Decomposing the late positive potential to cannabis cues in regular cannabis users: A temporal-spatial principal component analysis.

Cannabis use disorder (CUD) is increasing in the United States, yet, specific neural mechanisms of CUD are not well understood. Disordered substance use is characterized by heightened drug cue incentive salience, which can be measured using the late positive potential (LPP), an event-related potential (ERP) evoked by motivationally significant stimuli. The drug cue LPP is typically quantified by averaging the slow wave's scalp-recorded amplitude across its entire time course, which may obscure distinct underlying factors with differential predictive validity; however, no study to date has examined this possibility. In a sample of 105 cannabis users, temporo-spatial Principal Component Analysis was used to decompose cannabis cue modulation of the LPP into its underlying factors. Acute stress was also inducted to allow for identification of specific cannabis LPP factors sensitive to stress. Factor associations with CUD severity were also explored. Eight factors showed significantly increased amplitudes to cannabis images relative to neutral images. These factors spanned early (~372 ms), middle (~824 ms), and late (>1000 ms) windows across frontal, central, and parietal-occipital sites. CUD phenotype individual differences were primarily associated with frontal, middle/late latency factor amplitudes. Acute stress effects were limited to one early central and one late frontal factor. Taken together, results suggest that the cannabis LPP can be decomposed into distinct, temporal-spatial factors with differential responsivity to acute stress and CUD phenotype variability. Future individual difference studies examining drug cue modulation of the LPP should consider (1) frontalcentral poolings in addition to conventional central-parietal sites, and (2) later LPP time windows.

Obsessive-compulsive symptoms, perceived burdensomeness, and thwarted belongingness: Associations and implications among US veterans.

OBJECTIVE: Obsessive-compulsive disorder (OCD) is among the most debilitating psychiatric disorders worldwide, but has gone relatively unnoticed within the US veteran population. Simultaneously, suicide rates continue to remain high within this population despite the high volume of veterans who receive psychiatric care. With recent research demonstrating OCD's unique relationship with suicidality, it is imperative to explore this association and factors that may explain this association within veterans. METHODS: The present study investigated OCD symptoms and their relationship with two known risk factors of suicide, perceived burdensomeness (PB) and thwarted belongingness (TB), in two samples of veterans. RESULTS: In the first study (N = 100), OCD symptoms were found to be uniquely related to both PB and TB even after covarying for demographics, trauma exposure, and probable depression. In the second study (N = 99), these relationships were replicated longitudinally. OCD symptoms at baseline were found to be indirectly related to suicidal ideation severity at a 1-month follow-up via PB and TB at post-treatment. CONCLUSION: This study highlights the importance of assessing and addressing OCD symptoms within veterans due to the unique relationship these symptoms have with suicidal constructs. A deeper understanding of the impact of OCD within the veteran population will inform future prevention and intervention efforts.

Efficacy of a brief web-based tonic immobility psychoeducation intervention among trauma-exposed adults: A randomized clinical trial.

Tonic immobility (TI) is a defensive response that may occur during traumatic events. Although TI is adaptive in certain circumstances, it has been shown to contribute to increased trauma-related symptoms and poorer recovery. However, current frontline treatments for posttraumatic stress disorder (PTSD) have not focused significant attention on the experience of TI. Thus, the aim of this study was to develop and test the impact of a brief TI-focused psychoeducation (TIP) intervention on posttraumatic cognitions and PTSD symptoms relative to a health education control intervention. The sample included 46 adults with elevated PTSD symptoms who endorsed prior TI episodes. After providing informed consent, participants were randomly assigned to either the active or control intervention and completed self-report questionnaires including the tonic immobility questionnaire (TIQ-R), Life Events Checklist for DSM-5 (LEC-5), Posttraumatic Stress Checklist for DSM-5 (PCL-5), Posttraumatic Cognitions Inventory (PTCI), and Positive and Negative Affect Schedule (PANAS) at baseline, 1-week, and 1-month follow-up assessments. Results from linear mixed effects models indicated that participants in the TIP condition reported significantly larger reductions in posttraumatic cognitions and PTSD symptoms at 1-week, ds = 0.48 and 0.84, respectively, and 1-month, ds = 0.67 and 0.74. The findings suggest that TIP is a promising intervention that may be used to reduce posttraumatic cognitions and PTSD symptoms associated with TI. Given the ease of access, TIP could be used as a standalone intervention or as an add-on to existing evidence-based treatments for PTSD.

Minority stress and mental health in lesbian, gay, bisexual, transgender, and queer survivors of sexual assault.

Extant research has shown that sexual violence disproportionately affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals, conferring risk for the development of posttraumatic stress symptoms (PTSS) and related mental health conditions. However, little research has focused on specific vulnerabilities among LGBTQ+-identified sexual assault (SA) survivors (e.g., minority stress) and their associations with post-SA psychopathology. To address this gap, we examined associations between experiences of minority stress and post-SA psychopathology in a sample of LGBTQ+ individuals who experienced SA (N = 92) and completed a battery of self-report measures. Results revealed significant differences in internalized stigma, community connectedness, alcohol use, and cannabis use across sexual orientation and gender modality groups, ηp 2 = .08-11. Additionally, regression analyses indicated that experiences of violence and victimization were significantly associated with higher PTSS, ß = .31, p = .020; anxiety, ß = .39, p = .003; and alcohol use severity, ß = .31, p = .027, over and above other experiences of minority stress and psychopathology risk factors. Internalized stigma was significantly associated with cannabis use severity, ß =.34, p = .011. Finally, community connectedness was significantly associated with lower anxiety symptom severity, ß = -.42, p = .001. Although longitudinal work is needed, findings indicate that experiences of minority stress may serve as risk or maintenance factors for post-SA psychopathology. These results offer important considerations for future treatment approaches tailored to LGBTQ+ survivors of SA.

Potentially traumatic pandemic stressors and anxiety-related sleep disturbance among Latinx persons.

Latinx persons have endured elevated rates of traumatic stress related to the COVID-19 pandemic. The effect of potentially traumatic pandemic stressors on anxiety-related sleep disturbances, a factor implicated in trauma-related psychopathology, is largely unexamined in this population. The present study evaluated the additive effect of potentially traumatic pandemic stressors (e.g., hospitalization) on anxiety-related sleep disturbances. Further, given within-group disparities across Latinx communities with intersectional identities and COVID-19-related risk factors, comparisons of the likelihood of pandemic stressors, by subgroup (i.e., older persons, individuals with chronic illness, and Black Latinx persons), were evaluated. Participants were 292 (29.8% female, Mage = 35.03 years, SD = 8.72) Latinx adults who completed a questionnaire battery during a period of high contagion (June 2020-July 2021). There were statistically significant differences across groups such that participants who experienced any potentially traumatic pandemic stressors reported elevated scores on indices of anxiety, depressive symptoms, and anxiety-related sleep disturbances compared to those who had not experienced these stressors, ds = 0.54-93. Hierarchical regression analysis revealed that hospitalization was associated with anxiety-related sleep disturbances after controlling for age, sex, chronic illness history, other stressors, anxiety, depressive symptoms, and somatic symptom burden, ΔR2 = .01. Black Latinx identity and chronic illness were significantly associated with potentially traumatic pandemic-related stressors. This is the first empirical work to evaluate the role of potentially traumatic pandemic stressors on sleep disturbances among Latinx persons and indicates that hospitalization in a pandemic context has an incremental effect on sleep disturbances in this minoritized group.

A replication and extension of bifactor modelling of perseverative thought in an at-risk community sample: Exploring sex differences in the structure of PT.

BACKGROUND: Perseverative thought (PT) is a transdiagnostic construct associated with internalizing disorders. Bifactor models have shown that PT can be split into a general PT factor and lower-order factors for specific forms of PT, such as rumination and worry. No bifactor study to date has investigated if the structure of PT differs across sexes. METHODS: The study consisted of 280 individuals recruited for a larger study targeting risk factors for suicidal ideation and behaviours. Participants completed a diagnostic interview and self-report questionnaires. RESULTS: A two-factor model of PT fit best in males, whereas a bifactor model fit best in females. In a structural equation model, worry was associated with generalized anxiety disorder diagnoses in females, but not males. Rumination was associated with depressive disorder diagnoses in females, but not males. CONCLUSIONS: The present study contributes to a growing literature on PT; we found that dimensionality of PT varied by sex. We also found that relations between PT factors and generalized anxiety disorder differed by sex. Sex differences in the internalizing spectrum and related risk factors need to be considered when examining the structure and function of risk factors.

Acceptability, feasibility, and utility of a safety aid reduction treatment in underserved veterans: a pilot investigation.

Access to mental health services, particularly for veterans residing in underserved communities, remain scarce. One approach to addressing availability barriers is through the use of group-based transdiagnostic or unified treatment protocols. One such protocol, Safety Aid Reduction Treatment (START), previously termed False Safety Behavior Elimination Treatment (FSET), has received increasing empirical support. However, prior research has only examined this treatment among civilians with a primary anxiety diagnosis. Thus, the purpose of the current study was to replicate and extend prior research by examining the acceptability, feasibility, and utility of START among veterans, particularly those living in underserved communities, and across a wider array of diagnoses. Veterans (n = 22) were assessed prior to, immediately after, and one month following the 8-week treatment. The majority of veterans found START useful and acceptable. Additionally, recruitment and retention rates suggest that the treatment was feasible. Notably, results revealed reductions in overall anxiety, depression, and safety aid usage, which were maintained throughout the brief follow-up period. These findings add to a growing body of literature highlighting the utility of transdiagnostic approaches in the amelioration of various anxiety and related disorders. Limitations include the small sample size and uncontrolled design.

Brief, interoceptive exposure focused treatment for anxiety in mild cognitive impairment.

Anxiety is common in older adults with mild cognitive impairment (MCI), and Alzheimer's disease and related dementias (ADRD). Anxiety has also been identified as a risk factor for cognitive decline. Brief interventions targeting risk mechanisms of anxiety, such as anxiety sensitivity (AS), have been effective in reducing overall anxiety in a variety of populations. This case series investigated the feasibility and efficacy of a brief AS intervention in anxious older adults with MCI (n = 9). Paired samples t-test results indicate that this intervention is capable of significantly reducing AS as measured by the Anxiety Sensitivity Index-3 (Δ = 5.11, Hedges g = 0.82, P < 0.05). Given these large AS reductions and high acceptability, further investigation of this intervention is warranted in older adults with MCI.

Perceptions of childhood unpredictability, delay discounting, risk-taking, and adult externalizing behaviors: A life-history approach.

Guided by principles from life-history theory, theories of adaptive calibration provide an overarching theoretical framework for understanding the developmental roots of impulsivity and externalizing psychopathology. The current research provides evidence for robust associations between perceptions of childhood unpredictability, delay discounting (Studies 1a and 1b), and adult externalizing traits and behaviors (Study 2). Both associations were observed while controlling for perceptions of the harshness of childhood environments, as well as a range of demographic characteristics. The association with externalizing traits and behavior was observed over and above current mood and depressive symptoms. Study 2 also replicated a previously documented association between changes in maternal employment, residence, and cohabitation during childhood and externalizing behavior and, furthermore, suggested that this association was mediated by perceptions of unpredictability. These studies provided no evidence for links between perceived childhood unpredictability and basic forms of risk-taking (Studies 1a and 1c). This research adds to a growing body of work leveraging principles from life-history theory to demonstrate links between childhood experiences, impulsivity, and potentially debilitating forms of mental illness. This work also highlights the value of assessing people's perceptions of their childhood environments.

Anxiety sensitivity and cannabis use motives among trauma-exposed young adult cannabis users.

BACKGROUND AND OBJECTIVES: Anxiety sensitivity, or fear of anxious arousal, may be an important risk factor for problematic cannabis use. Specifically, anxiety sensitivity may motivate cannabis use to cope with distress, particularly among trauma-exposed individuals. The current study tested associations among anxiety sensitivity, its subdomains, and cannabis use motives in a sample of trauma-exposed cannabis users. We hypothesized elevated anxiety sensitivity, particularly cognitive concerns, would be associated with increased maladaptive coping use motives, after covarying for the number of traumas and cannabis use quantity. METHOD: Hypotheses were tested in a cross-sectional study of trauma-exposed young adult cannabis users (N = 56) (Mage = 20.7 years, 59% women, 73% white). Participants completed self-report measures, and a clinical interview assessing cannabis use quantity. RESULTS: Multiple regression analyses indicated that elevated anxiety sensitivity was associated with increased cannabis use coping motives, after covarying for the number of traumas experienced and cannabis use quantity. Specifically, higher levels of anxiety sensitivity cognitive and social concerns were associated with coping motives for cannabis use. DISCUSSION AND CONCLUSIONS: Anxiety sensitivity, particularly concerns about cognitive dyscontrol and negative social evaluations of anxious arousal, may motivate cannabis use to cope with stress among trauma-exposed cannabis users. Future research should include prospective studies with diverse samples to replicate results and determine whether intervening on anxiety sensitivity could reduce maladaptive coping motives for cannabis use. SCIENTIFIC SIGNIFICANCE: The current study replicates prior research indicating anxiety sensitivity, particularly cognitive concerns, is associated with maladaptive cannabis use. Expanding on prior research, findings indicated anxiety sensitivity is associated with coping motives for cannabis use among trauma-exposed cannabis users.

Examination of a brief computerized Cognitive Anxiety Sensitivity intervention on obsessive-compulsive symptoms.

OBJECTIVES: Despite the existence of several first-line treatments for obsessive-compulsive disorder (OCD), many patients fail to experience symptom reduction and/or do not complete treatment. As a result, the field has increasingly moved towards identifying and treating malleable underlying risk factors that may in turn improve treatment efficacy. One salient underlying risk factor, anxiety sensitivity (AS) cognitive concerns, has been found to be uniquely associated with obsessive-compulsive (OC) symptom dimensions. However, no studies have yet examined whether reductions in AS cognitive concerns will lead to subsequent reductions in OC symptoms. METHODS: The current study attempted to fill this gap by recruiting individuals reporting elevations on both AS cognitive concerns and at least one OC symptom dimension. Participants were randomly assigned to receive either a one-session AS cognitive concerns intervention (n = 35) or a single health information control session (n = 37). AS cognitive concerns were assessed at post-intervention and one-month follow-up. RESULTS: The active intervention produced significantly greater reductions in AS cognitive concerns post-intervention than the control intervention. However, this effect was no longer significant at one-month follow-up. Further, while there was not an effect of treatment condition on OC symptoms at one-month follow-up, changes in AS cognitive concerns from baseline to post-intervention mediated changes in OC symptoms at one-month follow-up. CONCLUSIONS: Findings support previous research attesting to the malleable nature of AS. Extending this research, findings provide initial support for the efficacy of AS interventions among individuals with elevated OC symptoms. PRACTITIONER POINTS: Clinicians should consider assessing anxiety sensitivity (AS) among patients with obsessive-compulsive disorder. If elevated, clinicians should consider targeting AS as an adjunct to treatment as usual.

Computer-delivered intervention for individuals with obesity and elevated anxiety sensitivity: feasibility, acceptability, and initial test.

Obesity is one the fastest growing public health problems related to numerous chronic diseases and frequently co-occurs with negative mood states. One promising approach to address the heterogeneity of affective vulnerabilities and obesity is to focus on processes (e.g. anxiety sensitivity [AS]) that underpin both conditions. Thus, this study aimed to evaluate the feasibility, acceptability, and initial efficacy of a brief, computer-delivered AS reduction program (AST) for adults with obesity and elevated AS. Participants were 131 individuals with obesity and elevated AS who received either AST or a health information control (HC). Latent growth curve modeling was utilized to examine the effect of treatment condition on change in AS, emotional eating, expectancies of eating to manage mood, and exercise self-efficacy from baseline to 1-week, 2-weeks, and 1-month follow-up. Results indicated it was feasible to recruit and retain individuals with obesity and elevated AS through the 1-month follow-up. Positive qualitative feedback was also provided for both AST and HC. AST was a statistically significant predictor of change in expectancies of eating to manage negative affect. No other statistically significant treatment effects were indicated. Current data provide initial empirical support for future work focused on persons with obesity and elevated AS.

Vulnerability to COVID-19-Related Disability: The Impact of Posttraumatic Stress Symptoms on Psychosocial Impairment During the Pandemic.

As a result of the COVID-19 pandemic, many individuals have experienced disruptions in social, occupational, and daily life activities. Individuals with mental health difficulties, particularly those with elevated posttraumatic stress symptoms (PTSS), may be especially vulnerable to increased impairment as a result of COVID-19. Additionally, demographic factors, such as age, gender, and race/ethnicity, may impact individual difficulties related to the pandemic. The current study examined the concurrent and prospective associations between posttraumatic stress disorder (PTSD) symptoms, broader anxiety and depression symptoms, and COVID-19-related disability. Participants recruited through Amazon's Mechanical Turk (N = 136) completed questionnaire batteries approximately 1 month apart during the COVID-19 pandemic (i.e., Wave 1 and Wave 2). The results indicated that PTSD, anxiety, and depressive symptoms were all associated with increased COVID-19-related disability across assessment points, rs = .44-.68. PTSD symptoms, specifically negative alterations in cognition and mood, significantly predicted COVID-19-related disability after accounting for anxiety and depressive symptoms as well as demographic factors, ßs = .31-.38. Overall, these findings suggest that individuals experiencing elevated PTSS are particularly vulnerable to increased functional impairment as a result of COVID-19 and suggest a need for additional outreach and clinical care among individuals with elevated PTSD symptoms during the pandemic.

COVID-related fear maintains controlling parenting behaviors during the pandemic.

The direct threat posed by the 2019 novel coronavirus (COVID-19), uncertainty surrounding best safety practices, and secondary consequences of the virus have led to widespread stress and declining mental health across communities and individuals. These stresses may impact parenting behaviors, potentially leading to negative consequences for children. Controlling parenting behaviors increase in the face of perceived environmental threat and are associated with adverse mental health outcomes for children; however, determinants of parenting behaviors have not been investigated during the COVID-19 pandemic. The current study prospectively evaluated parenting behaviors during the pandemic (N=87). Results indicated that all negative affect emotions investigated were positively associated with controlling parenting behaviors. However, only COVID-related fear predicted changes in controlling parenting behaviors across timepoints. Specifically, although controlling parenting behaviors decreased in the overall sample from time 1 to time 2, higher COVID-related fear scores at time 1 predicted maintenance of high levels of controlling parenting behaviors at time 2. Additionally, this effect was specific to controlling, as opposed to more adaptive, parenting behaviors. Future studies should investigate the association between parents' COVID-related fear, controlling parenting behaviors, and adverse mental health outcomes for children in the context of the COVID-19 pandemic.

A brief, computerized intervention targeting error sensitivity reduces the error-related negativity.

Research has identified the neural response to errors (the error-related negativity; ERN) as a marker of current anxiety, as well as risk for future anxiety. Previous work found that traditional cognitive behavioral therapy approaches do not impact the ERN. However, none of these approaches directly target the psychological constructs linked to an increased ERN (e.g., error sensitivity). In the current study, we examine the extent to which a brief, computerized intervention ("Treating the ERN"; i.e., TERN) might impact the ERN by reducing error sensitivity. Results suggest that TERN reduced the ERN and that the impact of the intervention was larger amongst individuals with an increased baseline ERN. This study is an important first step in the development of a novel intervention approach that directly targets error sensitivity, and thereby the ERN.

Insomnia symptoms predict the development of post-traumatic stress symptoms following an experimental trauma.

Insomnia symptoms prior to traumatic event exposure predict the development of post-traumatic stress symptoms. However, potential mechanisms underlying the association between insomnia and risk for post-traumatic stress disorder symptoms have not been prospectively tested. The current study used the trauma film paradigm to test whether insomnia symptoms prior to analogue trauma exposure predict subsequent analogue post-traumatic stress disorder symptoms, and potential mediators of this relationship, among an at-risk sample of 108 participants. Results indicated that, after covarying for negative affectivity, insomnia symptoms in the 2 weeks prior to analogue trauma exposure significantly predicted increased post-traumatic stress disorder symptoms 3 days and 1 week post-exposure. Moreover, distress immediately after exposure and post-traumatic avoidance mediated the association between insomnia symptoms and post-traumatic stress disorder symptoms 1 week after exposure. Effect sizes were small. The current study uses an analogue trauma and analogue post-traumatic stress disorder symptoms to model clinical symptoms, includes an additional intervention prior to analogue trauma, and lacks a control film. Findings suggest increased reactivity to trauma exposure and subsequent reminders, and attempts to suppress trauma memories may be mechanisms in the association between insomnia symptoms and risk for post-traumatic stress disorder symptoms.

A multiple mediation model of trait worry and hazardous drinking among treatment-seeking smokers: the roles of coping and conformity drinking motives.

Alcohol use is associated with poorer smoking cessation-related outcomes, and smokers with elevated levels of worry experience greater smoking cessation problems. Yet, little is known about the explanatory mechanisms that may underlie the relationship between trait worry and hazardous drinking among smokers. Therefore, this study explored the explanatory roles of coping and conformity drinking motives in the relationship between trait worry and hazardous drinking outcomes including alcohol consumption, alcohol problems, maximum number of drinks, and the number of prior alcohol quit attempts among treatment-seeking smokers. Participants included 377 treatment-seeking smokers who consumed at least one alcoholic drink in the last year (48% female; 86.2% Caucasian; Mage = 34.83 years, SD = 13.38). Results showed a significant indirect effect of trait worry through coping-related drinking motives in relation to alcohol consumption, alcohol problems, maximum number of drinks, and number of prior drinking quit attempts. These findings were evident after controlling for gender, cigarette dependence, and current psychopathology. These findings suggest that coping drinking motives are one mechanism that may explain the relation between trait worry and hazardous drinking outcomes among treatment-seeking smokers.

Emotion dysregulation as a maintenance factor for posttraumatic stress symptoms: The role of anxiety sensitivity.

OBJECTIVES: The current study tested whether emotion dysregulation, assessed by the Difficulties in Emotion Regulation Scale (DERS), would predict posttraumatic stress symptoms (PTSS) through anxiety sensitivity (AS). Alternate cognitive-affective mediators (i.e., distress tolerance and intolerance of uncertainty) were explored. METHOD: A total of 259 trauma-exposed community members (ages averaging 37.39; evenly distributed by gender) from a larger clinical trial targeting suicide risk factors completed a clinical interview and self-report questionnaires at baseline, Week-3, and 1-month follow-up appointments. RESULTS: AS at Week 3 significantly mediated the relationship between initial emotion dysregulation and 1-month follow-up posttraumatic stress symptoms (PTSS) after controlling for condition and baseline symptoms (ß = .07; standard error = 0.03; 95% confidence interval = [0.01, 0.14]). Effects held for one out of six emotion dysregulation subscales. Distress tolerance and intolerance of uncertainty were not significant mediators (ps > .05). CONCLUSIONS: This study demonstrates that emotion dysregulation may confer maintenance of PTSS through AS. Findings highlight potentially malleable targets for interventions.

Development of the Response to Fearful Situations Scale.

BACKGROUND: Most measures of anxious avoidance are limited to disorder-specific mechanisms and ignore the measurement of courage/approach responding in confronting fearful situations. AIMS: The purpose of the present study was to construct and validate a self-report assessment of the tendency towards avoidant or approach responding in fearful situations, the Response to Fearful Situations Scale (RFSS). METHOD AND RESULTS: In Study 1 (n = 241), exploratory factor analysis resulted in two factors, avoidance and approach. Study 2 (n = 423) replicated the two-factor structure and established test-re-test reliability. In Study 3 (n = 44), the RFSS demonstrated predictive validity on a behavioural avoidance task. In Studies 4 (n = 253) and 5 (n = 256), the RFSS was associated with clinical symptoms above existing measures of avoidance. DISCUSSION: These results validate the use of the RFSS as a transdiagnostic measure of avoidance and approach.

Epidemiological and Clinical Gender Differences in OCD.

PURPOSE OF REVIEW: This review highlights recent research regarding gender differences in OCD, with a focus on prevalence, course of illness, symptom presentation, comorbidity, and treatment response. RECENT FINDINGS: Overall, findings remain mixed. OCD may be more common among males in childhood, but is more common among females in adolescence and adulthood. Males tend to report an earlier age of onset and present with symptoms related to blasphemous thoughts. Females often describe symptom onset as occurring during or after puberty or pregnancy and present with symptoms related to contamination and/or aggressive obsessions. Females also tend to report significantly higher depression and anxiety. There are no reported gender differences in treatment outcome. Gender may play a role in the onset, presentation, and impact of OCD symptoms. However, more work is needed to account for differences across studies, with one promising future direction being the study of reproductive hormones.