Overcoming Challenges in Preregistration to Improve Statistical Inferences in Clinical Science

Preregistration of hypotheses and analysis plans on a public, time-stamped registry (e.g., Open Science Framework; OSF) before observing research outcomes promotes transparency and distinguishes planned from unplanned analyses, thereby guarding against selective reporting, improving validity of inferences for planned analyses, and enabling calibration of confidence for unplanned analyses (Nosek et al., 2018; Nosek et al., 2019). Further, preregistration can benefit individual researchers by enabling credit for planned analyses (e.g., in-principle acceptance of Registered Reports, even for null results), signaling rigor (improving publishability), revealing design flaws early, aiding recall of study details and plans, and improving communication with collaborators (Logg & Dorison, 2021; Simmons et al., 2021; Wagenmakers & Dutilh, 2016). Clinical psychologists may be familiar with registering clinical trial procedures (e.g., eligibility criteria, conditions, outcomes) on websites such as ClincalTrials.gov; however, procedures are registered for only a fraction of trials (Nutu et al., 2019), and where registration is required (e.g., by U.S. law), detailed analysis plans (beyond listing outcomes) are not yet required (Cybulski et al., 2016; Nosek et al., 2018). Preregistering detailed hypotheses and analysis plans can be difficult (Nosek et al., 2019); the present article addresses calls for more training (Berenbaum et al., 2021) by presenting strategies for overcoming challenges in clinical science (for resources on creating a preregistration and applying key strategies, see Table S1 at https://doi.org/kbv8)

Data and Analysis Scripts

Raw data and anonymized analysis scripts for the project: Anxiety Sensitivity, Distress Intolerance, and Negative Interpretation Bias Strengthen the Relationship Between Trait Anxiety and Depersonalizatio

Using Advances from Cognitive Science to Understand the Etiology and Maintenance of Psychopathology

Far too often, psychologists stay isolated in their particular area—we identify as a cognitive psychologist or a clinical psychologist, but rarely as both; we attend clinical psychology conferences or cognitive ones, but there is little overlap in attendance; we recruit graduate students in one area or the other, but seldom advise across areas. Yet, so much of the exciting work happens at the intersection between areas and disciplines, as we integrate (and beg, borrow, and steal!) theories, paradigms, and methods from across fields to create a novel synthesis. This has been especially true in the marriage between clinical and cognitive science, and the results have taught us a great deal about how thinking changes along the continuum from mental health to mental illness. The aim of this special issue is to bring together reviews of cutting-edge research that illustrate how advances in cognitive science have improved our understanding of the etiology and maintenance of psychopathology, while also highlighting the many questions that remain unanswered. Authors were asked to consider how the application of cognitive science theories, methods, and paradigms has increased understanding of the etiology and maintenance of a particular clinical domain in light of the evidence related to distal and proximate risk and vulnerability. They were also asked to consider gaps in our understanding, such as the limited evidence for causal relationships between cognitive changes and onset of psychopathology. Beyond etiology, authors were encouraged to discuss how cognitive science has altered the ways we prevent, assess, diagnose, and treat each clinical domain, and they were asked to envision how these advances might alter clinical practice over the next 5, 10, and 20 years. Recognizing that we have far more questions than answers at this stage, we also asked authors to consider how to remove the barriers to making more rapid progress; that is, what methodological, theoretical, and infrastructure advances are needed to optimize the contributions that cognitive science can make to reducing the burden of mental illness? Along these lines, to make salient one obvious example of a gap in our knowledge that is hindering progress, all authors were asked to discuss what we currently know (and more importantly, don’t know) about the ways individual differences and identities, such as demographic characteristics tied to race and ethnicity, age, sex, and so forth, interact with cognitive processes to alter the expression of and outcomes for a given clinical domain. The authors rose to the challenge. They wrote about a wide variety of cognitive processes and clinical problem areas, and their papers make clear not only the tremendous progress that has occurred in this subfield, but also the long way that the marriage between clinical and cognitive science has to go to fulfill its promise

Multilevel Associations of Daily Skill Use and Effectiveness With Anxiety, Stress, and Depression in a Transdiagnostic Sample Undergoing Dialectical Behavior Therapy Skills Training

Dialectical Behavior Therapy (DBT) is relatively effective at treating disorders of emotion dysregulation. However, given researchers’ focus on group-level differences within disorder-specific treatments, it is unclear which transdiagnostic mechanisms influence these effects. Participants (n=19, Mage=31.8, 68% female, 95% Caucasian) with elevated emotion dysregulation completed daily reports of DBT skill use, perceived effectiveness, anxiety, stress, and depression during a DBT skills training group (1,344 observations). We tested whether within-person skill use was associated with same-day negative affect, predicted next-day changes in negative affect, and was moderated by perceived emotion regulation effectiveness. Participants used more within-person skills on days of greater stress and anxiety, which predicted next-day decreases in stress and anxiety. On days of high, but not low, perceived effectiveness, people used more skills in response to more intense negative affect. The use, and perceived effectiveness, of more skills may be mechanisms by which DBT skills groups promote improved emotional functioning

Adapting Cognitive Bias Modification to Train Healthy Prospection

Prospection, the mental simulation of future events, has been theoretically linked to physical and mental health. Prior studies have found that prospection is malleable; however, no research to our knowledge has tested whether a scalable intervention explicitly targeting the simulation of positive future outcomes can lead to more generalized positive prospection, and enhance positive outlook and reduce distress. The current study tested a novel, web-based cognitive bias modification for interpretation (CBM-I) program designed to shift prospective bias towards more positive (as opposed to negative) representations of future outcomes among 172 participants selected for having a relatively negative baseline expectancy bias. Results showed that following CBM-I, participants in active training conditions exhibited more positive expectations about the future, and increased self-efficacy and growth mindset. Also, optimism increased and depression and anxiety symptoms decreased following active training, but this also occurred for the control condition. Analyses did not suggest that changes in positive expectations mediated changes in positive outlook outcomes. Results suggest that an online prospection intervention can lead to more positive expectations about future events and improve positive outlook, though open questions remain about what accounts for the training effects

Anxiety Identity Centrality Is Associated With Avoidant Coping in Anxious Adults

Background. Some have suggested that labeling oneself as having clinical anxiety may promote avoidant coping, which is associated with poor clinical outcomes. However, the construct of anxiety identity centrality (seeing one’s anxiety as relatively important to one's self-concept) has rarely been assessed, and its relationship with avoidant coping has not been investigated. Methods. In a sample of N = 1,234 trait anxious adults, we analyzed the relationship between anxiety identity centrality and situational and experiential avoidance (preregistration: https://osf.io/g8qh9/). A Bayesian ordered probit regression framework was used to model the relationships between ordinal variables. Results. As hypothesized, anxiety identity centrality showed small-to-medium positive correlations with situational (r = .42, p < .001) and experiential (r = .12, p < .001) avoidance. After controlling for anxiety symptom severity, anxiety identity centrality was still positively associated with situational (b = 0.34, 95% credible interval [0.22, 0.48]) and experiential (b = 0.13, 95% CI [0.03, 0.28]) avoidance. Limitations. The present study is cross-sectional; we cannot infer causal or temporal relationships between anxiety identity centrality and avoidant coping. Conclusions. Anxiety identity centrality is a reliable correlate of avoidant coping that can be measured with a single-item ordinal measure. Future research should investigate their causal relationship