Amy Y. Cameron

Gender differences in sexual assault victimization among college students.

College students are at particular risk for sexual assault victimization, yet research tends to focus on women as victims and men as perpetrators. The purpose of this study was to investigate gender differences in the prevalence, context, and predictors of sexual assault victimization among college students. Results showed that women were significantly more likely to have been sexually assaulted in a 2-month time period, but the context of victimization varied little by gender. Victimization was predicted by sexual orientation, time spent socializing and partying, and severe dating violence victimization for men and by year in school, time spent on the Internet, drinking and using drugs, and being a stalking and dating violence victim for women. Results are discussed in the context of routine activities theory and implications for prevention and future research.

Acute changes in obsessions and compulsions following moderate-intensity aerobic exercise among patients with obsessive-compulsive disorder

Aerobic exercise can acutely influence anxious and depressive mood in both clinical and nonclinical populations. However, there are no existing studies that have examined the acute effect of exercise on mood, anxiety, obsessions, and compulsions in patients with OCD. The primary aim of this study was to examine acute changes in these symptoms after engaging in single exercise sessions during a 12-week exercise intervention for 15 (53% female; mean age=41.9 years) patients with OCD. Participants reported reductions in negative mood, anxiety, and OCD symptoms at the end of each exercise session relative to the beginning. Changes in the magnitude of the effect of exercise in reducing negative mood and anxiety remained fairly stable while levels of self-reported obsessions and compulsions decreased over the duration of the intervention. Results of this study point toward the promising effect of exercise for acute symptom reduction in patients with OCD.

Reaction to stressful life events: what predicts symptom severity?

This study examined the effect of Criterion A and non-Criterion A (as defined by the DSM-IV-TR) events on symptomatology related to Posttraumatic Stress Disorder (PTSD). Two hundred and forty-one college students completed a series of questionnaires related to symptoms of Posttraumatic Stress Disorder, psychological processes and psychopathology. Participants were divided into two groups: those that experienced a Criterion A traumatic life event as defined by the DSM-IV-TR, and those that experienced a non-Criterion A event. A chi-square analysis revealed a higher percentage of those with a Criterion A event meeting criteria for PTSD, although results indicated no differences on the overall severity of PTSD symptoms, or the re-experiencing, hyperarousal or avoidance subscales of PTSD symptoms between these two groups when time since event and distress were held constant. In a logistic regression analysis, the tendency to engage in thought suppression and level of distress were related to a diagnosis of PTSD, while type of event (Criterion A or non-Criterion A) was marginally related. Results are discussed in relation to ongoing discussion examining the description, classification and impact of a Criterion A event on PTSD symptoms, and the possible impact for treatment.

Single versus recurrent depression history: Differentiating risk factors among current US smokers

INTRODUCTION The strong relationship between persistent tobacco use and Major Depressive Disorder (MDD) has motivated clinical trials of specialized treatments targeting smokers with a history of MDD. Meta-analyses suggest positive responses to specialized treatments have been observed consistently among smokers with history of recurrent rather than a single episode of MDD. Approximately 15% of current US smokers have a history of recurrent MDD. Little is known about the risk factors that contribute to persistent smoking and differentiate these at-risk smokers, US. METHODS The National Comorbidity Survey - Replication (NCS-R) included a survey of 1560 smokers participants aged 18 and older in the United States. Lifetime history of MDD was categorized according to chronicity: no history (No MDD), single episode (MDD-S) and recurrent depression (MDD-R). The relationship between the chronicity of MDD, smoking characteristics, cessation history, nicotine dependence, comorbidity with psychiatric disorders, and current functional impairments were examined. RESULTS MDD-R smokers reported fewer lifetime cessation efforts, smoked more cigarettes, had higher levels of nicotine dependence, had higher rates of comorbid psychiatric disorders and greater functional impairment than smokers with No MDD. MDD-S smokers were not consistently distinguished from No MDD smokers on cessation attempts, level of daily smoking, nicotine dependence or functional impairment indices. CONCLUSIONS The study highlights the importance of chronicity when characterizing depression-related risk of persistent smoking behavior. Although, clinical trials suggest MDD-R smokers specifically benefit from specialized behavioral treatments, these services are not widely available and more efforts are needed to engage MDD-R smokers in efficacious treatments.

Addressing Treatment Motivation in Borderline Personality Disorder: Rationale for Incorporating Values-Based Exercises into Dialectical Behavior Therapy

Abstract:Dialectical behavior therapy (DBT) is one empirically supported treatment for individuals diagnosed with borderline personality disorder (BPD), and has demonstrated efficacy in reducing distress and behaviors that are often utilized by those with BPD to manage that distress. Treatment dropout rates of those with BPD receiving DBT are high, with serious deleterious effects. Increasing motivation for treatment, including treatment adherence, homework completion and skill use, in those with BPD is a critical factor in improving daily functioning and overall quality of life for these individuals. As described in ACT, values work in the service of increasing values-consistent behavior, or valued or committed action, may be one way to improve treatment motivation both in-session and out of session. This paper outlines the theoretical rationale for adding values components to existing DBT skills, including suggestions for where and how values work might be done in this population and potential difficulties.

Delineating Potential Mechanisms of Implicit Alcohol Cognitions: Drinking Restraint, Negative Affect, and their Relationship with Approach Alcohol Associations

Problem drinkers may use alcohol to avoid negative mood states and may develop implicit cognitive associations between negative emotional states and reinforcing properties of drinking. It is paradoxical that attempts to control drinking, such as among those high in drinking restraint, may inadvertently increase desire to drink and subsequent alcohol consumption, and this may be exaggerated under times of emotional distress when urges to drink are high. We examined whether individuals who are high on drinking restraint would demonstrate stronger alcohol-related thoughts elicited by stimuli that represent the desire to use alcohol, in response to stronger versus weaker negative mood arousal. Seventy hazardous drinkers completed measurements of drinking restraint, alcohol consumption, and consequences of use. After being randomized to view negative or positive pictures sets, participants completed an Implicit Association Task (IAT) to test differences in the strength of the association between desire to approach or avoid alcohol or water cues, and then a measurement of subjective craving following the IAT. Regression analyses showed that trait restriction not temptation was positively related to IAT scores, after controlling for relevant covariates and explained 7% of the total variance. Trait temptation not IAT predicted subjective craving. Negative affect was unrelated to IAT scores, singly or in conjunction with measures of drinking restraint, contrary to predictions. In sum, implicit alcohol cognitions are related to attempts to restrict drinking not temptation to drink and are less strongly influenced by mood state.

Reactivity to negative affect in smokers: The role of implicit associations and distress tolerance in smoking cessation

Avoidance of negative affect is one motivational factor that explains smoking cessation relapse during cessation attempts. This negative reinforcement model of smoking cessation and relapse has demonstrated the importance of ones ability to tolerate nicotine withdrawal symptoms, particularly negative affect states, in remaining abstinent from smoking. Distress tolerance and implicit associations are two individual constructs that may influence the strength of this relationship. In this pilot study the authors examined implicit associations related to avoidance and negative affect using a modified Implicit Association Test (IAT), a measure designed to examine implicit associations related to negative affect and avoidance, and the relationship of these associations to distress tolerance and smoking relapse. In total, 40 participants were recruited through community flyers as part of a larger smoking cessation study. Participants completed a brief smoking history, behavioral distress tolerance assessments, and the modified IAT. Smoking status was assessed via phone 3days and 6days post-quit date. Results from a Cox proportional hazard model revealed that implicit associations between avoidance and negative affect were significantly negatively correlated with time to relapse after a smoking cessation attempt, whereas the behavioral distress tolerance assessments did not predict time to relapse. This study provides novel information about the cognitive associations that may underlie avoidant behavior in smokers, and may be important for understanding smoking relapse when negative affect states are particularly difficult to tolerate. Authors discuss the importance of implicit associations in understanding smoking relapse and how they can be targeted in treatment.

A Contextual Behavior Science Framework for Understanding How Behavioral Flexibility Relates to Anxiety

There is a growing literature focusing on the emerging idea that behavioral flexibility, rather than particular emotion regulation strategies per se, provides greater promise in predicting and influencing anxiety-related psychopathology. Yet this line of research and theoretical analysis appear to be plagued by its own challenges. For example, middle-level constructs, such as behavioral flexibility, are difficult to define, difficult to measure, and difficult to interpret in relation to clinical interventions. A key point that some researchers have made is that previous studies examining flexible use of emotion regulation strategies (or, more broadly, coping) have failed due to a lack of focus on context. That is, examining strategies in isolation of the context in which they are used provides limited information on the suitability, rigid adherence, or effectiveness of a given strategy in that situation. Several of these researchers have proposed the development of new models to define and measure various types of behavioral flexibility. We would like to suggest that an explanation of the phenomenon already exists and that we can go back to our behavioral roots to understand this phenomenon rather than focusing on defining and capturing a new process. Indeed, thorough contextual behavioral analyses already yield a useful account of what has been observed. We will articulate a model explaining behavioral flexibility using a functional, contextual framework, with anxiety-related disorders as an example.

Using Storytelling to Heal Trauma and Bridge the Cultural Divide Between Veterans and Civilians

ABSTRACT There is a growing disconnect between the Veteran and civilian communities related to their understanding of war-related trauma, postdeployment reintegration difficulty, and the experience of Memorial Day. A therapeutic way to bridge this divide is through community storytelling. This paper describes a program development project at a Veterans Affairs Medical Center that was created to increase the connection between these communities. Using storytelling, six Veterans shared their personal experiences with a civilian audience in honor of Memorial Day. Qualitative data on the impact of the program is reported, and suggestions for future application and research are discussed.

Evaluation of an Intensive Outpatient Program for Combat Veterans With PTSD

ABSTRACT There is an identified need within the Veterans Affairs (VA) Healthcare System to provide robust treatment for combat veterans with PTSD. Although empirically supported treatments for PTSD are available within the VA system, the dropout rate is high and many veterans remain symptomatic after treatment has ended, indicating a need for further treatment development. In addition, some veterans require a higher level of care over the course of treatment but a stay at a residential facility is often not feasible. The purpose of this article is to present a newly developed intensive outpatient program, designed to bridge the gap between inpatient and outpatient levels of care, for combat veterans with PTSD. The program provides intensive psychoeducation on PTSD and associated symptoms such as guilt, shame, moral injury and avoidance, skill building to cope with intensive emotions, and in-vivo exposure activities delivered in an intensive group format. Initial results indicate that it may be feasible to implement an intensive outpatient program within existing outpatient resources, and that doing so may help veterans reduce PTSD symptoms, increase social support, and enhance the quality of individual psychotherapy after completion of the program.