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Perceived burdensomeness and thwarted belongingness are considered interpersonal risk factors for suicide. Examining these themes in personal text messages may help identify proximal suicide risk. Twenty-six suicide attempt survivors provided personal text messages and reported dates for past periods characterized by positive mood, depressed mood, suicidal ideation (with no attempt), or the two-week period leading up to suicide attempt(s). Texts were then classified into the applicable period based on matching dates. Texts (N = 194,083; including n = 86,705 outgoing texts) were coded for perceived burdensomeness and thwarted belongingness by masked trained raters. Multilevel models were fit to examine whether the target themes (combined into one overall interpersonal risk variable due to low base rate) were more prevalent in texts sent during higher risk episodes (e.g., suicide attempt vs. depressed mood episodes). 0.57% of outgoing texts contained either target theme. As hypothesized, logistic models showed participants were more likely to send texts containing the target themes during suicide attempt episodes relative to suicidal ideation (with no attempt) episodes, depressed mood episodes, and positive mood episodes, and during suicidal ideation (with no attempt) episodes relative to positive mood episodes. All contrasts were robust to post-hoc correction except for suicide attempt episodes vs. ideation (with no attempt) episodes. No other significant pairwise differences for episode type emerged. Despite the small sample size and low base rate of target themes in the texts, perceived burdensomeness and thwarted belongingness were associated with intra-individual suicide risk severity in personal text messages. [ABSTRACT FROM AUTHOR]

Background: Drinking identity (the extent to which one links the self with drinking alcohol) is a unique risk factor for college students' hazardous drinking that is not directly targeted by existing interventions. We conducted a study that aimed to decrease drinking identity among college students with hazardous drinking. We adapted a writing task about the future self and tested whether three writing sessions could decrease drinking identity and change drinking. We also investigated whether two additional factors (writing perspective and inclusion of participants' social networks) would enhance task impact. The present study evaluated whether posited proximal cognitive and motivational outcomes (drinking identity, self‐efficacy, readiness to change, and drinking intentions) changed immediately after each writing session. Method: The study is a randomized clinical trial in which hypotheses and analyses were pre‐registered. Participants were 328 college students who met hazardous drinking criteria. The study had a 2 (narrative writing topic: low‐risk drinker vs. reduced smartphone use) × 2 (writing perspective: first‐person vs. non‐first‐person) × 2 (social network instruction: instructed to include vs. not) factorial design. Proximal outcomes were drinking identity, self‐efficacy, readiness to change, and drinking intentions. The clinical outcome was alcohol consumption. Participants completed three laboratory sessions at weekly intervals that included the writing task and pre‐ and post‐task assessments. Results: Results were largely null, except that readiness to reduce drinking was higher in the low‐risk drinker condition and increased over the lab sessions. Time effects indicated that reductions in drinking identity, drinking intentions, and alcohol consumption, and increases in self‐efficacy were observed but did not change above and beyond control conditions. Conclusions: Findings indicate the need to strengthen the writing task and select a more appropriate control task to target proposed proximal outcomes. Future studies might try personalizing the task, evaluating its efficacy with individuals motivated to change their drinking, and using a control task that does not involve imagining a future self. [ABSTRACT FROM AUTHOR]

Interpreting ambiguous situations in a rigidly negative manner contributes to emotional disorders. Although negative interpretation biases have been well studied in relation to anxiety and depression, the relationship between interpretation flexibility (vs. rigidity) and emotional health remains understudied. The present study is a secondary analysis to test the hypothesis that higher interpretation flexibility is associated with better emotional health, as indicated by lower anxiety and depression levels, and higher quality of life. Here, interpretation flexibility focuses specifically on the ability to recognize multiple possible interpretations within and across ambiguous situations. Using baseline data from N = 939 high trait-anxious community participants who enrolled in an online anxiety intervention, multiple ways of computing interpretation flexibility were applied to help the field learn how different operationalizations can lead to varied conclusions about the connection between interpretation flexibility and emotional health. Using two measures of interpretation style, four approaches (some pre-registered, some exploratory) to computing interpretation flexibility were tested using an internal replication analytic approach. Results varied across type of approach, but in general, contrary to hypotheses, results indicated that higher interpretation flexibility was either unrelated to, or associated with higher, anxiety, and depression, and lower quality of life. [ABSTRACT FROM AUTHOR]

The ability to respond flexibly in situations is critical to individual well-being and couples' functioning in romantic relationships. The Flexibility in Partner Perspectives Scale (FiPPS) was developed and validated so that two key aspects of relational flexibility—specifically the ability to generate alternative perspectives and respond non-defensively when alternative perspectives are raised within challenging partner situations—can be studied and targeted in interventions for distressed couples. We introduce the FiPPS as an 8-item self-report questionnaire composed of two 4-item subscales that measure these aspects, respectively. In Study 1, individuals (N = 208) in committed relationships were recruited online to answer questionnaires relating to relational flexibility and various aspects of the couple's and individual's functioning. We used parallel analysis and exploratory factor analysis to examine the psychometric properties of the 25 items developed for the FiPPS and to reduce the number of items retained in the final measure. The FiPPS was then validated in Study 2 using confirmatory factor analysis with a separate online sample of individuals (N = 430) in committed relationships. A subset of Study 2's sample (N = 196) was used to establish test–retest reliability. Studies 3 and 4 demonstrated FiPPS' predictive validity by showing in two additional samples (N = 260 treatment-seeking couples, N = 85 Hispanic/Latinx couples) that individuals who scored higher on the FIPPS scale also reported greater relationship satisfaction. Taken together, the FiPPS appears to be a brief and useful measure that predicts relationship satisfaction above and beyond general cognitive flexibility and perspective taking. [ABSTRACT FROM AUTHOR]

We investigated the role of implicit and explicit associations between harm and COVID‐19 vaccines using a large sample (N = 4668) of online volunteers. The participants completed a brief implicit association test and explicit measures to evaluate the extent to which they associated COVID‐19 vaccines with concepts of harmfulness or helpfulness. We examined the relationship between these harmfulness/helpfulness COVID‐19 vaccine associations and vaccination status, intentions, beliefs, and behavior. We found that stronger implicit and explicit associations that COVID‐19 vaccines are helpful relate to vaccination status and beliefs about the COVID‐19 vaccine. That is, stronger pro‐helpful COVID‐19 vaccine associations, both implicitly and explicitly, related to greater intentions to be vaccinated, more positive beliefs about the vaccine, and greater vaccine uptake. [ABSTRACT FROM AUTHOR]

Given the sensitive nature of COVID-19 beliefs, evaluating them explicitly and implicitly may provide a fuller picture of how these beliefs vary based on identities and how they relate to mental health. Three novel brief implicit association tests (BIATs) were created and evaluated: two that measured COVID-19-as-dangerous (vs. safe) and one that measured COVID-19 precautions-as-necessary (vs. unnecessary). Implicit and explicit COVID-19 associations were examined based on individuals' demographic characteristics. Implicit associations were hypothesized to uniquely contribute to individuals' self-reports of mental health. Participants (N = 13,413 US residents; April-November 2020) were volunteers for a COVID-19 study. Participants completed one BIAT and self-report measures. This was a preregistered study with a planned internal replication. Results revealed older age was weakly associated with stronger implicit and explicit associations of COVID-as-dangerous and precautions-as-necessary. Black and Asian individuals reported greater necessity of taking precautions than White individuals (with small-to-medium effects); greater education was associated with greater explicit reports of COVID-19-as-dangerous and precautions-as-necessary with small effects. Replicated relationships between COVID-as-dangerous explicit associations and mental health had very small effects. Implicit associations did not predict mental health but there was evidence that stronger COVID-19-as-dangerous explicit associations are weakly associated with worse mental health. [ABSTRACT FROM AUTHOR]

We present a novel method for quantifying transitions within multivariate binary time series data, using a sliding series of transition matrices, to derive metrics of stability and spread. We define stability as the trace of a transition matrix divided by the sum of all observed elements within that matrix. We define spread as the number of all non-zero cells in a transition matrix divided by the number of all possible cells in that matrix. We developed this method to allow investigation into high-dimensional, sparse data matrices for which existing binary time series methods are not designed. Results from 1728 simulations varying six parameters suggest that unique information is captured by both metrics, and that stability and spread values have a moderate inverse association. Further, simulations suggest that this method can be reliably applied to time series with as few as nine observations per person, where at least five consecutive observations construct each overlapping transition matrix, and at least four time series variables compose each transition matrix. A pre-registered application of this method using 4 weeks of ecological momentary assessment data (N = 110) showed that stability and spread in the use of 20 emotion regulation strategies predict next timepoint affect after accounting for affect and anxiety's auto-regressive and cross-lagged effects. Stability, but not spread, also predicted next timepoint anxiety. This method shows promise for meaningfully quantifying two unique aspects of switching behavior in multivariate binary time series data. [ABSTRACT FROM AUTHOR]

Although the vast majority of people with mental illness (PWMI) are not violent, Americans tend to think they are more dangerous than the general population. Because negative media portrayals may contribute to stigma, we used time-series analyses to examine changes in the public's perceived dangerousness of PWMI around six mass shootings whose perpetrators were reported to have a mental illness. From 2011 to 2019, 38,094 U.S. participants completed an online study assessing implicit and explicit perceived dangerousness of PWMI. There were large, upward spikes in perceived dangerousness the week of the Sandy Hook mass shooting that were relatively short-lived. However, there was not a consistent pattern of effects for other events analyzed, and any other spikes observed were smaller. Effects tended to be larger for explicit versus implicit perceived dangerousness. Sandy Hook seemed to temporarily worsen perceived dangerousness of PWMI, but this pattern was not observed for other mass shootings. [ABSTRACT FROM AUTHOR]

Objectives: This study developed and pilot‐tested an adaptation of Cognitive Bias Modification (CBM) to target two aspects of relational flexibility in couples: the ability to generate alternative perspectives, and the ability to respond nondefensively when alternative partner perspectives are raised within challenging relationship situations (referred to as flexibility in partner perspectives). Methods: CBM‐FlexC training materials were developed in Phase 1, and expert users (N = 4) and end‐point users (N = 7) provided qualitative feedback. Feasibility and preliminary efficacy of CBM‐FlexC were evaluated in Phase 2, using an online sample of distressed couples (N = 18). Using a multiple baseline design, participants completed three baseline assessments, six CBM‐FlexC sessions over 2 weeks, and a 1‐month follow‐up. Results: CBM‐FlexC training resulted in greater flexibility in partner perspectives, relationship satisfaction, and general psychological flexibility compared to baseline, and improvements were maintained 1‐month after training when using mixed‐effects models. However, analyses of reliable change (based on graphical inspection and the Reliable Change Index) indicated that most participants did not experience reliable improvement in flexibility in partner perspectives, or relationship satisfaction. Conclusion: This pilot study provides some positive signals regarding the potential efficacy of CBM‐FlexC, while pointing to the need for further development to strengthen its effects. [ABSTRACT FROM AUTHOR]

Objective: Identifying digital markers of sleep disturbance—a known suicide risk factor—may aid in the detection of imminent suicide risk. This study examined sleep‐related communication and texting patterns in personal text messages (N = 86,705) of suicide attempt survivors. Method: Twenty‐six participants provided dates of past suicide attempts and 2‐week periods of positive mood, depressed mood, or suicidal ideation. Linguistic Inquiry Word Count was used to identify sleep‐related texts via a custom dictionary. Mixed effect models were fitted to test the association between suicide/mood episode type (e.g., attempt versus ideation) and three outcomes: likelihood of a text including sleep‐related content, nightly count of texts sent from midnight to 5:00 AM, and sum of unique hour bins from midnight to 5:00 AM with outgoing texts. Results: Analyses with a sleep dictionary that was manually revised to be more accurate (but not the original unedited dictionary) showed sleep‐related communication was more likely during depressed mood episodes than positive mood episodes. Otherwise, there were no significant differences in sleep‐related communication or objective texting patterns across episode type. Conclusions: Although we did not detect differences in sleep‐related communication tied to suicidal thoughts or behaviors, sleep‐related communication may differ as a function of within‐person mood level. [ABSTRACT FROM AUTHOR]

Introduction: The current studies examined how smartphone-assessed contextual features (i.e., location, time-of-day, social situation, and affect) contribute to the relative likelihood of emotion regulation strategy endorsement in daily life. Methods: Emotion regulation strategy endorsement and concurrent contextual features were assessed either passively (e.g., via GPS coordinates) or via self-report among unselected (Study 1: N = 112; duration = 2 weeks) and socially anxious (Study 2: N = 106; duration = 5 weeks) young adults. Results: An analysis of 2,891 (Study 1) and 12,289 (Study 2) mobile phone survey responses indicated small differences in rates of emotion regulation strategy endorsement across location (e.g., home vs. work/education settings), time-of-day (e.g., afternoon vs. evening), time-of-week (i.e., weekdays vs. weekends) and social context (e.g., with others vs. alone). However, emotion regulation patterns differed markedly depending on the set of emotion regulation strategies examined, which likely partly explains some inconsistent results across the studies. Also, many observed effects were no longer significant after accounting for state affect in the models. Discussion: Results demonstrate how contextual information collected with relatively low (or no) participant burden can add to our understanding of emotion regulation in daily life, yet it is important to consider state affect alongside other contextual features when drawing conclusions about how people regulate their emotions. [ABSTRACT FROM AUTHOR]

Depersonalization is common in anxiety disorders, but little is known about factors that influence co-occurring anxiety and depersonalization. We investigated trait moderators of the relationships between state and trait anxiety and depersonalization to better understand their co-occurrence and to identify potential points of intervention. Adults recruited on Amazon Mechanical Turk (N = 303) completed two computer tasks designed to increase variability in state anxiety and depersonalization as well as several self-report questionnaires. As hypothesized, anxiety positively predicted depersonalization at both a state level and trait level. Moreover, as hypothesized, the trait anxiety-trait depersonalization relationship was strengthened by greater anxiety sensitivity; distress intolerance; and negative interpretation bias for anxiety sensations, and for depersonalization sensations. None of these hypothesized trait moderators significantly strengthened the state anxiety-state depersonalization relationship. These findings suggest that, on a trait level, anxiety and depersonalization more frequently co-occur when people catastrophically misinterpret their symptoms or have lower emotional distress tolerance. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether variables related to unequal access to mental health resources (including Black and Latinx racial‐ethnic group membership, lower education level, and lower number of community‐level treatment providers, and facilities) were associated with current mental health treatment use; and, whether these variables moderated the likelihood that individuals would receive their preferred effective treatment. Methods: In a preregistered (osf.io/z28wr) study, 5626 individuals completed a mental health history form and measures of implicit and explicit beliefs about the effectiveness of therapy versus medication. Results: Individuals with more (vs. less) education were more likely to report current treatment use. Individuals who were Black/Latinx (vs. non‐Latinx White) or who lived in a community with fewer (vs. more) providers sometimes had a lower probability of accessing preferred effective treatment, though results varied across implicit and explicit measures. Conclusions: Findings highlight the need to increase access to mental health resources among marginalized groups. [ABSTRACT FROM AUTHOR]

Social anxiety disorder is associated with distinct mobility patterns (e.g., increased time spent at home compared to non-anxious individuals), but we know little about if these patterns change following interventions. The ubiquity of GPS-enabled smartphones offers new opportunities to assess the benefits of mental health interventions beyond self-reported data. This pre-registered study () assesses the impact of a brief, online cognitive training intervention for threat interpretations using passively-collected mobile sensing data. Ninety-eight participants scoring high on a measure of trait social anxiety completed five weeks of mobile phone monitoring, with 49 participants randomly assigned to receive the intervention halfway through the monitoring period. The brief intervention was not reliably associated with changes to participant mobility patterns. Despite the lack of significant findings, this paper offers a framework within which to test future intervention effects using GPS data. We present a template for combining clinical theory and empirical GPS findings to derive testable hypotheses, outline data processing steps, and provide human-readable data processing scripts to guide future research. This manuscript illustrates how data processing steps common in engineering can be harnessed to extend our understanding of the impact of mental health interventions in daily life. [ABSTRACT FROM AUTHOR]

Objectives: Poor emotion regulation (ER) has been implicated in many mental illnesses, including social anxiety disorder. To work towards a scalable, low‐cost intervention for improving ER, we developed a novel contextual recommender algorithm for ER strategies. Design: N = 114 socially anxious participants were prompted via a mobile app up to six times daily for five weeks to report their emotional state, use of 19 different ER strategies (or no strategy), physical location, and social context. Information from passive sensors was also collected. Methods: Given the large number of ER strategies, we used two different approaches for variable reduction: (1) grouping ER strategies into categories based on a prior meta‐analysis, and (2) considering only the ten most frequently used strategies. For each approach, an algorithm that recommends strategies based on one's current context was compared with an algorithm that recommends ER strategies randomly, an algorithm that always recommends cognitive reappraisal, and the person's observed ER strategy use. Contextual bandits were used to predict the effectiveness of the strategies recommended by each policy. Results: When strategies were grouped into categories, the contextual algorithm was not the best performing policy. However, when the top ten strategies were considered individually, the contextual algorithm outperformed all other policies. Conclusions: Grouping strategies into categories may obscure differences in their contextual effectiveness. Further, using strategies tailored to context is more effective than using cognitive reappraisal indiscriminately across all contexts. Future directions include deploying the contextual recommender algorithm as part of a just‐in‐time intervention to assess real‐world efficacy. Practitioner points: Emotion regulation strategies vary in their effectiveness across different contexts.An algorithm that recommends emotion regulation strategies based on a person's current context may one day be used as an adjunct to treatment to help dysregulated individuals optimize their in‐the‐moment emotion regulation.Recommending flexible use of emotion regulation strategies across different contexts may be more effective than recommending cognitive reappraisal indiscriminately across all contexts. [ABSTRACT FROM AUTHOR]

Background: Brief computerized programs that train less threatening interpretations (termed Cognitive Bias Modification for Interpretations, or CBM-I) can shift interpretation biases and subsequent anxiety symptoms. However, results have been inconsistent, particularly for studies conducted over the Internet. Methods: The current exploratory study tests 13 variations of a single brief session of CBM-I, a non-CBM-I cognitive flexibility condition, a neutral condition, and a no task control condition in an analogue sample with moderate to severe anxiety. Results: Results suggest that all conditions, except the neutral scenarios condition and the alternative way to improve cognitive flexibility, led to changes in interpretations (when compared to the no task control condition). Only conditions geared toward increasing imagery during CBM-I and targeting flexibility related to emotional material differed from the no task control condition on other post-training measures. Conclusions: Presenting valenced interpretations of ambiguous information during brief CBM-I, regardless of the format, can lead to changes in interpretation bias. However, most conditions did not differ from the no task control condition on other post-training assessments (and differences that did occur may be due to chance). Future trials should consider further testing of CBM-I that targets flexibility related to emotional material, and should include an increased number of sessions and trials. [ABSTRACT FROM AUTHOR]

Background: The extent to which a person believes they can change or control their own emotions is associated with trait-level symptoms of mood and anxiety-related psychopathology. Method: The present study examined how this belief relates to momentary and daily self-reports of affect, emotion regulation tendencies, and perceived effectiveness of emotion regulation attempts throughout a five-week experience sampling study conducted in N = 113 high socially anxious people (https://osf.io/eprwt/). Results: Results suggest that people with relatively stronger beliefs that their emotions are malleable experienced more momentary and daily positive affect (relative to negative affect), even after controlling for social anxiety symptom severity (although only daily positive affect, and not momentary positive affect, remained significant after correcting for false discovery rate). However, emotion malleability beliefs were not uniquely associated with other emotion regulation-related outcomes in daily life, despite theory suggesting malleability beliefs influence motivation to engage in emotion regulation. Conclusion: The paucity of significant associations observed between trait malleability beliefs and momentary and daily self-reports of emotion regulation (despite consistent findings of such relationships at trait levels) calls for additional research to better understand the complex dynamics of emotion beliefs in daily life. [ABSTRACT FROM AUTHOR]

Background: Approach bias modification (ApBM) and interpretation bias modification (IBM) are two promising adjunct treatments for alcohol use and social anxiety, respectively. However, the acceptability of combining ApBM and IBM into one program for people who experience both of these disorders is unknown. The present study describes the codevelopment of a new, hybrid ApBM + IBM program and provides insight into the perceptions of acceptability from service providers and emerging adults. Methods: Service providers (n = 14) and emerging adults aged 18 to 25 years with lived experience of hazardous alcohol use and heightened social anxiety (n = 15) were recruited via online advertisements and through existing networks. All participants were shown a beta version of the program and asked to complete qualitative and quantitative questions to ascertain feedback on the program's acceptability and suggestions for improvement. Results: Themes emerged relating to the ApBM + IBM program's quality and usefulness, appropriateness, motivation and engagement, and potential clinical value. The program was well received and deemed acceptable for the target age group. It was rated particularly highly with regard to the overall quality and ease of use. Emerging adults had fewer suggestions for how the intervention might be revised; however, there were suggestions from both groups regarding the need for a compelling rationale at the outset of treatment and a suggestion to include a motivational interviewing and psychoeducational‐based module prior to the first training session, to increase user buy‐in and engagement. Conclusions: The current findings reflect positively on the acceptability of a hybrid ApBM + IBM for emerging adults with co‐occurring hazardous alcohol use and social anxiety. Service providers and emerging adults identified a number of ways to improve the design and implementation of the program, which will likely improve adherence to, and outcomes of, the intervention when added as an adjunct to treatment as usual. [ABSTRACT FROM AUTHOR]

Introduction: This study explores the associations in the United States between each state's stereotypes about the dangerousness of people with mental illness and important outcomes for people with mental illness. Methods: Implicit association test and questionnaire data from 17,312 online participants were aggregated within states and years. Each state's annual average implicit and explicit stereotypes were used to predict state differences in prevalence, and treatment, unemployment, and homelessness among people with mental illness. Results: Implicit and explicit perceived dangerousness interact such that in states with low explicit perceived dangerousness, implicit perceived dangerousness is positively associated with all outcomes. In states with high explicit perceived dangerousness, implicit perceived dangerousness is negatively associated with homelessness. Discussion: Explicit-implicit discrepancy in macro-level perceived dangerousness is generally associated with worse outcomes for people with mental illness, but the effects are small. Macro-level stereotypes might have larger effects in smaller regions, like counties, than in states. [ABSTRACT FROM AUTHOR]

The Death/Suicide Implicit Association Test (IAT) is effective at detecting and prospectively predicting suicidal thoughts and behaviors. However, traditional IAT scoring procedures used in all prior studies (i.e., D-scores) provide an aggregate score that is inherently relative, obfuscating the separate associations (i.e., "Me = Death/Suicide," "Me = Life") that might be most relevant for understanding suicide-related implicit cognition. Here, we decompose the D-scores and validate a new analytic technique called the Decomposed D-scores ("DD-scores") that creates separate scores for each category ("Me," "Not Me") in the IAT. Across large online volunteer samples (N > 12,000), results consistently showed that a weakened association between "Me = Life" is more strongly predictive of having a history of suicidal attempts than is a stronger association between "Me = Death/Suicide." These findings replicated across three different versions of the IAT and were observed when calculated using both reaction times and error rates. However, among those who previously attempted suicide, a strengthened association between "Me = Death" is more strongly predictive of the recency of a suicide attempt. These results suggest that decomposing traditional IAT D-scores can offer new insights into the mental associations that may underlie clinical phenomena and may help to improve the prediction, and ultimately the prevention, of these clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Reducing one's tendency to interpret ambiguous situations negatively can improve symptoms of social anxiety. This study examines the effectiveness of a 1-week period of online Cognitive Bias Modification for Interpretations (CBM-I) for socially anxious individuals. In addition to measuring intervention effectiveness through traditional trait measures, this study investigates whether associated state measures are sensitive to intervention effects in daily life. Methods: One-hundred and six participants scoring high on a measure of trait social anxiety completed two in-lab sessions separated by 5 weeks of ecological momentary assessment, with 51 participants randomly assigned to receive the online CBM-I intervention halfway through the 5-week monitoring period. Results: CBM-I training was more effective than monitoring alone in reducing trait negative interpretation bias, indicating target engagement. However, this change was not reliably accompanied by changes on other cognitive processing style outcomes. Further, while trait and state social anxiety symptoms and fear of negative evaluation improved, these changes were not unique to the CBM-I intervention group. Conclusion: This study demonstrates the challenges and opportunities associated with investigating intervention effects in daily life. [ABSTRACT FROM AUTHOR]

The tendency for individuals to interpret ambiguous information in a threatening way is theorised to maintain anxiety disorders. Recent findings suggest that positive and negative interpretation biases may have unique effects. This study tested the relationships between threat and benign biases with state and trait anxiety and quality of life, and whether individual differences moderate these relationships. N = 699 individuals with elevated trait anxiety symptoms completed web-based measures of interpretation bias, trait anxiety, state anxiety, and quality of life. Results demonstrated that threat interpretations predicted state anxiety, trait anxiety, and quality of life. Benign interpretations also predicted quality of life. However, benign interpretations only weakly (or not at all) predicted state and trait anxiety. Individual differences (e.g. gender, race, ethnicity, age) did not moderate findings. Results emphasise the need to consider benign and threat biases separately, both in cognitive models of anxiety and experimental designs. [ABSTRACT FROM AUTHOR]

Few studies have examined how trait emotion dysregulation relates to momentary affective experiences and the emotion regulation (ER) strategies people use in daily life. In the current study, 112 college students completed a trait measure of emotion dysregulation and completed experience sampling and end-of-day surveys over a two- to three-week period, asking about their emotional experiences and ER strategy use. Participants completed a total of 3798 experience sampling (in-the-moment) and 995 nightly diary surveys. We examined the top 40% of each participant's reported instances of negative affect (to capture times when emotions more likely need regulation). Results indicated that a higher level of trait emotion dysregulation was associated with the following in-the-moment responses: (a) higher level of negative affect; (b) greater desire to change emotions; (c) more attempts to regulate emotion; (d) higher relative endorsements of avoidant (e.g. thought suppression) versus engagement (e.g. acceptance) ER strategy use; and (e) lower perceived effectiveness of ER. Further, individuals with a higher (vs. lower) level of trait emotion dysregulation were less able to identify emotions over the course of the day. Findings demonstrate how trait emotion dysregulation may predict emotional experiences and ER in daily life. [ABSTRACT FROM AUTHOR]

Background: Despite the growing literature about recovery from eating disorders (EDs), it is still unknown if women who report being recovered from EDs present with differing implicit attitudes about high-fat (vs. low-fat) food relative to women who report having a current ED and women who report never having had an ED. Methods: Female volunteers (N = 2,785) to the Project Implicit Mental Health (PIMH) website (https://implicit.harvard.edu/) were divided into three ED groups: current ED (n = 335), prior ED (n = 393), and healthy controls (n = 1,843). Participants completed, between 2016 and 2017, a background questionnaire, together with the Implicit Association Test (IAT), measuring implicit associations between high-fat (vs. low-fat) food and shame (vs. acceptableness). Linear regression models were conducted to examine cross-sectional differences between groups. Results: Women with prior EDs had stronger implicit associations relative to healthy controls (p = 0.041) and similar implicit associations relative to women with current EDs (p = 0.424). Discussion: The implicit association between high-fat food and shame may not diminish over time among women with EDs. Future longitudinal studies are warranted to clarify whether an experience of EDs may leave a "scar," manifested in specific implicit associations, that may potentially lead to recurrence after remission. [ABSTRACT FROM AUTHOR]

Background: Effective emotion regulation (ER) is important to long-term healthy functioning, but little is known about what constitutes effective ER in the moment or how social anxiety symptoms and different strategies influence short-term effectiveness outcomes.Methods: Intensive ecological momentary data from N = 124 college students illustrate how different ways of operationalizing ER effectiveness leads to different conclusions about the short-term effectiveness of different strategies in daily life.Results: When effectiveness is operationalized as the degree to which participants judged that their ER attempts made them feel better, social anxiety severity was negatively associated with effectiveness, and avoidance-oriented strategies were judged to be less effective than engagement-oriented strategies. In contrast, when effectiveness is operationalized as the degree of change in self-reported affect following ER attempts, social anxiety severity was not related to effectiveness, and avoidance-oriented strategies were more effective than engagement-oriented strategies. Social anxiety and ER strategy type did not interact in either model, regardless of how effectiveness was measured.Conclusions: The study highlights discrepancies when examining two common but distinct ways of measuring the same overarching effectiveness construct, and raises intriguing questions about how forms of psychopathology that are intimately tied to emotion dysregulation, like social anxiety, moderate different ways of measuring the effectiveness of ER attempts. [ABSTRACT FROM AUTHOR]

Socially anxious individuals typically select more avoidant emotion regulation (ER) strategies than non-anxious individuals, contributing to interpersonal difficulties. The present study utilized smartphone-delivered experience sampling over 14 days to assess how actual and desired social situations predicted reports of ER strategy use in 115 undergraduate students with varying levels of social anxiety symptoms. After controlling for multiple comparisons, results indicated that higher (vs. lower) baseline social anxiety symptoms predicted endorsing at least one of the available eight ER strategies relatively more often than reporting no strategy use, in the context of high negative affect. We did not find the hypothesized positive relationship between social anxiety symptoms and endorsements of avoidant- (e.g., expressive suppression) versus engagement-oriented (e.g., cognitive reappraisal) ER strategies in the context of high negative affect. However, state social desire interacted with trait social anxiety at high negative affect to predict the use of an ER strategy, although the simple effects analyses at high and low levels of social desire were not statistically reliable. Collectively, our results demonstrate the importance of considering both trait-level social anxiety symptoms and in-the-moment social context when studying ER strategy selection. The importance of assessing intrinsic motivational goals and beliefs in the context of ER strategy use is also discussed. [ABSTRACT FROM AUTHOR]

Introduction: The current study investigated whether high and low socially-anxious individuals would show differences in affective forecasting accuracy (i.e., the prediction of emotional states in response to future events) to positive versus negative social evaluation. Method: High (n = 94) and low (n = 98) socially-anxious participants gave a speech and were randomly assigned to receive a positive or negative evaluation. Results: For affective forecasts made proximally (moments before the speech), those low in social anxiety overpredicted their affect to a greater extent to a negative evaluation versus a positive evaluation. In contrast, those high in social anxiety overpredicted their affect to positive and negative evaluations comparably, and failed to adjust their prediction for a future hypothetical negative evaluation—in effect, not learning from their prior forecasting error. Discussion: Results suggest that affective forecasting biases deserve further study as a maintaining factor for social anxiety symptoms. [ABSTRACT FROM AUTHOR]

The high levels of problematic drinking in college students make clear the need for improvement in the prediction of problematic drinking. We conducted a laboratory-based experiment that investigated whether implicit measures of alcohol-related associations, self-control, and their interaction predicted drinking. Although a few studies have evaluated self-control as a moderator of the relationship between implicit measures of alcohol-related associations and drinking, this study extended that work by using a previously-validated manipulation that included a more (vs. less) cognitively demanding task and incentive to restrain drinking and by evaluating multiple validated measures of alcohol-related associations. Experimental condition was expected to moderate the relationship between implicit measures of alcohol-related associations and drinking, with a more positive relationship between alcohol-related associations and drinking among participants who completed the more (vs. less) cognitive demanding task. Secondary aims were to evaluate how individual differences in control factors (implicit theories about willpower and working memory capacity) might further moderate those relationships. One hundred and five U.S. undergraduate heavy episodic drinkers completed baseline measures of: drinking patterns, three Implicit Association Tests (evaluating drinking identity, alcohol excite, alcohol approach associations) and their explicit measure counterparts, implicit theories about willpower, and working memory capacity. Participants were randomized to complete a task that was more (vs. less) cognitively demanding and were given an incentive to restrain their drinking. They then completed an alcohol taste test. Results were not consistent with expectations. Despite using a previously validated manipulation, there was no evidence that one condition was more demanding than the other, and none of the predicted interactions reached statistical significance. The findings raise questions about the relation between self-control, implicit measures of alcohol-related associations, and drinking, as well as the conditions under which implicit measures of alcohol-related associations predict alcohol consumption in the laboratory. [ABSTRACT FROM AUTHOR]

Cognitive Bias Modification to reduce threat interpretations (CBM-I) is a computer-based paradigm designed to train a less negative interpretation bias that has shown some success in the lab, but results for web-based CBM-I are often mixed. To test possible explanations for the poorer results online, participants high in social anxiety (N = 379) were recruited from Amazon’s Mechanical Turk to complete a single-session, proof-of-principle study to investigate: (1) whether web-based CBM-I can shift interpretations of social situations to be less negative and reduce anticipatory social anxiety, (2) whether a common “control” condition used in CBM-I studies is in fact inert by incorporating an alternate control condition, and (2) whether priming anxious imagery prior to training moderates CBM-I’s effects. Participants were randomly assigned to one of three training conditions: all positive, half positive/half negative, or neutral unemotional scenarios. Participants also received an anxious or neutral imagery prime before training. Although results were somewhat mixed across outcome measures, findings generally suggested that participants exhibited less negative interpretations of ambiguous social scenarios following positive training with an anxious imagery prime. There was also some evidence that the neutral training condition was associated with less negative interpretations, and evidence that the half positive/half negative training condition led to the least anticipatory anxiety, especially when paired with anxious imagery. Findings are discussed in light of different training effects for near- and far-transfer outcomes. [ABSTRACT FROM AUTHOR]

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.Design: Cross-sectional, quantitative surveys.Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.Results: In Study 1 (N = 447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N = 325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity. [ABSTRACT FROM AUTHOR]

Aims: Implicit measures of alcohol associations (i.e. measures designed to assess associations that are fast/reflexive/impulsive) have received substantial research attention. Alcohol associations related to the self (drinking identity), the effects of alcohol (alcohol excite) and appetitive inclinations (alcohol approach) have been found to predict drinking cross-sectionally and over time. A critical next step in this line of research and the goal of this study is to evaluate whether increases in the strength of these associations predict increases in drinking and vice versa. These hypotheses were tested in a sample of first- and second-year US university students: a sample selected because this time period is associated with initiation and escalation of drinking, peak levels of alcohol consumption and severe alcohol-related negative consequences. Short summary: This study's purpose was to evaluate whether increases in the strength of alcohol associations with the self (drinking identity), excitement (alcohol excite) and approach (alcohol approach) as assessed by implicit measures predicted subsequent increases in drinking risk and vice versa using a longitudinal, university student sample. Results were consistent with hypotheses. Methods: A sample of 506 students' (57% women) alcohol associations and alcohol consumption were assessed every 3 months over a 2-year period. Participants' consumption was converted to risk categories based on NIAAA's criteria: non-drinkers, low-risk drinkers and high-risk drinkers. A series of cross-lagged panel models tested whether changes in alcohol associations predicted subsequent change in drinking risk (and vice versa). Results: Across all three measures of alcohol associations, increases in the strength of alcohol associations were associated with subsequent increases in drinking risk and vice versa. Conclusion: Results from this study indicate bi-directional relationships between increases in alcohol associations (drinking identity, alcohol excite and alcohol approach) and subsequent increases in drinking risk. Intervention and prevention efforts may benefit from targeting these associations. [ABSTRACT FROM AUTHOR]

The present research examined the degree to which facets of trait mindfulness were associated with level and changes in psychological distress in response to a repeated carbon dioxide (CO2) breathing challenge. Undergraduate students (N = 93) completed a self-report measure of mindfulness and underwent two 7.5% CO2 challenges, spaced 1 week apart. Subjective distress, physical/fear symptoms, and threat cognitions were assessed at multiple times throughout each administration. A pattern emerged such that although mindfulness facets were not reliably associated with distress at either administration separately, a low (but not high) level of mindfulness was associated with a significant decrease in distress across administrations, likely indicative of habituation, for the facets Describing (β = − 0.25, p < − 0.01), Acting with Awareness (β = − 0.27, p < .01), and Observing (β = − 0.25, p < 0.01). This suggests that those components of mindfulness tied to noticing/attending to the present moment may at times interfere with typical habituation processes. In contrast, those high in components of mindfulness tied to not evaluating—Non-judging (β = − 0.23, p < 0.01) and Non-reacting (β = − 0.12, p < 0.01)—tended to report less distress, as expected. Findings suggest that the relation between trait mindfulness and stress response is more complex and nuanced than previously thought and that focusing on both mindfulness facets and repeated exposure to stressors may help elucidate this relationship. [ABSTRACT FROM AUTHOR]

Objective: Explicit reports of one's health self-concept (e.g. rate your overall health) are commonly used in research and clinical practice. These measures predict important health outcomes, but rely on conscious introspection so may not fully capture the different components of the health self-concept (e.g. more automatic components) that relate to actual health. This study examined the health-implicit association test (health-IAT), and how it may add to our prediction of health from self-reports. Design: 1004 participants (ages 18–85) completed this web-based study with the health-IAT (assessing self-healthy implicit associations) and explicit assessments of health. Main outcome measures: Self-reported measures of physical functioning. Results: The health-IAT was valid and reliable. Older age was correlated with stronger self-healthy implicit associations. Although the health-IAT did not incrementally predict self-reported markers of physical functioning when only controlling for explicit health self-concept, it was an incremental predictor once age was entered for all four models tested. Conclusions: The health-IAT appears to be a valid and reliable new measure that assesses implicit self-concept relating to physical health. Results reveal the potential value of assessing implicit health self-concept in both research and practice, especially when taking into account age. [ABSTRACT FROM AUTHOR]

Socially anxious individuals exhibit cognitive performance impairments; it is unclear whether this is due to trait differences in abilities or effects of the experimental context. This study sought to determine how social context, individual differences in fear of negative evaluation (FNE), and task difficulty interact to influence working memory performance as indicated by effectiveness (accuracy) and efficiency (reaction times). Participants (N = 61) performed the n-back task at 2-back and 3-back difficulty levels under three conditions: alone ("Anonymous"), in presence of a non-evaluative experimenter ("Presence"), and under explicit performance evaluation by the experimenter ("Threat"). Overall, participants showed improved accuracy during Threat, but only on 2-back trials. FNE was positively associated with longer reaction times during Threat on 3-back trials. FNE did not relate to accuracy, suggesting that threat-related impairments tied to social anxiety may alter efficiency rather than effectiveness. Thus, social anxiety may elicit cognitive performance impairments even in minimally evaluative environments. [ABSTRACT FROM AUTHOR]

This case features an adult male with moderate social anxiety disorder and mild depressive symptoms who showed an initial positive response to an earlier experience of cognitive behavior therapy, but then relapsed when he started avoiding social situations again because of continuing beliefs that experiencing anxiety was unacceptable. His treatment at our clinic focused on shifting unhelpful thinking about the likelihood and consequences of becoming anxious and reengaging in avoided social situations so he could learn to tolerate negative affect and uncertainty. The treatment approach draws from cognitive behavioral models of social anxiety and highlights advances in clinical science, especially recent work on the causal role of interpretation biases (the tendency to assign negative or threatening meaning to ambiguous situations) in the maintenance and reduction of anxiety. [ABSTRACT FROM AUTHOR]

Maladaptive coping with failure can cause considerable distress and impairment. This study tested a novel cognitive strategy that induces participants to process both the value ("why") and means ("how") of reengaging in adaptive goal-pursuit after a failure. Students (N = 263) received bogus failure feedback on an academic test battery, and were randomly assigned to Why-only, How-only, or Combined (How+Why) goal-focused processing, or a "freethinking" Control condition, before completing a second battery. Cognitive performance, rumination, and negative affect during both batteries were assessed. Trait rumination and an aggregate of emotion-related symptoms were examined as moderators. Results in the overall sample were mixed, with Combined and Control participants both showing some benefits from training. Notably, among high-ruminative and high-symptom participants, Combined training yielded the greatest improvement in reading comprehension and rumination, as expected. Results, though mixed, suggest this novel cognitive strategy may hold promise for enhancing failure resilience in emotionally vulnerable samples. [ABSTRACT FROM AUTHOR]

Current treatments for disorders of emotion, such as pathological anxiety, are often less effective in older adults than in younger adults and have poorly understood mechanisms, pointing to the need for psychopathology models that better account for age-related changes in normative emotional functioning and the expression of disordered emotion. This article describes ways in which the healthy aging and emotion literature can enhance understanding and treatment of symptoms of anxiety and depression in later life. We offer recommendations on how to integrate the theories and findings of healthy aging literature with psychopathology research and clinical practice and highlight opportunities for future research. [ABSTRACT FROM AUTHOR]

This study tested an intervention to enhance resilience among people at risk for developing panic disorder. Participants ( N = 50) high in anxiety sensitivity (fear of anxiety symptoms) were randomly assigned to either four sessions of resilience-enhancing interpretation bias modification (CBM-I) or a control (Sham) condition. Following the intervention, participants engaged in a 7.5 % steady state carbon dioxide (CO) breathing challenge, an established panic stressor. In line with hypotheses, CBM-I resulted in an increase in resilience-congruent interpretations (though no change for general panic interpretation bias) at post-training, and a trend for a greater reduction in anxiety sensitivity at 2-month follow-up. Additionally, CBM-I resulted in less intense cognitive symptoms of panic during the CO challenge, though not less intense physical or total panic symptoms. These results, though somewhat mixed, provide preliminary support for the value of training resilience using CBM-I. [ABSTRACT FROM AUTHOR]

Objectives:Memory complaints are present in adults of all ages but are only weakly related to objective memory deficits, raising the question of what their presence may indicate. In older adults, memory complaints are moderately related to negative affect, but there is little research examining this relationship in young and middle-aged adults. This study examined whether memory complaints and negative affect were similarly related across the adult lifespan and in adults with varying levels of objective memory performance. Method:The sample included 3798 healthy adults, aged 18 to 99, and was divided into five groups: young, middle-aged, young-old, old-old, and oldest-old adults. Participants completed questionnaire measures of memory complaints and negative affect (neuroticism and depressive and anxiety symptoms), in addition to lab measures of objective memory. Results:Using structural equation models, we found that the relationship between memory complaints and negative affect was moderate in all the age groups, and there was no evidence for moderation by objective memory. Conclusion:For adults of all ages, perceived memory decline may be distressing and/or negative affect may lead to negative self-evaluations of memory. [ABSTRACT FROM AUTHOR]

Little is known about how to predict which individuals with known temperament vulnerabilities will go on to develop social anxiety problems. Adolescents (N = 185) were followed from age 13 to 18 to evaluate psychosocial, prospective predictors of social anxiety symptoms and fears of negative evaluation (FNE), after accounting for pre-existing social withdrawal symptoms. Results from structural equation modeling suggest that lack of perceived social acceptance predicts subsequent explicit social anxiety and FNE, whereas the emotional intensity of close peer interactions predicts subsequent implicit FNE. Results are discussed in terms of the importance of peer interaction in the development of social anxiety, and the value of measuring both implicit and explicit FNE. [ABSTRACT FROM AUTHOR]

Cognitive Bias Modification for anxious interpretations (CBM-I) is a computerized training program designed to reduce threatening interpretations of ambiguous information. In addition to testing the efficacy of CBM-I for contamination fear on various cognitive outcomes and emotional vulnerability, the current study examined whether the content of CBM-I must match a person's fear domain to be efficacious, and examined the moderating role of preexisting interpretation bias on CBM-I's efficacy. Participants (n = 121) high in contamination fear were assigned to one session of either CBM-I focused on contamination fear content, CBM-I focused on height fear content, or a sham control condition. Planned contrasts indicated that fear domain match does tend to enhance CBM-I's effects: compared to the heights condition, those in the contamination training condition improved on five of the eight cognitive bias-related variables, though there was no change on measures of emotional vulnerability. In contrast, there was little difference between the heights training and sham conditions. Minimal evidence was found for baseline interpretation bias as a moderator. Results support the use of CBM-I that matches the fear domain of the participant, regardless of baseline bias level. [ABSTRACT FROM AUTHOR]

Cognitive paradigms allow clinical psychologists to examine memory processes, such as false memory production, to better understand psychopathology. The current study uses the Deese-Roediger-McDermott task to investigate true and false memories in a sample with social anxiety disorder ( n = 37) compared to a non-anxious control group ( n = 40) before and after a three-day delay following list presentation. Additionally, the study examines anticipation of a social stressor and stimuli content (social versus nonsocial) as moderators of memory effects. Contrary to hypotheses, results for true memories showed no effects involving social anxiety or stressor group. However, nonsocial false memories were reported more frequently when participants with social anxiety disorder were anticipating a speech and when control participants were not (the latter at the level of a trend). Notably, when lists were socially relevant, these group differences in false memory disappeared. Results suggest that individuals with social anxiety disorder may be vulnerable to some unexpected memory distortions when anticipating social stress. [ABSTRACT FROM AUTHOR]

There is preliminary evidence that approach avoid training can shift implicit alcohol associations and improve treatment outcomes. We sought to replicate and extend those findings in US undergraduate social drinkers (Study 1) and at-risk drinkers (Study 2). Three adaptations of the approach avoid task (AAT) were tested. The first adaptation – the approach avoid training – was a replication and targeted implicit alcohol approach associations. The remaining two adaptations – the general identity and personalized identity trainings – targeted implicit drinking identity associations, which are robust predictors of hazardous drinking in US undergraduates. Study 1 included 300 undergraduate social drinkers. They were randomly assigned to real or sham training conditions for one of the three training adaptations, and completed two training sessions, spaced one week apart. Study 2 included 288 undergraduates at risk for alcohol use disorders. The same training procedures were used, but the two training sessions occurred within a single week. Results were not as expected. Across both studies, the approach avoid training yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes. The general identity training also yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes with one exception; individuals who completed real training demonstrated no changes in drinking refusal self-efficacy whereas individuals who completed sham training had reductions in self-efficacy. Finally, across both studies, the personalized identity training yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes. Despite having relatively large samples and using a well-validated training task, study results indicated all three training adaptations were ineffective at this dose in US undergraduates. These findings are important because training studies are costly and labor-intensive. Future research may benefit from focusing on more severe populations, pairing training with other interventions, increasing training dose, and increasing gamification of training tasks. [ABSTRACT FROM AUTHOR]

Understanding the primary triggers of anxiety for African Americans, and the cultural factors associated with these triggers, can enhance our knowledge of emotional responding in African Americans and can ultimately influence how we assess and treat anxiety disorders in this population. In the current study, we investigated the experience of anxiety for African Americans following physical stressors, with an emphasis on cardiovascular arousal. Specifically, anxious responding, following cardiovascular arousal, other physical stressors, and a control task, was evaluated among African American (n = 23) and European American (n = 23) groups on affective, cognitive, and physiological measures of anxiety. Findings suggest physical stressors in general (as opposed to cardiovascular arousal specifically) may be a prominent trigger of anxiety for African Americans. Discussion centers on the idea that the observed relationship between anxiety and physical stressors for African Americans may stem from a cultural sense of vulnerability regarding physical disease. [ABSTRACT FROM AUTHOR]