Experiential Avoidance and Emotion Dysregulation as Mediators in the LGBTQ Minority Stress Model.

Gender and sexual minorities are at increased risk for psychological disorders compared to the general population. The minority stress model has been proposed to explain these elevated rates of psychological distress. Per this model, minority stress factors (e.g., prejudice, discrimination, rejection, internalized homophobia/ transphobia) combine to create a unique stress which negatively impacts the mental health of gender and sexual minority individuals. With support for the general minority stress model established, attention has turned to investigating possible mediators in this model. In other words, how does minority stress cause psychological distress and negative mental health outcomes? The aim of the present study was to investigate experiential avoidance and emotion dysregulation as potential mediators in the relationship between minority stress factors and psychological distress. Final parallel mediation models supported that experiential avoidance and emotion dysregulation were significant mediators in the relationship between minority stress variables and psychological distress. These final models support that minority stress experiences, experiential avoidance, and emotion dysregulation are all factors that contribute to psychological distress in gender and sexual minority individuals. The implications of these findings are discussed.

Therapist training in empirically supported treatments: a review of evaluation methods for short- and long-term outcomes.

Therapist training efforts have been assessed using several outcomes. A model for evaluating therapist training in empirically supported treatments is presented, adapted from Kirkpatrick's (in: Craig and Bittel (eds.) Training and development handbook, 1967) training evaluation model. The adapted framework includes short-term outcomes, such as reactions to training and changes in attitude, knowledge, or skills, and longer-term outcomes, such as changes in therapist behavior in practice or client outcomes. Evaluation methods for these outcomes are reviewed, with information on their validity, reliability, and feasibility. An agenda for further research to improve therapist training evaluation is presented, with discussion of how evaluation can inform other areas of the field.

Cognitive-behavioral psychology: implications for disaster and terrorism response.

Given the personal and societal costs associated with acute impairment and enduring post-traumatic stress disorder (PTSD), the mental health response to disasters is an integral component of disaster response planning. The purpose of this paper is to explore the compatibility between cognitive-behavioral psychology and the disaster mental health model, and explicate how cognitive-behavioral perspectives and intervention methods can enhance the effectiveness of disaster mental health services. It is argued that cognitive-behavioral methods, if matched to the contexts of the disaster and the needs of individuals, will improve efforts to prevent the development of PTSD and other trauma-related problems in survivors of disaster or terrorist events. First, the similarities between models of care underlying both disaster mental health services and cognitive-behavioral therapies are described. Second, examples of prior cognitive-behavioral therapy-informed work with persons exposed to disaster and terrorism are provided, potential cognitive-behavioral therapy applications to disaster and terrorism are explored, and implications of cognitive-behavioral therapy for common challenges in disaster mental health is discussed. Finally, steps that can be taken to integrate cognitive-behavioral therapy into disaster mental health are outlined. The aim is to prompt disaster mental health agencies and workers to consider using cognitive-behavioral therapy to improve services and training, and to motivate cognitive-behavioral researchers and practitioners to develop and support disaster mental health response.

Effects of social desirability on students' self-reporting of partner abuse perpetration and victimization.

Little is still known about the degree to which social desirability affects reports of partner abuse. The current study builds on existing research exploring the relationship between social desirability and partner abuse reports by analyzing 49 male and 155 female students' responses to the Revised Conflict Tactics Scale (CTS2) and the Marlowe-Crowne Social Desirability Scale (MCSDS). Sex differences were not associated with partner abuse rates, regardless of type, severity, and violence role. Women had significantly higher social desirability scores than men, and women's MCSDS scores were negatively correlated with partner abuse perpetration and victimization rates. Social desirability was a significant predictor of psychological abuse perpetration, whereas gender was a significant predictor of sexual coercion perpetration. In all partner abuse cases, however, social desirability and gender accounted for less than 10% of the variance in partner abuse reports.

The role of emotion regulation in predicting personality dimensions.

Dimensional models of personality have been widely acknowledged in the field as alternatives to a trait-based system of nomenclature. While the importance of dimensional models has been established, less is known about the constructs underlying these personality dimensions. Emotion regulation is one such potential construct. The goal of the current study was to examine the relationship between personality dimensions and emotion regulation. More specifically, the predictive capacity of emotion regulation in accounting for personality dimensions and symptoms on the Schedule for Nonadaptive and Adaptive Personality-2 above and beyond a measure of general distress was evaluated. Emotion regulation was found to be predictive of most personality dimensions and symptoms of most personality disorders. Consistent with hypotheses, emotion regulation variables associated with undercontrol of emotions were most predictive of traits associated with Cluster B personality disorders whereas Cluster A and C traits were most associated with emotion regulation related to overcontrol of emotions. These findings provide preliminary evidence that some personality dimensions never assessed in relation to emotion regulation are strongly predicted by emotion regulation variables. Thus, the present study facilitates an initial step in understanding the relationship between personality dimensions and a multidimensional model of emotion regulation. Copyright © 2017 John Wiley & Sons, Ltd.

Child sexual abuse and adulthood sexual assault among military veteran and civilian women.

The purpose of this study was to investigate childhood sexual abuse (CSA), adulthood sexual victimization (ASV), and adulthood sexual assault experiences in a comparison sample of female military veterans (n = 142) and civilian community members (n = 81). Women veterans were significantly more likely than civilian women to report adult sexual assault. Although comparable rates of CSA and ASV were found across groups, veterans more frequently reported having been sexually abused by a parental figure, reported longer durations of CSA, and significantly greater severity of ASV than civilians. Implications for mental health professionals providing sexual trauma services to female military personnel and veterans are discussed.

An Experimental Examination of the Interaction between Mood Induction Task and Personality Psychopathology on State Emotion Dysregulation.

While emotion dysregulation has been investigated as a key variable in the development and persistence of personality psychopathology, few studies have explored state emotion dysregulation among individuals with personality disorders (PDs). The current study addresses this void in the literature through a laboratory investigation of state emotion dysregulation among participants with and without PDs. To facilitate this goal, participants were matched to pairs based on similar personality features and were randomized to one of two behavioral analogues; either the Paced Auditory Serial Addition Task-Computerized (PASAT-C) or an interpersonally based mood induction. As hypothesized, PD participants in the PASAT-C reported significantly more difficulty with impulsivity and emotion regulation strategies. Contrary to expectations, the PD group in the interpersonal task demonstrated significantly less difficulty with non-acceptance of emotion and emotional clarity and significantly greater positive affect compared to non-PD participants. Implications for these findings and directions for future research are discussed.

Common behavioral dilemmas of the school-aged child.

PCPs are typically the first professionals to come into contact with children who have behavioral or developmental problems. The most common behavioral concerns that PCPs encounter in the pediatric primary care setting include noncompliance, temper tantrums, and problems with eating and sleeping routines. To adequately detect these types of problems, it essential that PCPs incorporate behavioral assessment procedures (eg, clinical interviews, behavior rating scales, ABC recording form) into the consultation process. Behavioral assessment procedures are useful in identifying the environmental events (ie, antecedents and consequences) that may be maintaining the problem behavior. Data that are collected from behavioral assessment can be used to develop a tentative hypothesis on functions of the behavioral problem. By identifying the potential function of the behavior, more effective behavioral management strategies can be developed. An existing model of behavioral consultation can be used by PCPs during office visits to more effectively identify and manage many of the common and less severe behavioral problems.

Disaster and terrorism: Cognitive-Behavioral interventions.

The mental health effects of disaster and terrorism have moved to the forefront in the recent past following the events of 11 September 2001 in the United States. Although there has been a protracted history by mental health researchers and practitioners to study, understand, prevent, and treat mental health problems arising as a result of disasters and terrorism, there still is much to learn about the effects and treatment of trauma. Continued communication among disaster workers, first-response medical personnel, and mental health professionals is part of this process. This paper outlines current knowledge regarding the psychological effects of trauma and best cognitive-behavioral practices used to treat trauma reactions. More specifically, the information presented is a summary of Cognitive-Behavioral Therapy (CBT) interventions that are relevant for responding to and dealing with the aftermath of disasters.

Sexual assault prevention with college-aged women: a bibliotherapy approach.

The present research evaluated the efficacy of a skills-based bibliotherapy approach to sexual assault prevention for college-aged women. One hundred and ten participants were followed prospectively for 16 weeks. A self-help book, written by the authors, was compared to a wait-list control on several self-report measures. Results revealed significant differences between groups, with bibliotherapy participants reporting decreased participation in risky dating behaviors and improvement in sexual communication strategies across a variety of dating situations. However, results suggested that the self-help book was no more effective than the wait-list control in reducing rates of sexual victimization. Limitations of the study and directions for future sexual assault prevention research with women are discussed.

The structure of the cognitive revolution: an examination from the philosophy of science.

The received view is that psychology has undergone several scientific revolutions similar to those that occurred in the physical sciences. Of these, this paper will consider the cognitive revolution. Because the arguments in favor of the existence of a cognitive revolution are cast using the concepts and terms of revolutionary science, we will examine the cognitive revolution using accounts of revolutionary science advanced by five influential philosophers of science. Specifically, we will draw from the philosophical positions of Popper, Kuhn, Lakatos, Laudan, and Gross for the purpose of discussion. We conclude that no substantive revolution took place according to these accounts. This conclusion is based on data gathered from some of the major participants in the "cognitive revolution" and on a general scholarly survey of the literature. We argue that the so-called cognitive revolution is best characterized as a socio-rhetorical phenomenon.

Ethical issues in research on sensitive topics: participants' experiences of distress and benefit.

While many studies ask participants to disclose sensitive information or to participate in emotionally arousing tasks, little is known about participants' subjective experiences of discomfort and benefit. Ethics review committees, therefore, have little information about participant experiences to guide their informed decision-making. We asked undergraduate females about their experiences in a study that included an experimental session, interviews, and self-report measures on sensitive topics. We examined results overall, and compared the responses of individuals with and without childhood abuse experiences. Participants who had experienced child abuse were more likely to report distress due to remembering the past, but also more likely to report that participation was helpful. Implications for future research, and recommendations for review boards, are discussed.

Intimate partner violence theoretical considerations: moving towards a contextual framework.

Several theories have been developed to provide a conceptual understanding of intimate partner violence (IPV) episodes. Although each of these theories has found some degree of empirical support, they are limited in their explanatory power of IPV episodes and their ability to significantly impact the efficacy of IPV prevention and treatment programs. The current paper provides a review and critique of current IPV theories and highlights strategies for improving upon these theories. An alternative theoretical conceptualization is introduced that incorporates existing IPV and functional analytic literature into a contextual framework for conceptualizing IPV episodes. Components of the IPV contextual framework include distal, static and proximal antecedents; motivating factors; behavioral repertoire; discriminative stimuli (i.e. environmental cues/signals); verbal rules; and IPV consequences. The proposed theoretical framework offers two primary advantages over former IPV theories. First, it provides a comprehensive conceptualization of IPV by integrating components of previous IPV theories and their related empirical findings into one, cohesive conceptual framework. Additionally, it allows for a more fine-grained analysis of more proximal variables potentially related to discrete IPV episodes. A discussion of how the proposed theoretical framework may influence future IPV research and clinical practice is provided.

Ethics of asking trauma-related questions and exposing participants to arousal-inducing stimuli.

This study examined ethical concerns related to exposing participants with childhood victimization histories to both trauma-specific and non-trauma-specific stimuli. We asked participants questions about childhood victimization experiences and exposed participants to a negatively-arousing experimental condition. Following each of these procedures and at a one-week follow-up session, participants completed a measure designed to asses their reactions to participation. The measure included several questions to assess reactions including questions about distress, benefit, and willingness to participate in the study again. Overall, participants reported low levels of distress and described their participation experience as interesting, enjoyable, and somewhat beneficial. Participants also indicated that they would be willing to participate in the study again with the knowledge of what participation was actually like. Participants with childhood trauma histories and PTSD symptoms reported more distress during the childhood maltreatment screening compared to other participants. However, the level of distress they experienced was mild and transitory. Our findings add to the emerging data indicating that individuals find their participation in trauma-related research to be a positive experience overall, rather than a harmful one.

Risk factors for suicidal behavior among a national sample of adolescents: implications for prevention.

Factors associated with suicidal ideation and attempts were examined among a national probability sample of adolescents. Sample prevalences of suicidal ideation and attempts were 24.3% and 3.3%, respectively, yielding weighted population prevalence estimates of 23.3% and 3.1%. Suicidal ideation was positively associated with female gender, age, family alcohol and drug problems, violence exposure, lifetime depression, and posttraumatic stress disorder (PTSD). Suicide attempts were associated with female gender, age, sexual and physical assault, lifetime substance abuse or dependence, PTSD, and depression. Implications for intervention and prevention are discussed.

Psychological assessment and treatment of somatization: adolescents with medically unexplained neurologic symptoms.

Adolescent patients who report physical symptoms that are unexplained by physical disease or pathophysiologic processes are prevalent in health care settings. Physical symptoms with no notable physical pathology are often referred to as medically unexplained symptoms (MUS). Common MUS found in adolescent populations include headaches, abdominal pain, back pain, fatigue, dizziness, numbness and tingling sensations in the limbs, and gastrointestinal symptoms. The most important diagnostic concern is the exclusion of neurologic and other general medical conditions. Failure to diagnose real physical pathology appropriately can have serious, deleterious consequences. However, it is also important for physicians to address psychological and other psychosocial factors that may play a role in the etiology or maintenance of MUS. The onus often falls on the primary care physician to screen for such problems and to make cost-effective and appropriate referrals. This article reviews some alternative treatment guidelines for physicians to assist in the assessment, intervention, and referral process for adolescent patients with MUS. The advantages of integrating psychological screening practices into the evaluation process and present recommendations regarding the management of such patients are discussed.