Giao Q. Tran

Predictors of Response to Cognitive-Behavioral Group Therapy for Social Phobia

Response to cognitive-behavioral group therapy for social phobia was assessed at posttest and 6-month follow-up in a sample of 62 clients (41 generalized subtype, 21 nongeneralized). Predictors assessed were depression, expectancy, personality disorder traits, clinician-rated breadth and severity of impairment, and frequency of negative thoughts during social interactions. Outcome measures included self-report questionnaires and behavioral tests of dyadic interaction and a public speech. Although no predictor was related to outcome across all domains of measurement, higher depression, more avoidant personality traits, and lower treatment expectancy were each related to poorer treatment response on one or more outcome criteria. Cognitive change was consistently associated with change on self-report symptom measures, but, contrary to expectation, lower rates of negative thinking at posttest did not predict better maintenance of treatment gains at follow-up.

Expecting that alcohol use will reduce social anxiety moderates the relation between social anxiety and alcohol consumption

We examined the hypothesis that social anxiety and alcohol outcome expectancies interact in relating to the quantity and frequency of alcohol consumption. Two hundred twenty-nine undergraduates completed self-report questionnaires. The results showed situational specificity of alcohol expectancies. Expecting that alcohol would reduce anxiety in social situations moderated the relation between social anxiety and alcohol consumption; no such moderating effect was found for expectancy of general tension reduction. Among those who did not expect alcohol to reduce their anxiety in social situations, high-social-anxiety participants reported lower frequency and quantity of alcohol consumption than did low-social-anxiety individuals. High- and low-social-anxiety participants who expected alcohol to reduce their social anxiety did not differ in their alcohol consumption.

Psychopathology of social phobia: Effects of subtype and of avoidant personality disorder

The effects of social phobia subtypes and of comorbid avoidant personality disorder (APD) on the symptoms of 45 outpatients with a primary diagnosis of social phobia were examined. Generalized social phobic subjects with (GSP-APD, n = 16) and without APD (GSP-NAPD, n = 13) reported greater social anxiety and fear of negative evaluation than specific social phobic subjects without APD (SSP-NAPD, n = 16). Compared to SSP-NAPD clients, GSP-APD clients tended to exhibit poorer social skills during behavioral testing and were more likely to be unmarried and to use medication. GSP-APD subjects were more depressed than both SSP-NAPD and GSP-NAPD subjects, while non-APD groups did not differ. The results showed that both social phobia subtype and APD comorbidity contributed to the differences found among the three subgroups of social phobic clients.

Behavioral avoidance test for obsessive compulsive disorder

Few treatment outcome studies of Obsessive Compulsive Disorder (OCD) have employed Behavioral Avoidance Tests (BATs) to assess changes in symptomatology, probably because of the difficulty of constructing such tests for a disorder which has widely varying symptoms. The few studies that have examined the psychometric properties of BATs for OCD have found mixed evidence for validity but good treatment sensitivity. The present study presents psychometric findings for a multi-step/multi-task BAT that assessed percentage of steps completed, subjective anxiety, global avoidance, and rituals. This measure was used with 50 clients diagnosed with OCD whose symptoms varied widely. The BAT demonstrated good convergent and divergent validity, as well as treatment sensitivity according to effect size calculations. A composite score combining steps, anxiety level, avoidance and rituals also performed well in psychometric tests. Strategies to reduce the complexity of scoring are presented, along with examples of several BAT tasks to enable researchers to employ this behavioral measure.

Alcohol expectancies and drinking motives in college drinkers: Mediating effects on the relationship between generalized anxiety and heavy drinking in negative-affect situations

The current study tested the hypotheses that drinking to cope motives and alcohol expectancies of tension- and worry-reduction mediate the relationship between generalized anxiety (GA) and negative-affect heavy drinking in a cross-sectional sample of 782 college drinkers. As expected, structural equation modeling results indicated that alcohol expectancies mediated the relationship between GA and drinking to cope motives, and drinking to cope motives mediated the relationship between alcohol expectancies and heavy drinking in negative-affect situations. Unexpectedly, drinking to cope motives also mediated the relationship between GA and negative-affect heavy drinking. The model predicting negative-affect heavy drinking was tested in subsamples of 413 hazardous and 366 nonhazardous drinkers and did not differ structurally; however, omnibus measurement of model indirect effects was stronger for hazardous than nonhazardous drinkers. Finally, the results of a similar post-hoc model to predict general problem drinking support the specificity of the interrelationships among GA, cognitive mediators and to negative-affect drinking. These results inform cognitive-behavioral theories and interventions for comorbid GA and alcohol use problems.

Bulimic symptoms and mood predict food relevant Stroop interference in women with troubled eating patterns

Cognitive processing differences based on attentional biases of words pertaining to eating disorders were investigated to assess peoples pathological thoughts. Participants were 165 undergraduate women (mean age=19.2) at a large Midwestern university. This Stroop task that included color identification of three word groups (food-related words, neutral words, and color words) was administered to measure differential speed in cognitive processing of salient words in individuals with and without troubled eating patterns. As predicted by the moderator hypothesis, a statistically significant interaction effect between bulimic symptoms and negative mood was found on food-related reaction time. Post hoc analysis of the interaction showed that women endorsing more bulimic symptoms responded slower to food-related cues than women with fewer bulimic symptoms among individuals who reported negative mood. The study results indicate that women who have problematic eating patterns and experience negative mood are hyperattentive to food-related cues.

Drinking refusal self-efficacy and tension-reduction alcohol expectancies moderating the relationship between generalized anxiety and drinking behaviors in young adult drinkers.

Despite the substantial comorbidity between generalized anxiety disorder (GAD) and alcohol use disorders (AUD), little is known about contributing factors to this relationship. This lack of knowledge has limited the development of theoretical models explicating the interesting yet complex relationship between GAD and AUD. The current study examined the roles of generalized anxiety, tension-reduction alcohol expectancies, and drinking refusal self-efficacy in accounting for the variance of alcohol consumption and alcohol-related consequences in a sample of young adult drinkers (N = 474; 18-25 years of age, median age 19, 66% female) from a large, urban Midwestern university. Results showed that generalized anxiety level interacted with both tension-reduction alcohol expectancies and drinking refusal self-efficacy to predict alcohol consumption and alcohol-related consequences. Findings support the assessment of both alcohol-related consequences and alcohol consumption, and highlight the importance of drinking refusal self-efficacy, which is a currently underexamined variable. Study results also enhance the knowledge about the underlining mechanisms of GAD and AUD comorbidity, which facilitates the development of an empirically based theoretical paradigm for their relationship.

Day treatment for cocaine dependence: Incremental utility over outpatient counseling and voucher incentives

Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling (n=39) or day treatment (n=40). Participants in both conditions received equivalent individual cognitive-behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.

Intimate partner violence experience and expectations among college women in dating relationships: implications for behavioral interventions

Studies suggest that experience and expectations of intimate partner violence (IPV) among college women may be positively related. We investigated their association using modified versions of two standard measures: the Conflict Tactics Scale and the Multidimensional Emotional Abuse Scale. Five hundred and thirty-four college women completed each measure twice: once based on their partner’s actual behaviors and once based on what they expected a male partner would do in a relationship. Results demonstrated that IPV experience and IPV expectations are significantly and positively related. Results also showed that respondents expected more IPV than they reportedly experienced, suggesting that college women may believe that IPV occurs more frequently in others’ relationships than in their own. Findings suggest that behavioral interventions for IPV victims should address IPV expectations.

Gender Trends in the U.S. Army and a Discussion of Implications for Readiness and Retention

The percentage of female soldiers and officers in the U.S. Army has increased dramatically during the last few decades. Gender appears to be correlated with rank, age, education, and race, making it difficult to draw definitive conclusions about the effects of gender on retention or readiness. Evidence regarding gender and retention is mixed, but available evidence on gender and individual and unit readiness suggests that gender does not adversely influence readiness at either level. However, there is little evidence to date on the effects of gender within combat units, leaving that question open to debate.