major depressive disorder (MDD) is a devastating, sometimes fatal, psychiatric condition that afflicts nearly one fifth of the population (Kessler, 2002).The Diagnostic and Statistical Manual of Mental Disorders(DSM-IV) classifies MDD as a mood disorder (American Psychiatric Association (APA), 1994).Indeed, durable disturbance of mood is one of the most salient features of MDD. DSM-IV diagnostic criteria specify symptoms of at least 2 weeks' duration that implicate deficient positive affect (e.g., anhedonia), excessive negative affect (e.g., guilt), or both. Consistent with these diagnostic criteria, depressed patients consistently report low levels of positive affect and high levels of negative affect on questionnaire and interview measures (Clark, Watson, & Mineka, 1994). Researchers studying depression have increasingly sought to clarify how this mood disorder alters emotional reactivity.One problem in addressing this question is that the core terms of mood and emotion are notoriously slippery and have often been used in confusing and contradictory ways.Following contemporary affec- tive science (e.g., Rottenberg & Gross, 2003), here we refer to moods as diffuse, slow-moving feeling states that are weakly tied to specific objects or elicitors (Watson, 2000).In contrast, emo- tions refer to quick-moving reactions that occur when an organism processes a meaningful stimulus that exercises its adaptive capac- ities (e.g., Ekman, 1992; Tooby & Cosmides, 1990). Emotional reactions typically involve coordinated changes in emotional feel- ings, behavior, and physiology and last for seconds or minutes (Keltner & Gross, 1999).Again by contrast, moods last for hours or days and exert their clearest effects on feelings and cognitions (as opposed to behavior or physiology).Using these definitions, we see that the syndrome of depression necessarily involves changes in mood but does not require changes in emotional reactions. Most conceptions of the relation between moods and emotions view these constructs as linked, with moods altering the probabil- ity of having specific emotions.More specifically, moods are generally thought to potentiate like-valenced or matching emotions (e.g., irritable mood facilitates angry reactions; Rosenberg, 1998). If this logic were to be extended to clinical mood states, one would expect depressed persons' lack of positive mood to attenuate positive emotional reactivity and their high levels of negative mood to potentiate negative emotional reactivity.In the following sections, we review experimental evidence that bears on these predictions.
564 citations
TL;DR: Evidence is presented that comorbidity among externalizing disorders is best modeled by an underlying normally distributed continuum of risk for multiple disorders within the externalizing spectrum.
Abstract: Problems with antisocial behavior and substance use and personality traits such as aggression and impulsivity commonly co-occur. In the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM–IV; American Psychiatric Association, 1994), these problems constitute the symptoms of a variety of specific mental disorders, and these mental disorders are described in a variety of distinct sections of the manual. In this article, we argue that in the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–V), these problems should be classified together under the rubric of externalizing disorders. We argue that etiologic commonalities should be a major consideration in efforts to classify psychopathological entities (cf. Gottesman, 2002; Skinner, 1981; Tsuang, Stone, & Faraone, 2000; Westen, Heim, Morrison, Patterson, & Campbell, 2002). Moreover, classification of entities in science in general tends to proceed from being more initially descriptive to being based more on underlying principles as these underlying principles become more clearly articulated (Hempel, 1965). Current evidence, reviewed herein, indicates that various externalizing syndromes are linked to the same underlying etiologic factors.
We also consider the issue of whether externalizing problems are better conceived of in terms of dimensions or categories. We evaluate this issue both within specific syndromes and in terms of the co-occurrence of syndromes within the externalizing spectrum, and we conclude by endorsing a dimensional conceptualization on the basis of the existing evidence. However, even if externalizing syndromes and their patterns of co-occurrence are dimensional in nature, this does not preclude categorical decision making for clinical purposes. The key is to make clear the distinction between the empirical structure of these syndromes and the ways in which knowledge of that structure can be brought to bear on categorical decisions that need to be made in clinical practice (Widiger & Clark, 2000). We begin by reviewing evidence for the existence of an etiologically coherent spectrum of externalizing problems encompassing substance dependence and antisocial behaviors and personality traits. Although our focus is primarily on adulthood, we also refer to some literature on adolescence to the extent that it pertains to these problems and is relevant to the development of a dimensional-spectrum conceptualization of the externalizing spectrum.
504 citations
TL;DR: There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction, and anxiety, but not depression, made an independent contribution to delusional conviction.
Abstract: The aim of the study was to elucidate the factors contributing to the severity and persistence of delusional conviction. One hundred participants with current delusions, recruited for a treatment trial of psychological therapy (PRP trial), were assessed at baseline on measures of reasoning, emotions, and dimensions of delusional experience. Reasoning biases (belief inflexibility, jumping to conclusions, and extreme responding) were found to be present in one half of the sample. The hypothesis was confirmed that reasoning biases would be related to delusional conviction. There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction. Emotional states were not associated with the reasoning processes investigated. Anxiety, but not depression, made an independent contribution to delusional conviction.
412 citations
TL;DR: Findings support the predictive validity of the Chapman psychosis-proneness scales and may enhance the power of early detection efforts in schizophrenia-spectrum disorders.
Abstract: The authors hypothesized that at-risk individuals identified on the basis of their Chapman scale scores would be diagnosed with schizophrenia-spectrum disorders at follow-up. In the present study, the authors interviewed 135 young adults approximately 5 years following their initial assessment. The at-risk groups included high scorers on the Perceptual Aberration and/or Magical Ideation Scales (n = 59) and high scorers on the revised Social Anhedonia Scale (n = 32). The control participants (n = 44) scored below 0.5 SD of the same-sex group means on all the scales. At the follow-up, the groups differed in terms of their likelihood of having a schizophrenia-spectrum diagnosis, X 2 (2) = 9.79, p <.01. The at-risk groups reported more frequent and severe psychotic-like experiences relative to the control group. These findings support the predictive validity of the Chapman psychosis-proneness scales and may enhance the power of early detection efforts.
TL;DR: The authors examined the latent structure of depression in a population-based sample of children and adolescents and used Meehl's (1995) taxometric procedures to discern whether youth depression is dimensional or categorical.
Abstract: The authors examined the latent structure of depression in a population-based sample of children and adolescents. Youth's self-reports and parents' reports of the youth's Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) major depressive symptoms were assessed via a structured clinical interview. The authors used Meehl's (1995) taxometric procedures to discern whether youth depression is dimensional or categorical. Taxometric analyses that explicitly took into account the skewness of depressive symptoms suggested that depression is a dimensional, not categorical, construct. The dimensional structure of depression was obtained for all of the DSM-IV major depressive symptoms as well as for different domains of depression (emotional distress symptoms and vegetative, involuntary defeat symptoms), youth and parent reports, and different subsamples (i.e., boys vs. girls and younger vs. older youth).
TL;DR: Across settings, age groups, and impairment levels, the association between past suicidal behavior and current suicidal symptoms held, even when controlling for strong covariates like hopelessness and symptoms of various Axis I and II syndromes.
Abstract: T. E. Joiner's (2004, in press) theory of suicidal behavior suggests that past suicidal behavior plays an important role in future suicidality. However, the mechanism by which this risk is transferred and the causal implications have not been well studied. The current study provides evaluation of the nature and limits of this relationship across 4 populations, with varying degrees of suicidal behavior. Across settings, age groups, and impairment levels, the association between past suicidal behavior and current suicidal symptoms held, even when controlling for strong covariates like hopelessness and symptoms of various Axis I and II syndromes. Results provide additional support for the importance of past suicidality as a substantive risk factor for later suicidal behavior.
TL;DR: This study addresses 5 unresolved issues in the neuropsychology of antisocial behavior using a community sample of 325 school boys in whom neurocognitive measures were assessed at age 16-17 years to suggest that (a) neuroc cognitive impairments are profound and not artifactual and (b) childhood-limited antisocials may not be free of long-lasting functional impairment.
Abstract: This study addresses 5 unresolved issues in the neuropsychology of antisocial behavior using a community sample of 325 school boys in whom neurocognitive measures were assessed at age 16-17 years. Antisocial behavior measures collected from age 7-17 years were cluster analyzed and produced 4 groups: control, childhood-limited, adolescent-limited, and life-course persistent. Those on the lifecourse persistent path and also on the childhood-limited path were particularly impaired on spatial and memory functions. Impairments were independent of abuse, psychosocial adversity, head injury, and hyperactivity. Findings provide some support for the life-course persistent versus adolescent-limited theory of antisocial behavior and suggest that (a) neurocognitive impairments are profound and not artifactual and (b) childhood-limited antisocials may not be free of long-lasting functional impairment.
TL;DR: In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables.
Abstract: A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.
TL;DR: Results for secondary psychopathy clearly supported the strong BAS prediction but provided mixed support for the normal BIS prediction, while results for primary psychopathy were as predicted.
Abstract: Investigators commonly distinguish between primary and secondary psychopathy (H. Cleckley, 1976; D.T. Lykken, 1995), though there is a lack of consensus regarding the best means to achieve this distinction. To address the validity of using R. D. Hare's (2003) Psychopathy Checklist and the G. Welsh (1956) Anxiety Scale for this purpose, the authors used 2 measures of J. A. Gray's (1987) behavioral inhibition system/behavioral activation system (BIS/BAS). Following D. T. Lykken (1995) and D. C. Fowles (1980), the authors hypothesized that primary psychopathy would be associated with a weak BIS and a normal BAS, whereas secondary psychopathy would be associated with a strong BAS and a normal BIS. Results for primary psychopathy were as predicted. Results for secondary psychopathy clearly supported the strong BAS prediction but provided mixed support for the normal BIS prediction.
TL;DR: Dual-process models of attention-deficit/hyperactivity disorder (ADHD) suggest that both executive functioning and regulatory functions are involved and that executive function weaknesses may be associated specifically with symptoms of inattention-disorganization but not hyperactivity-impulsivity.
Abstract: Dual-process models of attention-deficit/hyperactivity disorder (ADHD) suggest that both executive functioning and regulatory functions (e.g., processing speed) are involved and that executive function weaknesses may be associated specifically with symptoms of inattention–disorganization but not hyperactivity–impulsivity. Adults aged 18–37 (105 with ADHD, 90 controls) completed a neuropsychological battery. The ADHD group had weaker performance than did the control group (p .01) on both executive and speed measures. Symptoms of inattention–disorganization were uniquely related to executive functioning with hyperactivity–impulsivity controlled. Inattention was associated with slower response speed, and hyperactivity–impulsivity with faster output speed. Results were not accounted for by IQ, age, gender, education level, or comorbid disorders. Findings are discussed in terms of developmental and dual-process models of ADHD leading into adulthood.
TL;DR: A transactional, interpersonal framework involving adolescents' reassurance-seeking and peer experiences may be useful for understanding the emergence of gender differences in depression prevalence during the adolescent transition.
Abstract: A transactional, interpersonal framework involving adolescents' reassurance-seeking and peer experiences may be useful for understanding the emergence of gender differences in depression prevalence during the adolescent transition. Sociometric nominations of peer acceptance/rejection and ratings of friendship quality provided by adolescents and their friends were used to measure peer experiences among 6th-8th-grade adolescents (N = 520) over 3 annual time points. After controlling for age and pubertal development, significant but small prospective effects offered mixed support for hypotheses: (a) depressive symptoms and negative peer relations predicted increasing levels of girls' reassurance-seeking; (b) initial levels of reassurance-seeking and depressive symptoms predicted deteriorating friendship quality among girls and low friendship stability, respectively; and (c) reassurance-seeking combined with poor peer experiences predicted increases in girls' depressive symptoms.
TL;DR: Introducing dimensional severity ratings to the extant diagnostic categories and criteria sets would begin to determine the feasibility of dimensional classification and address some limitations of the purely categorical approach.
Abstract: The value of including dimensional elements in the Diagnostic and Statistical Manual of Mental Disorders (DSM) has been recognized for decades. Nevertheless, no proposals have been made for introducing dimensional classification in the diagnostic system in a valid and feasible manner. As an initial step in this endeavor, the authors suggest introducing dimensional severity ratings to the extant diagnostic categories and criteria sets. Although not without difficulties, this would begin to determine the feasibility of dimensional classification and would address some limitations of the purely categorical approach (e.g., failure to capture individual differences in disorder severity, and clinically significant features subsumed by other disorders or falling below conventional DSM thresholds). The utility of incorporating broader dimensions of temperament and personality in diagnostic systems beyond the fifth edition of the DSM is also discussed.
TL;DR: Daily ASE and POEs predicted the occurrence of a 1st lapse on the following day and variations in daily ASE predicted the onset of relapse, even after controlling for concurrent smoking.
Abstract: According to social learning models of drug relapse, decreases in abstinence self-efficacy (ASE) and increases in positive smoking outcome expectancies (POEs) should foreshadow lapses and relapse. In this study, the authors examined this hypothesis by using ecological momentary assessment data from 305 smokers who achieved initial abstinence from smoking and monitored their smoking and their ASE and POEs by using palmtop computers. Daily ASE and POEs predicted the occurrence of a 1st lapse on the following day. Following a lapse, variations in daily ASE predicted the onset of relapse, even after controlling for concurrent smoking. ASE and POEs generally neither mediated nor moderated each other's effects. These data emphasize the role of dynamic factors in the relapse process.
TL;DR: Women who experienced recent negative life events and lived in high disadvantage/disorder neighborhoods were more likely to become depressed than were those who lived in more benign settings, both concurrently and over a 2-year period.
Abstract: The neighborhood contexts in which people live affect many aspects of their lives, including their daily stress level, personal safety, and available resources. Contextual effects have been hypothesized for development in general and for mental health in particular (Bronfenbrenner, 1979a, 1979b, 1986; Jessor, 1992, 1993). The MacArthur Foundation issued a set of recommendations calling for systematic consideration of the role of context in the etiology of psychopathology (Boyce, Frank, Jensen, Kessler, Nelson, & Steinberg, 1998). However, to date, neighborhood contexts have received relatively little attention as a factor in mental health. Considerably more work has been done on the effects of neighborhood context on delinquency, crime, physical health, and parenting practices (e.g., Anderson, Sorlie, Backlund, Johnson, & Kaplan, 1997; Brody et al., 2003; Jencks & Mayer, 1990; Jessor, 1992; Jones & Duncan, 1995; LeClere, Rogers, & Peters, 1997; Robert, 1998; Sampson, 1992; Sampson, Raudenbush, & Earls, 1997). A key question is the extent to which community context affects people’s mental health beyond the effects of individual-level demographic characteristics, personality, and stressors.
In the current study, we tested the extent to which neighborhood context was associated with diagnosable depression in a large sample of African American women, both directly and through interaction with personal risk variables. The personal risk variables we examined were negative life events and the personality trait of negative affectivity. We reasoned that an adverse neighborhood environment would amplify the effects of these known risk factors for depression. In other words, we predicted that women with these individual-level risk factors who reside in impoverished and/or dangerous neighborhoods would be more likely to experience episodes of major depression than would those who reside in more affluent, safe neighborhoods.
TL;DR: Assessment of interpersonal problem-solving performance using the Means-Ends Problem-Solving (MEPS) task before and after a mood-induction procedure showed that only those formerly depressed people with a history of suicidal ideation shifted in MEPS performance, producing significantly less effective problem solutions following mood challenge.
Abstract: The authors divided 34 participants who had a history of depression into 2 groups, those having previous suicidal ideation or behavior (n=19) and those having no such symptoms (n=15), then compared the 2 groups with a group of participants who had no history of depression (n=22). Assessment of interpersonal problem-solving performance using the Means-Ends Problem-Solving (MEPS) task before and after a mood-induction procedure showed that only those formerly depressed people with a history of suicidal ideation shifted in MEPS performance, producing significantly less effective problem solutions following mood challenge, consistent with a differential activation account of vulnerability for recurrence of suicidal ideation and behavior. The deterioration in effectiveness following mood challenge was moderated by lack of specificity in autobiographical memory.
TL;DR: Diverse issues that arise in contemplating dimensional constructs as targets for psychopathology research are articulate and discussed.
Abstract: Much current psychopathology research is framed by categorical constructs. Limitations of categorical constructs have been articulated, and dimensional constructs are often proposed as viable alternatives to categories of psychopathology. The purpose of this Special Section is to articulate and discuss diverse issues that arise in contemplating dimensional constructs as targets for psychopathology research.
TL;DR: Multilevel modeling analyses revealed that sexual orientation predicted suicidal ideation, suicide attempts, self-injurious behavior, use of psychotherapy, and use of psychiatric medications over and above the effects of family adjustment.
Abstract: Self-identified lesbian, gay male, and bisexual (LGB) individuals were recruited via convenience sampling, and they in turn recruited their siblings (79% heterosexual, 19% LGB). The resulting sample of 533 heterosexual, 558 lesbian or gay male, and 163 bisexual participants was compared on mental health variables and their use of mental health services. Multilevel modeling analyses revealed that sexual orientation predicted suicidal ideation, suicide attempts, self-injurious behavior, use of psychotherapy, and use of psychiatric medications over and above the effects of family adjustment. Sexual orientation was unrelated to current psychological distress, psychiatric hospitalizations, and self-esteem. This is the 1st study to model family effects on the mental health of LGB participants and their siblings.
TL;DR: Among the nondepressed but not among depressed women, time of waking, and number of social contacts were independently associated with CAR, and these psychosocial factors may contribute to a normal CAR, but their regulatory influence may become disrupted during mild to moderate clinical depression.
Abstract: Cortisol is elevated during severe depression. However, some studies of outpatients suggest reduced cortisol levels, either basal or poststress. More definite evidence of this phenomenon is needed, and correlates that may explain the disparate findings should be identified. Women from the community (37 depressed and 36 nondepressed) completed electronic diaries in order to help researchers assess the cortisol awakening response (CAR), sleep, and social contacts. Depressed women had a blunted CAR compared with nondepressed women. Among the nondepressed but not among depressed women, time of waking, and number of social contacts (especially positive ones) were independently associated with CAR. These psychosocial factors may contribute to a normal CAR, but their regulatory influence may become disrupted during mild to moderate clinical depression.
TL;DR: Efforts to empirically demonstrate the clinical utility of dimensional alternatives should be a prerequisite for their future implementation in order to establish that their advantages outweigh the disadvantages.
Abstract: A potential obstacle to implementing dimensional representations in the Diagnostic and Statistical Manual of Mental Disorders (DSM) is lack of data about clinical utility and user acceptability. Adopting a dimensional approach would likely complicate medical record keeping, create administrative and clinical barriers between mental disorders and medical conditions, require a massive retreating effort, disrupt research efforts (e.g., meta-analyses), and complicate clinicians' efforts to integrate prior clinical research using DSM categories into clinical practice. Efforts to empirically demonstrate the clinical utility of dimensional alternatives should be a prerequisite for their future implementation in order to establish that their advantages outweigh the disadvantages. Approaches to promote user acceptability and the development of an empirical database include dimensionalizing existing DSM categories and including research dimensions in the DSM appendix.
TL;DR: Both clinical groups exhibited attentional biases for disorder-related words, whereas only depressed participants showed clear evidence of explicit and implicit memory biases.
Abstract: Cognitive processes play an important role in the etiology and maintenance of anxiety and depression. Current theories differ, however, in their predictions regarding the occurrence of attentional biases and memory biases in depression and anxiety. To allow for a systematic comparison of disorders and cognitive processes, 117 women (35 with generalized social phobia, 27 with major depression, and 55 healthy controls) participated in a test of visual attention (visual search), an explicit memory test (free recall), and an implicit memory test (anagram solving). Both clinical groups exhibited attentional biases for disorder-related words, whereas only depressed participants showed clear evidence of explicit and implicit memory biases. The implications of these results for competing theories are discussed.
TL;DR: The low PE-maternal depression link was relatively specific, as there were few associations between low PE and other forms of parental psychopathology or between NE and BI and parental mood disorders.
Abstract: A number of models developed in the adult psychopathology literature (i.e., L. A. Clark & D. Watson, 1991) have asserted that low levels of positive emotionality (PE) are predisposing factors or precursors for depression and represent a form of temperamental risk for depression. Further support for this claim would derive from evidence linking low PE to known indicators of risk for depression. The authors examined the association between temperamental emotionality in young children and parental mood disorders. One hundred unselected preschool-aged children completed a battery of emotion-eliciting tasks tapping aspects of PE, negative emotionality (NE), and behavioral inhibition (BI). Parental psychopathology was assessed with semistructured diagnostic interviews. Low PE in children was associated with maternal, but not paternal, mood disorder. The low PE-maternal depression link was relatively specific, as there were few associations between low PE and other forms of parental psychopathology or between NE and BI and parental mood disorders.
TL;DR: Evidence for disorder-specific increased distraction by threat was found in all tasks, whereas speeded threat detection did not occur in the target search task, particularly in relation to the concept of disengagement from threat.
Abstract: Anxiety patients exhibit attentional biases toward threat, which have often been demonstrated as increased distractibility by threatening stimuli. In contrast, speeded detection of threat has rarely been shown. Therefore, the authors studied both phenomena in 3 versions of a visual search task while eye movements were recorded continuously. Spider-fearful individuals and nonanxious control participants participated in a target search task, an odd-one-out search task, and a category search task. Evidence for disorder-specific increased distraction by threat was found in all tasks, whereas speeded threat detection did not occur in the target search task. The implications of these findings for cognitive theories of anxiety are discussed, particularly in relation to the concept of disengagement from threat.
TL;DR: Results showed that socially anxious participants exhibited an attentional bias toward cues of internal, but not external, sources of potential threat.
Abstract: D. M. Clark and A. Wells (1995) proposed that a shift of attention inward toward interoceptive information is a central feature of social phobia. However, few studies have examined attentional biases toward internal physiological cues in social phobia. The current experiment assessed whether socially anxious individuals exhibit an attentional bias (a) toward cues for an internal source of potential threat (heart-rate information), (b) toward cues for an external source of potential threat (threatening faces) or (c) both. Ninety-one participants who were selected to form extreme groups based on a social anxiety screening measure performed a dot-probe task to assess location of attention. Results showed that socially anxious participants exhibited an attentional bias toward cues of internal, but not external, sources of potential threat.