Personality Pathology and Substance Misuse in Later Life: Perspectives from Interviewer-, Self-, and Informant-Reports

Research indicates a robust association between personality and substance use and misuse. The high prevalence and pervasive detrimental impacts of alcohol use disorder (AUD) and smoking of tobacco necessitate more studies designed to identify factors closely associated with these outcomes in specific populations. The analyses reported in the present paper concern the relative utilities of five measures of personality and personality pathology rated by three sources (self, informant, and interviewer) in predicting AUD and regular smoking in a representative sample of 987 older adults, an understudied and uniquely vulnerable population. All measures and sources contributed to the predictions, with notable parallels as well as some important differences identified across substances and sources of information. In particular, low agreeableness robustly predicted AUD and smoking across self- and informant-reports. High interviewer-rated borderline personality pathology also strongly predicted AUD. Model fit indices suggested that measures of personality and personality pathology have stronger utility in predicting AUD as compared to regular smoking. These findings have important implications for the assessment of older adults in research and clinical settings and for the understanding of enduring risk factors for substance misuse later in life. Multi-source personality information is valuable for generating a complete picture of the relationship between personality and substance misuse.

     

Parent-Implemented Early Social Communication Intervention for Young Children with Autism Spectrum Disorder

Journal of Behavioral Education - Numerous developmental difficulties differentiate children with autism from typically developing children, including delays in social communication skills. In this...     

Constant Time Delay and System of Least Prompts: Efficiency and Child Preference

Prompting procedures are effective for teaching skills, but limited comparative data exist to guide practitioners to select the best procedures for individuals. This study compared efficiency of two prompting procedures—constant time delay (CTD) and system of least prompts (SLP)—to teach expressive identification of 32 targets to 10 preschoolers with and without disabilities. To assess efficiency differences between conditions and analyze changes in learning over time, we used adapted alternating treatments designs in the measurement context of cumulative records. CTD was more efficient for five children, SLP was more efficient for three children, and results were inconclusive for two children. We measured children’s choices between procedures via simultaneous treatments designs, to assess child preference and whether preferences and efficiency aligned. Preference outcomes were mixed and did not consistently align with efficiency. We used exploratory analyses to assess whether child characteristics moderated outcomes. Children for whom CTD was more efficient had significantly fewer sessions to mastery, non-significantly fewer errors, and non-significantly higher developmental assessment scores, compared to children for whom SLP was more efficient.

     

Neighborhood Risk and Interpersonal Support as Predictors of Parents’ Sense of Community

Parents’ sense of community (SOC) may ease the impact of neighborhood risk on children’s outcomes, but not all parents feel part of a trusted community. In this study, we examined whether parents’ ratings of neighborhood risk and interpersonal support were related to their SOC, and whether interpersonal support moderated the relationship between neighborhood risk and parents’ SOC. Participants included 161 parents (M?=?40.25 years; 92.3% female) of minor children who were enrolled in youth mentoring programs. Results indicated that greater interpersonal support and less neighborhood risk was associated with parents’ SOC. Post-hoc analyses showed that living in a neighborhood with gangs and illegal drugs, but not residential instability or living in public housing, was a salient risk factor for lower SOC. Contrary to our prediction, interpersonal support did not moderate the link between neighborhood risk and parents’ SOC. These findings may inform interventions designed to bolster parents’ connectedness to community and ability to promote children’s positive development.

     

Development and Implementation of a Transdiagnostic,Stepped-Care Approach to Treating Emotional Disorders in Children via Telehealth

Stepped-care interventions may increase the accessibility of evidence-based treatments but remain relatively underexplored in the child mental health literature. Further, while the feasibility and efficacy of stepped-care interventions have been examined for specific diagnoses or classes or disorders, transdiagnostic stepped-care interventions have not yet been developed. We discuss the development and initial implementation of a transdiagnostic approach to emotional disorders using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C; Ehrenreich-May et al., 2018). A case series is presented to illustrate the delivery of UP-C stepped care (UPC-SC) via telehealth, using a collaborative decision-making process to inform step-up/step-down decisions. Lessons learned are discussed to guide refinements of UPC-SC and inform a larger trial.     

A Single-Session Workshop to Enhance Emotional Awareness and Emotion Regulation for Graduate Students: A Pilot Study

Emerging adults are at substantial risk for developing or worsening psychopathology and university students appear to be particularly vulnerable. Interventions targeted at these young adults that can mitigate transdiagnostic causal risk factors or burgeoning mental health problems have the potential to make a large impact. We aimed to develop and pilot test an accessible, single-session, transdiagnostic group intervention with the goals of enhancing emotion regulation skills and reducing risk for mental health problems in graduate students. The intervention included psychoeducation, skills instruction (e.g., mindful emotion awareness, cognitive flexibility, countering emotion-driven behaviors), group discussion, and supervised practice based on content from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. The pilot program demonstrated strong feasibility and acceptability. Baseline, 1-month, and 3-month follow-up surveys also suggested benefits for reducing emotional avoidance and suppression, increasing use of cognitive reappraisal, and reducing symptoms of depression and neuroticism. Graduate students have seldom been the beneficiaries of university-based intervention and prevention research. Furthermore, most college and university mental health centers do not have the capacity to provide psychoeducation, preventative, or early intervention services to the many students who need or could benefit from them. Results suggest that future iterations of this intervention could address such barriers to meaningfully supporting emerging adults in graduate school.     

Research in counselling and psychotherapy Post‐COVID‐19

The COVID‐19 pandemic brings to light many areas the field of counselling and psychotherapy may need to address in future research. We outline several issues stemming from or exacerbated by the pandemic and offer suggestions for future research to address the mental health needs of those impacted. Our suggestions focus on five domains: (a) the health and well‐being of helping professionals, (b) the infodemic, (c) discrimination and minority stress, (d) spiritual and existential dynamics in mental health and (e) couple and family stress and resilience. We aim to provide a multi‐systemic perspective of mental health and well‐being in the time of COVID‐19, as well as encourage current and future studies to incorporate these suggestions to advance the health and well‐being of our communities through evidence‐based treatment approaches.     

Affect and emotions in placebo and nocebo effects: What do we know so far?

Once considered nuisance variance in clinical trials, placebo effects and nocebo effects are now widely recognized as important and mutable psychobiological contributors to mental and physical health. Psychological theory explaining these effects emphasizes associative learning and conscious expectations. It has long been suggested, however, that affective states such as moods, emotions, and distress could play a significant role. In this paper, we draw together and review the empirical data linking affective states to placebo and nocebo effects. To organize this disparate literature, three questions are addressed: (1) Does pre‐existing state and trait affect modulate placebo and nocebo effects? (2) Does administering placebo and nocebo treatments change affective states, and if so, does the resulting affect causally influence placebo and nocebo effects? Finally, (3) Can placebo treatments be successfully employed as a regulation strategy to modulate different affective states? In reviewing the evidence in relation to these three questions, it is clear that affect does play a key role in placebo and nocebo effects in many circumstances, and further, there may be a reciprocal dynamic at play between a treatment event, affect, and placebo/nocebo effects. The paper concludes by discussing implications for theory and intervention and recommends future research priorities.