Adapted group-based dialectical behaviour therapy for binge eating in a practicing clinic: clinical outcomes and attrition

Research evidence has been accumulating for the efficacy of dialectical behaviour therapy (DBT) for binge eating. However, support for its effectiveness and transportability beyond efficacy trials is lacking. The current study evaluated the feasibility of group-based DBT for binge eating within the context of an operating community clinic. Women ages 24-49 (M?=?39.60, SD?=?9.53) with either subthreshold and full-threshold binge eating disorder or bulimia nervosa formed the group and comprised the sample (n?=?5 treatment completers). Positive outcomes included significant improvement in both binge eating and secondary outcomes with the Eating Disorder Inventory subscales of Bulimia, Ineffectiveness, Perfectionism and Interpersonal Distrust. Attrition was elevated compared with previous efficacy trials, suggesting the need for increased attention to how to improve retention within routine practice settings. Given our limited sample size, these findings are viewed as promising but preliminary.     

Parental Divorce,Parental Religious Characteristics,and Religious Outcomes in Adulthood

Parental divorce has been linked to religious outcomes in adulthood. Previous research, however, has not adequately accounted for parental religious characteristics, which may render the association spurious and/or moderate the relationship. Many studies also do not consider subsequent family context, namely, whether one's custodial parent remarries. Using pooled data from three waves of the General Social Survey, we examine the nature of the relationships among parental divorce, subsequent family structure, and religiosity in adulthood. Growing up in a single‐parent family—but not a stepparent family—is positively associated with religious disaffiliation and religious switching and negatively associated with regular religious service attendance. Accounting for parental religious characteristics, however, explains sizable proportions of these relationships. In fact, after accounting for parental religious affiliation and service attendance, growing up with a single parent does not have a significant effect on religious service attendance. Parental religiosity also moderates the relationship between growing up with a single parent and religious service attendance: being raised in a single‐parent home does have a negative effect on religious service attendance among adults who had two religiously involved parents. There is modest evidence of this moderating relationship for other religious outcomes. Implications of these findings are discussed.     

Religious Schools,Home Schools,and the Timing of First Marriage and First Birth

The timing of individuals’ family formation is important for a number of socioeconomic and health outcomes. We examine the influence of religious schools and home schools on the timing of first marriage and first birth using data from the Cardus Education Study Graduate Survey (N = 1,496). Our results from life tables and event-history regression models show that, on average, graduates of evangelical Protestant schools—but not Catholic school or homeschool graduates—have earlier marriages and births than public school graduates. Catholic school students have later first births on average than public school graduates. Models interacting schooling type with age and age-squared suggest that evangelical schoolers’ higher odds of marriage stem from higher odds of marrying at ages 21–30, and their higher odds of first birth stem from higher odds of births from ages 25–34. Catholic school and nonreligious private school students also have higher odds of marrying in the mid-20s and early-30s than do public school students. Evangelical, non-religious private, and Catholic school students all have lower odds of teenage births than public school students but higher odds of birth later in the life course. Homeschoolers do not differ on either outcome at any age. Our findings suggest that schools socialize their students with distinctive attitudes toward family formation that influence their behavior even many years after graduation, though these schools do not appear to be particularly harmful to life chances in terms of fostering marriage or childbearing at very young ages.     

Memory search for the first target modulates the magnitude of the attentional blink

The resolution of temporal attention is limited in a manner that makes it difficult to identify two targets in short succession. This limitation produces the phenomenon known as the attentional blink (AB), in which processing of a first target (T1) impairs identification of a second target (T2). In the AB literature, there is broad agreement that increasing the time it takes to process T1 leads to a larger AB. One might, therefore, predict that increasing the number of possible T1 identities, or target set, from 1 to 16 would lead to a larger AB. We were surprised to find that this manipulation of T1 difficulty had no influence on AB magnitude. In subsequent experiments, we found that AB magnitude interacts with T1 processing time only under certain circumstances. Specifically, when the T1 task was either well masked or had to be completed online, we found a reliable interaction between AB magnitude and the target set size. When neither of these conditions was fulfilled, there was no interaction between target set size and the AB. Previous research found that when the target set changes from trial to trial, trials with more possible targets elicited a larger AB. In the present study, the target set is held constant, reducing the demands on working memory. Nevertheless, AB magnitude still interacts with target set size, as long as the T1 task cannot be processed offline. Thus, the act of searching memory delays subsequent processing, even when the role of working memory has been minimized.     

Changes in Problematic Anger,Shame, and Disgust in Anxious and Depressed Adults Undergoing Treatment for Emotion Dysregulation

Emotion dysregulation, the pervasive difficulty managing negative emotions, is a core problem across mood and anxiety disorders. Anger, shame, and disgust are particularly problematic emotions, impacting both disorder severity and treatment outcome. We previously found that a 16-week dialectical behavior therapy skills training group (DBT-ST) was superior to an activities-based support group (ASG) in decreasing emotion dysregulation in 44 adults with high emotion dysregulation who met diagnostic criteria for an anxiety or depressive disorder. We presently examine these participants’ changes in anger, shame, disgust, and distress using self-reports collected over 6 months during and after treatment. Hierarchical linear modeling analyses show that DBT-ST was superior to ASG in decreasing anger suppression (d = 0.93) and distress (d = 1.04). Both conditions significantly reduced shame, disgust propensity, and disgust sensitivity, but neither was superior for these outcomes. The treatments did not significantly reduce anger expression. Mediation analyses suggest that condition indirectly influenced 4-month anger suppression, shame, and distress through its effect on 2-month emotion dysregulation. These findings suggest that DBT-ST is efficacious for certain problematic emotions and distress in depressed and anxious adults and that common factors may account for some, but not all, of its benefits.     

Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents

Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13–19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Expressions of positive emotion in photographs,personality, and later-life marital and health outcomes

A previous study of females at an elite liberal arts college found that the degree of positive emotion expressed in persons’ college yearbook photos was correlated with personality, marital, and health outcomes decades later in life. We examine whether the same pattern is observed among respondents in the Wisconsin Longitudinal Study, using high school yearbook photographs and outcome measures obtained mostly when respondents were in their fifties. Despite some seeming advantages of our design, we were unable, with a few exceptions, to replicate the findings of the previous study. Possible explanations for this divergence in findings are discussed, including differences in measurement, the sample, and the photographic occasion itself.