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ObjectiveAdvances in clinical psychology must be accompanied by advances in training. This study assessed training content, quality, and needs during clinical psychology doctoral programs among current or past doctoral students.MethodsCurrent or past clinical psychology doctoral students (N = 343) completed an anonymous survey assessing training experiences and needs. A descriptive-focused exploratory factor analysis (EFA) also examined whether common subgroups of academic interests emerged.ResultsMost participants reported that they sought training beyond required coursework, primarily in clinical training, cultural competency, and professional development, and reported having taken one or more unhelpful course, including discipline-specific knowledge requirements. Descriptive results from the EFA demonstrated common training areas of interest: diversity topics, biological sciences, clinical practice, and research methods.DiscussionThis study demonstrates that trainees and early career psychologists are aware of their nuanced and in some cases, unmet training needs.ConclusionThis work foregrounds the need to adapt extant training opportunities to support the next generation of clinical psychologists.

ObjectiveThis study examined sleep disorders and sleep medication use rates, nighttime tics, and sleep and chronotype in relation to tic and co-occurring symptoms in adults with persistent tic disorders (PTDs), including Tourette's disorder (TD).MethodsOne hundred twenty-five adult internet survey respondents rated sleep history, sleep, chronotype, tic severity, impairment, attention deficit hyperactivity disorder, obsessive-compulsive symptoms, anxiety, depression, and emotional and behavioral dyscontrol.ResultsBruxism, insomnia, tic-related difficulty falling asleep, and melatonin use were commonly endorsed. Sleep disturbance correlated with impairment, obsessive-compulsive symptoms, and emotional and behavioral dyscontrol. Eveningness correlated with vocal and total tic severity only in TD. Controlling for age and sex, age, impairment, and obsessive-compulsive symptoms predicted sleep disturbance, and age and tic severity predicted chronotype.ConclusionsImpairment and obsessive-compulsive symptoms play a role in sleep disturbance in adults with PTDs, and may be intervention targets. Eveningness relates to tic severity, which may suggest the utility of interventions to advance chronotype.

ObjectivesThis study aims to test the psychometric proprieties of the Reflective Functioning Questionnaire (RFQ) applied to younger (13-16 years) and older (17-20 years) Italian adolescents examining (1) the factorial structure of RFQ; (2) its invariance across age and sex; (3) correlations between RFQ subscale scores, as well as the associations of the RFQ with (4) psychological problems and alexithymia dimensions.MethodsA cross-sectional study was conducted with 593 adolescents between the ages of 13 and 20 years old recruited from the community within Italy. These participants completed the RFQ, Symptom Checklist-90, and Toronto Alexithymia Scale.ResultsThe two-factor structure of the RFQ was confirmed. However, higher internal consistency of RFQ was obtained by removing two items that seemed problematic within this sample. Using a six-item version of RFQ, the two-factor structure was invariant across adolescent age and sex. Significant correlations among RFQ subscale scores, and between RFQ subscales with both psychological problems and alexithymia dimensions were found.ConclusionsPreliminary results reveal a short version of RFQ (six-item) is a suitable measure to assess mentalizing in adolescents in the Italian context.

ObjectiveTo test the acculturation gap hypothesis by examining mother-youth value discrepancies (both acculturative and enculturative) and their association with mother-youth acculturative conflict and youth mental health outcomes.MethodParticipants were 273 Mexican descent college students attending a large, public, Hispanic Serving Institution (HSI) in West Texas (72% women). The participants' ages ranged 18-25 years (M = 19.33 years; SD = 1.54 years).ResultsThree models assessed the relationship between mother-youth value discrepancies and mental health outcomes (suicidal ideation, non-suicidal self-injury, and depressive symptoms) as mediated by mother-youth acculturative conflict. Consistently, Mexican heritage cultural values were related to mental health outcomes while American cultural values were not.ConclusionsThe study found that increased mother-youth discrepancies on Mexican cultural values were associated with increased negative mental health outcomes. Our findings suggest that adopting or learning new mainstream American values does not substitute for the Mexican cultural values that protect against negative outcomes.

OBJECTIVE:Although much empirical attention has been devoted to emotion regulation (ER) in individuals with eating disorders, little is known about ER across a wide age range and among different ED subtypes. The current study sought to examine ER in a sample of eating disorder patients. METHOD:A total of 364 adults and adolescents with anorexia nervosa restricting subtype (AN-R), anorexia nervosa binge/purge subtype (AN-BP), or bulimia nervosa (BN) were assessed with the Difficulties in Emotion Regulation Scale (DERS). RESULTS:Older ages were associated with higher DERS total, nonacceptance, goals, and impulsivity scores. When controlling for age, patients with BN and AN-BP had higher overall DERS scores than those with AN, and there were some differences among diagnostic subtypes on specific facets of ER. CONCLUSIONS:These results indicate that treatments for emotion dysregulation may be applied across eating disorder diagnoses and ages, and inform how these strategies apply to different diagnostic groups.

ObjectiveInnovative approaches to the treatment of war-related posttraumatic stress disorder (PTSD) are needed. We report on secondary psychological outcomes of a randomized controlled trial of integrative exercise (IE) using aerobic and resistance exercise with mindfulness-based principles and yoga. We expected-in parallel to observed improvements in PTSD intensity and quality of life-improvements in mindfulness, interoceptive bodily awareness, and positive states of mind.MethodA total of 47 war veterans with PTSD were randomized to 12-week IE versus waitlist. Changes in mindfulness, interoceptive awareness, and states of mind were assessed by self-report standard measures.ResultsLarge effect sizes for the intervention were observed on Five-Facet Mindfulness Questionnaire Non-Reactivity (d = .85), Multidimensional Assessment of Interoceptive Awareness Body Listening (d = .80), and Self-Regulation (d = 1.05).ConclusionIn a randomized controlled trial of a 12-week IE program for war veterans with PTSD, we saw significant improvements in mindfulness, interoceptive bodily awareness, and positive states of mind compared to a waitlist.

ObjectiveTo develop a more reliable and comprehensive version of the Parental Facilitation of Mastery Scale (PFMS) METHOD: In Study 1, 387 undergraduates completed an expanded PFMS (PFMS-II) and measures of parenting, perceived control, responses to early life challenges, and psychopathology. In Study 2, 182 trauma-exposed community participants completed the PFMS-II and measures of perceived control, psychopathology, and well-being RESULTS: In Study 1, exploratory factor analysis of the PFMS-II revealed two factors. These factors replicated in Study 2; one item was removed to achieve measurement invariance across race. The final PFMS-II comprised a 10-item overprotection scale and a 7-item challenge scale. In both samples, this measure demonstrated good convergent and discriminant validity and was more reliable than the original PFMS. Parental challenge was a unique predictor of perceived control in both samples CONCLUSION: The PFMS-II is a valid measure of important parenting behaviors not fully captured in other measures.

Perceived criticism (PC) is a construct that plays a key role in family relationships of persons with psychiatric disorders. It can be assessed in a brief and simple way using the Perceived Criticism Measure. PC ratings made by patients about their caregivers predict adverse clinical outcomes including increases in symptoms and relapse across a broad range of psychiatric diagnoses. Although research supports the concurrent and predictive validity of PC, the measure is not widely used in clinical practice. Here, we describe the construct of PC and review evidence supporting its clinical utility. We then illustrate how criticism and perceptions of criticism can be addressed in a clinical context, describing a family focused treatment approach used with a depressed adolescent at high risk for bipolar disorder.

Objective: The aim of this study was to analyze the characteristics of the COVID‐19 publications in the ten psychology‐related Web of Science categories in the social science citation index 10‐month following the COVID‐19 outbreak. Methods: Six publication indicators were examined across authors, institutions, and countries. Results: Analyses showed that the United States has produced the highest number of empirical investigations into the psychological impact of COVID‐19, and the majority of the research across all countries was in clinical and psychopathology. Distribution of journals and psychology‐related Web of Science categories were analyzed. Frequently used words in article title, author keywords, and KeyWords Plus were also presented. Conclusions: The findings suggest that there are substantial clinical implications associated with COVID‐19. There are recommendations offered for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The present study reports on the long-term effects of a mindfulness-based stress reduction (MBSR) program for adult survivors of childhood sexual abuse. Method: Of the study participants, 73% returned to the clinic for a single-session follow-up assessment of depression, posttraumatic stress disorder (PTSD), anxiety, and mindfulness at 2.5 years. Results: Repeated measures mixed regression analyses revealed significant long-term improvements in depression, PTSD, anxiety symptoms, and mindfulness scores. The magnitude of intervention effects at 128 weeks ranged from d = .5 to d = 1.1. Conclusion: MBSR may be an effective long-term treatment for adults who have experienced childhood sexual abuse. Further investigation of MBSR with this population is warranted given the durability of treatment effects described here.

ObjectiveThe current study explores relationships between mindfulness, emotional regulation, impulsivity, and stress proneness in a sample of participants recruited in a Diagnostic and Statistical Manual of Mental Disorder Fifth Edition Field Trial for Hypersexual Disorder and healthy controls to assess whether mindfulness attenuates symptoms of hypersexuality.MethodHierarchal regression analysis was used to assess whether significant relationships between mindfulness and hypersexuality exist beyond associations commonly found with emotional dysregulation, impulsivity, and stress proneness in a sample of male hypersexual patients (n = 40) and control subjects (n = 30).ResultsOur results show a robust inverse relationship of mindfulness to hypersexuality over and above associations with emotional regulation, impulsivity, and stress proneness.ConclusionsThese results suggest that mindfulness may be a meaningful component of successful therapy among patients seeking help for hypersexual behavior in attenuating hypersexuality, improving affect regulation, stress coping, and increasing tolerance for desires to act on maladaptive sexual urges and impulses.

ObjectivesTo examine how legal age status, gender, and self-reported reasons for pregaming are linked to pregaming for two common drinking contexts: a bar and a Greek party.MethodParticipants who reported pregaming at least once a month (n = 2888 students aged 18-25 years) were recruited from 30 colleges/universities across the United States.ResultsMany students pregame for social reasons regardless of pregaming destination. Multivariate analyses indicated that legal age students were more likely than underage students to pregame before going to a bar, whereas the opposite was true with respect to pregaming for a Greek party. Women were more likely than men to pregame before going to a bar or a Greek party, whereas men reported higher levels of consumption while pregaming for these destinations compared with women.ConclusionsThe present findings suggest areas for targeted intervention efforts and promising avenues for research on context-specific pregaming behaviors among college students.

Objective: The current study aims to sharpen the understanding of the psychotherapy dose–response effect and its moderators in a psychology training clinic. Method: Data were extracted from 58 client records. Weekly Patient Health Questionnaire‐9 and Generalized Anxiety Disorder‐7, as well as Outcomes Questionnaire‐45.2, administered every fifth session, assessed whether clients achieved reliable change (RC) and clinically significant and reliable change (CSR) during treatment. Survival analyses were conducted to determine the sessions required for 50% of the sample to achieve these outcomes. Multilevel Cox frailty regressions were used to investigate client‐and‐therapy‐based moderators. Results: The median time for 50% of the sample to achieve RC was 8–10 sessions and 11 sessions to achieve initial CSR. Past treatment history was a significant moderator of time to achieve RC. Conclusions: From a population perspective, psychotherapy is most beneficial to patients early in treatment. Sharper understanding of the number of sessions required to achieve meaningful change can inform practice in training settings. [ABSTRACT FROM AUTHOR]

Objective: This article positions the special issue on telepsychology amidst the COVID‐19 pandemic, which has dramatically accelerated the adoption and dissemination of telepsychology. Method: The article makes general observations about the themes emerging in the special issue with considerations for application, training, theory‐driven research, and policy. It then presents as a case example the rapid deployment during the pandemic of telepsychology doctoral training and services at the Virginia Commonwealth University (VCU) Primary Care Psychology Collaborative. Results: Facilitators to VCU telepsychology deployment included trainee and supervisor resources, strong telepsychology training, and prior experience. Barriers to overcome included limited clinic capacity, scheduling, technology, and accessibility and diversity issues. Lessons learned involved presenting clinical issues, supervision, and working with children and adolescents. Conclusions: Telepsychology is crucial for psychological service provision, during the COVID‐19 pandemic more than ever, and that is unlikely to change as psychologists and patients increasingly continue to appreciate its value. [ABSTRACT FROM AUTHOR]

The use of telecommunication technologies in the field of psychology is increasingly widespread. This paper is intended to discuss the authors' perspectives and experiences as current and former telepsychology trainees (ranging from current students to 3 years post-graduate) at a graduate telepsychology clinic in a rural setting. Telepsychology trainees delivered individual and group treatments via videoconference and telephone to clients living in a predominantly rural and historically underserved region of Texas, and they also conducted telepsychology-related research during and after their clinical training. This experience helped trainees understand their clients' perspectives of telepsychology in an experiential way and was viewed by many trainees as useful for enriching their empathy for telepsychology clients. [Extracted from the article]

Objective: To measure the profile of diversity among specialists certified by the American Board of Professional Psychology (ABPP). Method: A survey of ABPP specialists consisting of 18 demographic questions, and two questions regarding board certification and experience with diversity. Results: Although ABPP specialists appear to be more diverse in certain aspects, especially regarding sex/gender (female, 43% vs 34% in prior survey), the majority remain non‐Hispanic, White in race/ethnicity (87%), followed by only 3% Black, and 3% Hispanic/Latinx representation. Recognition as a specialist, job requirement, and professional expectations were the top three reasons for board certification. The top three themes regarding specialists' experiences with diversity were (a) Need for active outreach and mentoring, (b) ABPP does a good job regarding diversity, and (c) Make it more affordable. Conclusion: With the need for a competent and diverse workforce, ABPP will continue to conduct this survey to determine the progress that has been made in increasing the diversity of certified specialists. [ABSTRACT FROM AUTHOR]

Objective: Exercise dependence has been linked to capability for suicide and suicidal behavior; however, less understood are which facets of exercise dependence confer risk for suicidal behavior and the potential mechanisms of this association. This study examined relationships between exercise dependence, capability for suicide, and past suicidal behavior. Methods: A sample of 540 individuals recruited via MTurk completed online measures of their exercise dependence, capability for suicide, and history of suicidal behavior. Results: Suicide attempters reported higher levels of continuance in exercise despite physical or psychological consequences, lack of control over exercise, and reductions in other activities due to exercise than nonattempters. Capability for suicide accounted for the relationship between continuance in exercise despite adverse consequences and lifetime number of suicide attempts. Conclusions: When exercise becomes pathological in the form of exercise dependence, steps should be taken to reduce such engagement due to its observed association with suicidal behavior. [ABSTRACT FROM AUTHOR]

Twenty-five new psychiatric outpatient were clinically evaluated and were routinely administered a brief psychological screening battery which included measures of symptoms, personality, and cognitive function. Included in this assessment procedure were the Gottschalk-Gleser Content Analysis Scales on which scores were derived from five-minute speech samples by means of an artificial intelligence-based computer program. Intercorrelations of these content analysis measures with scores obtained from the MMPI-2, SCL90, and other measures confirmed previously published construct validation findings. The use of this computerized content analysis procedure for initial, rapid diagnostic neuropsychiatric appraisal is supported by this research.

Abstract: Political events leading up to, and following the results of, the November, 2016 election have affected patients in psychotherapy as well as clients working with executive coaches. This article follows developments in coaching work with one male, middle‐aged, highly successful but “interpersonally challenged” client that are traceable to the client's reactions to the election and to the president himself. [ABSTRACT FROM AUTHOR]

Abstract: The primary aim of this study was to investigate the effects of the 2016 United States presidential election and ensuing political climate on patients’ experiences in psychotherapy. A sample of 604 self‐described Democrat and Republican patients from 50 states participated in the study. Results showed that most therapists disclosed their political stance (explicitly or implicitly) and most patients discussed politics with their therapists. 64% of Clinton supporters and 38% of Trump supporters assumed political similarity with their therapist. Stronger patient‐reported alliance levels were found for patients who (a) perceived political similarity; (b) reported implicit therapist political disclosure; and (c) found in‐session political discussions helpful. Additionally, Clinton (but not Trump) supporters reported significant pre‐post‐election decreases in expression of positive emotions and increases in both expression of negative emotions and engagement in discussions about socio‐political topics. Our findings suggest that the current political climate infiltrates the therapeutic space and affects therapeutic process and content. [ABSTRACT FROM AUTHOR]

Abstract: A recent survey of Americans found that the majority experienced stress during and after the 2016 United States presidential election. Psychosocial, environmental stressors can have a unique impact on symptom presentation in mental health disorders. This manuscript details a case illustration of an individual whose symptoms of obsessive‐compulsive disorder were directly linked to the election, as well as how these symptoms were addressed via treatment with intensive exposure and response prevention. [ABSTRACT FROM AUTHOR]

Abstract: Psychologists’ work is always impacted by political events. Donald Trump's election raised many questions regarding my work with clients and students. How would they be impacted? What would they need? How would I respond? How transparent would I be? Students needed to process it. Most clients wanted to talk about it. However, reactions and needs of those who wanted to talk about it varied, and a few did not want to talk about it at all. Nevertheless, the election has been a royal road to the therapeutic alliance and interventions with clients, and it has been a path to deeper learning for students. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The impact of number, length, and time between (i.e., “dwell time”) deployments on long‐term Diagnostic and Statistical Manual of Mental Disorders Fourth Edition posttraumatic stress disorder (PTSD) symptoms was examined in post‐9/11 U.S. veterans. Method: This cross‐sectional design includes data from 278 veterans participating in a larger longitudinal research program of postdeployment recovery. Measures included self‐report questionnaires and the Clinician Administered PTSD Scale. Results: Hierarchical regression was used to evaluate the independent contributions of deployment characteristics on long‐term PTSD symptoms after controlling for demographics and combat exposure. As expected, dwell time was a significant predictor of long‐term PTSD symptoms (β = − 0.17, p = .042; F5,108 = 8.21, ∆R2 = 0.03, p < .001). Follow‐up analyses indicated that dwell time of less than 12 months was associated with significantly greater long‐term PTSD symptoms than those deployed once or with dwell time greater than 12 months. Conclusion: In addition to combat exposure, time between deployments warrants clinical attention as an important deployment characteristic for predicting long‐term PTSD symptoms. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to compare a sample of Portuguese individuals exposed to suicide in their families with a control group, for lifetime suicidality. This study also evaluated the incremental value of psychache (i.e., extreme psychological pain) in determining suicide risk beyond the contribution associated with having lost a family member by suicide. Method: A total of 225 community adults participated. Two groups were defined: a group exposed to suicide (n = 53), and a control group (n = 172). Results: Results demonstrated that groups did significantly differ on the total score of the Suicide Behaviors Questionnaire‐Revised (SBQ‐R), on the four individual SBQ‐R items, and on psychache. Results from a hierarchical multiple regression analysis demonstrated that having lost a family member by suicide and the construct of psychache each provided a significant unique contribution to explaining variance in suicide risk. The interaction between group membership and psychache also provided a further enhancement to the statistical prediction of suicide risk. Conclusion: Findings are discussed with regard to their implications for clinical intervention and postvention. [ABSTRACT FROM AUTHOR]

Background: Body‐focused repetitive behaviors (BFRBs), such as hair pulling, skin picking, and nail biting, are repetitive, destructive, and nonfunctional habits that cause significant distress. Separate BFRBs form a cohesive group and could be assessed as part of the Tourette/tic spectrum or obsessive‐compulsive spectrum of disorders. The treatment of choice is either antidepressant or behavioral treatment, both of which have shown effectiveness. The cognitive psychophysiological (CoPs) model focuses on the tension and emotional build up that triggers habits by addressing cognitive‐behavioral, emotional and psychophysiological processes preceding onset rather than the habit itself. The CoPs approach has already shown efficacy in treatment of tic and Tourette disorder. Objective: The aim of the current open trial was to view whether BFRBs can be validly assessed on a standard tic scale (Tourette Symptom Global Scale; TSGS) and evaluate the efficacy of the CoPs intervention on 64 participants (54 completers) with 1 of 3 subtypes of BFRBs (hair pulling, nail biting, and skin picking) compared to a waitlist control. Method: Participants were assessed at baseline on an adapted TSGS and after receving 14 weeks of CoPs therapy with six months follow up. Results: The TSGS was reliably and validly adapted to measure BFRBs. The CoPs intervention was effective for all BRFB subtypes with a large effect size (intention‐to‐treat g = 1.54; completers g = 2.04), with 74% of patients showing clinically significant improvement. Mood and self‐esteem also improved posttreatment. The decrease in symptoms was maintained at the 6‐month follow‐up, with a further decrease in perfectionism. Conclusion: BFRBs can be reliably assessed as a tic spectrum disorder rather than as part of the obsessive‐compulsive spectrum. The CoPs model may offer a complementary treatment for BFRBs. [ABSTRACT FROM AUTHOR]

Objective: We aim to elucidate misophonia, a condition in which particular sounds elicit disproportionally strong aversive reactions. Method: A large online study extensively surveyed personal, developmental, and clinical characteristics of over 300 misophonics. Results: Most participants indicated that their symptoms started in childhood or early teenage years. Severity of misophonic responses increases over time. One third of participants reported having family members with similar symptoms. Half of our participants reported no comorbid clinical conditions, and the other half reported a variety of conditions. Only posttraumatic stress disorder (PTSD) was related to the severity of the misophonic symptoms. Remarkably, half of the participants reported experiencing euphoric, relaxing, and tingling sensations with particular sounds or sights, a relatively unfamiliar phenomenon called autonomous sensory meridian response (ASMR). Conclusion: It is unlikely that another “real” underlying clinical, psychiatric, or psychological disorder can explain away the misophonia. The possible relationship with PTSD and ASMR warrants further investigation. [ABSTRACT FROM AUTHOR]

Abstract: This issue of the Journal of Clinical Psychology: In Session contains seven essays that give expression to three basic convictions. The first is that therapists who are consistently able to help their patients make constructive changes in their lives practice psychotherapy creatively, whether or not they conceive of therapy as an applied science or as an art form. The second is that cultivating an aesthetic perspective on the communicative exchanges that take place in therapy can enhance a therapist's capacity to serve creatively as an agent of change. The third is that therapists can make better choices on behalf of their patients if they take inspiration from what artists have to teach us about the aesthetic domain of existence. [ABSTRACT FROM AUTHOR]

Objective Although meditation practice is an important component of many mindfulness-based interventions (MBIs), empirical findings of its effects on psychological functioning are mixed and the mechanisms for the effects remain unclear. Responding with mindfulness (i.e., returning one's attention back to a nonjudgmental, present-oriented awareness) is a fundamental skill practiced in meditations. With repeated meditation practice, this skill is thought to become internalized and be applied to one's daily life. We thus hypothesized that the extent to which individuals responded to daily events with mindfulness would mediate the effects of meditation practice (instance, duration, and adherence to instructions) on psychological well-being. Method Using a daily diary methodology, we tracked the meditation practice, use of mindful responding during the day, and psychological outcomes (perceived stress, negative and positive affect) of 117 mindfulness-based stress reduction program participants. Results We found that on days when participants meditated, they responded with greater mindfulness to daily events, which accounted for the beneficial effects of meditating on psychological outcomes. Furthermore, findings suggest that on meditation days, longer and more closely adhered meditation practices were independently associated with increases in mindful responding, which in turn were associated with better psychological outcomes. Conclusion These results suggest that regular, longer, and more closely adhered meditation practice is an important component of MBIs, in part because it leads to responding more mindfully in daily life, which promotes well-being. [ABSTRACT FROM AUTHOR]

Objective This pilot study tested the efficacy of a voluntary 84-hour abstinence protocol for modifying problematic Internet gaming cognitions and behaviors Method Twenty-four adults from online gaming communities, including 9 individuals who screened positively for Internet gaming disorder (IGD), abstained from Internet games for 84 hours. Surveys were collected at baseline, at daily intervals during abstinence, and at 7-day and 28-day follow-up Results Brief voluntary abstinence was successful in reducing hours of gaming, maladaptive gaming cognitions, and IGD symptoms. Abstinence was highly acceptable to participants with total compliance and no study attrition. Clinically significant improvement in IGD symptoms occurred in 75% of the IGD group at 28-day follow-up. Reliable improvement in maladaptive gaming cognitions occurred in 63% of the IGD group, whose cognition score reduced by 50% and was comparable to the non-IGD group at 28-day follow-up Conclusions Despite limitations of sample size, this study provides promising support for brief abstinence as a simple, practical, and cost-effective treatment technique for modifying unhelpful gaming cognitions and reducing Internet gaming problems. [ABSTRACT FROM AUTHOR]