Gabrielle I. Liverant

Psychometric Evaluation of the Behavioral Inhibition/Behavioral Activation Scales in a Large Sample of Outpatients With Anxiety and Mood Disorders.

The latent structure, reliability, and validity of the Behavioral Inhibition/Behavioral Activation Scales (BIS/BAS; C. L. Carver and T. L. White, 1994) were examined in a large sample of outpatients (N = 1,825) with anxiety and mood disorders. Four subsamples were used for exploratory and confirmatory factor analyses. In addition to generally upholding a latent structure found previously in nonclinical samples, results indicated measurement invariance of the BIS/BAS between genders and a higher order structure of the BAS scales. Convergent and discriminant validity of the BIS/BAS were supported by findings that the subscales correlated most strongly with measures of neighboring personality constructs (e.g., BIS with neuroticism, BAS with positive affect) than with measures of current anxiety and depression symptoms. Overall, the results support the psychometric properties of the BIS/BAS in this clinical sample.

Emotion regulation in unipolar depression: The effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect

This study examined the effects of emotional suppression and acceptance in a depressed sample. Sixty participants with diagnoses of unipolar depression completed a questionnaire packet and participated in an experiment. The experiment utilized two conditions to explore correlates of the spontaneous use of emotion regulation strategies and the effects of an experimental manipulation of acceptance and suppression. Results demonstrated that suppression produced short-term reductions in sadness. Notably, anxiety about the experience of depressed mood influenced the efficacy of emotional suppression with findings showing that suppression was no longer effective at moderate and higher levels of anxiety about the experience of depressed mood. Implications of study findings for understanding emotion dysregulation in depressive disorders and the treatment of depression are discussed.

Coping and anxiety in college students after the September 11th terrorist attacks

This study investigated the presence of a stress response after the September 11th terrorist attacks in a sample of indirectly affected college students living in Boston, Massachusetts. Anxiety was examined at two time intervals, approximately 2 and 4 months after the attacks. Methods of coping with the stress of the attacks (assessed using the COPE Inventory) and their impact on initial and longer-term anxiety were also examined. Results demonstrated that the majority of college students in the study were severely psychologically impacted initially by the terrorist attacks. However, this initial impact appears to decay over time for most people. Several potentially maladaptive coping strategies were found to be predictive of initial anxiety, including denial, behavioral disengagement, mental disengagement, and focus on and venting of emotions. However, only focus on and venting of emotions was found to be uniquely predictive of longer-term anxiety.

Rumination in Clinical Depression: A Type of Emotional Suppression?

This study examined the relationship between rumination and the use of other emotion-regulation strategies in a depressed sample. Sixty outpatients diagnosed with unipolar depression completed questionnaires and participated in a sad mood induction. The mood induction was used to investigate the relationship between the use of rumination and each of two theoretically relevant emotion-regulation strategies—suppression and acceptance. Findings demonstrated that rumination was positively associated with other types of suppression and negatively related to acceptance. Results offer tentative support for the conceptualization of rumination as a maladaptive, cognitive emotion-regulation strategy utilized by depressed individuals in an attempt to suppress their experience of negative emotion. Findings also suggest a potential mechanism of action for efficacious mindfulness and acceptance-based treatments for depression.

The relationship between reward-based learning and nicotine dependence in smokers with schizophrenia.

Cigarette smoking rates remain remarkably high in schizophrenia relative to smoking in other psychiatric groups. Impairments in the reward system may be related to elevated rates of nicotine dependence and lower cessation rates in this psychiatric group. Smokers with schizophrenia and schizoaffective disorder (SWS; n=15; M(age)=54.87, S.D.=6.51, 100% male) and a non-psychiatric control group of smokers (NCL; n=16; M(age)=50.38, S.D.=11.52; 93.8% male) were administered a computerized signal detection task to measure reward-based learning. Performance on the signal detection task was assessed by response bias, discriminability, reaction time, and hit rate. Clinician-assessed and self-reported measures of smoking and psychiatric symptoms were completed. SWS exhibited similar patterns of reward-based learning compared to control smokers. However, decreased reward-based learning was associated with increased levels of nicotine dependence in SWS, but not among control smokers. Nicotine withdrawal and urge to smoke were correlated with anhedonia within the SWS group. Among SWS, reduced reward responsiveness and increased anhedonia were associated with and may contribute to greater co-occurring nicotine dependence. These findings emphasize the importance of targeting reward system functioning in smoking cessation treatment for individuals with schizophrenia.

Changes in Posttraumatic Stress Disorder and Depressive Symptoms during Cognitive Processing Therapy: Evidence for Concurrent Change.

OBJECTIVE Trauma-focused psychotherapies reduce both posttraumatic stress disorder (PTSD) and co-occurring depression. However, little is known about the relationship between changes in PTSD and depression during treatment. This study examined the association between changes in PTSD and depression during the course of cognitive processing therapy (CPT) and its treatment components. METHOD Data were drawn from a dismantling trial investigating the comparative efficacy of the components of CPT (Resick, Galovski, et al., 2008). One hundred twenty-six women (mean age = 36.14 years) from the original randomized intent-to-treat sample (N = 150) who attended at least 1 treatment session were included in this study. Participants diagnosed with PTSD were assigned to 1 of 3 treatment conditions: the full CPT protocol (n = 44), the cognitive therapy component of CPT (n = 39), and the written account component of CPT (n = 43). The majority of the sample self-identified as Caucasian (67%; 29% African American and 4% Other). Primary outcome measures included the Posttraumatic Diagnostic Scale and Beck Depression Inventory-II, administered at 8 time points (baseline, weekly throughout 6 weeks of treatment, and posttreatment). RESULTS Multilevel regression analyses were conducted to examine relationships between PTSD and depression during treatment. Results indicated that changes in PTSD and depression were strongly related. Multilevel mediation analyses revealed that changes in PTSD and depression occurred concurrently, with lagged analyses providing no evidence that changes in symptoms of 1 disorder preceded changes in the other. CONCLUSIONS Results suggest that changes in PTSD and depression occur contemporaneously during CPT.

Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis.

Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the contributions of these two types of measures in predicting PTSD diagnosis. One hundred fifty trauma-exposed participants who were classified into PTSD or non-PTSD groups based on structured diagnostic interviews completed the same script-driven imagery procedure, which quantified measures of psychophysiologic reactivity and self-reported emotional responses. We derived four discriminant functions (DiscFxs) that each maximally separated the PTSD from the non-PTSD group using (1) psychophysiologic measures recorded during personal mental imagery of the traumatic event; (2) self-report ratings in response to the trauma imagery; (3) psychophysiologic measures recorded during personal mental imagery of another highly stressful experience unrelated to the index traumatic event; and (4) self-report ratings in response to this other stressor. When PTSD status was simultaneously regressed on all four DiscFxs, trauma-related psychophysiological reactivity was a significant predictor, but physiological reactivity resulting from the highly stressful, but not traumatic script, was not. Self-reported distress to the traumatic experience and the other stressful event were both predictive of PTSD diagnosis. Trauma-related psychophysiologic reactivity was the best predictor of PTSD diagnosis, but self-reported distress contributed additional variance. These results are discussed in relation to the Research Domain Criteria framework.

Association Between Smoking and Heart Rate Variability Among Individuals with Depression

BackgroundBoth depression and smoking have been independently associated with lower heart rate variability (HRV), suggesting dysregulation of cardiac autonomic function. However, no studies have systematically explored the effects of smoking on HRV among depressed patients.PurposeThis study examined differences in HRV based on smoking status among depressed individuals.MethodsElectrophysiological data were examined among 77 adult outpatients without a history of myocardial infarction, who met criteria for major depressive disorder or dysthymia. Frequency domain [low frequency (LF), high frequency (HF), LF/HF ratio, respiratory sinus arrhythmia (RSA)] parameters of HRV, and heart rate and inter-beat interval (IBI) data were compared between depressed smokers (n = 34) and depressed nonsmokers (n = 44).ResultsAfter controlling for covariates, depressed smokers, compared to depressed nonsmokers, displayed significantly lower LF, HF, and RSA.ConclusionsAmong depressed patients, smoking is associated with significantly lower HRV, indicating dysregulated autonomic modulation of the heart.

Associations Among Posttraumatic Stress Disorder Symptoms, Substance Use, and Affective Attentional Processing in OEF/OIF/OND Veterans

Abstract The majority of research examining affective attentional bias in posttraumatic stress disorder (PTSD) has not examined the influence of co-occurring psychiatric disorders. This study examined the individual and interactive effects of PTSD symptoms and substance use disorders (SUDs) on affective attentional processing among 323 veterans deployed to Iraq or Afghanistan. Participants were divided into those with SUD (SUD+, n = 46) and those without (SUD−, n = 277). Substance use disorder was determined using the Structured Clinical Interview for DSM-IV. Posttraumatic stress disorder was measured using the Clinician Administered PTSD Scale. A computerized go/no-go task (Robbins et al., 1994, Robbins et al.,1998) assessed affective attentional processing. Relative to those without SUD, those with SUD showed a significant association between PTSD symptoms and increased omission and commission accuracy rates and decreased d prime. No effects of valence were found. Findings suggest the need to consider co-occurring SUD when investigating the effects of PTSD on attentional control.