A Pilot Study of Emotion Regulation Therapy for Generalized Anxiety and Depression: Findings From a Diverse Sample of Young Adults

Emotion regulation therapy (ERT) for generalized anxiety disorder (GAD) and accompanying major depressive disorder (MDD) is a theoretically derived, evidence-based treatment that integrates principles from traditional and contemporary cognitive-behavioral and experiential approaches with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding self-referential regulatory characteristics. Preliminary evidence supports the efficacy of a 20-session version of ERT. However, previous trials of ERT and other traditional and contemporary cognitive-behavioral therapies have often utilized relatively homogeneous samples. Various contextual and demographic factors may be associated with challenges that increase risk for negative mental and social outcomes for young adults ages 18–29, particularly for individuals from diverse backgrounds. The aim of this pilot study was to examine the effectiveness of a briefer 16-session version of ERT in a racially and ethnically diverse sample of young adults. Participants (N = 31) were enrolled at an urban-based, commuter college who consented to treatment for anxiety, worry, or depression at an on-campus counseling center. Open-trial results demonstrate strong ameliorative changes in worry, rumination, self-reported and clinician-rated GAD and MDD severity, social disability, quality of life, attentional flexibility, decentering/distancing, reappraisal, trait mindfulness, and negative emotionality from pre- to posttreatment. These gains were maintained throughout a 3- and 9-month follow-up. These findings provide preliminary evidence for the efficacy of ERT in treating a racially and ethnically heterogeneous population. Further, this study highlights comparable effectiveness of a briefer 16-session version of ERT.     

Irrational Beliefs and Self-Management as Separable Predictors of Anxiety and Depression

Irrational beliefs and self-management are both cognitive-behavioral constructs that are integral in modern Rational-Emotive Behavior Therapy and Self-Management Therapy, respectively. Both irrational beliefs and self-management have been linked to anxiety and depression, and there is evidence for their usefulness for these types of distress. This is the first study to consider irrational beliefs and self-management as simultaneous predictors of anxiety and depression. An outpatient clinical sample (n = 51) completed measures of irrational beliefs, self-management, and emotional symptoms. Results indicated that as simultaneous predictors of fear and worry, self-management did not account for any additional variance accounted for by irrational beliefs. However, both irrational beliefs and self-management predicted unique variance in depression, negative affect, and positive affect. Exploratory analyses with single diagnosis (n = 26) and multiple diagnoses (n = 25) subsamples provided some divergent results. These results are discussed in terms of case conceptualization and potential future applications in the treatment of affective disorders, in particular depression.     

Bullying and cyberbullying in adulthood and the workplace

Two studies generated profiles of cyberbullying/cyberincivility and traditional bullying/incivility in adults, particularly within the workplace. In Study 1, 20% of 3,699 participants had the majority of cyberbullying victimization and 7.5% had the majority of traditional bullying victimization occur in adulthood, with 30% saying they were bullied at work. Relationships between bullying and negative outcomes were found. Because of the clear evidence of bullying and cyberbullying in the workplace in Study 1, Study 2 addressed the relationship of these constructs to workplace incivility. Workplace face-to-face incivility and bullying were related among 321 participants, as were workplace cyberbullying and cyberincivility. Face-to-face incivility was more common than online incivility, face-to-face bullying, or online bullying, yet all four behaviors were associated with negative outcomes. Differences in intentionality, acceptability, and severity were observed, with workplace face-to-face bullying perceived as the most severe and having the greatest intentionality to harm. These results emphasize the importance of studying bullying among adults, and highlight the conceptual independence of bullying and incivility. Correlates of workplace aggression are discussed using job demands-resources theory.     

Free to be me: The relationship between the true self,rejection sensitivity,and use of online dating sites

Prior research (Blackhart et al., 2014) found that rejection-sensitive individuals are more likely to use online dating sites. The purpose of the current research was to explain the relationship between rejection sensitivity and online dating site usage. Study 1 examined whether true self mediated the relation between rejection sensitivity and online dating. Study 2 sought to replicate the findings of Study 1 and to examine whether self-disclosure moderated the relationship between true self and online dating in the mediation model. Results replicated those found by Blackhart et al. and also found that true self mediated the relationship between rejection sensitivity and online dating site usage. These findings suggest that rejection-sensitive individuals feel they can more easily represent their “true” selves in online environments, such as online dating sites, which partially explains why they are more likely to engage in online dating.     

Extreme Response Style and the Measurement of Intra-Individual Variability in Affect

Extreme response style (ERS) has the potential to bias the measurement of intra-individual variability in psychological constructs. This paper explores such bias through a multilevel extension of a latent trait model for modeling response styles applied to repeated measures rating scale data. Modeling responses to multi-item scales of positive and negative affect collected from smokers at clinic visits following a smoking cessation attempt revealed considerable ERS bias in the intra-individual sum score variances. In addition, simulation studies suggest the magnitude and direction of bias due to ERS is heavily dependent on the mean affect level, supporting a model-based approach to the study and control of ERS effects. Application of the proposed model-based adjustment is found to improve intra-individual variability as a predictor of smoking cessation.     

Individual Personality and Emotional Readiness Characteristics Associated with Marriage Preparation Outcomes of Perceived Helpfulness and Change

Little is known about the characteristics of individual participants for whom particular marriage preparation interventions are most helpful and change producing. Data collected from 1,655 intervention participants via the online RELATionship Evaluation Questionnaire (RELATE) were used to analyze the association of eight individual personality characteristics with perceived helpfulness and positive change resulting from participation in four marriage preparation interventions (classes, community workshops, premarital counseling, self-directed) and whether this association would also be related to gender, age, and education of the participants. General linear modeling (GLM) analysis revealed different patterns of prediction for each type of intervention. Kindness was identified most often, predicting perceived change in individual, couple, and context areas among community workshop participants, perceived couple-level change, and helpfulness among self-directed participants, and perceived individual-level change among class participants. No factors significantly predicted perceived helpfulness and change among premarital counseling participants. Implications for premarital interventions are discussed.     

The effects of a wisdom intervention in a Christian congregation*

Psychological research on the topic of wisdom is limited in its incorporation of religion and spirituality. This gap in psychological literature may serve to limit a thorough understanding of wisdom. Positive psychology may allow for some rapprochement in wisdom and spirituality. In collaboration with leaders of a local Friends (Quaker) congregation, two studies investigated the effects of a spiritually informed wisdom intervention delivered in the context of a faith community. Participants for Study 1 consisted of 27 young adults (24 completed both the pre and post questionnaire) and a comparison group consisting of 32 young adults. The intervention was designed to increase participants’ abilities in cognitive, affective and moral domains. Significant group by time interaction effects were found among measurements of practical wisdom, post-formal thinking and subjective well-being, with those in the experimental group showing changes in the expected direction. Study 2 involved qualitative analyses of interviews with 15 of the wisdom participants regarding their changing views of wisdom. Themes emerging from the interviews included a multiple-perspectives view of wisdom, the relational nature of learning wisdom, the importance of taking a reflective perspective, and congruence between what one knows and how one lives. Implications for studying wisdom alongside religion and spirituality are considered.     

Anxiety,depression, and the suicidal spectrum: a latent class analysis of overlapping and distinctive features

ABSTRACT

Anxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: (1) a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious arousal; (2) a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and (3) a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report of worthlessness, crying, and sadness; higher levels of anxious arousal and negative affect; and lower levels of positive affect. Depression and anxiety diagnoses were not discriminant between higher and lower suicide risk classes. This transdiagnostic and dimensional approach to understanding the suicidal spectrum contrasts with treating it as a depressive symptom, and illustrates the advantages of a tripartite model for conceptualising suicide risk.     

Review and Comparison of Electronic Patient-Facing Family Health History Tools

Family health history (FHx) is one of the most important pieces of information available to help genetic counselors and other clinicians identify risk and prevent disease. Unfortunately, the collection of FHx from patients is often too time consuming to be done during a clinical visit. Fortunately, there are many electronic FHx tools designed to help patients gather and organize their own FHx information prior to a clinic visit. We conducted a review and analysis of electronic FHx tools to better understand what tools are available, to compare and contrast to each other, to highlight features of various tools, and to provide a foundation for future evaluation and comparisons across FHx tools. Through our analysis, we included and abstracted 17 patient-facing electronic FHx tools and explored these tools around four axes: organization information, family history collection and display, clinical data collected, and clinical workflow integration. We found a large number of differences among FHx tools, with no two the same. This paper provides a useful review for health care providers, researchers, and patient advocates interested in understanding the differences among the available patient-facing electronic FHx tools.