On initial item selection in cognitive diagnostic computerized adaptive testing

There has recently been much interest in computerized adaptive testing (CAT) for cognitive diagnosis. While there exist various item selection criteria and different asymptotically optimal designs, these are mostly constructed based on the asymptotic theory assuming the test length goes to infinity. In practice, with limited test lengths, the desired asymptotic optimality may not always apply, and there are few studies in the literature concerning the optimal design of finite items. Related questions, such as how many items we need in order to be able to identify the attribute pattern of an examinee and what types of initial items provide the optimal classification results, are still open. This paper aims to answer these questions by providing non‐asymptotic theory of the optimal selection of initial items in cognitive diagnostic CAT. In particular, for the optimal design, we provide necessary and sufficient conditions for the Q ‐matrix structure of the initial items. The theoretical development is suitable for a general family of cognitive diagnostic models. The results not only provide a guideline for the design of optimal item selection procedures, but also may be applied to guide item bank construction.     

Conducting Exposure-Based Groups via Telehealth for Adolescents and Young Adults With Social Anxiety Disorder

The rapid spread of COVID-19 and subsequent social distancing measures posed unprecedented challenges in providing mental health care and a swift transition of services to telehealth platforms. Social distancing measures create unique concerns for young people with social anxiety disorder who already struggle with social connection and isolation; therefore, the continuation of care via telehealth platforms is especially important for this population. To date, there is little literature regarding use of telehealth groups for this population and the current commentary aims to fill in this gap in the literature while also providing general guidelines for telehealth groups. The commentary discusses the delivery of an exposure-based cognitive behavioral therapy group for adolescents and young adults via telehealth and provides considerations, challenges, and benefits of conducting a group through a telehealth platform. In conjunction with clinically relevant examples and in-depth exposure discussions, we aim to provide guidance for youth-focused practitioners who are considering conducting groups in a telehealth format for a range of presentations.     

父母教育卷入与小学儿童数学焦虑的纵向联系:数学态度的中介作用

为探讨父母教育卷入与学龄期儿童数学焦虑之间的纵向联系及内在作用机制,从山东省聊城市两所普通小学选取1734名三、四年级学生,对其进行为期一年的追踪研究。结果发现：（1）T1父母教育卷入能够显著负向预测T2儿童数学焦虑,但T1儿童数学焦虑对T2父母教育卷入的预测不显著;（2）在同一时间点上,儿童数学态度在父母教育卷入与儿童数学焦虑之间发挥显著中介作用;（3）在不同时间点上,儿童数学态度的中介作用仍然成立,表明儿童数学态度的中介作用具有跨时间的稳定性。该结果强调了父母教育卷入对学龄期儿童数学焦虑变化的重要作用,亦为从父母教育卷入和数学态度角度降低儿童的数学焦虑水平提供了初步有力证据。     

困境儿童孤独与社交焦虑对抑郁的影响——自尊的中介作用

为探讨困境儿童孤独、社交焦虑、抑郁和自尊的现状、特点、关系以及自尊在其中的中介作用,进而为困境儿童心理帮扶及救助提供依据。本研究使用儿童抑郁障碍自评量表、儿童孤独量表、儿童社交焦虑量表和自尊量表对重庆市17个区县1733名困境儿童进行调查。结果发现:(1)抑郁、社交焦虑和自尊存在性别差异,抑郁、孤独、社交焦虑和自尊存在年龄差异;(2)孤独和社交焦虑与抑郁呈显著正相关并显著预测抑郁,自尊与抑郁呈显著负相关并显著预测抑郁。(3)困境儿童的自尊在孤独和抑郁之间,社交焦虑和抑郁之间起中介作用。结果表明:困境儿童的孤独、社交焦虑既可直接影响其抑郁水平,也可通过自尊的中介作用间接影响其抑郁水平。     

Psychometric Evaluation of a Controlled Social Affiliation Paradigm: Findings From Anxiety,Depressive Disorder,and Healthy Samples

Social impairments are common across many psychiatric conditions. Standardized dyadic assessments intended to elicit social affiliation between unacquainted partners are used to elucidate mechanisms that disrupt relationship formation and inform possible treatment targets; however, the psychometric properties of such paradigms remain poorly understood. This study evaluated the psychometric properties of a controlled social affiliation paradigm intended to induce connectedness between a target participant and trained confederate. Individuals with an anxiety or depressive disorder diagnosis (clinical group; n = 132) and those without (control group; n = 35) interacted face-to-face with a trained confederate; partners took turns answering a series of increasingly intimate questions about themselves. Social connectedness, affect, and affiliative behavior measures were collected during the interaction. Participant symptom and social functioning measures were collected to examine validity. The paradigm elicited escalating social connectedness throughout the task for both participants and confederates. Parallel forms (i.e., different question sets) elicited similar affiliation outcomes. Self-reported (but not behavioral) affiliation differed across some demographic variables (e.g., participant gender, Hispanic ethnicity). Within-task affiliation measures were associated with one another and with global social connectedness and social anxiety symptom measures, but not with somatic anxiety measures. Clinical participants reported lower social affiliation and positive affect reactivity and higher negative affect reactivity than healthy participants. These findings provide initial psychometric support for a standardized and controlled dyadic affiliation paradigm that could be used to reliably probe social disconnection mechanisms across psychopathology.     

Cognitive Behavior Therapy for Women With Generalized Anxiety Disorder in the Perinatal Period: Impact on Problematic Behaviors

Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder among women in the perinatal period (pregnancy to one year postpartum). Recent studies have examined the relationship between problematic behaviors and GAD symptoms. Studies in nonperinatal samples indicate that adults with GAD engage in avoidance and safety behaviors and these behaviors are associated with greater symptom severity. Little research has examined the use of problematic behaviors among pregnant or postpartum women. However, preliminary research suggests that these behaviors may have a negative impact on both anxious women and their children. Our aim was to examine the extent to which women with GAD in pregnancy or the postpartum engage in problematic behaviors and whether cognitive behavioral therapy is effective in reducing these behaviors. Fifty-eight women with GAD in pregnancy or postpartum were recruited from a larger clinical trial (Clinicaltrials.gov ID NCT02850523) evaluating the effectiveness of group-based cognitive behavioral therapy (CBGT) for perinatal anxiety disorders. The results indicated that women with perinatal GAD reported high levels of avoidance and safety behaviors and greater engagement in these behaviors was associated with higher levels of worry and related symptoms. CBGT was effective in reducing GAD symptoms and problematic behaviors and a bidirectional relationship was found between changes in worry and problematic behaviors during treatment. Limitations and future directions are discussed.     

Homework Compliance and Quality in Cognitive Behavioral Therapies for Anxiety Disorders and Obsessive-Compulsive Disorder

Homework assignments are an integral part of cognitive behavioral therapy, providing patients with opportunities to practice skills between sessions. Generally, greater homework compliance is associated with better treatment outcomes. However, fewer studies have examined the effect of homework quality on treatment outcomes. This study examined homework compliance and quality as predictors of outcome and attrition across five CBT protocols. A sample of 179 individuals with principal diagnoses of generalized anxiety disorder, panic disorder, social anxiety disorder, or obsessive-compulsive disorder were randomized to receive a transdiagnostic CBT protocol (the Unified Protocol) or a single-diagnosis CBT protocol corresponding to their principal diagnosis. The Unified Protocol had a lower homework burden than the majority of the single-diagnosis protocols, which varied in degree of assigned homework. Despite this, there were no differences in average homework compliance or quality across principal diagnosis, treatment condition, or their interaction. Homework quality was significantly related to all symptom outcomes (self-reported and clinician-rated anxiety and depressive symptoms, clinician-rated clinical severity). Homework compliance was significantly related to clinician-rated anxiety symptom outcomes. Additionally, greater homework quality and compliance were both significantly associated with increased odds of completing treatment, suggesting homework variables can be useful and easily obtainable predictors of treatment retention.     

On the advantage of autobiographical memory pliability: implantation of positive self-defining memories reduces trait anxiety

This paper is devoted to the mechanism of the positive construction of autobiographical memory. Positive construction consists of the spontaneous transformation of memories in the direction of the subjective enhancement of self-competence in past activities to anticipate improvement over time. We speculated that trait anxiety may indicate a failure to exhibit this mechanism that results in a deficit of affirmative self-esteem. We hypothesised that the implantation of positive self-defining memories in anxiety-evoking domains would decrease trait anxiety. One hundred twenty adults recollected three negative self-defining memories. Then, half of the participants imagined episodes of desired behaviour that differed from the originally recollected ones either in discussion or in hypnosis. Thirty participants experienced a hypnotic state without any references to memories, and the rest formed the control group. Subjects from the “Memory Implantation in Hypnosis” group became unable to distinguish the originally reported memories from the imagined ones, exhibited decreased trait anxiety scores after a 4-month delay, and reported enhanced self-esteem. In contrast, the participants from the “Hypnosis with no reference to the past” group exhibited decreased scores at a short delay but later returned to their original scores. These findings highlight the power of cured episodic-like autobiographical memory for updating the self.