An experimental investigation of emotional willingness and physical pain tolerance in deliberate self-harm: the moderating role of interpersonal distress.

Although theoretical and clinical literature emphasize the role of both an unwillingness to experience emotional distress and physical pain tolerance in deliberate self-harm (DSH), research on their associations with DSH remains limited. This study sought to examine the relationships between DSH and the willingness to experience emotional distress and tolerate physical pain, including the moderating role of interpersonal distress in these relationships. To this end, young adults with recent DSH (n = 43) and controls without any DSH (n = 52) were randomly assigned to 1 of 2 emotion-induction conditions (distressing or neutral), after which behavioral measures of both the willingness to experience distress and physical pain tolerance were obtained. Consistent with hypotheses, findings indicated heightened physical pain tolerance among self-harming individuals only under conditions of interpersonal distress. Furthermore, findings provided some support for the hypothesized association between DSH and the unwillingness to experience emotional distress, suggesting that self-harming women evidence less willingness to experience emotional distress only under conditions of depleted regulatory capacity (eg, following an interpersonal stressor).

Behavioral activation as a primary care-based treatment for PTSD and depression among returning veterans.

This preliminary study examined treatment-satisfaction and potential therapeutic benefits of Behavioral Activation as a primary care-based treatment for posttraumatic stress disorder (PTSD) and depression among Iraq and Afghanistan War veterans. Eight veterans were enrolled, 6 completed at least 4 sessions, and 5 veterans completed posttreatment and 3-month follow-up assessments after receiving 5-8 weekly sessions of Behavioral Activation delivered in a specialty postdeployment primary care clinic. Significant and meaningful reductions in PTSD symptoms were found on structured clinical assessments and self-report measures. Posttraumatic stress disorder treatment gains (measured by structured clinical assessments) were maintained at 3-month follow-up. The majority of veterans demonstrated meaningful improvements on depression and quality of life and veterans reported a high satisfaction with treatment.

Exploring the relationship between childhood maltreatment and intimate partner abuse: gender differences in the mediating role of emotion dysregulation.

Despite evidence that childhood maltreatment is associated with increased risk for intimate partner abuse perpetration, the mechanisms underlying this relationship remain unclear. Given literature suggesting that violent behaviors may serve an emotion regulating function, this study examined the mediating role of emotion dysregulation in the relationship between childhood maltreatment and intimate partner abuse perpetration among 341 male and female undergraduates. However, given evidence of gender differences in the underlying mechanisms of intimate partner abuse, emotion dysregulation was expected to be more relevant to the perpetration of partner abuse among men. Consistent with hypotheses, emotion dysregulation mediated the relationship between childhood maltreatment and intimate partner abuse among men; conversely, emotion dysregulation was not associated with partner abuse among women.

Anxiety sensitivity: a unique predictor of dropout among inner-city heroin and crack/cocaine users in residential substance use treatment.

The present study examined the extent to which anxiety sensitivity (AS) at treatment entry was related to prospective treatment dropout among 182 crack/cocaine and/or heroin-dependent patients in a substance use residential treatment facility in Northeast Washington, DC. Results indicated that AS incrementally and prospectively predicted treatment dropout after controlling for the variance accounted for by demographics and other drug use variables, legal obligation to treatment (i.e., court-ordered vs. self-referred), alcohol use frequency, and depressive symptoms. Findings are discussed in relation to the role of AS in treatment dropout and substance use problems more generally.

Temperamental and environmental risk factors for borderline personality disorder among inner-city substance users in residential treatment.

Borderline Personality Disorder (BPD) is widely considered the result of biological vulnerability and environmental adversity. Despite growing evidence for the role of several temperamental and environmental risk factors in the development of BPD, the unique contribution of each to the development of this disorder remains unclear. Furthermore, the extent to which these factors are associated with BPD among underserved and diverse populations is unknown. The current study examined the temperamental and environmental factors uniquely associated with BPD among a sample of 93 inner-city individuals receiving residential substance use treatment. Results indicate that BPD was associated with higher impulsivity and emotional instability/vulnerability, lower well-being, and several interpersonal manifestations of positive and negative temperament (i.e., greater alienation and lower achievement and social closeness). BPD was also associated with several forms of childhood maltreatment, including emotional and physical abuse and neglect. However, only emotional instability or vulnerability, impulsivity, and emotional abuse emerged as unique predictors of BPD status.

Social effectiveness therapy for children: three-year follow-up.

This study reports the results of a 3-year follow-up assessment of children and adolescents diagnosed with social anxiety disorder (social phobia) and treated with Social Effectiveness Therapy for Children (SET-C), a comprehensive behavioral treatment program combining social skills training, peer generalization, and individualized exposure. Among 32 children initially treated with the protocol, 29 completed the follow-up assessment and were evaluated with a multidimensional assessment strategy, including self-report, parental report, clinician ratings, and behavioral assessment. Results indicated that the majority of posttreatment gains were maintained at 3-year follow-up, and 72% of treated children continued to be free of a social phobia diagnosis 3 years later. These findings support the long-term efficacy of SET-C for children and adolescents suffering from social phobia.

The role of emotional inexpressivity and experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and aggressive behavior among men exposed to interpersonal violence.

Posttraumatic stress disorder (PTSD) has been found to be associated with aggressive behavior. Recent evidence suggests that the ways in which individuals respond to their emotions may account for this relationship. In particular, to the extent that aggressive behaviors serve an emotion regulatory function, responding to emotions with avoidance (i.e., experiential avoidance) or the active suppression of emotional expression may heighten emotion dysregulation, increasing the risk for aggressive behavior as individuals attempt to regulate that dysregulated state. This study examined whether these two ways of responding to emotions account for the relationship between PTSD symptom severity and self-reported engagement in aggressive behavior among a diverse sample of 113 men with past exposure to interpersonal violence. Experiential avoidance and emotional inexpressivity each accounted for a significant amount of unique variance in aggressive behavior, above and beyond PTSD symptom severity and trait anger. Clinical and research implications of findings are discussed.