The hierarchical taxonomy of psychopathology in clinical high risk for psychosis: Validation and extension.

The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium's transdiagnostic dimensional model of psychopathology has considerable support; however, this model has been underresearched in individuals at clinical high risk for psychosis (CHR-P), a population that may advance the model. CHR-P individuals not only have attenuated psychotic symptoms that vary in severity, but also have many comorbid diagnoses and varied clinical outcomes, including disorders with uncertain relations to HiTOP (e.g., obsessive-compulsive disorder). The present study used self-report and interview data from North American Prodrome Longitudinal Study-3 (710 CHR, 96 controls) to replicate the HiTOP model and test specific hypotheses regarding disorders with uncertain relations to its dimensions. Additionally, the present study examined the HiTOP model in relation to childhood trauma, declines in social functioning, and development of full psychosis. Confirmatory factor analysis indicated that the HiTOP model's fit was nearly adequate (e.g., comparative fit index = .89), though several theory-relevant modifications were indicated. Additionally, specific tests were conducted to gain a more fine-grained perspective on how disorders with less clear prior evidence were related to the HiTOP model. Notable findings from these analyses include bipolar spectrum disorders relating to the psychosis super spectrum (i.e., .39 loading), and obsessive-compulsive disorder showing a complex pattern of loadings (e.g., internalizing and psychosis). The final model parsimoniously accounted for childhood trauma (e.g., super spectra rs = .22-.32), associations with current functioning, and predicted future conversion to a psychotic disorder (e.g., super spectra R² = .13). Overall, these results inform the HiTOP model and suggest its promise for CHR-P research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sensitivity to change of the Systemic Therapy Inventory of Change (STIC) intersession scales.

Objective: The Systemic Therapy Inventory of Change (STIC) is a systemic measurement feedback system that provides therapists with feedback regarding the multidimensional clinical change in individual, couple, and family therapy. The STIC Intersession scales include Individual Problems and Strengths (IPS), Relationship with Partner (RWP), Family/Household (FH), and Child Problems and Strengths (CPS). They are administered to clients before each therapy session. The purpose of the current study is to investigate the STIC Intersession scales' sensitivity to change, the ability to detect reliable and valid changes that occur after an intervention. Method: Participants (N = 583) who voluntarily received individual, couple, or family therapy services in a randomized clinical trial attended the study. Results: By comparing the changes in pre-therapy and post-therapy scores of the STIC Intersession scales with those of the corresponding reference measures, the external sensitivity to change of the STIC Intersession scales was supported. The IPS Intersession scale showed greater change than the Beck Anxiety Inventory. However, no evidence supported the discriminant validity of CPS's change scores. Conclusion: Thus, the STIC Intersession IPS, RWP, and FH can be validly used to assess multi-systemic changes in both research and clinical work.

Personality predicts pre-COVID-19 to COVID-19 trajectories of transdiagnostic anxiety and depression symptoms.

This study aimed to characterize within-person pre-COVID-19 and coronavirus pandemic (COVID-19) transdiagnostic anxiety and depression symptom trajectories in emerging adults and determine the roles of neuroticism and behavioral activation in predicting these COVID-19-related changes. We recruited a sample of 342 emerging adults (aged 18-19 at baseline) who were screened on neuroticism and behavioral activation and completed symptom questionnaires on multiple occasions before and after the start of the pandemic. We examined estimates of the symptom factors of General Distress, Anhedonia-Apprehension, and Fears at each wave. The stress amplification model predicts a multiplicative neuroticism-adversity interaction with those high on neuroticism showing the greatest symptom increases to the pandemic. The stably elevated negative affect model is an additive model and predicts that persons high on neuroticism will display elevated symptoms at every wave. General Distress and Anhedonia-Apprehension showed large increases from the pre-COVID-19 to COVID-19 transition then decreased thereafter. The increase brought the average General Distress score to clinical levels at the first COVID-19 wave. There was a small decrease in Fears from the pre-COVID-19 to COVID-19 transition followed by a large increase. Thus, COVID-19 was associated with both increases in psychological symptoms and some resilience. Neuroticism positively predicted the pre-COVID-19 to COVID-19 transition change in Fears but was associated with a dampening of increases in General Distress and Anhedonia-Apprehension. The results disconfirmed the stress amplification model of neuroticism but partially supported the stably elevated negative affect model. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Fear-potentiated startle predicts longitudinal change in transdiagnostic symptom dimensions of anxiety and depression.

BACKGROUND: Elevated defensive responding, through startle reflex (SR) and skin conductance response (SCR), may contribute to onset and maintenance of depression and anxiety. Most work examining SR and SCR has predicted psychiatric diagnoses. There is a paucity of research examining links between SR or SCR and dimensional measures of psychopathology. METHODS: We used latent growth curve modeling to predict longitudinal change in three symptom factors (i.e., General Distress, Fears, Anhedonia-Apprehension) from SR and SCR measured during a fear-potentiated startle paradigm among adolescents oversampled for neuroticism (N = 129). RESULTS: Elevated SCR in danger phases before and after an unpleasant muscle contraction predicted increasing Fears over time. Elevated SR in safe phases post-contraction also predicted increasing Fears over time. Attenuated SR in safe phases post-contraction predicted elevated General Distress longitudinally. Attenuated SCR pre-contraction in danger phases predicted elevated Anhedonia-Apprehension over time. LIMITATIONS: Our non-clinical sample may limit generalizability of results. Additionally, we did not assess change in SR and SCR over time. CONCLUSIONS: The present study demonstrates that SR and SCR during a fear-potentiated startle paradigm predict longitudinal change in dimensional anxiety and depression symptom factors and relatedly, that SR and SCR may represent risk factors for the exacerbation of symptomatology.

A Current Learning Theory Approach to the Etiology and Course of Anxiety and Related Disorders.

The authors describe how contemporary learning theory and research provide the basis for models of the etiology and maintenance of anxiety and related disorders. They argue that contemporary learning theory accounts for much of the complexity associated with individual differences in the development and course of these disorders. These insights from modern research on learning overcome the limitations of earlier behavioral approaches, which were overly simplistic and have been justifiably criticized. The authors show how considerations of early learning histories and temperamental vulnerabilities affect the short- and long-term likelihood that experiences with stressful events will lead to the development of anxiety disorders. They also discuss how contextual variables during and after stressful learning experiences influence the maintenance of anxiety disorder symptoms. Thus, contemporary learning models provide a rich and nuanced understanding of the etiology and course of anxiety and related disorders.

Correlation between laboratory-based vicarious threat learning and emotional disorder symptom dimensions.

BACKGROUND AND OBJECTIVES: Vicarious threat conditioning abnormalities are theorized to confer vulnerability to a wide range of emotional problems. We tested two different conceptual models of this non-specificity. First, hypersensitivity to socially conditioned danger cues might predict standing on a general internalizing dimension that represents commonalities among various forms of anxiety and depression. Second, this hypersensitivity might predict specific symptom clusters, such as panic or social anxiety. METHODS: We examined university students' (N = 150) defensive responses during a vicarious threat conditioning task in relation to both broad and specific components of the internalizing domain. RESULTS: Vicarious conditioning was successful, such that participants exhibited larger subjective and skin conductance responses during their first direct encounters with threatening, as compared to nonthreatening, conditioned stimuli. But, contrary to hypotheses, individual differences in this threat learning process were not robustly correlated with any internalizing dimension. LIMITATIONS: The threat value of the conditioned stimuli was readily apparent, possibly limiting individual differences in defensive responding and, in turn, the correlations between conditioned responses and symptom dimensions. Also, results may differ in clinical populations. CONCLUSIONS: Our findings suggest that the association between vicarious threat learning and emotional disorder risk-whether it is conceptualized in terms of broad symptom dimensions that span many categorical diagnoses or more fine-grain symptom processes-is weaker than previously believed, at least in this population. Data, analysis code, and stimulus materials are available at https://osf.io/m3xst/.

Reciprocal effects of personality and general distress: Neuroticism vulnerability is stronger than scarring.

Internalizing (anxiety and depressive) disorders, and the symptoms that comprise them, are known for being chronic and recurrent. Neuroticism, reflecting dispositional tendencies toward negative affect, is a personality trait that bears durable cross-sectional and prospective associations with internalizing symptoms. There are also indications that extraversion, consisting of tendencies such as the heightened experience of positive emotion, is associated with these symptoms. Some investigators have posited that the experience of internalizing symptoms leaves residual effects, or scars, on personality traits, with the effect of raising risk of symptom reexacerbation. In the present study, we compare vulnerability and scar effects in a sample of older adolescents (N = 606) at risk for the development of internalizing disorders. Anxiety and depressive symptoms were assessed annually, as were neuroticism, extraversion, and other trait-like cognitive vulnerabilities. Cross-lagged panel models compared the relative strength of vulnerability and scar effects, revealing support for vulnerability effects but little evidence of scar effects. The results also showed that whatever scar effects might be present are weaker than vulnerability effects in the case of neuroticism. These findings underscore the importance of personality vulnerability for internalizing symptom risk by suggesting that neuroticism vulnerability is stronger than any lasting scars the experience of internalizing symptoms produce. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Neuroticism and the longitudinal trajectories of anxiety and depressive symptoms in older adolescents.

Adolescence is a developmental period characterized by remarkable volatility and comorbidity in internalizing disorders. Delineating internalizing symptom change in a manner that accounts for symptoms' shared versus distinctive features is imperative to an understanding of their development. An additional question concerns how vulnerabilities for internalizing disorders relate to development of internalizing symptoms. Cross-sectional and prospective associations between neuroticism and internalizing psychopathology are well-established, yet conclusive evidence on neuroticism's relation to the progression of symptom dimensions relevant to internalizing disorders remains absent. In this investigation, we used latent growth curve modeling to characterize the trajectories of tri-level model internalizing dimensions (General Distress, Anhedonia-Apprehension, Fears, Anxious Arousal, Fears of Specific Stimuli, Social Fears, Narrow Depression, Interoceptive/Agoraphobic Fears) and examined whether a general neuroticism factor predicted their growth. We used anxiety and depressive symptom data spanning 6 years, collected from 606 high school juniors mostly vulnerable for internalizing disorders. We observed a pattern of results that varied by symptom dimension. Only Anhedonia-Apprehension showed a distinct increasing trend, on average. Neuroticism predicted an adverse symptom course for the dimension of General Distress. Our results reinforce the notion that neuroticism confers substantial risk for internalizing symptom maintenance and extend past findings by demonstrating that neuroticism forecasts a poor symptom course for General Distress but not narrower dimensions of internalizing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Five-year prospective neuroticism-stress effects on major depressive episodes: Primarily additive effects of the general neuroticism factor and stress.

The past decades of research on predictors of depression have frequently emphasized interactive diathesis-stress questions: What kinds of vulnerabilities under stressful circumstances increase risk of developing depression? This study addresses 3 theoretically important gaps in our knowledge regarding diathesis-stress models of depression: the role of temperament (neuroticism), interactive versus additive effects of neuroticism-stress relationships, and effects of stressor characteristics (acute vs. chronic, major vs. minor events, interpersonal vs. noninterpersonal content). We addressed these gaps in the prediction of major depressive episodes (MDEs) in a sample of high schoolers (n = 559) oversampled for high neuroticism and assessed for presence of MDEs annually for 5 years. Survival analyses provided relatively consistent support for the main effects of the broad vulnerability factor of the general neuroticism factor, acute stressors, and chronic stressors in the prediction of MDEs. In contrast, the majority of our analyses failed to support interactive neuroticism-stress accounts of MDE risk. Integrating our results with the extant literature reinforces the notion that both the general neuroticism factor and stress prospectively predict depressive disorders and highlight that their main effects are significantly larger than their interaction. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Empathy does not amplify vicarious threat learning.

Clinically significant fears and phobias can be acquired vicariously. Witnessing another person's defensive reactions to potentially dangerous objects and situations can instill conditioned threat responses in the observer. The present study investigated individual differences in this social learning process. Specifically, we hypothesized that dispositional empathy modulates vicarious threat conditioning. We examined university students' (N = 150) conditioned threat responding after they observed strangers undergo Pavlovian threat conditioning. There was evidence of a substantial conditioned defensive response (Cohen's d = 0.66), as indexed by elevated electrodermal activity during participants' direct exposure to the vicariously conditioned stimuli. Contrary to expectations, indices of dispositional empathy were weakly related to the size of conditioned responses (median r = .04). Our results confirm that vicarious threat learning can be evaluated experimentally, but they do not support the hypothesis that empathy amplifies this process. The preregistration, stimulus materials, data, and analysis code for this study are available at https://osf.io/h6hm2.

The Systemic Therapy Inventory of Change (STIC) Initial Scales: Are they sensitive to change?

The Systemic Therapy Inventory of Change (STIC) is a multisystemic and multidimensional feedback system that provides therapists feedback about systemic domains of client change in individual, couple, and family therapy over time. The goal of the present study is to investigate the sensitivity to change of the scores of the STIC Initial Scales. In total, 583 clients who voluntarily sought individual, couple, or family therapy services and participated in a randomized controlled trial study were included in the study. Their pre- and posttherapy responses to the STIC Initial measures and corresponding validation measures for individual functioning, couple relationship, child adjustment, and family functioning were compared. The results support the sensitivity to change of the scores of the four STIC Initial Scales investigated: Individual Problems and Strengths (IPS), Relationship with Partner (RWP), Family/Household (FH), and Child Problems and Strengths (CPS). Of particular note, the IPS demonstrated even greater change over time than the BDI-II, BAI, and OQ-45. The discriminant validity of measuring change with the CPS was not supported. Thus, the STIC Initial IPS, RWP, and FH can be usefully employed to measure multisystemic changes in both research and clinical work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).