Cognitive Behavioral Therapy for Anxiety Disorders in Youth

Cognitive behavioral therapies (CBTs) have been shown to be efficacious for the treatment of anxiety disorders in children and adolescents. Randomized clinical trials indicate that approximately two-thirds of children treated with CBT will be free of their primary diagnosis at posttreatment. Although several CBT treatment packages have been investigated in youth with diverse anxiety disorders, common core components have been identified. A comprehensive assessment, development of a good therapeutic relationship and working alliance, cognitive restructuring, repeated exposure with reduction of avoidance behavior, and skills training comprise the core procedures for the treatment of anxiety disorders in youth

An analogue study examining Attitude Change Theory and its implications for dissemination and implementation of empirically supported treatments

Despite the promise of research-based treatments, dissemination into community settings has been problematic. Attitudes toward these treatments may be partially responsible for the slow uptake. Building on the functional theory of attitudes, it was hypothesized that presenting emotion-focused rather than cognitively-focused information about a treatment would produce more positive attitudes toward the treatment in individuals interested in clinical practice. To test this hypothesis, 144 students (116 women; Mage = 22.46 years) completed a measure of vocational interest and evaluated a treatment after reading either an emotional or cognitive passage about the treatment. Consistent with the hypothesis, participants’ interests in clinical activities were related to more favorable reactions to the emotional passage but not the cognitive passage. This effect was partially mediated by message elaboration. Findings suggest that presenting clinicians with emotionally rich information on treatment options may help bridge the gap between research and practice

An Association Between Perceived Social Support and Posttraumatic Stress Symptom Severity Among Women With Lifetime Sexual Victimization: The Serial Mediating Role of Resilience and Coping

This study examined the association between perceived social support and severity of posttraumatic stress symptoms, serially mediated by resilience and coping among women exposed to different patterns of sexual victimization experiences: childhood sexual abuse (CSA) only, adult sexual assault (ASA) only, and sexual revictimization (SR). A total of 255 sexually victimized women recruited from four U.S. universities completed self-report measures online; 112 participants reported provisionally diagnosable levels of symptoms of posttraumatic stress disorder (PTSD). The proposed model was largely supported in the CSA only group and the SR group. Different patterns of mediational effects were found across the three groups. Clinical and theoretical implications are discussed

Latino and Non-Latino Parental Treatment Preferences for Child and Adolescent Anxiety Disorders

There is frequently a presumption that Latino parents have a greater preference for involvement in their child’s treatment for anxiety compared to non-Latino white parents. However, parent involvement may increase burdens associated with treatment and research suggests that Hispanic individuals already face significantly greater barriers to obtaining mental health treatment. In the current study, we compared Latino and non-Latino parents’ preferences for parental involvement and perceptions of burdens in cognitive behavioral therapy (CBT) for youth anxiety. 117 parents (57 Latino) completed measures to assess child anxiety, perceptions of treatment involvement, and burdens associated with treatment. There were no significant differences between Latino and non-Latino parents except for a trend toward Latino parents reporting more concerns about the feasibility of obtaining CBT for their child’s anxiety. Because Latino parents expressed concern about potential treatment barriers, cultural adaptations for treatment should focus on decreasing burden rather than increasing parental involvement

Positive Health and Health Assets: Re-analysis of Longitudinal Datasets

Most approaches to health over the centuries have focused on the absence of illness. In contrast, we are investigating Positive Health —well-being beyond the mere absence of disease. In this article, we describe our theoretical framework and empirical work to date on Positive Health. Positive Health empirically identifies health assets by determining factors that predict health and illness over and above conventional risk factors. Biological health assets might include, for example, high heart rate variability, high levels of HDL, and cardiorespiratory fitness. Subjective health assets might include positive emotions, life satisfaction, hope, optimism, and a sense of meaning and purpose. Functional health assets might include close friends and family members; a stable marriage; meaningful work; participation in a social community; and the ability to carry out work, family, and social roles

Preparing Women In Academic Psychology for Their First Compensation Negotiation: A Panel Perspective of Challenges & Future Recommendations

Successfully landing and then negotiating for your first position is an exciting and challenging task. In this paper, we use a narrative review to present the literature on gender and negotiation with a focus on academic psychology work contexts. We highlight important differences between factors that are within the individual’s control vs. factors at the institutional or societal level. Drawing directly from the research literature, we make several recommendations for women trying to manage negotiation in contexts that are likely biased against them at the institutional and cultural level. For example, we recommend that women take steps to reduce situational ambiguity, use niceness and assertion strategically, and cognitive re-framing to improve performance. We also make parallel recommendations for institutions, to create a more equal playing field in employment negotiations in academia. We conclude with expert advice on how to manage the important task of negotiation throughout the career from successful psychologists to contextualize the research findings at the personal level

Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study protocol

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but \u3e95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, https://www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5000 richly phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity

Study protocol of an investigation of attention and prediction error as mechanisms of action for latent inhibition of dental fear in humans

Background Evidence suggests that dental anxiety and phobia are frequently the result of direct associative fear conditioning but that pre-exposure to dental stimuli prior to conditioning results in latent inhibition of fear learning. The mechanisms underlying the pre-exposure effect in humans, however, are poorly understood. Moreover, pain sensitivity has been linked to dental fear conditioning in correlational investigations and theory suggests it may moderate the latent inhibition effect, but this hypothesis has not been directly tested. These gaps in our understanding are a barrier to the development of evidence-based dental phobia prevention efforts. Methods Healthy volunteers between the ages of 6 and 35 years will be enrolled across two sites. Participants will complete a conditioning task in a novel virtual reality environment, allowing for control over pre-exposure and the examination of behaviour. A dental startle (a brief, pressurized puff of air to a tooth) will serve as the unconditioned stimulus. Using a within-subjects experimental design, participants will experience a pre-exposed to-be conditioned stimulus, a non-pre-exposed to-be conditioned stimulus, and a neutral control stimulus. Two hypothesized mechanisms, changes in prediction errors and attention, are expected to mediate the association between stimulus condition and fear acquisition, recall, and retention. To ascertain the involvement of pain sensitivity, this construct will be measured through self-report and the cold pressor task. Discussion Dental phobia negatively affects the dental health and overall health of individuals. This study aims to determine the mechanisms through which pre-exposure retards conditioned dental fear acquisition, recall, and retention. A randomized control trial will be used to identify these mechanisms so that they can be precisely targeted and maximally engaged in preventative efforts

Optimism and Risk of Incident Hypertension: A Target for Primordial Prevention

Aims Optimism is associated with reduced cardiovascular disease risk; however, few prospective studies have considered optimism in relation to hypertension risk specifically. We investigated whether optimism was associated with a lower risk of developing hypertension in U.S. service members, who are more likely to develop high blood pressure early in life. We also evaluated race/ethnicity, sex and age as potential effect modifiers of these associations. Methods Participants were 103 486 hypertension-free U.S. Army active-duty soldiers (mean age 28.96 years, 61.76% White, 20.04% Black, 11.01% Hispanic, 4.09% Asian, and 3.10% others). We assessed optimism, sociodemographic characteristics, health conditions, health behaviours and depression status at baseline (2009–2010) via self-report and administrative records, and ascertained incident hypertension over follow-up (2010–2014) from electronic health records and health assessments. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and adjusted models for a broad range of relevant covariates. Results Over a mean follow-up of 3.51 years, 15 052 incident hypertension cases occurred. The highest v. lowest optimism levels were associated with a 22% reduced risk of developing hypertension, after adjusting for all covariates including baseline blood pressure (HR = 0.78; 95% CI = 0.74–0.83). The difference in hypertension risk between the highest v. lowest optimism was also maintained when we excluded soldiers with hypertension in the first two years of follow-up and, separately, when we excluded soldiers with prehypertension at baseline. A dose–response relationship was evident with higher optimism associated with a lower relative risk (p \u3c 0.001). Higher optimism was consistently associated with a lower risk of developing hypertension across sex, age and most race/ethnicity categories. Conclusions In a diverse cohort of initially healthy male and female service members particularly vulnerable to developing hypertension, higher optimism levels were associated with reduced hypertension risk independently of sociodemographic and health factors, a particularly notable finding given the young and healthy population. Results suggest optimism is a health asset and a potential target for public health interventions