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Self-regulation denotes the processes by which people initiate, maintain, and control their own thoughts, behaviors, or emotions to produce a desired outcome or avoid an undesired outcome. Self-regulation brings the influence of distal factors, such as biology, temperament, and socialization history, onto cognition, motivation, and behavior. Dysfunction in self-regulation represents a contributory causal factor for psychopathology. Accordingly, we previously proposed a risk phenotype model for depression drawing from regulatory focus theory and traditional studies using task-based functional magnetic resonance imaging. In this article, we revise and expand our risk phenotype model using insights from new methodologies allowing quantification of individual differences in task-free macroscale brain organization. We offer a set of hypotheses as examples of how examination of intrinsic macroscale brain organization can extend and enrich investigations of self-regulation and depression. In doing so, we hope to promote a useful heuristic for model development and for identifying transdiagnostic risk phenotypes in psychopathology.

BACKGROUND: Substance use is a major risk factor for negative health and functioning outcomes among middle schoolers. The purpose of this study was to assess whether individual differences in the adolescents’ goal orientation are associated with elevated or attenuated risk for substance use. Regulatory focus theory stipulates that individuals vary in their strength of orientation toward promotion goals (“making good things happen”) and prevention goals (“keeping bad things from happening”). OBJECTIVES: We sought to examine the association between individual differences in regulatory focus and adolescents’ reports of their own and their friends’ substance use. METHODS: Participants were 241 seventh grade students who completed measures of regulatory focus (promotion and prevention orientation), self-reported substance use, perceived substance use habits of peers, and demographics. Logistic regression models were used to examine adjusted odds of lifetime tobacco use, alcohol use, and marijuana use for both participants’ own use and their reports of friends’ use. RESULTS: Prevention orientation was associated with lower odds of all self-reported lifetime substance use outcomes (tobacco, alcohol, and marijuana). Prevention orientation was also associated with lower odds of reporting all types of substance use among friends. Promotion orientation was not associated with any self-reported substance use outcome, and was only associated with higher odds of reporting lifetime alcohol use among friends. CONCLUSIONS: These findings underscore the importance of regulatory focus as it relates to adolescent substance use. Future research may seek to incorporate regulatory focus within interventions intended to prevent or delay initiation of substance use in adolescents.

Objective Innovative treatments and outcome measures are needed for binge-eating disorder (BED). This randomized controlled trial compared Integrative Cognitive-Affective Therapy (ICAT-BED), an individual psychotherapy targeting momentary behavioral and emotional precipitants of binge eating, with an established cognitive-behavioral guided self-help (CBTgsh) treatment using standard and ecological momentary assessment (EMA) outcome measures. Method A total of 112 participants were randomized to 17 weeks of treatment (21 sessions for ICAT-BED and 10 sessions for CBTgsh). Binge-eating frequency was assessed with the Eating Disorder Examination (EDE) as well as EMA using cell phone-based real-time, naturalistic assessment at end of treatment (EOT) and 6-month follow-up. Hypothesized maintenance mechanisms were assessed using self-report questionnaires. Results Binge-eating frequency as measured by the EDE and real-time assessment showed significant reductions at EOT and follow-up, with no significant differences between treatments. Hypothesized maintenance mechanisms, including emotion regulation, cognitive self-discrepancy, self-directed style, as well as measures of associated eating disorder psychopathology, depression, anxiety, impulsivity, and negative affect, showed similar improvement at EOT and follow-up with no differences between treatments. Abstinence rates at EOT (ICAT-BED: 57.1%; CBTgsh: 42.9%) and 6-month follow-up (ICAT-BED: 46.4%; CBTgsh: 42.9%) were not significantly different. Treatment retention was significantly higher for ICAT-BED (87.5%) than CBTgsh (71.4%). Discussion These findings suggest that ICAT-BED and CBTgsh were associated with similar improvements in binge eating, psychopathology, and putative maintenance mechanisms as measured by traditional self-report and momentary, naturalistic assessments and that these changes were generally sustained at 6-month follow-up.

Health disciplines have increasingly required competency-based evaluations as a licensure prerequisite. In keeping with this trend, the Association of State and Provincial Psychology Boards (ASPPB) has begun to develop a second part to the Examination for Professional Practice in Psychology (EPPP). The resulting 2-part examination is collectively referred to as the Enhanced EPPP. Part 1 of the Enhanced EPPP, which consists of the current exam, is designed to be an assessment of knowledge. Part 2 of the Enhanced EPPP is newly developed and intended to address the need for a competency-based evaluation. To date, ASPPB has addressed some standard facets of validity for the EPPP Part 2, but not others. In addition, the EPPP Part 2 has yet to be subjected to a broader validation process, in which the suitability of the test for its intended purpose is evaluated. Implementation of the EPPP Part 2 before validation could have negative consequences for those seeking to enter the profession and for the general public (e.g., potential restriction of diversity in the psychology workforce). For jurisdictions implementing the EPPP Part 2, failure to gather and report the evidence required for use of a test in a forensic context may also open the door for legal challenges. We end with suggestions for feasible research that could significantly enhance the validation process for the EPPP Part 2 and offer jurisdictions concrete suggestions of features to look for in determining whether and when to implement the Enhanced EPPP. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

A person’s preferred timing of nocturnal sleep (chronotype) has important implications for cognitive performance. Students who prefer to sleep late may have a selective learning disadvantage for morning classes due to inadequate sleep and circadian desynchrony. Here, (1) we tested whether late-type students perform worse only for morning classes, and (2) we investigated factors that may contribute to their poorer academic achievement. Chronotype was determined objectively in 33,645 university students (early, n=3,965; intermediate, n=23,787; late, n=5,893) by analyzing the diurnal distribution of their logins on the university’s Learning Management System (LMS). Late-type students had lower grades than their peers for courses held at all different times of day, and during semesters when they had no morning classes. Actigraphy studies (n=261) confirmed LMS-derived chronotype was associated with students’ sleep patterns. Nocturnal sleep on school days was shortest in late-type students because they went to bed the latest and woke up early compared with non-school days. Surveys showed that late-type students had lower self-rated health and mood (n=357), and lower metacognitive self-regulation (n=752). Wi-Fi connection data for classrooms (n=17,356) revealed that late-type students had lower lecture attendance than their peers for classes held in both the morning and the afternoon. Our findings suggest that multiple factors converge to impair learning in late-type students. Shifting classes later can improve sleep and circadian synchrony in late-type students but is unlikely to eliminate the performance gap. Interventions that focus on improving students’ well-being and learning strategies may be important for addressing the late-type academic disadvantage.

INTRODUCTION: Burnout is considered to be at the opposite end of the continuum from engagement. People who experience burnout first go through various intermediate patterns that lead to burnout, which in medical students is associated with reduced empathy, intention to leave school, and suicidal ideation. Thus, understanding how to mitigate burnout is of primary importance. In this study, we investigate if students’ positive perceptions of the educational program’s alignment with adult education principles decreased symptoms suggestive of typical patterns of intermediate burnout. METHODS: We conducted a cross-sectional survey study of all currently enrolled Duke-NUS Medical School students in Singapore (n = 238). An electronic questionnaire contained demographic questions and additional measures for factors known to be associated with burnout, including depression, anxiety, social support, and workload. In addition, we measured students’ perceptions of how well the educational program aligned with adult learning principles by using a modified version of the Andragogical Practices Inventory (API) to suit medical education. An intermediate pattern of burnout was measured using the Maslach Burnout Inventory (MBI). Using logistic regression, we then assessed the unique association between the presence of an intermediate pattern of burnout with students’ perceptions of the educational program’s alignment with adult learning principles. RESULTS: The survey response rate was 52%. Overall, 76% (95% CI 67–84%) displayed symptoms suggestive of an intermediate pattern of burnout. Perceptions of the educational program’s alignment with adult learning principles were found to be inversely related to the pattern of burnout after controlling for depression, anxiety, and subjective workload. DISCUSSION AND CONCLUSION: Though adult learning theory is the subject of rich debate, the results of this study suggest that promoting educational activities that are aligned with adult learning principles may help to ultimately reduce the risk of burnout in medical school students.

Self-discrepancy theory (SDT) is a model of the relations between the self and affect which has been applied to the study of different types of psychopathology including depression, anxiety, and eating disorders. Although the theory itself is compatible with a transdiagnostic perspective on psychopathology, to date no systematic review of the literature has examined that possibility. We conducted a meta-analysis that synthesized the literature on self-discrepancy and psychopathology across a heterogeneous range of 70 studies. Results showed a small-to-medium association between self-discrepancy and psychopathology that was highly robust and similar in magnitude across domains. Furthermore, self-discrepancy was related to higher levels of a range of negative emotions and lower levels of a range of positive emotions. Meta-regression models showed that the effects were greater for actual:ideal discrepancy compared with actual:ought discrepancy for both depression and anxiety, which was contrary to the tenets of SDT which suggests specific associations between actual:ideal discrepancy and depression and actual:ought discrepancy and anxiety. Measurement type (i.e., idiographic vs. nomothetic) was a significant predictor of the effects for depression and anxiety, such that nomothetic measures evidenced greater associations compared with idiographic measures. Our findings could suggest that self-discrepancy represents a contributory factor related to a number of psychiatric disorders. However, the tenet of SDT suggesting unique associations between actual:ideal and actual:ought discrepancy and anxiety and depression respectively was not supported. Implications are discussed for future research on self-discrepancy and psychopathology including the study of mechanistic frameworks. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Major depression is an episodic disorder which, for many individuals, has its onset in a distinct change of emotional state which then persists over time. The present article explores the utility of combining a dynamical systems approach to depression, focusing specifically on the change of state associated with episode onset, with a self-regulation perspective, which operationalizes how feedback received in the ongoing process of goal pursuit influences affect, motivation, and behavior, for understanding how a depressive episode begins. The goals of this review are to survey the recent literature modeling the onset of a depressive episode and to illustrate how a self-regulation perspective can provide a conceptual framework and testable hypotheses regarding episode onset within a dynamical systems model of depression.

Turner et al. (2021) subtly relapse in conceptualizing the Examination for Professional Practice in Psychology (Part 2-Skills) exam as a competency evaluation despite Association of State and Provincial Psychology Boards' (ASPPB) prior concession that Part 2 measures only the knowledge of skills (not skill competency). They do not address the purpose of redundant evaluation or the other concerns raised in Callahan et al. (2020). Instead, Turner et al. remain narrowly focused on defense of content validity and a reliance on outdated standards that fail to meet contemporary expectations for assessment of health care professionals. The adopted processes and procedures, albeit time consuming and effortful, are known to be methodologically inadequate. ASPPB's methods demonstrably foster linguistic biases and systemic racism that constricts licensure of diverse individuals as psychologists. Specific suggestions are offered, and ASPPB is urged to take drastic corrective action. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A general psychopathology (‘p’) factor captures transdiagnostic features of mental illness; however, the meaning of the p factor remains unclear. Regulatory focus theory postulates that individuals regulate goal pursuit either by maximizing gains (promotion) or minimizing losses (prevention). As maladaptive goal pursuit has been associated with multiple categorical disorders, we examined whether individual differences in promotion and prevention goal pursuit are associated with p as well as internalizing- and externalizing-specific factors using structural equation modeling of data from 1330 volunteers aged 18–22. Unsuccessful attainment of promotion and prevention goals was related to increased levels of p. Over and above relations with the p factor, unsuccessful attainment of promotion goals was associated with higher internalizing-specific psychopathology, whereas unsuccessful attainment of prevention goals was related to higher externalizing-specific psychopathology. These associations also were separable from related personality traits. After controlling for sex differences in the composition of the psychopathology factors, there were no sex differences in the relations between promotion and prevention goal pursuit and p and specific internalizing and externalizing factors. These findings suggest higher general psychopathology reflects poorer overall self-regulation of goal pursuit and that maladaptive promotion and prevention orientations also are associated with internalizing- and externalizing-specific psychopathology, respectively.

PURPOSE: Self-discrepancy (i.e., perceived differences between one’s actual self and personal standards) has been associated with binge eating disorder (BED) symptoms. However, little is known about how weight discrepancy (i.e., the difference between one’s actual and ideal weights) interacts with or is distinguished from nonappearance self-discrepancy (discrepancy unrelated to weight or shape) in predicting BED severity. The current study examined how these two forms of discrepancy independently and interactively relate to BED and associated symptoms to elucidate how facets of self-discrepancy may operate to precipitate and maintain BED. METHODS: Adults with BED (N=111) completed questionnaires and interviews prior to treatment that assessed self-discrepancy (Computerized Selves) and weight discrepancy (assessed during the Eating Disorder Examination [EDE]) as predictors of global eating disorder (ED) symptomatology (EDE Global score), depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), self-esteem (Rosenberg Self-Esteem Scale), and ED-related impairment (Clinical Impairment Assessment). RESULTS: Multivariate regression models indicated nonappearance self-discrepancy and weight discrepancy were not significantly related to the severity of global ED symptoms, but both independently predicted impairment (ps

Regulatory focus theory (RFT) postulates two cognitive-motivational systems for personal goal pursuit: the promotion system, which is associated with ideal goals (an individual’s hopes, dreams, and aspirations), and the prevention system, which is associated with ought goals (an individual’s duties, responsibilities, and obligations). The two systems have been studied extensively in behavioral research with reference to differences between promotion and prevention goal pursuit as well as the consequences of perceived attainment versus nonattainment within each system. However, no study has examined the neural correlates of each combination of goal domain and goal attainment status. We used a rapid masked idiographic goal priming paradigm and functional magnetic resonance imaging to present individually selected promotion and prevention goals, which participants had reported previously that they were close to attaining (“match”) or far from attaining (“mismatch”). Across the four priming conditions, significant activations were observed in bilateral insula (Brodmann area (BA) 13) and visual association cortex (BA 18/19). Promotion priming discriminantly engaged left prefrontal cortex (BA 9), whereas prevention priming discriminantly engaged right prefrontal cortex (BA 8/9). Activation in response to promotion goal priming was also correlated with an individual difference measure of perceived success in promotion goal attainment. Our findings extend the construct validity of RFT by showing that the two systems postulated by RFT, under conditions of both attainment and nonattainment, have shared and distinct neural correlates that interface logically with established network models of self-regulatory cognition.

Despite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for unipolar depression, its typical effect sizes have been modest, and methodological and conceptual challenges remain regarding how to optimize its efficacy. Linking rTMS to a model of the neurocircuitry underlying depression and applying such a model to personalize the site of stimulation may improve the efficacy of rTMS. Recent developments in the psychology and neurobiology of self-regulation offer a conceptual framework for identifying mechanisms of action in rTMS for depression, as well as for developing guidelines for individualized rTMS treatment. We applied this framework to develop a multimodal treatment for depression by pairing self-system therapy (SST) with simultaneously administered rTMS delivered to an individually targeted region of dorsolateral prefrontal cortex identified via functional magnetic resonance imaging (fMRI).In this proof-of-concept study, we examined the acceptability, feasibility, and preliminary efficacy of combining individually fMRI-targeted rTMS with SST. Using the format of a cognitive paired associative stimulation paradigm, the treatment was administered to 5 adults with unipolar depression in an open-label trial.The rTMS/SST combination was well tolerated, feasible, and acceptable. Preliminary evidence of efficacy also was promising. We hypothesized that both treatment modalities were targeting the same neural circuitry through cognitive paired associative stimulation, and observed changes in task-based fMRI were consistent with our model. These neural changes were directly related to improvements in depression severity.The new combination treatment represents a promising exemplar for theory-based, individually targeted, multimodal intervention in mood disorders.

Distress tolerance is the capacity to withstand negative affective states in pursuit of a goal. Low distress tolerance may bias an individual to avoid or escape experiences that induce affective distress, but the neural mechanisms underlying the bottom-up generation of distress and its relationship to behavioral avoidance are poorly understood. During a neuroimaging scan, healthy participants completed a mental arithmetic task with easy and distress phases, which differed in cognitive demands and positive versus negative auditory feedback. Then, participants were given the opportunity to continue playing the distress phase for a financial bonus and were allowed to quit at any time. The persistence duration was the measure of distress tolerance. The easy and distress phases activated auditory cortices and fronto-parietal regions. A task-based functional connectivity analysis using the left secondary auditory cortex (i.e., planum temporale) as the seed region revealed stronger connectivity to fronto-parietal regions and anterior insula during the distress phase. The distress-related connectivity between the seed region and the left anterior insula was negatively correlated with distress tolerance. The results provide initial evidence of the role of the anterior insula as a mediating link between the bottom-up generation of affective distress and top-down behavioral avoidance of distress.

To benefit from cognitive behavioral therapy (CBT), individuals must not only learn new skills but also strategically implement them outside of session. Here, we tested a novel technique for personalizing CBT skills and facilitating their generalization to daily life. We hypothesized that showing participants the impact of specific CBT strategies on their own brain function using real-time functional magnetic imaging (rt-fMRI) neurofeedback would increase their metacognitive awareness, help them identify effective strategies, and motivate real-world use. In a within-subjects design, participants who had completed a clinical trial of a standardized course of CBT created a personal repertoire of negative autobiographical stimuli and mood regulation strategies. From each participant's repertoire, a set of experimental and control strategies were identified; only experimental strategies were practiced in the scanner. During the rt-fMRI neurofeedback session, participants used negative stimuli and strategies from their repertoire to manipulate activation in the anterior cingulate cortex, a region implicated in emotional distress. The primary outcome measures were changes in participant ratings of strategy difficulty, efficacy, and frequency of use. As predicted, ratings for unscanned control strategies were stable across observations, whereas ratings for experimental strategies changed after neurofeedback. At follow-up one month after the session, efficacy and frequency ratings for scanned strategies were predicted by neurofeedback during the rt-fMRI session. These results suggest that rt-fMRI neurofeedback created a salient and durable learning experience for patients, extending beyond the scan session to guide and motivate CBT skill use weeks later. This metacognitive approach to neurofeedback offers a promising model for increasing clinical benefits from cognitive behavioral therapy by personalizing skills and facilitating generalization. Keywords: Real-time fMRI, Neurofeedback, Cognitive behavioral therapy, Metacognition, Personalized therapy

This article presents a general framework in which different manifestations of psychopathology can be conceptualized as dysfunctions in one or more mechanisms of self-regulation, defined as the ongoing process of managing personal goal pursuit in the face of internal, interpersonal, and environmental forces that would derail it. The framework is based on the assertion that self-regulation is a critical locus for the proximal influence on motivation, cognition, emotion, and behavior of more distal factors such as genetics, temperament, socialization history, and neurophysiology. Psychological theories of self-regulation are ideal platforms from which to integrate the study of self-regulation both within and across traditional disciplines. This article has two related goals: to elucidate how the construct of self-regulation provides a unique conceptual platform for the study of psychopathology and to illustrate that platform by presenting our research on depression as an example.

The standard clinical technique for using repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) is associated with limited efficacy to date. Such limited efficacy may be due to reliance on scalp-based targeting rather than state-of-the-science methods which incorporate fMRI-guided neuronavigation based on a specific model of neurocircuit dysfunction. In this review, we examine such a specific model drawn from regulatory focus theory, which postulates two brain/behavior systems, the promotion and prevention systems, underlying goal pursuit. Individual differences in these systems have been shown to predict vulnerability to MDD as well as to comorbid generalized anxiety disorder (GAD). Activation of an individual’s promotion or prevention goals via priming leads to motivational and affective responses modulated by the individual’s appraisal of their progress in attaining the goal. In addition, priming promotion vs. prevention goals induces discriminable patterns of brain activation that are sensitive to the effects of depression and anxiety: MDD is associated with promotion system failure, anhedonic/dysphoric symptoms, and hypoactivation in specific regions in left prefrontal cortex, whereas GAD is associated with prevention system failure, hypervigilant/agitated symptoms, and hyperactivation in right prefrontal cortex (PFC). These left and right PFC locations can be directly targeted in an individualized manner for TMS. Additionally, this individually targeted rTMS can be integrated with cognitive interventions designed to activate the neural circuitry associated with promotion vs. prevention, thus allowing the neuroplasticity induced by the rTMS to benefit the systems likely to be involved in remediating depression. Targeted engagement of cortical systems involved in emotion regulation using individualized fMRI guidance may help increase the efficacy of rTMS in depression.

Auto-biological beliefs—beliefs about one’s own biology—are an understudied component of personal identity. Research participants who are led to believe they are biologically vulnerable to affective disorders report more symptoms and less ability to control their mood; however, little is known about the impact of self-originating beliefs about risk for psychopathology, and whether such beliefs correspond to empirically derived estimates of actual vulnerability. Participants in a neuroimaging study (n = 1256) completed self-report measures of affective symptoms, perceived stress, and neuroticism, and an emotional face processing task in the scanner designed to elicit threat responses from the amygdala. A subsample (n = 63) additionally rated their own perceived neural response to threat (i.e., amygdala activity) compared to peers. Self-ratings of neural threat response were uncorrelated with actual threat-related amygdala activity measured via BOLD fMRI. However, self-ratings predicted subjective distress across a variety of self-report measures. In contrast, in the full sample, threat-related amygdala activity was uncorrelated with self-report measures of affective distress. These findings suggest that beliefs about one’s own biological threat response—while unrelated to measured neural activation—may be informative indicators of psychological functioning.

Objective Recent studies on atypical interoceptive capabilities have focused on clinical populations, including anorexia nervosa[ 1 , 2 ]. The present exploratory study aims to characterize the influence of disordered eating symptomology on interoceptive capabilities in college students, a population for which dangerous dieting behaviors may emerge. Method Ninety-nine participants were randomized to consume a blinded high calorie or low calorie midday shake. Participants reported frequency of eating disorder cognitions and behaviors; indicated changes in satiety, happiness, and energy pre- and post-consumption; and guessed the calories in their shake. Outcomes (perceived satiety, changes in mood, and caloric guess) were regressed on eating disorder symptoms scores, the high/low calorie shake condition, and the interaction between these predictors. Results Those randomized to receive the high calorie shake reported feeling fuller, but only when endorsing lower levels of eating concern. Those randomized to the high calorie shake reported greater post-meal happiness, but only at greater levels of eating concerns. Lastly, those with lower levels of eating restraint reported an expected positive association between level of fullness and calorie guess, but those with higher levels of eating restraint did not exhibit any relationship between perceived fullness and calorie guess. Discussion Results of this exploratory suggest that irregular eating habits (e.g., not eating a sufficient amount for lunch) may have direct consequences on interoceptive capabilities. Further, these capacities may be impacted by individual differences in eating concern and restraint. Preliminary findings suggest that impairment in deciphering visceral signals may be associated with the degree of eating disorder symptomology; such impairment may occur at lower levels of symptomatology than normative data would indicate.

This study examined self-discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi-structured interviews assessing specific types of self-discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self-discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self-discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Despite a growing interest in understanding the cognitive deficits associated with major depressive disorder (MDD), it is largely unknown whether such deficits exist before disorder onset or how they might influence the severity of subsequent illness. The purpose of the present study was to conduct a systematic review and meta-analysis of longitudinal datasets to determine whether cognitive function acts as a predictor of later MDD diagnosis or change in depression symptoms. Eligible studies included longitudinal designs with baseline measures of cognitive functioning, and later unipolar MDD diagnosis or symptom assessment. The systematic review identified 29 publications, representing 34 unique samples, and 121 749 participants, that met the inclusion/exclusion criteria. Quantitative meta-analysis demonstrated that higher cognitive function was associated with decreased levels of subsequent depression (r = −0.088, 95% confidence interval. −0.121 to −0.054, p < 0.001). However, sensitivity analyses revealed that this association is likely driven by concurrent depression symptoms at the time of cognitive assessment. Our review and meta-analysis indicate that the association between lower cognitive function and later depression is confounded by the presence of contemporaneous depression symptoms at the time of cognitive assessment. Thus, cognitive deficits predicting MDD likely represent deleterious effects of subclinical depression symptoms on performance rather than premorbid risk factors for disorder.

Objective Inadequate nutrition adversely impacts brain development and cognitive functioning (Pollitt et al., 1983). Studies examining the acute impact of eating regular meals on cognition have reported inconsistent findings, necessitating the exploration of individual differences in samples contributing to equivocal results. The present study examines the impact of skipping lunch on cognitive ability in college-aged students by including eating restraint as a moderator. Methods Participants were 99 college-aged students (M = 19.7 years, SD = 1.5) randomized to a blinded ‘lunch’ or ‘lunch-omission’ condition, and assessed on memory, attention, processing speed, set shifting, and eating disorder symptomology. Results Regressing long and short-term memory on the lunch manipulation, eating restraint scores, and their interaction revealed significant interactions: those who had lunch had superior memory performance, but only for those reporting lower levels of eating restraint. Regressing set shifting speed on the manipulation, those who had lunch had slower set shifting speed than those who skipped, but only for those reporting lower levels of eating restraint. Conclusions Results suggest that skipping lunch may have immediate consequences on cognition, however, cognitive enhancing effects may be diminished in the presence of even low levels of eating restraint. Findings highlight the significance of purported subclinical levels of eating restraint and may inform health education strategies.

Cancer treatment poses significant challenges not just for those diagnosed with the disease but also for their intimate partners. Evidence suggests that couples' communication plays a major role in the adjustment of both individuals and in the quality of their relationship. Most descriptive studies linking communication to adjustment have relied on traditional questionnaire methodologies and cross-sectional designs, limiting external validity and discernment of temporal patterns. Using the systemic-transactional model of dyadic coping as a framework, we examined intra- and inter-personal associations between communication (both enacted and perceived) and relationship satisfaction (RS) among patients with stage II–IV breast or colorectal cancer and their spouses (N = 107 couples). Participants (mean age = 51, 64.5% female patients, and 37.4% female spouses) independently completed twice-daily ecological momentary assessments (EMA) via smartphone for 14 consecutive days. Items assessed RS and communication (expression of feelings, holding back from expression, support and criticism of partner, and parallel ratings of partner behavior). Linear mixed models employing an Actor Partner Interdependence Model were used to examine concurrent, time-lagged, and cross-lagged associations between communication and RS. Expressing one's feelings was unassociated with RS. Holding back from doing so, in contrast, was associated with lower RS for both patients and spouses in concurrent models. These effects were both intrapersonal and interpersonal, meaning that when individuals held back from expressing their feelings, they reported lower RS and so too did their partner. Giving and receiving support were associated with one's own higher RS for both patients and spouses in concurrent models, and for patients in lagged models. Conversely, criticizing one's partner and feeling criticized were maladaptive, associated with lower RS (own and in some cases, partner's). Cross-lagged analyses (evening RS to next-day afternoon communication) yielded virtually no effects, suggesting that communication may have a stronger influence on short-term RS than the reverse. Findings underscore the importance of responsive communication, more so than expression per se, in explaining both concurrent and later relationship adjustment. In addition, a focus on holding back from expressing feelings may enhance the understanding of RS for couples coping with cancer.

Background Individuals with extreme food avoidance such as Avoidant Restrictive Food Intake Disorder (ARFID) experience impairing physical and mental health consequences from nutrition of insufficient variety or/and quantity. Identifying mechanisms contributing to food avoidance is essential to develop effective interventions. Anxiety figures prominently in theoretical models of food avoidance; however, there is limited evidence that repeated exposures to foods increases approach behavior in ARFID. Studying disgust, and relationships between disgust and anxiety, may offer novel insights, as disgust is functionally associated with avoidance of contamination from pathogens (as may occur via ingestion) and is largely resistant to extinction. Method This exploratory, cross-sectional study included data from 1,644 adults who completed an online questionnaire. Participant responses were used to measure ARFID classification, picky eating, sensory sensitivity, disgust, and anxiety. Structural equation modeling tested a measurement model of latent disgust and anxiety factors as measured by self-reported frequency of disgust and anxiety reactions. Mediational models were used to explore causal ordering. Results A latent disgust factor was more strongly related to severity of picky eating (B ≈ 0.4) and ARFID classification (B ≈ 0.6) than the latent anxiety factor (B ≈ 0.1). Disgust partially mediated the association between anxiety and picky eating and fully mediated the association between anxiety and ARFID. Models testing the reverse causal ordering demonstrated poorer fit. Findings suggest anxiety may be associated with food avoidance in part due to increased disgust. Conclusions Disgust may play a prominent role in food avoidance. Findings may inform novel approaches to treatment.

Clarifying individual differences that predict resilience or vulnerability to emotional distress is crucial for identifying etiological factors contributing to affective disturbances, and to promoting emotional well-being. Despite recent progress identifying specific brain regions and personality traits, it remains unclear whether there are common factors underlying the structural aspects of the brain and the personality traits that, in turn, protect against symptoms of emotional distress. In the present study, an integrative structural equation model was developed to examine the associations among (1) a latent construct ofControl, representing the volumes of a system of prefrontal cortical (PFC) regions including middle, inferior, and orbital frontal cortices; (2) a latent construct ofResiliencepersonality traits including cognitive reappraisal, positive affectivity, and optimism; and (3)AnxietyandDepressionsymptoms, in a sample of 85 healthy young adults. Results showed that the latent construct of PFC volumes positively predicted the latent construct ofResilience, which in turn negatively predictedAnxiety. Mediation analysis confirmed that greater latent PFC volume is indirectly associated with lowerAnxietysymptoms through greater latent traitResilience. The model did not show a significant mediation forDepression. These results support the idea that there are common volumetric and personality factors that help protect against symptoms of emotional distress. These findings provide strong evidence that such brain-personality-symptom approaches can provide novel insights with valuable implications for understanding the interaction of these factors in healthy and clinically diagnosed individuals.

Individuals orient themselves in relationships using different goals and preoccupations, often conceptualized as four distinct attachment styles (Bartholomew & Horowitz, 1991). Individuals also orient themselves in the social world more broadly using different motivational preferences and styles. Self-discrepancy theory (Higgins, 1987) and regulatory focus theory (Higgins, 1997) are two frameworks used to conceptualize these motivational styles. In two studies we investigated the extent to which preoccupations in relationships reflected broader life goals. In Study 1, college participants reported attachment style and self-discrepancies (ideal and ought selves). In Study 2, community participants reported attachment style and regulatory focus (promotion and prevention orientations). Across two different samples, using distinct but complementary theoretical frameworks, we found a consistent pattern whereby a more approach-oriented relationship orientation (secure attachment), was related to a more approach-oriented general life orientation (lower actual-ideal discrepancy and greater promotion focus). Interestingly, attachment style was unrelated to avoidance-oriented motivational styles. These results suggest that motivations within relationships may be specifically related to growth motivations in broader aspects of life.

Self-system therapy (SST) for depression is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. The treatment is grounded in an extensive research literature on self-regulation, and it translates that empirical work into therapeutic strategies aimed at enhancing effective goal pursuit in clients with depression. Studies have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits and that SST works in part by restoring adaptive self-regulation. Presented in a simplified format, the Therapist Guide provides clinicians with the critical theoretical background that forms the foundation of SST. It includes worksheets to aid therapists in treatment planning. Detailed descriptions of the core SST interventions, which are conducted during a 16-week course of therapy, are provided along with an optional module for managing perfectionism, which is prevalent among clients with depression. The accompanying Client Workbook explains the core SST concepts using concrete examples; it includes worksheets that can be used by the client to enhance learning and at-home application of the skills.

Chapter 3 explains how relationships with other people can affect the ways in which people think about goals. The second goal of the orientation phase of self-system therapy is to determine the source of the client’s particular style of self-regulation. Style in this context refers to the client’s tendency to focus on promotion goals (i.e., trying to make good things happen) or prevention goals (i.e. trying to keep bad things from happening). Each type of goal is connected to certain emotional experiences and is influenced by personal relationships. Worksheets are included to help clients explore how their relationships have affected their expectations and standards.

Chapter 5 provides a session-by-session guide to the orientation phase of self-system therapy (SST). The main goals of orientation are to familiarize the client with the structure and focus of SST and to establish a strong, collaborative working alliance that supports the client’s efforts in identifying and addressing underlying sources of problems in self-regulation. The orientation phase involves educating the client about self-regulation, reinstating goal-directed activities, conducting a self-in-context assessment, and developing a problem formulation. The therapist completes an evaluation of the client’s presenting problems, introduces the idea of self-regulation, and searches for the possible origins of self-guides and standards to develop a formulation of the problems with self-regulation that are most directly associated with the depression. SST emphasizes the breakdown in motivation that characterizes episodes of depression and uses the orientation phase to begin to increase the client’s level of goal-directed activity (especially promotion-oriented activity) and identify targets for change.