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Objective: Discrimination disrupts sleep and contributes to race-based health inequities for Black Americans, but less is known about the psychological mechanisms underlying this relation. The current work tests whether emotion invalidation, termed Social Pain Minimization (SPM), mediates discrimination's negative effects on sleep quality. We focus on the experiences of Black Americans because of racism's disproportionate effect on the health outcomes of Black individuals in the U.S. Methods: Four studies with cross-sectional (Studies 1a-1b) and cross-lagged panel designs (Studies 2–3; Ntotal = 1,176) were used. Discrimination and SPM were assessed with established measures and self-reported sleep quality was assessed with three different operationalizations including the short form Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep-Related Impairment (SRI) subscale and composites of the Insomnia Severity Index (ISI). Results: Cross-sectional (Studies 1a-1b) and longitudinal mediation analyses (Studies 2–3) indicated discrimination's negative effect on sleep quality partially operated through SPM (Study 1a, 95% CI = [−.24, −.016]); Study 1b, 95% CI = [−.22, −.03]; Study 2, 95% CI = [−.268, −.007]]; Study 3, 95% CI = [−0.043, −.002]). Conclusion: Beyond its direct negative effect on sleep, discrimination also operates through SPM to reduce sleep quality. Emotion invalidation stemming from discrimination damages sleep. [ABSTRACT FROM AUTHOR] more...

Background Method Results Conclusion Self‐injurious urges are arguably the clearest antecedents of engaging in self‐injurious behaviors (SIBs; e.g., binge eating, self‐induced vomiting, cutting, burning). However, self‐injurious urges demonstrate great heterogeneity, and it is unknown which are most closely linked to SIBs. This study aims to identify latent profiles of self‐injurious urges and subsequently examine associations between profiles and engagement in SIBs.Adults (N = 124) who reported engaging in at least three SIBs in the past month completed six surveys a day assessing self‐injurious urges for 14 days (6600 responses). Latent profiles were constructed using within‐person intensity, variability, peak, duration, relative frequency, and overall stability of self‐injurious urges over the EMA period.Five distinct profiles were identified: “sustained,” “muted,” “sudden‐onset,” “volatile,” and “virtually absent.” SIB frequency differed across profiles, H(4) = 41.11, p < 0.001; η2 = 0.31, 95% CI [0.19, 0.48], and Dunn's post‐hocs indicated those in the “volatile” profile engaged in more SIBs than other profiles.Findings support the presence of meaningful profiles of self‐injurious urges and suggest these profiles differ in levels of SIB engagement. Future work should prospectively examine associations between profile membership and engagement in SIBs and identify treatment targets to intervene on SIBs. [ABSTRACT FROM AUTHOR] more...

Objective: Perceived burdensomeness (PB) and thwarted belongingness (TB), two proximal risk factors for suicide, may rise during residential eating disorder (ED) treatment when patients are separated from support and face exorbitant costs of care. In this setting, fostering motivation for treatment is challenging, and low motivation for treatment may exacerbate feelings of PB and TB. Simultaneously, PB and TB could reduce motivation for treatment, though no studies have explored this relationship longitudinally. Accordingly, this study examined associations between interpersonal needs (TB, PB) and motivation for treatment across the first 6 weeks of residential ED treatment. Methods: Participants (n = 98) completed the Interpersonal Needs Questionnaire (INQ) and rated treatment motivation weekly. Pearson bivariate correlations examined the relationship between motivation and interpersonal needs at each timepoint. Two autoregressive cross‐lagged panel models (AR‐CLPMs) tested reciprocal relationships between these constructs longitudinally across the first 6 weeks of treatment. Results: Motivation was significantly negatively correlated with PB and TB at all timepoints. In AR‐CLPM 1, Week 2 Motivation predicted Weeks 3 PB, then Week 3 PB predicted Week 4 Motivation. In AR‐CLPM 2, Week 2 TB predicted Week 3 Motivation, but Motivation did not predict TB at any timepoint. Discussion: This study is the first to examine longitudinal relations between interpersonal needs and treatment motivation in residential ED care. PB and TB may influence one's motivation for treatment, although motivation and PB had a stronger reciprocal relationship than motivation and TB. Interpersonal needs should be addressed early in residential treatment to mitigate negative cycling. [ABSTRACT FROM AUTHOR] more...

Interoception (e.g., abilities to recognize/attend to internal sensations) is robustly associated with psychopathology. One form of interoception, body trust, is relevant for the development of disordered eating and suicidal thoughts/behaviors. However, measures of body trust are narrow, despite research suggesting body trust is multifaceted. The aim of this study was to develop a comprehensive measure of body trust: The Body Trust Scale (BTS). 479 U.S. adults completed self-report surveys containing the BTS and psychopathology measures. Exploratory and confirmatory factor analyses revealed a three-factor structure: Comfort with One's Body, Physical Attractiveness, and Comfort with Internal Sensations. Factors showed strong construct, convergent, and divergent validity, as well as moderate predictive validity for suicidal thoughts/non-suicidal self-injury. Furthermore, factors showed strong internal consistency, test–retest reliability, and were invariant across the gender binary. The BTS can be used in research and clinical settings to understand how specific facets of body trust relate to psychopathology. [ABSTRACT FROM AUTHOR] more...

Recent work has identified fearlessness about suicide, rather than fearlessness about death, as more theoretically relevant in the assessment of capability for suicide and thus a more appropriate construct of measurement. The aim of the current project was to develop and validate a scale specifically assessing fearlessness about suicide. Across two studies, support for a 7-item, single-factor structure of the Fearlessness About Suicide Scale (FSS) emerged. The FSS factor structure demonstrated a good fit in the first study and was replicated in the second study. Measurement invariance was examined across those identifying as men and women and found to be comparable. The FSS also demonstrated test–rest reliability and good convergent and divergent validity in community and undergraduate samples. Overall, findings indicate that the FSS has a replicable factor structure that generalizes across those identifying as men and women and may better assess components of capability for suicide than existing scales. [ABSTRACT FROM AUTHOR] more...

Background Suicidal thoughts and behaviors are elevated among active-duty service members (ADSM) and veterans compared to the general population. Hence, it is a priority to examine maintenance factors underlying suicidal ideation among ADSM and veterans to develop effective, targeted interventions. In particular, interpersonal risk factors, hopelessness, and overarousal have been robustly connected to suicidal ideation and intent. Methods To identify the suicidal ideation risk factors that are most relevant, we employed network analysis to examine between-subjects (cross-sectional), contemporaneous (within seconds), and temporal (across four hours) group-level networks of suicidal ideation and related risk factors in a sample of ADSM and veterans (participant n = 92, observations n = 10 650). Participants completed ecological momentary assessment (EMA) surveys four times a day for 30 days, where they answered questions related to suicidal ideation, interpersonal risk factors, hopelessness, and overarousal. Results The between-subjects and contemporaneous networks identified agitation, not feeling close to others, and ineffectiveness as the most central symptoms. The temporal network revealed that feeling ineffective was most likely to influence other symptoms in the network over time. Conclusion Our findings suggest that ineffectiveness, low belongingness, and agitation are important drivers of moment-to-moment and longitudinal relations between risk factors for suicidal ideation in ADSM and veterans. Targeting these symptoms may disrupt suicidal ideation. [ABSTRACT FROM AUTHOR] more...

Objective: Individuals with eating disorders (EDs) display elevated rates of suicidality (i.e., suicidal ideation and behaviors) as well as nonsuicidal self‐injury (NSSI) (e.g., self‐harm behaviors without intent to die). NSSI—and particularly the functions of NSSI—predict suicidal ideation in general samples; however, to our knowledge, the relation between NSSI functions and suicidal ideation in ED populations has been unexplored. Method: This study examined whether specific functions of NSSI are relevant to suicidal ideation in a treatment‐seeking sample of women with EDs (n = 100). Participants completed self‐report measures of suicidal ideation, NSSI, and related psychopathology upon intake to an ED treatment program. Results: Using the four‐function model of NSSI, we found that intrapersonal and interpersonal‐negative reinforcement, but not interpersonal‐positive reinforcement functions, were related to suicidal ideation in women with EDs. Contrary to expectations, we did not find that endorsement of multiple NSSI functions was related to increased suicide risk. Discussion: Findings imply that some, but not all, functions of NSSI may be relevant to suicide risk in individuals with EDs. Implications for further research are discussed. [ABSTRACT FROM AUTHOR] more...

Objective: This preregistered randomized controlled trial tested the effects of a four‐session, online interoceptive awareness intervention relative to an active comparator, matched for time and attention on interoception and suicidal ideation. Method: Participants (N = 195; 69% male; mean age = 37) were active duty service members (62%) and veterans (38%) who completed measures of interoceptive sensibility, interoceptive accuracy, and suicidal ideation at baseline. They were randomized to either the interoceptive awareness intervention, Reconnecting to Internal Sensations and Experiences (RISE), or the comparator, Healthy Habits. Participants completed the assessment battery again at posttest as well as a 1 and 3‐month follow‐up. Results: RISE was rated as acceptable and demonstrated excellent feasibility per completion rates (85% completed all four modules). RISE improved the majority of interoceptive sensibility domains assessed (noticing body sensations, not worrying about sensations of pain or discomfort, emotional awareness, self‐regulation, body listening, and body trust), and most of these gains remained at 1 and 3‐month follow‐ups. There were no differences between conditions on suicidal ideation, perhaps due to the low levels of ideation reported, or interoceptive accuracy. Conclusions: RISE is a disseminable, cost‐effective, and transdiagnostic intervention that improves interoceptive sensibility up to 3 months. [ABSTRACT FROM AUTHOR] more...

Racism creates and sustains mental health disparities between Black and White Americans and the COVID-19 pandemic and ongoing harassment directed at Black Americans has exacerbated these inequities. Yet, as the mental health needs of Black Americans rise, there is reason to believe the public paradoxically believes that psychopathology hurts Black individuals less than White individuals and these biased distress judgments affect beliefs about treatment needs. Four studies (two pre-registered) with participants from the American public and the field of mental health support this hypothesis. When presented with identical mental illnesses (e.g., depression, anxiety, schizophrenia), both laypeople and clinicians believed that psychopathology would be less distressing to Black relative to White individuals. These distress biases mediate downstream treatment judgments. Across numerous contexts, racially-biased judgments of psychological distress may negatively affect mental healthcare and social support for Black Americans. [ABSTRACT FROM AUTHOR] more...

Objective: Cognitive behavioral therapy for Avoidant Restrictive Food Intake Disorder (ARFID; CBT‐AR) is an emerging treatment for ARFID. However, this treatment modality has yet to be examined among older adults (e.g., older than 50 years) or with adults presenting with feeding tubes. To inform future versions of CBT‐AR, we present the results of a singular case study (G) of an older male with the sensory sensitivity phenotype of ARFID who presented for treatment with a gastrostomy tube. Methods: G was a 71‐year‐old male who completed eight sessions of CBT‐AR in a doctoral training clinic. ARFID symptom severity and comorbid eating pathology changes were examined pre‐ and post‐treatment. Results: Posttreatment, G reported significant decreases in ARFID symptom severity and no longer met diagnostic criteria for ARFID. Furthermore, throughout treatment, G reported significant increases in his oral food consumption (vs. calories being pushed through the feeding tube), solid food consumption, and the feeding tube was ultimately removed. Discussion: This study provides proof of concept that CBT‐AR is potentially effective for older adults and/or those presenting for treatment with feeding tubes. Validation of patient efforts and severity of ARFID symptoms emerged as core to treatment success and should be emphasized when training clinicians in CBT‐AR. Public Significance: Cognitive behavior therapy for ARFID (CBT‐AR) is the leading treatment for this disorder; however, it has yet to be tested among older adults or those with feeding tubes. This single‐patient case study demonstrates that CBT‐AR may be efficacious in reducing ARFID symptom severity among older adults with a feeding tube. [ABSTRACT FROM AUTHOR] more...

Objective: Interoception (the sense of the body's state) is associated with eating disorders and nonsuicidal self‐injury, potentially through relationships with affect. We examined the relationship between interoceptive attention and both positive and negative affect. Methods: Participants (N = 128) who reported recent self‐harm (i.e., disordered eating and/or non‐suicidal self‐injury) completed ecological momentary assessment for 16 days. Participants completed multiple daily assessments of affect and interoceptive attention. We then tested the temporal dynamic relationship between interoceptive attention and affect. Results: There was a relationship between positive affect and interoceptive attention such that people with higher average positive affect, and times when people were above their typical positive affect, were associated with higher interoceptive attention. There was a negative relationship between negative affect and interoceptive attention, such that people with higher average negative affect, and times when people were above their own typical negative affect, were associated with lower interoceptive attention. Conclusions: Better mood may associate with greater willingness to attend to body sensations. Our findings support active inference models of interoception and highlight the importance of refining our understanding of the dynamic nature of interoception and its relationship with affect. [ABSTRACT FROM AUTHOR] more...