Rachel Hershenberg

Romantic and Sexual Activities, Parent-Adolescent Stress, and Depressive Symptoms among Early Adolescent Girls.

Building on evidence that romantic experiences are associated with depressive symptoms in adolescence, we examined their bidirectional association, as well as the role of sexual activity and parent-adolescent stress in their association. Data were collected from 71 early adolescent girls (M age 13.45 years; SD=0.68) and their primary caregiver initially and one year later. Results indicated that adolescents who engaged in more romantic activities experienced increases in depressive symptoms over time. Second, greater depressive symptoms predicted romantic involvement and sexual activities, including intercourse, one year later. Third, dysphoric adolescents who were experiencing higher parent-adolescent stress were the most likely to engage in subsequent sexual intercourse. Implications for understanding how the association between depressive symptoms and romantic and sexual experiences develops and the course of this association are discussed.

Bridging the gap between clinical research and clinical practice: introduction to the special section.

This Special Section, developed by the American Psychology Associations Division 12 (Clinical) 2011 Committee on Science and Practice, highlights different ideas to help bridge the gap between clinical research and clinical practice, and notes recent innovations that help make research-practice integration feasible. The articles consider how to break down the barriers to enhance researcher-practitioner dialogue, as well as how to make ongoing outcome assessment feasible for clinicians. Moreover, the articles address how to promote training in evidence-based practice, and how to translate efficacy research into clinical practice and clinical insight into empirical study to better establish a two-way bridge between research and practice. Ultimately, we hope this series can speak to many different types of psychologists, whether they work mainly as researchers or practitioners, so they can see new ways to integrate and learn from both research and practice.

An Opportunity to Bridge the Gap Between Clinical Research and Clinical Practice: Implications for Clinical Training

Clinical researchers and clinical practitioners share a goal of increasing the integration of research and clinical practice, which is reflected in an evidence-based practice (EBP) approach to psychology. The EBP framework involves the integration of research findings with clinical expertise and client characteristics, values, and preferences, and consequently provides an important foundation for conducting clinically relevant research, as well as empirically based and clinically sensitive practice. Given the critical role that early training can play in the integration of science and practice and in promoting the future of the field, the present article addresses predoctoral training programs as a context for adopting an EBP approach to clinical work. We address training in the three components of EBP and provide suggestions for curriculum development and practicum training that we hope will contribute to bridging the gap between research and practice.

Diminished effort on a progressive ratio task in both unipolar and bipolar depression

BACKGROUND Amotivation, or decisional anhedonia, is a prominent and disabling feature of depression. However, this aspect of depression remains understudied, and no prior work has applied objective laboratory tests of motivation in both unipolar and bipolar depression. METHODS We assessed motivation deficits using a Progressive Ratio Task (PRT) that indexes willingness to exert effort for monetary reward. The PRT was administered to 96 adults ages 18-60 including 25 participants with a current episode of unipolar depression, 28 with bipolar disorder (current episode depressed), and 43 controls without any Axis I psychiatric disorders. RESULTS Depressed participants exhibited significantly lower motivation than control participants as objectively defined by progressive ratio breakpoints. Both the unipolar and bipolar groups were lower than controls but did not differ from each other. LIMITATIONS Medication use differed across groups, and we did not have a separate control task to measure psychomotor activity; however neither medication effects or psychomotor slowing are likely to explain our findings. CONCLUSIONS Our study fills an important gap in the literature by providing evidence that diminished effort on the PRT is present across depressed patients who experience either unipolar or bipolar depression. This adds to growing evidence for shared mechanisms of reward and motivation dysfunction, and highlights the importance of improving the assessment and treatment of motivation deficits across the mood disorders spectrum.

Love Hurts (in More Ways Than One): Specificity of Psychological Symptoms as Predictors and Consequences of Romantic Activity Among Early Adolescent Girls

OBJECTIVE Research has linked adolescent romantic and sexual activities to depressive symptoms. The current study examines whether such activities are uniquely linked to depressive symptoms versus symptoms of other disorders (including anxiety, externalizing, and eating disorders), and whether co-occurring symptoms more precisely account for the association between depressive symptoms and romantic involvement. METHOD Early adolescent girls (N = 83; mean age = 13.45) participated in baseline and 1-year follow up data collection. RESULTS Romantic (i.e., dating and sexual) activities were longitudinally related to numerous types of symptoms. The association between depressive symptoms and romantic variables remained when considering co-occurring symptoms. Girls with more comorbid disorders reported more romantic activities. CONCLUSIONS Results suggest that the maladaptive consequences and precipitants of adolescent romantic activities extend beyond depression, but also imply that this association is not secondary to comorbid symptoms. Future work should clarify causal pathways.

Implications of RDoC for the research and practice of psychotherapy.

The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMHs prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroads. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development.

A translational model of research-practice integration.

We propose a four-level, recursive Research-Practice Integration framework as a heuristic to (a) integrate and reflect on the articles in this Special Section as contributing to a bidirectional bridge between research and practice, and (b) consider additional opportunities to address the research-practice gap. Level 1 addresses Treatment Validation studies and includes an article by Lochman and colleagues concerning the programmatic adaptation, implementation, and dissemination of the empirically supported Coping Power treatment program for youth aggression. Level 2 translation, Training in Evidence-Based Practice, includes a paper by Hershenberg, Drabick, and Vivian, which focuses on the critical role that predoctoral training plays in bridging the research-practice gap. Level 3 addresses the Assessment of Clinical Utility and Feedback to Research aspects of translation. The articles by Lambert and Youn, Kraus, and Castonguay illustrate the use of commercial outcome packages that enable psychotherapists to integrate ongoing client assessment, thus enhancing the effectiveness of treatment implementation and providing data that can be fed back to researchers. Lastly, Level 4 translation, the Cross-Level Integrative Research and Communication, concerns research efforts that integrate data from clinical practice and all other levels of translation, as well as communication efforts among all stakeholders, such as researchers, psychotherapists, and clients. Using a two-chair technique as a framework for his discussion, Wolfes article depicts the struggle inherent in research-practice integration efforts and proposes a rapprochement that highlights advancements in the field.

When Feelings Lack Precision: Low Positive and Negative Emotion Differentiation and Depressive Symptoms in Daily Life

Research suggests the ability to differentiate discrete emotions protects against psychopathology. Little is known about daily processes through which negative and positive emotion differentiation (NED, PED) influence depressive symptomatology. We examined NED and PED as moderators of associations between daily processes (negative/positive experiences, brooding, and savoring) and daily depressive symptoms. Hypotheses were tested using intensive longitudinal techniques in two samples oversampled for depression: 157 young adults (Study 1) and 50 veterans recruited from VA primary care (Study 2). In Study 1, low NED predicted stronger associations between daily brooding and depressive symptoms. In Study 2, low NED predicted stronger reactivity to daily negative events. In both studies, low PED strengthened salutary effects of positive experiences and savoring on symptoms. Largely consistent across demographically divergent samples, results suggest both low NED and PED enhance effects of daily events and perseverative self-focus on fluctuations in depressive symptoms.

The Safety Behavior Assessment Form: Development and Validation.

OBJECTIVE To develop and validate an easy to administer measure of safety behaviors called the Safety Behavior Assessment Form (SBAF). METHOD We provide reliability and validity evidence from four studies. The first study used a cross-sectional design with a sample consisting of both clinical (U.S. military Veterans; n = 42) and nonclinical participants (undergraduates; n = 198). Study 2 used a cross-sectional design with a sample of U.S. military Veterans (n = 215). Study 3 used a pre-post treatment design with a sample of U.S. military Veterans (n = 42). Study 4 used a 2-time-point longitudinal design with a sample of undergraduates (n = 77). RESULTS The SBAF demonstrated strong levels of internal consistency and test-retest reliability in all four studies. The SBAF also demonstrated predictive and discriminant validity. In Study 3, the SBAF predicted anxious, but not depressive, treatment outcomes in a sample of Veterans. In Study 4, the SBAF predicted prospective changes in anxiety over a 2-week interval in a sample of undergraduates even after controlling for a competing measure of safety behaviors. CONCLUSION Results of these four studies indicate that the SBAF is a reliable and valid measure of safety behaviors that can be used in both clinical and nonclinical settings.

U.S. College Students' Sexual Activity: The Unique and Interactive Effects of Emotion Regulation Difficulties and Attachment Style

ABSTACT Objectives: This study explored the association between emotion regulation difficulties and sexual activity, and whether emotion regulation difficulties moderated the link between attachment and sexual activity. Methods: U.S. college students (N = 373) from two institutions completed self-report measures of sexual activity, emotion regulation difficulties and attachment. Results: Findings indicated that greater emotion regulation difficulties were associated with less frequent exclusive sexual activity. Moreover, emotion regulation difficulties moderated links between attachment avoidance and sexual activity, and associations varied according to relational context and gender. Conclusions: Implications for promoting sexual health and relationship intimacy are discussed.