Darby E. Saxbe

Marital satisfaction, recovery from work, and diurnal cortisol among men and women.

DESIGN Multilevel modeling was used to model relationships between salivary cortisol, daily diary ratings of work experiences, and Marital Adjustment Test scores (Locke & Wallace, 1959), in a sample of 60 adults who sampled saliva 4 times per day over 3 days. RESULTS Among women but not men, marital satisfaction was significantly associated with a stronger basal cortisol cycle, with higher morning values and a steeper decline across the day. For women but not men, marital satisfaction moderated the within-subjects association between afternoon and evening cortisol level, such that marital quality appeared to bolster womens physiological recovery from work. For both men and women, evening cortisol was lower than usual on higher-workload days, and marital satisfaction augmented this association among women. Men showed higher evening cortisol after more distressing social experiences at work, an association that was strongest among men with higher marital satisfaction. CONCLUSION This work has implications for the study of physiological recovery from work, and also suggests a pathway by which marital satisfaction influences allostatic load and physical health.

A field (researcher's) guide to cortisol: tracking HPA axis functioning in everyday life

Abstract Researchers have been incorporating ambulatory cortisol sampling into studies of everyday life for over a decade. Such work provides an important supplement to acute laboratory stress paradigms and provides a novel perspective on the interrelationships between stress, psychological resources, and health. However, the results of many field studies have been inconclusive and more studies have been undertaken than published. We describe some of the challenges facing naturalistic cortisol researchers, including lack of power, methodological and analytical problems, and patterns of confusing or conflictual results. We then summarize key findings of published naturalistic cortisol studies to date, grouped by type of cortisol outcome (morning awakening response, diurnal slope, area under the curve, and associations between momentary experiences and cortisol). We propose research questions relevant to everyday stress researchers and suggest next steps for researchers who are interested in incorporating naturalistic cortisol sampling into future studies.

Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators

OBJECTIVE Cognitive behavioral therapy (CBT) is an empirically supported treatment for social phobia. However, not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term. Thus, alternative treatments are needed. METHOD The current study (N = 87) was a 3-arm randomized clinical trial comparing CBT, acceptance and commitment therapy (ACT), and a wait-list control group (WL) in participants with a diagnosis of social phobia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Participants completed 12 sessions of CBT or ACT or a 12-week waiting period. All participants completed assessments at baseline and posttreatment, and participants assigned to CBT and ACT also completed assessments 6 and 12 months following baseline. Assessments consisted of self-report measures, a public-speaking task, and clinician ratings. RESULTS Multilevel modeling was used to examine between-group differences on outcomes measures. Both treatment groups outperformed WL, with no differences observed between CBT and ACT on self-report, independent clinician, or public-speaking outcomes. Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-month follow-up in CBT compared with ACT. Self-reported fear of negative evaluation significantly moderated outcomes as well, with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT. Across treatment groups, higher perceived control and extraversion were associated with greater improvement, whereas comorbid depression was associated with poorer outcomes. CONCLUSIONS Implications for clinical practice and future research are discussed.

Does Dampened Physiological Reactivity Protect Youth in Aggressive Family Environments

Is an attenuated physiological response to family conflict, seen in some youth exposed to early adversity, protective or problematic? A longitudinal study including 54 youth (average age 15.2 years) found that those with higher cumulative family aggression exposure showed lower cortisol output during a laboratory-based conflict discussion with their parents, and were less likely to show the normative pattern of increased cortisol reactivity to a discussion they rated as more conflictual. Family aggression interacted with cortisol reactivity in predicting youth adjustment: Adolescents from more aggressive homes who were also more reactive to the discussion reported more posttraumatic stress symptoms and more antisocial behavior. These results suggest that attenuated reactivity may protect youth from the negative consequences associated with aggressive family environments.

Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy

Objective To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Method Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n = 25) for DSM-IV social anxiety disorder. Results Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms. Conclusions Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT.

Adult health in the context of everyday family life.

BackgroundCharacteristics of family life are linked both cross-sectionally and prospectively to adult mental and physical health.PurposeThis paper discusses social and biological processes that may explain how families influence the health of their members.MethodsWe review naturalistic studies of short-term biopsychosocial processes as they unfold within the family.ResultsDay-to-day fluctuations in stressors, demands, and social and emotional experiences in the family are reflected in short-term changes in adult members’ affect and in the activity of biological stress-response systems, particularly the hypothalamic–pituitary–adrenal axis.ConclusionsTo learn how family environments are linked to health, researchers should study the interlacing of different aspects of the everyday lives of family members, including their physiology, emotions, behavior, activities, and experiences.

Television as a Social or Solo Activity: Understanding Families' Everyday Television Viewing Patterns

Over four days, a researcher recorded the at-home activities of 30 families at 10-min intervals. Television viewing was the second most frequently observed activity for parents and the most frequently observed activity for children. Most television was watched in common areas of the home and in the presence of at least one other person, with the most common viewing configuration involving both parents and at least one child. When parents pursued another activity in conjunction with TV viewing, that activity was most likely to be in-person social interaction. In contrast, children were more likely to watch TV in bedroom spaces and were more likely to pair TV viewing with other leisure activities. In families with TVs in a childs bedroom (about ½ of the families), children were especially likely to watch TV alone and in non-common areas of the home. The results indicate that parents tend to engage in television viewing as a social activity, but that children may be more likely to be solo viewers.

No Place Like Home: Home Tours Correlate With Daily Patterns of Mood and Cortisol

The way people describe their homes may reflect whether their time at home feels restorative or stressful. This article uses linguistic analysis software (Linguistic Inquiry and Word Count) to analyze 60 dual-income spouses’ self-guided home tours by calculating the frequency of words describing clutter, a sense of the home as unfinished, restful words, and nature words. Based on a principal components analysis, the former two categories were combined into the variable stressful home and the latter two into restorative home. Over 3 weekdays following the home tours, wives with higher stressful home scores had flatter diurnal slopes of cortisol, a profile associated with adverse health outcomes, whereas women with higher restorative home scores had steeper cortisol slopes. These results held after controlling for marital satisfaction and neuroticism. Women with higher stressful home scores had increased depressed mood over the course of the day, whereas women with higher restorative home scores had decreased depressed mood over the day.

Treatment for social anxiety disorder alters functional connectivity in emotion regulation neural circuitry

Social anxiety disorder (SAD) is characterized at a neurobiological level by disrupted activity in emotion regulation neural circuitry. Previous work has demonstrated amygdala hyperreactivity and disrupted prefrontal responses to social cues in individuals with SAD (Kim et al., 2011). While exposure-based psychological treatments effectively reduce SAD symptoms, not all individuals respond to treatment. Better understanding of the neural mechanisms involved offers the potential to improve treatment efficacy. In this study, we investigated functional connectivity in emotion regulation neural circuitry in a randomized controlled treatment trial for SAD. Participants with SAD underwent fMRI scanning while performing an implicit emotion regulation task prior to treatment (n=62). Following 12 weeks of cognitive behavioral therapy, acceptance and commitment therapy, or wait-list, participants completed a second scan (n=42). Psychophysiological interaction analyses using amygdala seed regions demonstrated differences between SAD and healthy control participants (HC; n=16) in right amygdala-vmPFC connectivity. SAD participants demonstrated more negative amygdala-to-vmPFC connectivity, compared to HC participants, an effect that was correlated with SAD symptom severity. Post-treatment symptom reduction was correlated with altered amygdala-to-vm/vlPFC connectivity, independent of treatment type. Greater symptom reduction was associated with more negative amygdala-to-vm/vlPFC connectivity. These findings suggest that effective psychological treatment for SAD enhances amygdala-prefrontal functional connectivity.

Basic emotion processing and the adolescent brain: Task demands, analytic approaches, and trajectories of changes

Early neuroimaging studies suggested that adolescents show initial development in brain regions linked with emotional reactivity, but slower development in brain structures linked with emotion regulation. However, the increased sophistication of adolescent brain research has made this picture more complex. This review examines functional neuroimaging studies that test for differences in basic emotion processing (reactivity and regulation) between adolescents and either children or adults. We delineated different emotional processing demands across the experimental paradigms in the reviewed studies to synthesize the diverse results. The methods for assessing change (i.e., analytical approach) and cohort characteristics (e.g., age range) were also explored as potential factors influencing study results. Few unifying dimensions were found to successfully distill the results of the reviewed studies. However, this review highlights the potential impact of subtle methodological and analytic differences between studies, need for standardized and theory-driven experimental paradigms, and necessity of analytic approaches that are can adequately test the trajectories of developmental change that have recently been proposed. Recommendations for future research highlight connectivity analyses and non-linear developmental trajectories, which appear to be promising approaches for measuring change across adolescence. Recommendations are made for evaluating gender and biological markers of development beyond chronological age.