Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders,Co-Occurring ADHD,and Psychosocial Impairment

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10–17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.     

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.     

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

The sociodemographic and psychosocial correlates of COVID-19 vaccine concerns among urban college students

COVID-19 vaccine concerns remain high among Americans. Although recent studies have investigated the sociodemographic disparities in vaccine concerns, less attention has been given to reasons for vaccine skepticism and psychosocial factors that may explain it. The current study examined specific types of vaccine concerns among a diverse sample of college students (N = 1985) living in New York City. Participants who identified as Black, younger, with later immigrant generational status, and those with more conservative political leanings reported more vaccine concerns. Concerns regarding vaccine side effects were the most frequently reported source of concern. Reason for getting vaccinated, personal experiences with COVID, and COVID stress was also associated with vaccine concerns. Study results emphasize the importance of sociodemographic factors and COVID knowledge and stress in examining and addressing vaccine concerns.     

Differences in the importance of romantic structures among transgender and cisgender adults during the COVID-19 pandemic

The stressors of the global COVID-19 pandemic have led to an increased need for support. For adults, romantic relationships often represent an environment of emotional support and stability; as such, attitudes toward—and particularly the importance of—romantic relationships may have shifted as a result of the pandemic. The present cross-sectional study explores how U.S. transgender (n = 99) and cisgender people (n = 1886) report whether they have perceived a change in their feelings about the importance of long-term romantic structures (i.e., committed relationships, monogamy, cohabiting with a romantic partner, and marriage) as a result of the COVID-19 pandemic. Results found that transgender people reported a more positive perceived change in importance placed on all four romantic items relative to cisgender people. Different forms of stress (e.g., social, financial, health) associated with the COVID-19 pandemic may have contributed to an increased need, and subsequent desire, for social connection and support in the form of romantic relationships among transgender individuals to a greater extent than cisgender individuals, perhaps in part due to the additional layers of stress transgender people must navigate. Results are discussed through the lens of the minority stress framework.     

Coping with COVID: Use,factor structure,and health behavior implications of specific emotion regulation strategies during the coronavirus pandemic

This series of studies examined U.S. individuals' use of specific emotion regulation/coping strategies during the early months of the COVID-19 pandemic, investigated the factor structure among strategies during this universally experienced stressor, and the extent to which these factors predicted engagement in COVID-related health-promoting behaviors. In Study 1, participants (N = 520) rated their use of 17 strategies for coping with pandemic-related stress during the past 24 h. Differences emerged in strategy use across demographic groups (age, race, income). Results of exploratory factor analysis suggest a factor structure grouping strategies in terms of goals beyond emotion regulation per se, rather than phases of the emotion process or a binary adaptive versus maladaptive distinction. In Study 2 (N = 264), participants reported daily on their coping strategy use and weekly on their engagement in COVID-specific health behaviors for 22 days. Results of confirmatory factor analysis replicate the factor structure found in Study 1. Some significant associations of coping strategy use with health-promoting behaviors were observed, but these were sporadic and largely involved baseline measures rather than predicting change over time. Theoretical and practical implications are discussed.     

Information processing,neuropsychological function,and the inherited predisposition to alcoholism

Sons of male alcoholics are at particularly heightened risk for the development of alcoholism. This heightened risk frequently appears in association with increased incidence of conduct disorder or hyperactivity, with deficits in abstract thinking and poor school performance, with abnormalities in cued psychophysiological response, and with increased sensitivity to the putatively stress-response-dampening effects of alcohol intoxication. This risk and its associated features are discussed within the context of a neuropsychological theory, predicated on the notions (1) that deficits in cognitive functions theoretically dependent upon the intact functioning of the prefrontal cortex could underlie manifestation of the idiosyncracies commonly attributed to sons of male alcoholics, and (2) that acute alcohol intoxication could relieve the subjective discomfort associated with the consequences of such deficits.     

Prevalence of personality disorders among bulimics,nonbulimic binge eaters,and normal controls

We examined the comorbidity of bulimia and personality pathology among college women. Subjects included women (n=23) meeting DSM-III-R criteria for bulimia nervosa (bulimics), women (n=23) who reported binge eating but did not fulfill the criteria for bulimia nervosa (binge eaters), and women (n=23) who did not binge eat (normals). The subjects completed an assessment battery consisting of the Personality Disorders Examination and the SCID as well as the Beck Depression Inventory, the Rosenberg Self-Esteem Index, and measures of impulsivity and self-defeating tendencies. Fourteen of 23 bulimics (61%) met criterion for a personality disorder using DSM-III-R Axis II criteria. In comparison, 3 of 23 (13%) binge eaters and 1 of 23 (4%) normal subjects received an Axis II diagnosis. Borderline and self-defeating diagnoses were the predominant personality disorders in 96% of the bulimics exhibiting clinically significant personality pathology. Bulimics also exhibited significantly more depression, impulsivity, and self-defeating behavior and lower self-esteem than binge eaters and normals. The findings are discussed within a conceptual framework that posits an interaction between personality pathology and restrained eating.     

Validity of the DSM-III-R personality disorder Clusters

This study assessed the validity of the DSM-III-R personality disorder clusters (i.e., odd-eccentric, dramatic-emotional-erratic, and anxious-fearful) by examining the relationships between self-report measures that tap the core features shared by disorders from each cluster and Cluster scores established via a semistructured interview in a sample of 57 outpatients. Results indicated a high degree of correlation among the DSM-III-R personality disorder Cluster scores. In addition, a series of regression analyses revealed that self-report scores did not account for a significant amount of variance in their respective Cluster scores over and above that accounted for by other self-report measures and other Cluster scores. These results suggest that the current DSM-III-R cluster classification scheme may not be appropriate, and it is recommended that a more empirically justifiable classification of the personality disorders be adopted in DSM-IV.