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APA Journal of Abnormal Psychology

Seeking proxies for internal states in obsessive–compulsive disorder.Open in a New Window

Pervasive doubts are a central feature of obsessive–compulsive disorder (OCD). We have theorized that obsessive doubts can arise in relation to any internal state and lead to compensatory reliance on more discernible substitutes (proxies), including rules and rituals. Previous findings corroborated this hypothesis, but were based on students with high and low OCD tendencies and did not control for anxiety. The present study tested our hypothesis in OCD participants using both anxiety disorders and nonclinical controls. Twenty OCD participants, 20 anxiety disorders participants, and 20 nonclinical participants underwent 2 experimental procedures. In the first, participants had to produce specific levels of muscle tension with and without the aid of biofeedback. In the second, participants were asked to subjectively assess their own muscle tension after viewing preprogrammed false feedback showing either increasing or decreasing levels of muscle tension. As predicted, OCD participants were less accurate than anxiety disorder and nonclinical participants in producing designated levels of muscle tension when biofeedback was not available and more likely to request the biofeedback when given the opportunity to do so. In the false feedback procedure, OCD participants were more influenced by the false biofeedback when judging their own level of muscle tension compared with the 2 controls groups. In both procedures, anxiety disorder participants did not differ from the nonclinical controls. These results support the hypothesis that individuals with OCD have attenuated access to and reduced confidence in their internal states, and that this deficit is specific to OCD and not attributable to anxiety. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Performance monitoring in obsessive–compulsive disorder and social anxiety disorder.Open in a New Window

Overactive performance monitoring, indexed by greater error-related brain activity, has been frequently observed in individuals with obsessive–compulsive disorder (OCD). Similar alterations have been found in individuals with major depressive and generalized anxiety disorders. The main objective was to extend these findings by investigating performance monitoring in individuals with social anxiety disorder (SAD) and to evaluate the specificity of performance-monitoring changes in OCD. Event-related potentials were used to examine error-related brain activity during a flanker task in 24 individuals with OCD, 24 individuals with SAD, and 24 healthy controls with no history of neurological or psychiatric disorders. Error-related negativity (ERN) and correct-related negativity served as electrophysiological indicators for performance monitoring. Enhanced ERN was expected for both clinical groups, but differential associations with clinical symptoms were explored. ERN amplitudes were larger in individuals with OCD and SAD than in healthy controls. Correlational analyses did not reveal significant associations between ERN and clinical symptomatology in OCD, but a significant correlation with depressive symptoms was found in the SAD group. These findings further strengthen the idea that overactive performance monitoring is independent of clinical symptoms in OCD. Furthermore, it may also represent a transdiagnostic vulnerability indicator, although the relationship with clinical symptoms observed in the SAD group needs additional evaluation. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Self and friend’s differing views of social anxiety disorder’s effects on friendships.Open in a New Window

Social anxiety disorder is known to be associated with self-report of global friendship quality. However, information about specific friendships, as well as information beyond self-report, is lacking. Such information is crucial, because known biases in information processing related to social anxiety disorder render global self-ratings particularly difficult to interpret. We examined these issues focusing on diagnosed participants (n = 77) compared with community control participants (n = 63). We examined self-report regarding global (i.e., overall) friendship quality and a specific friendship’s quality; in addition, we examined friend-report of that friendship’s quality. Results suggested that social anxiety disorder has a negative impact on self-perception of friendship quality for a specific friendship, but that this effect is less evident as reported by the friends. Specifically, social anxiety disorder was associated with a tendency to report worse friendship quality in comparison to friend-report, particularly in participants who were younger or had less long-lasting friendships. However, friend-report did show clear differences based on diagnostic group, with friends reporting participants with social anxiety disorder to be less dominant in the friendship and less well-adjusted. Overall, the findings are consistent with results of other studies indicating that social anxiety disorder has a strong association with self-ratings of impairment, but that these ratings appear out of proportion with the report of observers (in this case, friends). (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Timing and tempo: Exploring the complex association between pubertal development and depression in African American and European American girls.Open in a New Window

The relative contribution of pubertal timing and tempo to the development of depression has not been tested in a large, representative sample, nor has the interface among pubertal maturation, depression, and race been tested. Participants were a community-based sample of 2,450 girls from the Pittsburgh Girls Study who were interviewed annually from ages 9 to 17 years. Pubertal timing and tempo were characterized as a unitary construct and also separately for pubic hair and breast development using child and maternal report. Depression symptoms were assessed annually. African American girls had higher depression symptoms and progressed through puberty earlier, but at a slower tempo than European American girls. Girls with earlier timing had higher levels of depression symptoms at age 10 years. Slower tempo was associated with higher depression symptoms at age 10, and faster tempo was associated with increases in depression from ages 10 to 13. As well, race moderated the associations among timing, tempo, and depression symptoms, and the association between race and depression was partially mediated by pubertal timing and tempo. Pubertal timing and tempo and race contribute to the developmental course of depression from early to late adolescence. The pattern of association varies as a function of the developmental window within which depression is assessed. Thus, repeated measures of depression symptoms and puberty across the span of pubertal development are necessary for exploring the relative importance of dimensions of pubertal development to depression etiology. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

What constitutes vulnerable self-esteem? Comparing the prospective effects of low, unstable, and contingent self-esteem on depressive symptoms.Open in a New Window

A growing body of longitudinal studies suggests that low self-esteem is a risk factor for depression. However, it is unclear whether other characteristics of self-esteem, besides its level, explain incremental or even greater variance in subsequent depression. We examined the prospective effects of self-esteem level, instability (i.e., the degree of variability in self-esteem across short periods), and contingency (i.e., the degree to which self-esteem fluctuates in response to self-relevant events) on depressive symptoms in 1 overarching model, using data from 2 longitudinal studies. In Study 1, 372 adults were assessed at 2 waves over 6 months, including 40 daily diary assessments at Wave 1. In Study 2, 235 young adults were assessed at 2 waves over 6 weeks, including about 6 daily diary assessments at each wave. Self-esteem contingency was measured by self-report and by a statistical index based on the diary data (capturing event-related fluctuations in self-esteem). In both studies self-esteem level, but not self-esteem contingency, predicted subsequent depressive symptoms. Self-esteem instability predicted subsequent depressive symptoms in Study 2 only, with a smaller effect size than self-esteem level. Also, level, instability, and contingency of self-esteem did not interact in the prediction of depressive symptoms. Moreover, the effect of self-esteem level held when controlling for neuroticism and for all other Big Five personality traits. Thus, the findings provide converging evidence for a vulnerability effect of self-esteem level, tentative evidence for a smaller vulnerability effect of self-esteem instability, and no evidence for a vulnerability effect of self-esteem contingency. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

The expression of depression in Asian Americans and European Americans.Open in a New Window

Past studies of the expression of depression in people of Asian descent have not considered whether observed ethnic differences in somatization or psychologization are a function of differences in the expression of the disorder or of group differences in the degree of depressive symptomatology. In the present study, we carried out χ² and Item Response Theory (IRT) analyses to examine ethnic differences in symptoms of Major Depressive Disorder in a nationally representative community sample of noninstitutionalized Asian Americans (n = 310) and European Americans (n = 1,763). IRT analyses were included because they can help discern whether there are differences in the expression of depressive symptoms, regardless of ethnic differences in the degree of depressive symptomatology. In general, although we found that Asian Americans have lower rates of depression than European Americans, when examining specific symptoms, there were more similarities (i.e., symptoms with no ethnic differences) than differences. An examination of the differences using both Χ² and IRT analyses revealed that when there were differences, Asian Americans were less likely to endorse specific somatic and psychological symptoms than European Americans, even when matched in degree of depressive symptomatology. Together, these community-based findings indicate that depression among Asian Americans is more similar than different to that of European Americans. When differences do occur, they are not an artifact of the degree of depressive symptomatology but instead a true difference in the expression of the disorder, specifically a lesser likelihood of expressing specific somatic and psychological symptoms in Asian Americans compared with European Americans. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Social cognition and functional outcome in schizophrenia: The moderating role of cardiac vagal tone.Open in a New Window

Individuals with schizophrenia face significant challenges in daily functioning, and although social cognition predicts how well patients respond to these challenges, associated physiological mechanisms remain unspecified. The present study draws from polyvagal theory and tested the hypothesis that respiratory sinus arrhythmia (RSA), an established indicator of the capacity to self-regulate and adapt to environmental demands, combines with social cognition to predict functional outcome. Using data from 41 schizophrenia patients and 36 healthy comparison subjects, we replicated group differences in RSA and social cognition and also demonstrated that RSA and social cognition interact to predict how effectively patients manage work and independent living activities. Specifically, RSA did not enhance functional outcomes when social cognition was already strong, but higher levels of RSA enabled effective role functioning when social–cognitive performance was impaired. Jointly, RSA and social cognition accounted for 40% of the variance in outcome success, compared with 21% when evaluating social cognition alone. As polyvagal theory suggests, physiological flexibility and self-regulatory capacity may compensate for poorer social–cognitive skills among schizophrenia patients. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Do people with schizophrenia have difficulty anticipating pleasure, engaging in effortful behavior, or both?Open in a New Window

Motivation deficits are common in schizophrenia, but little is known about underlying mechanisms, or the specific goals that people with schizophrenia set in daily life. Using neurobiological heuristics of pleasure anticipation and effort assessment, we examined the quality of activities and goals of 47 people with and 41 people without schizophrenia, utilizing ecological momentary assessment. Participants were provided cell phones and called 4 times a day for 7 days, and were asked about their current activities and anticipation of upcoming goals. Activities and goals were later coded by independent raters on pleasure and effort. In line with recent laboratory findings on effort computation deficits in schizophrenia, relative to healthy participants, people with schizophrenia reported engaging in less effortful activities and setting less effortful goals, which were related to patient functioning. In addition, patients showed some inaccuracy in estimating how difficult an effortful goal would be, which in turn was associated with lower neurocognition. In contrast to previous research, people with schizophrenia engaged in activities and set goals that were more pleasure-based, and anticipated goals as being more pleasurable than controls. Thus, this study provided evidence for difficulty with effortful behavior and not anticipation of pleasure. These findings may have psychosocial treatment implications, focusing on effort assessment or effort expenditure. For example, to help people with schizophrenia engage in more meaningful goal pursuits, treatment providers may leverage low-effort pleasurable goals by helping patients to break down larger, more complex goals into smaller, lower-effort steps that are associated with specific pleasurable rewards. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

"The effect of disgust and fear modeling on children's disgust and fear for animals": Correction to Askew et al. (2014).Open in a New Window

Reports an error in "The effect of disgust and fear modeling on children’s disgust and fear for animals" by Chris Askew, Kübra Çakır, Liine Põldsam and Gemma Reynolds (Journal of Abnormal Psychology, 2014[Aug], Vol 123[3], 566-577). The article was missing the acknowledgement of the funding source in the author note. The funding source is provided in the erratum, and the online version of this article has been corrected. (The following abstract of the original article appeared in record 2014-25367-001.) Disgust is a protective emotion associated with certain types of animal fears. Given that a primary function of disgust is to protect against harm, increasing children’s disgust-related beliefs for animals may affect how threatening they think animals are and their avoidance of them. One way that children’s disgust beliefs for animals might change is via vicarious learning: by observing others responding to the animal with disgust. In Experiment 1, children (ages 7–10 years) were presented with images of novel animals together with adult faces expressing disgust. Children’s fear beliefs and avoidance preferences increased for these disgust-paired animals compared with unpaired control animals. Experiment 2 used the same procedure and compared disgust vicarious learning with vicarious learning with fear faces. Children’s fear beliefs and avoidance preferences for animals again increased as a result of disgust vicarious learning, and animals seen with disgust or fear faces were also rated more disgusting than control animals. The relationship between increased fear beliefs and avoidance preferences for animals was mediated by disgust for the animals. The experiments demonstrate that children can learn to believe that animals are disgusting and threatening after observing an adult responding with disgust toward them. The findings also suggest a bidirectional relationship between fear and disgust with fear-related vicarious learning leading to increased disgust for animals and disgust-related vicarious learning leading to increased fear and avoidance. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Hyperfocusing in schizophrenia: Evidence from interactions between working memory and eye movements.Open in a New Window

Recent research suggests that processing resources are focused more narrowly but more intensely in people with schizophrenia (PSZ) than in healthy control subjects (HCS), possibly reflecting local cortical circuit abnormalities. This hyperfocusing hypothesis leads to the counterintuitive prediction that, although PSZ cannot store as much information in working memory as HCS, the working memory representations that are present in PSZ may be more intense than those in HCS. To test this hypothesis, we used a task in which participants make a saccadic eye movement to a peripheral target and avoid a parafoveal nontarget while they are holding a color in working memory. Previous research with this task has shown that the parafoveal nontarget is more distracting when it matches the color being held in working memory. This effect should be enhanced in PSZ if their working memory representations are more intense. Consistent with this prediction, we found that the effect of a match between the distractor color and the memory color was larger in PSZ than in HCS. We also observed evidence that PSZ hyperfocused spatially on the region surrounding the fixation point. These results provide further evidence that some aspects of cognitive dysfunction in schizophrenia may be a result of a narrower and more intense focusing of processing resources. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Diminished emotion expressivity but not experience in men and women with schizophrenia.Open in a New Window

Prior studies indicate that men with schizophrenia are less outwardly expressive but report similar emotion experience as healthy people. However, it is unclear whether women with schizophrenia show this same disconnect between expressivity and experience. Men (n = 24) and women (n = 25) with schizophrenia or schizoaffective disorder and women without schizophrenia (n = 25) viewed emotionally evocative film clips and were video recorded to assess facial expressivity. Participants also reported their emotion experience after each clip. Men and women with schizophrenia did not significantly differ from one another in the frequency of facial expressions, but both groups exhibited fewer expressions than women without schizophrenia. People with schizophrenia also reported lower levels of trait expressivity compared with women without schizophrenia. Overall, people with schizophrenia did not differ from controls on self-reported emotion experience with one exception: Women with schizophrenia reported more unpleasant emotion than controls. These results indicate that both women and men with schizophrenia exhibit fewer outward expressions but experience comparable emotion experience as people without schizophrenia. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Comparing criterion- and trait-based personality disorder diagnoses in DSM-5.Open in a New Window

In the recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the official personality disorder (PD) classification system remains unchanged. However, DSM-5 also includes an alternative hybrid categorical-dimensional PD system in Section III to spur additional research. One defining feature of the alternative system is the incorporation of a trait model with PD-specific trait configurations, but relatively little work has evaluated how these traits map onto official PD diagnoses or their implications for diagnosis rates. To that end, we compared official PD criteria to Section III PD traits in a sample of current or recent psychiatric patients. We (a) evaluated the extent to which PD traits predicted traditional PD criterion counts, and (b) computed trait-based diagnosis rates and compared them to those reported in several published outpatient and epidemiological samples. Overall, PD traits generally predicted PD criterion counts, but with less than ideal specificity. In addition, we identified differences in diagnosis rates across approaches. These results provide some support for the Section III approach, but they also identify important areas in need of refinement and future study before the field could reasonably switch to a hybrid PD classification approach like that in Section III. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Personality disorders and the persistence of substance use disorders: A reanalysis of published NESARC findings.Open in a New Window

The purpose of this study was to examine whether published findings regarding the association of personality disorders (PDs) with the persistence of substance use disorders (SUDs) are attributable to an artifact due to time of assessment of the PD. Two previous studies analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and found that Antisocial PD, Schizotypal PD, and Borderline PD are unique predictors of SUDs. However, a design limitation in NESARC (assessment of PDs at different waves) can potentially compromise these findings. To assess the influence of time of assessment of PDs and to identify associations that might be robust to time of assessment, we compared the association of PDs with 2 estimates of SUD persistence that were based on different populations at risk: (a) among those who were diagnosed with SUD at baseline, the proportion who continued to meet full criteria at follow-up (“prediction”); and (b) among those who were diagnosed with SUD at follow-up, the proportion who met full criteria at baseline (“postdiction”). Differences between prediction and postdiction revealed a robust pattern of higher odds ratios for postdiction among PDs assessed at baseline, and lower odds ratios for postdiction among PDs assessed at follow-up. All published significant associations between PDs and persistence of SUDs became nonsignificant in the postdiction analyses, with the exception of obsessive-compulsive PD predicting nicotine dependence persistence. The present results raise serious doubts about the validity of published findings on PDs and SUD persistence from the NESARC. Design limitations in NESARC preclude a direct comparison among PDs measured at different waves. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

The temporal relationship between posttraumatic stress disorder and problem alcohol use following traumatic injury.Open in a New Window

Chronic alcohol abuse is a major public health concern following trauma exposure; however, little is known about the temporal association between posttraumatic stress disorder (PTSD) symptoms and problem alcohol use. The current study examined the temporal relationship between PTSD symptom clusters (re-experiencing, effortful avoidance, emotional numbing, and hyperarousal) and problem alcohol use following trauma exposure. This study was a longitudinal survey of randomly selected traumatic injury patients interviewed at baseline, 3 months, 12 months, and 24 months following injury. Participants were 1,139 injury patients recruited upon admission from 4 Level 1 trauma centers across Australia. Participants were assessed using the Clinician Administered PTSD Scale and Alcohol Use Disorders Identification Test. Results indicated that high levels of re-experiencing, effortful avoidance, and hyperarousal symptoms at 12 months were associated with greater increases (or smaller decreases) in problem alcohol use between 12 and 24 months. Findings also suggested that high levels of problem alcohol use at 12 months were associated with greater increases (or smaller decreases) in emotional numbing symptoms between 12 and 24 months. These findings highlight the critical importance of the chronic period following trauma exposure in the relationship between PTSD symptoms and problem alcohol use. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

The modal suicide decedent did not consume alcohol just prior to the time of death: An analysis with implications for understanding suicidal behavior.Open in a New Window

We identified and analyzed a total of 92 studies, representing 167,894 suicide decedents, to determine if there is evidence to support what appears to be a widely held cultural, clinical, and scholarly view that many people who die by suicide had been drinking at the time of death. It was determined that, based on weighted averages, approximately 27% of suicide decedents had above-zero blood alcohol concentrations (BACs) at the time of death. We emphasize that it was not 27% who were intoxicated at the time of death; rather, 27% had above-zero BACs and 73% had BACs of 0.00%. Among studies of suicide decedents, BACs differed as a function of race (higher in non-White individuals). We conclude that the role of alcohol use at the time of death may be less than some assume, and this interpretation can inform clinical practice and theories of suicide. Important unanswered questions are posed which will help refine research in this area going forward. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

 

Identifying the irritability dimension of ODD: Application of a modified bifactor model across five large community samples of children.Open in a New Window

The importance of irritability, as measured among the symptoms of oppositional defiant disorder (ODD), has dramatically come to the fore in recent years. New diagnostic categories rely on the distinct clinical utility of irritability, and models of psychopathology suggest it plays a key role in explaining developmental pathways within and between disorders into adulthood. However, only a few studies have tested multidimensional models of ODD, and the results have been conflicting. Further, consensus has not been reached regarding which symptoms best identify irritability. The present analyses use 5 large community data sets with 5 different measures of parent-reported ODD, comprising 16,280 youth in total, to help resolve these questions. Across the samples, ages ranged from 5 to 18, and included both boys and girls. Confirmatory factor analyses demonstrated that a modified bifactor model showed the best fit in each data set. The structure of the model included 2 correlated specific factors (irritability and oppositional behavior) in addition to a general ODD factor. In 4 models, the best fit was obtained using the items “being touchy,” “angry,” and “often losing temper” as indicators of irritability. Given the structure of the models and the generally high correlation between the specific dimensions, the results suggest that irritability may not be sufficiently distinct from oppositional behavior to support an entirely independent diagnosis. Rather, irritability may be better understood as a dimension of psychopathology that can be distinguished within ODD, and which may be related to particular forms of psychopathology apart from ODD. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
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