The dimensional structure of internalizing psychopathology: Relation to diagnostic categories.

Recent approaches aim to represent the dimensional structure of psychopathology, but relatively little research has rigorously tested sub-dimensions within internalizing psychopathology. This study tests pre-registered models of the dimensional structure of internalizing psychopathology, and their relations with current and lifetime depressive and anxiety disorders diagnostic data, in adult samples harmonized across three sites (n=427). Across S-1 bifactor and hierarchical models, we found converging evidence for both general and specific internalizing dimensions. Depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic attacks were all associated with a general internalizing factor that we posit primarily represents motivational anhedonia. GAD was also associated with a specific anxious apprehension factor, and SAD with specific anxious apprehension and low positive affect factors. We suggest that dimensional approaches capturing shared and specific internalizing symptom facets more accurately describe the structure of internalizing psychopathology and provide useful alternatives to categorical diagnoses to advance clinical science.

Theories of psychopathology: Potential to promote clinical science, empowerment, and justice.

This invited commentary evaluates eight target articles that offer ambitious theoretical frameworks intended to advance psychopathology research. We discuss their consideration of the perspectives and priorities of treatment-seekers, including respect for and promotion of individuals' agency and self-determination; their positioning of individuals within dynamic social systems and their consideration of interventions beyond the individual level; their assumptions and proposals about the relationship between psychological and biological concepts and phenomena, relative to the reductionism that has been dominant but unsuccessful in the psychopathology literature in recent decades; and their implications for clinical care and for individual and community health. Despite some overlapping features, the articles cover very different ground and offer different challenges to the status quo, which has seen strikingly slow progress for decades. None of the proposed theories is comprehensive, but each has unique appeals; each has limitations, and each warrants consideration and development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily exposure to virtual nature reduces symptoms of anxiety in college students.

Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single "doses" of virtual nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks, anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users, experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact mental health outcomes.

Threat effects on attention networks in individuals with a history of externalizing behaviors.

Research identifying the biobehavioral processes that link threat exposure to cognitive alterations can inform treatments designed to reduce perpetration of stress-induced aggression. The present study attempted to specify the effects of relatively predictable versus unpredictable threat on two attention networks, attentional alerting and executive control. In a sample of adults (n = 74, 35 % identifying as women, Mage = 32.85) with high rates of externalizing behaviors (e.g., substance use, criminal/legal system involvement, aggressivity), we measured event-related brain activity during an attention network test that manipulated cognitive systems activation under relatively unpredictable and predictable threat conditions. Results showed that threat exposure alters attentional alerting and executive control. The predictable threat condition, relative to unpredictable threat, increased visual alerting (N1 amplitude to alert vs. no alert cue conditions) and decreased attention to the task (P3 amplitude to subsequent task-relevant flankers, but these effects did not survive adjusting for multiple tests. In contrast, overall threat and unpredictable threat conditions were associated with faster response time to alert cue (versus no cue) and poorer conflict processing, operationalized as flanker N2 reductions and slower response time to incongruent (versus congruent) flanker trials. These results expand what is known about threat-related modulation of cognition in a sample of individuals with histories of externalizing behaviors.

Dignity of Risk in Adolescent Development: A Neuropsychological Perspective.

Although the notion of "dignity of risk" has primarily been used in reference to adolescents with disabilities, this concept can be applied to all adolescents, as parents and guardians are challenged by how to balance adolescents' need for self-determination with the need for safety and supervision. In the context of maturing cognitive and emotional neural circuits, normative adolescent development involves temporal shifts in social and environmental factors that are inherently associated with both higher risk-taking and opportunities for growth and new learning. The challenge for parents of balancing risk and opportunity is influenced by social, cultural, and environmental factors, previous experience, personality, and the perceived capability of the adolescent. When perceived capability is lower, the challenge becomes even more acute, such as when an adolescent has a developmental, physical, or psychiatric disability that impacts cognitive, emotional, or adaptive functioning. This article reviews the literature on normative brain development from the perspective of balancing risk and self-determination in adolescence and discusses the implications for families and clinicians across a range of ability and disability. Potential approaches to fostering self-determination are discussed.

A double-blind study of empathic support and expectation as mechanisms of symptom change.

Objective: A novel brief intervention was used to investigate how empathic support and expectation can induce changes in mood, anxiety, and perceived stress. Method: Seventy-six undergraduates with high negative affect were assigned to three conditions of a program involving tasks with no known therapeutic benefit. In Group 1: Expectation Only, participants were given a deceptive description of the benefits of the program to quantify the magnitude of symptom change due to expectation alone. In Group 2: Empathic Support + Expectation, participants were also instructed to write about past and current sources of distress and provided with supportive notes each week to quantify the role of empathic support plus expectation. In Group 3: Control, participants were told they were "norming" the instruments. Results: Participants in Groups 1 and 2 demonstrated decreases in depression, anxiety, and rumination, with significant medium effect reductions found in the empathic support plus expectation condition. Conclusions: Evidence suggests that empathic support and expectation cause reduction of symptoms spanning depression and anxiety.

The costs of anticipating and perseverating about racism: Mechanisms of the associations between racial discrimination, anxious arousal, and low positive affect.

Although numerous studies have documented an association between racial discrimination and internalizing psychopathology symptoms, there is a lack of empirical work that establishes cognitive and emotional mechanisms through which racial discrimination is associated with specific transdiagnostic mental health outcomes (i.e., anxious arousal and low positive affect) among Black Americans. OBJECTIVE: The goal of this study was to test a new etiological model of how racial discrimination is associated with anxious arousal and low positive affect. The overarching model posits that racial discrimination will be associated with anxious arousal and low positive affect through prolonged activation of race-related stress processes (i.e., anticipatory race-related fear and race-related rumination), the effects of which are conditioned on attention bias to threat. METHOD: A total of 326 Black participants (72.4% women) completed the study. RESULTS: For anxious arousal, the indirect effect of racial discrimination through anticipatory race-related fear depended on degree of attention bias, with the effect only reaching statistical significance at mean and relatively higher levels of attention bias to threat. For low positive affect, the indirect effect of racial discrimination through race-related rumination only reached a statistical significance at mean and relatively lower levels of attention bias to threat. CONCLUSIONS: Racial discrimination is indirectly associated with anxious arousal and low positive affect through the effects of anticipatory race-related fear and race-related rumination, respectively. Implications for etiology and treatment of anxious arousal and low positive affect are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotion mindsets and depressive symptoms in adolescence: The role of emotion regulation competence.

Recent theories posit that emotion mindsets (i.e., the extent to which individuals believe emotions are malleable or fixed) play a crucial role in experiences of emotion and influence emotion regulation (ER) processes. Drawing from mindset theory, this study examined the hypothesis that fixed emotion mindsets (FEMs) would predict depressive symptoms via compromised ER competence in adolescence, a period when many first episodes of depression occur. Results supported these hypotheses across two studies assessing participants in midadolescence (ages 14-18; M age = 16.17) and late adolescence (ages 18-21; M age = 18.52). Using a comprehensive approach to assessing ER, results demonstrated that FEMs were associated with less voluntary engagement and more disengagement and emotion dysregulation. In turn, higher voluntary engagement was associated with lower depressive symptoms, whereas higher disengagement and emotion dysregulation were associated with higher depressive symptoms. These findings highlight that one understudied pathway from FEMs to depressive symptoms may be the manner in which individuals respond to their emotions, implicating emotion mindsets as one target for efforts to improve clinical outcomes during adolescence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Alterations in the default mode-salience network circuit provide a potential mechanism supporting negativity bias in depression.

Aberrant effective connectivity between default mode (DMN) and salience (SAL) networks may support the tendency of depressed individuals to find it difficult to disengage from self-focused, negatively-biased thinking and may contribute to the onset and maintenance of depression. Assessment of effective connectivity, which can statistically characterize the direction of influence between regions within neural circuits, may provide new insights into the nature of DMN-SAL connectivity disruptions in depression. Functional magnetic resonance imaging (fMRI) was collected from 38 individuals with a history of major depression and 50 healthy comparison participants during completion of an emotion-word Stroop task. Activation within DMN and SAL networks and effective connectivity between DMN and SAL, assessed via Granger causality, were examined. Individuals with a history of depression exhibited greater overall network activation, greater directed connectivity from DMN to SAL, and less directed connectivity from SAL to DMN than healthy comparison participants during negative-word trials. Among individuals with a history of depression, greater DMN-to-SAL connectivity was associated with lower overall network activation and worse task performance during positive-word trials; this pattern was not observed among healthy participants. Present findings indicate that greater network activation and, specifically, influence of DMN on SAL, support negativity bias among previously depressed individuals.

Mothers' neural response to valenced infant interactions predicts postpartum depression and anxiety.

It is currently unknown whether differences in neural responsiveness to infant cues observed in postpartum affective disturbance are specific to depression/anxiety or are better attributed to a common component of internalizing distress. It is also unknown whether differences in mothers' brain response can be accounted for by effects of past episodes, or if current neural processing of her child may serve as a risk factor for development of future symptoms. Twenty-four mothers from a community-based sample participated in an fMRI session viewing their 3-month- old infant during tasks evoking positive or negative emotion. They were tracked across the ensuing 15 months to monitor changes in affective symptoms. Past and current episodes of depression and anxiety, as well as future symptoms, were used to predict differences in mothers' hemodynamic response to their infant in positive compared to negative emotion contexts. Lower relative activation in largely overlapping brain regions involving frontal lobe structures to own infant positive vs. negative emotion was associated with concurrent (3-month) depression diagnosis and prospective (3-18 month) depression and anxiety symptoms. There was little evidence for impacts of past psychopathology (more limited effect of past anxiety and nonsignificant effect of past depression). Results suggest biased maternal processing of infant emotions during postpartum depression and anxiety is largely accounted for by a shared source of variance (internalizing distress). Furthermore, differential maternal responsiveness to her infant's emotional cues is specifically associated with the perpetuation of postpartum symptoms, as opposed to more general phenotypic or scarring effects of past psychopathology.

Can a Theater Acting Intervention Enhance Inhibitory Control in Older Adults? A Brain-Behavior Investigation.

Purpose: Studies of reactive and proactive modes of inhibitory control tend to show age-related declines and are accompanied by abnormalities in the prefrontal cortex. We explored which mode of inhibitory control would be more amenable to change and accrue greater benefits following engagement in a 4-week theater acting intervention in older adults. These gains were evaluated by performance on the AX-CPT task. We hypothesized that an increase in proactive control would relate to an increase in AY errors and a decrease in BX errors. In contrast, an increase in reactive control would be associated with a decrease in AY errors, no change in AY reaction time, and an increase in BX response time. Further, we posited that an increase in behavioral proactive control would accompany greater cue versus probe activity for previously identified regions in the prefrontal cortex. In contrast, an increase in behavioral reactive control would be accompanied by greater probe activation in these identified brain areas. Materials and Methods: The participants were 179 community-dwelling adults aged 60-89 years who were on average, college-educated. Participants were pseudo-randomly assigned to either an active-experiencing acting intervention condition (n = 93) or the active control condition (n = 86); participant assignment was subject to time of enrollment. Participants in both groups were trained by theater-actor researchers with expertise in acting interventions. In contrast to the active control participants who attended a course on theater acting, the acting-intervention group was required to consistently deploy proactive and reactive control mechanisms. Both groups met two times/week for 75-min for 4 weeks. Participant brain-behavioral performance on the AX-CPT task was evaluated prior to and after this four-week period. Results: No intervention effects were found in favor of proactive control. Behavioral evidence in favor of reactive control was weak. Brain-related benefits to reactive control was illustrated by greater probe-activation in Brodmann areas 6 and 8, relative to controls and pre-intervention. Conclusion: We found some evidence for improvements in reactive control via brain measures, attributed to engagement in the acting intervention.

Inhibitory control of emotional processing: Theoretical and empirical considerations.

Although inhibitory control appears to support successful emotion regulation (ER; Joorman and Gotlib, 2010; McCabe et al., 2010), few emotion inhibition studies position themselves in the literature on ER, and even fewer ER studies reference the role of emotion inhibition. Perhaps contributing to this, the ER literature is frequently divided into implicit or "automatic" (which subsumes emotion inhibition) and explicit or "effortful" control (Braunstein et al., 2017; Gyurak et al., 2011). The present paper evaluates relationships among constructs of inhibitory control, emotion inhibition, and ER to assess neural evidence for and against distinctions between implicit and explicit ER. We argue that, whereas the distinction between implicit and explicit ER may appear organizationally or conceptually helpful, such categorical distinctions are not supported by available research and in fact contribute to imbalances in the research literature.

The Structure of Executive Dysfunction in Depression and Anxiety.

BACKGROUND: Although research has demonstrated that depression and anxiety are associated with problematic executive function (EF), results are often inconsistent and underspecified. Delineating specific EF impairments in depression and anxiety has the potential to provide a mechanistic account of symptom presentation and course in these highly co-occurring disorders. The present study evaluated associations between components of EF and symptom dimensions of depression (depressed mood) and anxiety (anxious apprehension, anxious arousal) using factor analyses and structural equation modeling. METHODS: Undergraduates (N = 1,123) completed self-report measures of EF in everyday life and of psychopathology. Based on a three-factor model (Miyake et al., 2000), item-level exploratory (n = 561) and confirmatory (n = 562) factor analyses were conducted on inhibition, shifting, and working memory scales chosen from the EF measure. Structural equation modeling tested the relationship of EF factors to dimensions of psychopathology using the total sample. RESULTS: A three-factor model of EF best fit the data and was replicated via confirmatory factor analysis. Depressed mood and anxious arousal evidenced broad deficits across all EF domains, whereas anxious apprehension evidenced shifting disruptions. LIMITATIONS: Perceived EF may not index the same constructs as performance-based EF tests. Further, the present study was restricted to college students, warranting replication in other samples. CONCLUSIONS: Findings suggest that depressed mood and anxious arousal are characterized by a general disruption in the ability to maintain task goals, whereas anxious apprehension is characterized by cognitive inflexibility. EF impairments are likely contributory factors in the maintenance of affective disorders.

The Future of Women in Psychological Science.

There has been extensive discussion about gender gaps in representation and career advancement in the sciences. However, psychological science itself has yet to be the focus of discussion or systematic review, despite our field's investment in questions of equity, status, well-being, gender bias, and gender disparities. In the present article, we consider 10 topics relevant for women's career advancement in psychological science. We focus on issues that have been the subject of empirical study, discuss relevant evidence within and outside of psychological science, and draw on established psychological theory and social-science research to begin to chart a path forward. We hope that better understanding of these issues within the field will shed light on areas of existing gender gaps in the discipline and areas where positive change has happened, and spark conversation within our field about how to create lasting change to mitigate remaining gender differences in psychological science.

Effective connectivity between Broca's area and amygdala as a mechanism of top-down control in worry.

Individuals higher in trait worry exhibit increased activation in Broca's area during inhibitory processing tasks. To identify whether such activity represents an adaptive mechanism supporting top-down control, functional and effective connectivity of Broca's area were investigated during a task of inhibitory control. fMRI data obtained from 106 participants performing an emotion-word Stroop task were examined using psychophysiological interaction and Granger Causality (GC) analyses. Findings revealed greater directed connectivity from Broca's to amygdala in the presence of emotional distraction. Furthermore, a predictive relationship was observed between worry and the asymmetry in effective connectivity, with worriers exhibiting greater directed connectivity from Broca's to amygdala. When performing the task, worriers with greater GC directional asymmetry were more accurate than worriers with less asymmetry. Present findings indicate that individuals with elevated trait worry employ a mechanism of top-down control in which communication from Broca's to amygdala fosters successful compensation for interference effects.

The Impact of Focused Attention on Emotional Experience: A Functional MRI Investigation.

Emotional well-being depends on the ability to adaptively cope with various emotional challenges. Most studies have investigated the neural mechanisms of emotion regulation strategies deployed relatively later in the timing of processing that leads to full emotional experiences. However, less is known about strategies that are engaged in earlier stages of emotion processing, such as those involving attentional deployment. We investigated the neural mechanisms associated with self-guided Focused Attention (FA) in mitigating subjective negative emotional experiences. Functional magnetic resonance imaging (fMRI) data were recorded while participants viewed a series of composite negative and neutral images with distinguishable foreground (FG) and background (BG) areas. Participants were instructed to focus either on the FG or BG components of the images, and then rated their emotional experiences. Behavioral results showed that FA was successful in decreasing emotional ratings for negative images viewed in BG Focus condition. At the neural level, the BG Focus was associated with increased activity in regions typically implicated in top-down executive control (dorsolateral prefrontal cortex and lateral parietal cortex) and decreased activity in regions linked to affective processing (amygdala and ventrolateral prefrontal cortex). Dissociable brain activity linked to FA also was identified in visual cortices, including between the parahippocampal and fusiform gyri, showing increased versus decreased activity, respectively, during the BG Focus. These findings complement the evidence from prior FA studies with recollected emotional memories as internal stimuli and further demonstrate the effectiveness of self-guided FA in mitigating negative emotional experiences associated with processing of external unpleasant stimuli.

Childhood abuse history and attention bias in adults.

Attention biases toward unpleasant information are evident among children and adults with a history of abuse and have been identified as a potential pathway through which abused children develop psychopathology. Identifying whether a history of childhood abuse affects the time course of attention biases in adults is critical, as this may provide intervention targets. The present study examined the time course of attention bias during an emotion-word Stroop task using event-related potentials (ERPs) in a sample of adults with a range of child abuse histories using a categorical approach (comparing adults with or without a history of moderate-to-severe childhood abuse) and a dimensional approach (analyzing the range from no abuse to severe abuse in a continuous manner). Although behavioral performance did not vary as a function of abuse history, adults with a history of moderate-to-severe childhood abuse showed ERP evidence of early reduced processing of emotional stimuli (smaller N200) and later reduced processing of emotional and nonemotional stimuli (smaller P300), followed by later increased processing of unpleasant stimuli (larger slow wave [SW]). Results suggest that early disengagement from emotional stimuli may help individuals with moderate-to-severe abuse histories to achieve normal behavioral performance on the emotion-word Stroop task. Additionally, regardless of analytic approach, adults with elevated levels of childhood abuse exhibited prolonged engagement (larger SW) specifically with unpleasant stimuli. Present results demonstrate attention bias patterns in adults with a history of childhood abuse and clarify the time course of attention bias. Results are discussed in the context of potential treatment implications.

Common and specific dimensions of internalizing disorders are characterized by unique patterns of brain activity on a task of emotional cognitive control.

Alterations in neural systems underlying cognitive control are well-documented across individuals with various internalizing disorders. The current study examined how individual differences in underlying traits related to internalizing disorders influence brain activation, as assessed by fMRI, when cognitive control must be exerted to make a decision about the emotional valence (positive, negative) of a task-relevant word displayed concurrently with a task-irrelevant emotional face. Taking a bi-factor model approach, fifty-five middle-aged female participants were characterized on symptom level on a common internalizing latent factor representing shared symptoms across anxiety and depression, as well as on specific factors remaining after taking the common internalizing factor into account: low positive affect, anxious arousal, and anxious apprehension. Contrasting activation on trials requiring higher vs. lower control revealed that higher levels of the Common Internalizing factor are associated with less deactivation of regions of the default mode network. Higher levels of the Low Positive Affect-specific factor are associated with less differentiation in engagement of portions of the fronto-parietal control network, while higher levels of the Anxious Arousal-specific factor are associated with less of a differentiation in activation of the thalamus. No effects were observed for level of the Anxious Apprehension-specific factor. These results suggest that prior findings of alterations in default mode activity associated with depression may not be specific to depressive symptoms per se but may characterize internalizing symptoms more generally. In addition, they suggest that reduced engagement of cognitive control regions may be more associated with low positive affect than depressive symptoms more generally.

Regulating positive emotions: Implications for promoting well-being in individuals with depression.

Experiencing positive emotions is paramount to derive vitality from daily lived experiences. Positive emotions are associated with a range of beneficial outcomes, including longevity, reduced incidents of stroke, improved sleep quality, larger social networks, increased prosocial behavior, lower cortisol levels, and increased endogenous opioids and oxytocin. Despite these benefits, only limited research has focused on understanding positive emotion regulation within the context of depression. Rather, mechanisms related to the regulation of negative emotion have been the focus of research and evidence-based treatments. This interdisciplinary review article aims to advance knowledge regarding the role of positive emotion regulation in individuals with depression to inform the development of transdiagnostic evidenced-based approaches to treatment that bolster the experience of positive life events. We drew on research findings across the fields of clinical psychology, affective science, and social psychology to identify future directions for novel interdisciplinary translational research regarding mechanisms associated with positive emotion regulation. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Response interference by central foils is modulated by dimensions of depression and anxiety.

We used a maximum-likelihood-based model selection approach to investigate what aspects of affective traits influence flanker interference in a nonaffective task. A total of 153 undergraduates completed measures of anhedonic depression, anxious arousal, anxious apprehension, and a modified flanker task with two levels of perceptual load. For central foils, the most parsimonious model included load, depression, and anxious arousal. Participants scoring low on the depression and anxious arousal scales exhibited a typical perceptual load effect, with larger interference effects observed under low perceptual load compared with high perceptual load conditions. Increased depression symptoms were associated with a reduced perceptual load effect. However, the load effect reemerged in individuals who scored high on both depression and anxious arousal scales, but to a lesser extent than those scoring low on both. This pattern of results underscores the importance of studying co-occurring affective traits and their interactions in the same sample. For peripherally presented foils, the model that only included load as a factor was more parsimonious than any of the models incorporating affective traits. These findings suggest avenues for future research and highlight the role of diverse affective symptoms on various aspects of nonemotional attentional processing.