Lance M. Rappaport

Genetic and Environmental Contributions of Negative Valence Systems to Internalizing Pathways

The genetic and environmental contributions of negative valence systems (NVS) to internalizing pathways study (also referred to as the Adolescent and Young Adult Twin Study) was designed to examine varying constructs of the NVS as they relate to the development of internalizing disorders from a genetically informed perspective. The goal of this study was to evaluate genetic and environmental contributions to potential psychiatric endophenotypes that contribute to internalizing psychopathology by studying adolescent and young adult twins longitudinally over a 2-year period. This report details the sample characteristics, study design, and methodology of this study. The first wave of data collection (i.e., time 1) is complete; the 2-year follow-up (i.e., time 2) is currently underway. A total of 430 twin pairs (N = 860 individual twins; 166 monozygotic pairs; 57.2% female) and 422 parents or legal guardians participated at time 1. Twin participants completed self-report surveys and participated in experimental paradigms to assess processes within the NVS. Additionally, parents completed surveys to report on themselves and their twin children. Findings from this study will help clarify the genetic and environmental influences of the NVS and their association with internalizing risk. The goal of this line of research is to develop methods for early internalizing disorder risk detection.

Likelihood-Based Confidence Intervals for a Parameter With an Upper or Lower Bound

The precision of estimates in many statistical models can be expressed by a confidence interval (CI). CIs based on standard errors (SEs) are common in practice, but likelihood-based CIs are worth consideration. In comparison to SEs, likelihood-based CIs are typically more difficult to estimate, but are more robust to model (re)parameterization. In latent variable models, some parameters might take on values outside of their interpretable range. Therefore, it is desirable to place a bound to keep the parameter interpretable. For likelihood-based CI, a correction is needed when a parameter is bounded. The correction is known (Wu & Neale, 2012), but is difficult to implement in practice. A novel automatic implementation that is simple for an applied researcher to use is introduced. A simulation study demonstrates the accuracy of the correction using a latent growth curve model and the method is illustrated with a multilevel confirmatory factor analysis.

Test-Retest Reliability of the Facial Expression Labeling Task

Recognizing others’ emotional expressions is vital for socioemotional development; impairments in this ability occur in several psychiatric disorders. Further study is needed to map the development of this ability and to evaluate its components as potential transdiagnostic endophenotypes. Before doing so, however, research is required to substantiate the test–retest reliability of scores of the face emotion identification tasks linked to developmental psychopathology. The current study estimated test–retest reliability of scores of one such task, the facial expression labeling task (FELT) among a sample of twin children (N = 157; ages 9–14). Participants completed the FELT at two visits two to five weeks apart. Participants discerned the emotion presented of faces depicting six emotions (i.e., happiness, anger, sadness, fear, surprise, and disgust) morphed with a neutral face to provide 10 levels of increasing emotional expressivity. The present study found strong test–retest reliability (Pearson r) of the FELT scores across all emotions. Results suggested that data from this task may be effectively analyzed using a latent growth curve model to estimate overall ability (i.e., intercept; r’s = 0.76—0.85) and improvement as emotions become clearer (i.e., linear slope; r’s = 0.69—0.83). Evidence of high test–retest reliability of this task’s scores informs future developmental research and the potential identification of transdiagnostic endophenotypes for child psychopathology.

Age of alcohol use initiation and psychiatric symptoms among young adult trauma survivors

Alcohol use disorder (AUD) evidences high rates of comorbidity with a range of psychiatric disorders, particularly within high-risk populations, such as individuals exposed to physical or sexual violence. Increasing efforts are focused on understanding the role of early alcohol use (e.g., during adolescence) on emotional and psychiatric functioning over time, as well as sex differences in these associations. The aim of the current study was to evaluate patterns of association between age of initiation of regular alcohol use and posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms as a function of sex. Participants were 269 college students with a history of interpersonal trauma and alcohol use who completed a battery of questionnaires regarding alcohol use and emotional health. Neither bivariate correlations nor results from structural equation models covarying for key factors showed a relationship between age of alcohol use initiation and current psychiatric symptoms among men (n = 63). Results of a structural equation model supported an association between earlier age of alcohol use initiation and greater levels of current PTSD (β = -0.14), anxiety (β = -0.15), and depression symptoms (β = -0.16) in the female sub-sample (n = 202), after controlling for covariates, as well as intercorrelations among criterion variables. Statistical support for sex as a moderator of these associations was not detected. The current study provides preliminary evidence for potential sex differences in the role of early alcohol use in the development of psychiatric symptoms and highlights the need for systematic longitudinal research.

Adaptive Equilibrium Regulation: Modeling Individual Dynamics on Multiple Timescales

Damped Linear Oscillators estimated by 2nd-order Latent Differential Equation have assumed a constant equilibrium and one oscillatory component. Lower-frequency oscillations may come from seasonal background processes, which non-randomly contribute to deviation from equilibrium at each occasion and confound estimation of dynamics over shorter timescales. Boker (2015) proposed a model of individual change on multiple timescales, but implementation, simulation, and applications to data have not been demonstrated. This study implemented a generalization of the proposed model; examined robustness to varied timescale ratios, measurement error, and occasions-per-person in simulated data; and tested for dynamics at multiple timescales in experience sampling affect data. Results show small standard errors and low bias to dynamic estimates at timescale ratios greater than 3:1. Below 3:1, estimate error was sensitive to noise and total occasions; rates of non-convergence increased. For affect data, model comparisons showed statistically significant dynamics at both timescales for both participants.

Moderation of improvement in self-efficacy following group psychotherapy for PTSD.

Posttraumatic stress disorder (PTSD) is a primary mental health concern of veterans. In clinical settings, efforts to improve broad facets beyond symptom amelioration and consideration of moderators of treatment effectiveness in this population are needed for continued improvement in care. General self-efficacy (GSE) has been indicated as a useful treatment target because of its association with positive outcomes such as increased positive health behaviors. Both race and educational attainment represent potential moderators of treatment response that are relevant for a veteran PTSD population. This study aimed to determine whether a PTSD Recovery Group Therapy Program resulted in improvement in GSE and whether racial and educational differences moderated GSE outcomes. Archival data were examined from male veterans (N = 450) receiving mental health services at a Veterans Affairs medical center using multilevel modeling to examine change in GSE over the course of treatment as well as moderation of change in GSE as a function of race and educational attainment. After completion of group therapy, results indicated there was significant improvement in GSE, with significantly different improvement based on education. Higher levels of education were associated with greater increases in GSE after treatment. Improvement in GSE did not differ by participant race. In clinical settings, efforts to increase GSE and attending to moderators such as educational attainment may be useful for improving PTSD treatment approaches. (PsycINFO Database Record

Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population

ABSTRACT Individual differences in cognitive processes and coping behaviors play a role in the development and maintenance of posttraumatic stress disorder (PTSD). Given the large numbers of combat-exposed service members returning from the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) conflicts, exploring individual differences in cognitive-affective processes is important for informing our understanding of PTSD etiology and early intervention in military samples. The present study examined the unique main and interactive effects of negative posttrauma cognitions (i.e., negative beliefs about self [NS], the world [NW], and self-blame [SB]) and coping strategies (i.e., positive behavioral, positive cognitive, avoidant coping, and social and emotional coping) on PTSD diagnosis within 155 (Mage = 30.7, SD = 4.48) OEF/OIF/OND combat trauma-exposed Veterans recruited from an ongoing study examining the effects of combat trauma and stress reactivity. In the final, stepwise logistic regression analysis, avoidant coping, but no other coping strategy, was significantly positively related to PTSD diagnosis in the initial step. Higher levels of NS, but not NW, were significantly associated with having a PTSD diagnosis, whereas SB was associated with decreased likelihood of PTSD, above and beyond coping strategies. A significant interaction effect was found between NS and positive cognitive coping, such that greater positive cognitive coping weakened the relationship between NS and PTSD. Examining and addressing coping behaviors and negative thoughts of self jointly may benefit assessment and intervention approaches in a combat-trauma population.

A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood

ABSTRACT Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.

Examination of racial differences in a posttraumatic stress disorder group therapy program for veterans.

Posttraumatic stress disorder (PTSD) is 1 of the more prevalent mental health diagnoses for veterans. Group therapy can be an effective and efficient means of treating PTSD, yet the literature exploring treatment outcomes for racial minorities has been mixed and limited. The present study was an evaluation across racial groups of the PTSD Recovery Program, a manualized group therapy implemented at a Veterans Affairs hospital. Data were collected from male veterans (N = 450) who identified as non-Hispanic White or non-Hispanic African American and participated in a 10-week, combat-related, group therapy program between 2010 and 2014. Participants completed the Posttraumatic Stress Disorder Checklist—Military Version (PCL–M) measure at pretreatment and posttreatment. The program led to a statistically significant reduction in PCL–M scores (Cohen’s d = .64). Symptom reduction occurred regardless of race, with no racial differences in improvement. Racial and ethnic composition of groups was not related to outcomes. The program was effective regardless of veteran group or provider. Results imply that the PTSD Recovery Program is an effective 1st-line option to treating non-Hispanic White and non-Hispanic African American veterans with PTSD. Future research should continue to explore the associations between group characteristics and treatment outcomes.

Social support, negative social exchange, and response to case formulation-based cognitive behavior therapy

ABSTRACT We investigated associations between pretreatment social support, negative social exchange, and slope of weekly symptom change for depression, anxiety, and stress over the course of ideographic, case formulation-based, cognitive behavior therapy. Participants were 74 adults treated in a private practice setting. We used self-report measures to assess social support and negative social exchange at intake and to assess symptoms on a weekly basis. At pretreatment, a higher level of social support was associated with lower levels of depression, and a higher level of negative social exchanges was associated with higher levels of depression and stress. Pretreatment social support was not significantly associated with slope of symptom change. However, a higher level of pretreatment negative social exchanges was associated with steeper slope of change in symptoms of depression and stress during treatment. These findings suggest that the association between pretreatment negative social exchanges and subsequent symptoms may be stronger than that of social support and subsequent symptoms. Additionally, we discuss the possibility that having data on negative social exchanges at the start of treatment may benefit the outcome of ideographic, case formulation-based, cognitive behavior therapy.