Behav Res Ther 2017 Sep 11;99:47-56. Epub 2017 Sep 11.
Centre for the Advancement of Research on Emotion, School of Psychology, University of Western Australia, Australia; School Psychology and Speech Pathology, Curtin University, Australia.
Procedures that effectively modify attentional bias to negative information have been examined for their potential to be a source of therapeutic change in emotional vulnerability. However, the degree to which these procedures modify attentional bias is subject to individual differences. This generates the need to understand the mechanisms that influence attentional bias change across individuals. Read More
Department of Psychology, Stockholm University, Sweden. Electronic address:
Atkins et al. strongly criticize my (Öst, 2014) systematic review and meta-analysis of ACT. The bulk of their re-examination of my article is divided into four parts: a) Selection of studies, b) Ratings of methodological quality, c) Meta-analysis, and d) Judgments of quality of evidence. Read More
Objective: Mindfulness is being promoted in schools as a prevention program despite a current small evidence base. The aim of this research was to conduct a rigorous evaluation of the .b ("Dot be") mindfulness curriculum, with or without parental involvement, compared to a control condition. Read More
The cognitive theory of social anxiety disorder (SAD) is one of the most widely accepted accounts of the maintenance of the disorder in adults, yet it remains unknown if, or to what extent, the same cognitive and behavioral maintenance mechanisms that occur in adult SAD also apply to SAD among pre-adolescent children. In contrast to the adult literature, current models of SAD in children mostly account for etiology and maintenance processes are given limited attention. Consequently, their clinical utility for the treatment of SAD in children may be limited. Read More
Cognitive-behavioral therapy (CBT) is considered first-line treatment for childhood obsessive-compulsive disorder (OCD). Despite CBT's efficacy, too many children and adolescents do not fully respond to treatment, making the identification of predictors of treatment response highly relevant. Executive functions (EF) have been suggested to constitute such predictors, but studies with pediatric samples are scarce. Read More
We investigated the relationship between consumer, clinician, and organizational factors and clinician use of therapy strategies within a system-wide effort to increase the use of cognitive-behavioral therapy. Data from 247 clinicians in 28 child-serving organizations were collected. Clinicians participating in evidence-based practice training initiatives were more likely to report using cognitive-behavioral therapy when they endorsed more clinical experience, being salaried clinicians, and more openness to evidence-based practice. Read More
Behav Res Ther 2017 Oct 23;97:252-258. Epub 2017 Aug 23.
Child Youth and Family Service, Center for Addiction and Mental Health, 80 Workman Way, M6J 1H4 Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Canada. Electronic address:
Parent Training (PT) is not as effective for parents with histories of internalizing symptoms as it is for other parents. This study aimed to determine which dimensions of parenting, notably parenting efficacy, positive parenting, inconsistent discipline, and poor supervision, mediate the association between parent lifetime internalizing symptoms and post-PT child emotional and behavioral difficulties. One hundred fourteen parents (82% biological mothers) of children aged 9-12 years received PT at an urban children's mental health clinic. Read More
Anxiety disorders are highly prevalent in children with asthma yet very little is known about the parenting factors that may underlie this relationship. The aim of the current study was to examine observed parenting behaviours - involvement and negativity - associated with asthma and anxiety in children using the tangram task and the Five Minute Speech Sample (FMSS). Eighty-nine parent-child dyads were included across four groups of children (8-13 years old): asthma and anxiety, anxiety only, asthma only and healthy controls. Read More
Insomnia identity refers to the conviction that one has insomnia, and this sleep complaint can be measured independently of sleep. Conventional wisdom predicts that sleep complaints are synchronous with poor sleep, but crossing the presence or absence of poor sleep with the presence or absence of insomnia identity reveals incongruity with expected patterns. This review of existing research on insomnia identity processes and influence finds that about one-fourth of the population are uncoupled sleepers, meaning there is an uncoupling of sleep and sleep appraisal, and daytime impairment accrues more strongly to those who endorse an insomnia identity. Read More
Recent research supports the efficacy of Strength at Home-Men's Program (SAH-M), a trauma-informed group intervention designed to reduce use of intimate partner violence (IPV) in veterans (Taft, Macdonald, Creech, Monson, & Murphy, 2016). However, change-processes facilitating the effectiveness of SAH-M have yet to be specified. Alexithymia, a deficit in the cognitive processing of emotional experience characterized by difficulty identifying and distinguishing between feelings, difficulty describing feelings, and use of an externally oriented thinking style, has been shown to predict PTSD severity and impulsive aggression; however, no studies have investigated the relationship between alexithymia and IPV. Read More
Network analysis has recently been introduced as a clinically relevant methodology for understanding the structure of mental disorders and for evaluating cognitive behavioral models of psychopathology. The current study uses network analysis to validate the transdiagnostic model of eating disorders by examining the association between overvaluation of shape and weight and eating disorder symptoms. Eating disorder symptoms were measured among a sample of 194 treatment-seeking children, adolescents, and adults presenting to an outpatient eating disorder clinic. Read More
Functional abdominal pain (FAP) is a common childhood somatic complaint that contributes to impairment in daily functioning (e.g., school absences) and increases risk for chronic pain and psychiatric illness. Read More
The current study examined whether and which specific contents of patients' memory for cognitive therapy (CT) were associated with treatment adherence and outcome. Data were drawn from a pilot RCT of forty-eight depressed adults, who received either CT plus Memory Support Intervention (CT + Memory Support) or CT-as-usual. Patients' memory for treatment was measured using the Patient Recall Task and responses were coded into cognitive behavioral therapy (CBT) codes, such as CBT Model and Cognitive Restructuring, and non-CBT codes, such as individual coping strategies and no code. Read More
Behavioral theories posit that depression is characterized by heightened levels of avoidance, and recent research has supported this notion. Whether avoidance persists after remission from depression is unknown, however. In this study, we investigated levels of cognitive and behavioral avoidance in remitted, currently, and never depressed individuals. Read More
Objective: To investigate whether the change in dysfunctional posttraumatic cognitions (PTC) during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a mediator of posttraumatic stress symptom (PTSS) reduction in a sample of children and adolescents.
Method: A bootstrap mediation analysis was performed to investigate the indirect effect of dysfunctional PTC on treatment outcome in a recently completed RCT study with children and adolescents (n = 123; 7-17 years old) that investigated the effectiveness of TF-CBT.
Results: The mediation model revealed that changes in dysfunctional PTC mediated the relationship between the group (TF-CBT vs. Read More
Anhedonia-defined as loss of interest or pleasure-is one of two core symptoms of major depressive disorder (MDD). Anhedonia may involve decreased enjoyment of potentially rewarding activities and decreased motivation to engage in such activities. Increased engagement with reinforcers-activities with the potential to be positive experiences-is a frequent target of cognitive-behavioral therapies. Read More
Behav Res Ther 2017 Oct 4;97:163-169. Epub 2017 Aug 4.
New York University School of Medicine, United States.
Previous studies have suggested that children with Attention-Deficit/Hyperactivity Disorder (ADHD) may benefit less from behavioral parent training (BPT) if their parents have high levels of ADHD symptoms. We conducted a secondary analysis of data from a randomized controlled trial to test the hypothesis that parental ADHD symptoms reduce the efficacy of two BPT programs in a sample of preschoolers with ADHD. One intervention was specifically designed for children with ADHD (NFPP: New Forest Parenting Programme) and one was designed for children with Oppositional Defiant Disorder (ODD) (HNC: Helping the Noncompliant Child). Read More
Background: Internet interventions are effective in treating depressive symptoms but few studies conducted a long-term follow-up. The aim of this study was to test the effectiveness of an internet intervention in increasing the remission rate over a twelve months period.
Methods: A total of 1013 participants with mild to moderate depressive symptoms were randomized to either care as usual alone or a 12-week internet intervention (Deprexis) plus usual care. Read More
Recent research has highlighted the etiological role of sleep disturbance in posttraumatic stress disorder (PTSD); however it is currently unknown how daily changes in sleep are associated with next-day PTSD symptoms. Furthermore, sleep is critical for maintaining appropriate affect, leading some to hypothesize that affective dysfunction may account for the link between sleep disturbances and PTSD symptoms. Thus, the current study tested the relationship between sleep disturbances, affective valence, and PTSD symptoms utilizing an ecological momentary assessment (EMA) design among individuals with PTSD (n=30) who participated in 4 EMA-based assessments daily over 8 days. Read More
Anxiety disorders are among the most common disorders affecting youths in the general population, with up to 10% of children and 20% of adolescents meeting criteria for an anxiety disorder at any one point in time. Cognitive-behavior therapies (CBT), varying between 9 and 18 weeks of treatment, are considered evidence-based for the treatment of anxiety disorders in youth. During the last two decades treatments that are brief, intensive, or concentrated (BIC) have been developed and this meta-analysis includes 23 RCTs of these new approaches across the anxiety disorders. Read More
Depression often is characterized by inflexible autonomic and metacognitive processes that interfere with effective self-regulation. However, few studies have integrated these factors to improve the prediction of which individuals are at greatest risk for depression. Among 134 undergraduates, we evaluated whether parasympathetic inflexibility (a lack of reduction in respiratory sinus arrhythmia) in response to a sadness induction involving loss would prospectively predict symptoms of depression across four waves of follow-up over twelve weeks. Read More
Background: Auditory Hallucinations may arise from people confusing their own inner speech with external spoken speech. People with visual hallucinations (VH) may similarly confuse vivid mental imagery with external events. This paper reports two experiments exploring confusion between internal and external visual material. Read More
The neural mechanism underlying attentional bias in OCD (Obsessive-Compulsive Disorder) remains unclear. The goal of this study was to examine and compare the time course and the event related potential (ERP) components in OCD patients and healthy controls (HC) to reveal the complex brain activation pattern associated with attentional bias in OCD. The behavioural and electroencephalogram (EEG) data were recorded while the participants performed an emotional Stroop task. Read More
Behav Res Ther 2017 Oct 19;97:105-114. Epub 2017 Jul 19.
Department of Psychology, Université de Montréal, 90 Avenue Vincent-D'Indy, Montreal, QC H2V 2S9, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada; Centre de recherche en neuropsychologie et cognition (CERNEC), Montréal, Canada. Electronic address:
This study tested the hypotheses that borderline personality (BP) features are characterized by a negativity bias and instability in spontaneous and deliberate evaluations of others. Undergraduate women (N = 204) watched two movie clips depicting either positive or negative conjugal interactions. Spontaneous and deliberate evaluations of the male character were assessed after each clip with an Evaluative Priming Task and a self-report measure, respectively. Read More
Behav Res Ther 2017 Oct 16;97:86-95. Epub 2017 Jul 16.
Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, United States. Electronic address:
Rumination is a well-established vulnerability factor for depression that may exert deleterious effects both independently and in interaction with stress. The current study examined momentary ruminative self-focus (MRS) and stress-reactive rumination (SRR) as predictors of depressive symptoms utilizing a smartphone ecological momentary assessment (EMA) design. 121 undergraduates responded to four text message alerts per day for one week in which they indicated the occurrence of life stress, rumination, and depressed mood. Read More
Behav Res Ther 2017 Oct 8;97:75-85. Epub 2017 Jul 8.
Department of Experimental Psychology, University of Oxford, UK; National Institute for Health Research (NIHR), Oxford Health Biomedical Research Centre, Oxford, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London Maudsley NHS Foundation Trust, King's College London, UK. Electronic address:
The effectiveness and mechanisms of psychotherapies for posttraumatic stress disorder (PTSD) in treating sleep problems is of interest. This study compared the effects of a trauma-focused and a non-trauma-focused psychotherapy on sleep, to investigate whether 1) sleep improves with psychotherapy for PTSD; 2) the degree of sleep improvement depends on whether the intervention is trauma or nontrauma-focused; 3) the memory-updating procedure in cognitive therapy for PTSD (CT-PTSD) is associated with sleep improvements; 4) initial sleep duration affects PTSD treatment outcome; and 5) which symptom changes are associated with sleep duration improvements. Self-reported sleep was assessed during a randomized controlled trial (Ehlers et al. Read More
Extinction memories are fragile and their formation has been proposed to partially rely on vagus nerve activity. We tested whether stimulating the auricular branch of the vagus (transcutaneous VNS; tVNS) accelerates extinction and reduces spontaneous recovery of fear. Forty-two healthy students participated in a 3-day fear conditioning study, where we tested fear acquisition (day 1), fear extinction (day 2) and the retention of the extinction memory (day 3). Read More
Behav Res Ther 2017 Oct 8;97:52-63. Epub 2017 Jul 8.
Centre for Youth Substance Abuse Research, The University of Queensland, K Floor, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia; Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, K Floor, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia.
Impulsivity is a core characteristic of externalizing problems and a robust predictor of alcohol use in adolescence. There is little evidence on the causal mechanisms through which impulsivity influences drinking or how they are affected by key social factors (peer influence). This study reports the development of the first comprehensive laboratory model of adolescent impulsivity and alcohol use. Read More
Borderline personality disorder (BPD) is a severe mental condition characterized by a range of cognitive and behavioral vulnerabilities, including chronic shame and deficits in social problem solving (SPS) abilities. Little research however, has examined strategies that may alleviate shame and SPS deficits among individuals with BPD traits. Using a laboratory experimental approach, the present study compared the effects of a brief mindfulness versus loving-kindness meditation (LKM) induction on shame and SPS abilities in a sample of adults with high BPD traits. Read More
Behav Res Ther 2017 Oct 28;97:33-42. Epub 2017 Jun 28.
Klinik am Waldschlosschen, Germany.
Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions would predict relatively better response to rescripting as compared to exposure, (b) rescripting would be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions would predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Read More
Repetitive negative thinking and perfectionism have both been proposed as processes that are related to depressive symptoms. The purpose of this study was to investigate concurrent and prospective relationships between antenatal and postnatal depression, perfectionism, and repetitive negative thinking. A longitudinal design was used and 71 women were followed from their third trimester of pregnancy to six weeks post birth. Read More
Nightmares can be effectively treated with cognitive-behavioral therapies. Though it remains elusive which therapeutic elements are responsible for the beneficial effects on nightmare symptoms, imagery rescripting (IR) and imaginal exposure (IE) are commonly identified as active treatment components of nightmare therapies. With this randomized controlled trial, we compared IR and IE as individual treatments to a wait-list (WL) condition to determine whether these particular therapeutic elements ameliorate nightmare symptoms. Read More
Cognitive-Behavioral Group Therapy (CBGT) and Mindfulness-Based Stress Reduction (MBSR) are efficacious in treating social anxiety disorder (SAD). It is not yet clear, however, whether they share similar trajectories of change and underlying mechanisms in the context of SAD. This randomized controlled study of 108 unmedicated adults with generalized SAD investigated the impact of CBGT vs. Read More
Behav Res Ther 2017 Oct 29;97:259-272. Epub 2017 May 29.
Department of Psychology, University of Nevada, Reno, NV 89557-0062, USA.
Öst's (2014) systematic review and meta-analysis of Acceptance and Commitment Therapy (ACT) has received wide attention. On the basis of his review, Öst argued that ACT research was not increasing in its quality and that, in contradiction to the views of Division 12 of the American Psychological Association (APA), ACT is "not yet well-established for any disorder" (2014, p. 105). Read More
Dysfunction in romantic relationships constitutes one of the most burdensome symptoms of borderline personality disorder (BPD). The aim of this study was to ascertain how emotional dysregulation affects behavior and relationship related feelings of women with BPD in threatening conversations with their own romantic partner. Thirty couples in which the women were diagnosed with BPD and 34 healthy control (HC) couples were videotaped while discussing personally threatening (i. Read More
Recent evidence suggests that reduced generosity among individuals with social anxiety disorder (SAD) in behavioral economic tasks may result from constraint in changing behavior according to interpersonal contingencies. That is, people with SAD may be slower to be more generous when the situation warrants. Conversely, more global effects on generosity may be related to interpersonal vindictiveness, a dimension only somewhat related to SAD. Read More
Little is known about the efficacy of parent-only interventions and the maintenance of gains over time with anxiety-disordered children and adolescents. The current study aimed to evaluate the efficacy of a 6-session parent-focused intervention (Fear-less Triple P) in reducing children's anxiety symptomatology. The parents of 61 anxiety-disordered children (7-14 years) were randomly assigned to either the 6-session parent-only group CBT intervention or a wait-list control (WL) group. Read More
Objective: We tested whether mindfulness de-couples the expected anxiogenic effects of distress intolerance on psychological and physiological reactivity to and recovery from an anxiogenic stressor among participants experimentally sensitized to experience distress.
Method: N = 104 daily smokers underwent 18-hours of biochemically-verified smoking deprivation. Participants were then randomized to a 7-min analogue mindfulness intervention (present moment attention and awareness training; PMAA) or a cope-as-usual control condition; and subsequently exposed to a 2. Read More
An internet guided self-help cognitive-behavioural treatment (ICBT) for perfectionism was recently found to be effective (see this issue). Such studies stand in need of replication. The aim of this study was to report the outcomes and predictors of change when the treatment is delivered in a UK setting. Read More
Shape of change, sudden gains and depression spikes were examined in an online 12-session Behavioral Activation (BA) treatment for depression. Client and therapist factors related to sudden gains were examined to investigate processes associated with outcome.
Methods: Participants were postpartum Women with Major Depressive Disorder (n=42) who received online BA supported in 30-minute telephone sessions by a mental health worker. Read More
Objective: This study examined the effectiveness of manualized cognitive therapy (mCT) following the Clark-Wells approach versus non-manualized cognitive-behavioral treatment-as-usual (CBTAU) for social anxiety disorder (SAD) in routine practice.
Methods: Forty-eight private practitioners were recruited within a multi-center trial and either received training in manualized CT for SAD or no such training. Practitioners treated 162 patients with SAD in routine practice (N = 107 completers, n = 57 for mCT, n = 50 for CBTAU). Read More
Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. Read More
This paper reviews and offers tutorials on robust statistical methods relevant to clinical and experimental psychopathology researchers. We review the assumptions of one of the most commonly applied models in this journal (the general linear model, GLM) and the effects of violating them. We then present evidence that psychological data are more likely than not to violate these assumptions. Read More
Behav Res Ther 2017 Aug 17;95:71-78. Epub 2017 May 17.
Centre for the Advancement of Research on Emotion, School of Psychology, University of Western Australia, Australia; School of Psychology and Speech Pathology, Curtin University, Australia. Electronic address:
Cognitive models of insomnia consistently suggest that negative expectations regarding the consequences of poor sleep contribute to the maintenance of insomnia. To date, however, no research has sought to determine whether insomnia is indeed characterised by such a negative sleep-related expectancy bias, using objective cognitive assessment tasks which are more immune to response biases than questionnaire assessments. Therefore, the current study employed a reaction-time task assessing biased expectations among a group with clinically significant insomnia symptoms (n = 30) and a low insomnia symptoms group (n = 40). Read More
Behav Res Ther 2017 Jul 8;94:81-92. Epub 2017 May 8.
Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
The present study explored the temporal relationships between change in five candidate causal mechanisms and change in depressive symptoms in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression. Furthermore, hypotheses concerning the mediation of change in these treatments were tested. Patients were 151 depressed adult outpatients treated with either CT (n = 76) or IPT (n = 75). Read More
The facial dot-probe task is one of the most common experimental paradigms used to assess attentional bias toward emotional information. In recent years, however, the psychometric properties of this paradigm have been questioned. In the present study, attentional bias to emotional face stimuli was measured with dynamic and static images of realistic human faces in 97 college students (63 women) who underwent either a positive or a negative mood-induction prior to the experiment. Read More
Intolerance of uncertainty (IU) is an important transdiagnostic variable within various anxiety and mood disorders. Theory suggests that individuals high in IU interpret ambiguous information in a more threatening manner. A parallel line of research has shown that interpretive biases can be modified through cognitive training and previous research aimed at modifying negative interpretations through Cognitive Bias Modification (CBM-I) has yielded promising results. Read More
Two behavioural strategies for reducing learned fear are extinction and counter-conditioning, and in this study we compared the relative effectiveness of the two procedures at diminishing fear in children. Seventy-three children aged 7-12 years old (M = 9.30, SD = 1. Read More