Intolerance of Uncertainty, Negative Reinforcement Alcohol Use Motives, and Hazardous Drinking in College Students with Clinically Elevated Worry.

Background: Hazardous drinking has remained high for college students in recent years, and individuals who endorse drinking to cope with emotional distress or to conform socially report higher levels of alcohol use. Intolerance of uncertainty, a core process underlying generalized anxiety disorder, has been linked to negative reinforcement drinking motives; however, no research, to date, has examined the role of intolerance of uncertainty in terms of alcohol use motives and hazardous drinking among individuals with generalized anxiety disorder. Objective: The current study was designed to examine the relationships between intolerance of uncertainty, coping and conformity alcohol use motives, and hazardous drinking in an analogue generalized anxiety disorder sample. Methods: Participants were 323 college students (Mage = 19.25, SD = 2.23, Range = 18-40) who endorsed past-year alcohol use and clinically elevated levels of worry. Self-report measures were completed online for course credit. Results: Partially consistent with our hypotheses, uncertainty paralysis predicted greater levels of coping motives, but not conformity motives. Desire for predictability did not predict either drinking motive. Mediation analyses revealed that there was a significant indirect effect of uncertainty paralysis on more hazardous drinking through greater coping motives. Conclusion: Overall, these findings highlight the potential utility of targeting behavioral inhibition due to uncertainty to reduce unhealthy coping via alcohol use and subsequent hazardous alcohol use.

The DIAMOND-KID: Psychometric Properties of a Structured Diagnostic Interview for DSM-5 Anxiety, Mood, and Obsessive-Compulsive and Related Disorders in Children and Adolescents.

The objective of the present study was to examine the reliability and validity of a new semi-structured interview for pediatric psychiatric disorders, which is needed as existing interviews do not cover the full range of anxiety, mood, and obsessive-compulsive disorder (OCD)-related disorders. Three hundred eleven child patients (aged 10-17) were administered the Diagnostic Interview for Anxiety, Mood, and OCD and Related Neuropsychiatric Disorders-Child and Adolescent Version (DIAMOND-KID). Of these, 65 provided interrater reliability data and 59 provided test-retest reliability data. Participants also completed self-report measures that assessed symptoms of anxiety, mood, and OCD and related disorders. Although parents/guardians could participate in the interview at the clinician's discretion, most of the initial interviews and all of the reliability interviews were based on the child's self-report. Test-retest reliability ranged from very good to excellent. Interrater reliability was more variable, with estimates for generalized anxiety disorder and major depressive disorder in the questionable range; the other interrater reliability estimates ranged from good to very good. Convergent validity was established by significant between-group comparisons on applicable self-report measures for all diagnoses. The results of the present study indicate that the DIAMOND-KID is a promising semi-structured diagnostic interview for 5th edition of the Diagnostic and Statistical Manual of Mental Disorders in pediatric populations.

Low Estradiol May Not Impede Cognitive Restructuring in Women With Anxiety Disorders.

Prior research suggests that estradiol may moderate fear extinction in animal models and humans. Based on these findings, estradiol may also moderate cognitive reappraisal, which is theorized to be an important mechanism of change in extinction-based therapy (exposure therapy). We compared cognitive restructuring (CR) skills acquisition and outcome between women with primary anxiety disorders who had high versus low estradiol using a standardized CR task that closely resembles clinical practice. As a proxy of CR outcome, we assessed subjective distress ratings before and after the task and psychophysiological arousal (heart rate and electrodermal activity) throughout the task. Contrary to predictions, results showed that CR skills acquisition and outcome did not differ between the high and low estradiol groups. Although both groups demonstrated reductions in negative affect and skin conductance responses during the CR task, suggesting that participants were able to acquire CR skills and use them effectively to regulate distress, the groups did not differ with respect to CR ability or outcome. The findings suggest that estradiol may not moderate cognitive reappraisal, and may have more of an effect on basic habituation and extinction processes instead.