Clinical Psychology Science and Practice

Olatunji, Bunmi O.; Naragon-Gainey, Kristin; Wolitzky-Taylor, Kate B.

doi: 10.1037/h0101719pmid: N/A

The present investigation employed a meta-analysis of 179 correlational studies and 37 clinical group comparison studies to examine the association between rumination and symptoms of anxiety and depression. Meta-analytic correlations revealed moderate associations between rumination and symptoms of anxiety and depression that were strongest for brooding and emotion-driven rumination. Symptoms of anxiety and depression also had significant independent effects on overall rumination and emotion-driven rumination. However, worry partially accounted for the associations of both depression and anxiety with rumination. Those with mood and anxiety disorders also reported more rumination than controls, an effect that was amplified by increased comorbidity. Those with mood disorders reported significantly more rumination than those with anxiety disorders. The implications of these findings for a transdiagnostic view of rumination are discussed.

Mennin, Douglas S.; Fresco, David M.

doi: 10.1111/cpsp.12038pmid: 27890972

Rumination, worry, and other forms of negative self-referential processing (NSRP) are familiar to everyone, as reflecting on the self is perhaps our most human characteristic. However, for a substantial subgroup of patients, NSRP arises in response to intense emotionality, worsening the clinical presentation, and diminishing the treatment response. The combination of emotionality and NSRP likely reflects an endophenotype of complicated and treatment refractory patients who fail to achieve a satisfactory treatment response in our trials and our clinics. An important next step is to personalize treatments by deliberately targeting NSRPs within established treatment protocols or in as yet novel treatments. Enriching treatments with mindfulness meditation is one possible avenue for personalized care of patients with this hypothesized endophenotype.

Teng, Ellen J.; Hiatt, Emily L.; McClair, Vetisha; Kunik, Mark E.; Frueh, B. Christopher; Stanley, Melinda A.

doi: 10.1111/cpsp.12039pmid: N/A

A systematic review of trauma treatment outcome literature was conducted to determine the impact of treatment on comorbid panic symptoms. Major databases were searched (from 1989 to 2013) and 64 randomized controlled trials using cognitive behavioral approaches to treat acute stress disorder, subthreshold posttraumatic stress disorder (PTSD), and full PTSD met inclusion criteria for this review. Results showed that 41% of the studies reviewed did not assess for Axis I psychiatric comorbidity at any point during the course of treatment. Only 5% of the studies reviewed reported rates of comorbid panic disorder (PD) at more than one time point during the study. Results indicate that approximately 56% of people no longer meet PD criteria following PTSD treatment.

Rizvi, Shireen L.; Harned, Melanie S.

doi: 10.1111/cpsp.12040pmid: N/A

The review by Teng and colleagues (2013) makes clear that there exist a number of problems in how we currently conceptualize, assess, and treat (or not treat) comorbid disorders. We make a number of assessments and clinical research suggestions that are meant to improve our understanding and treatment of comorbid conditions that likely share important psychological mechanisms. These suggestions involve (a) including individuals with multiple and serious comorbidities in treatment outcome research, (b) implementing assessment of relevant comorbid conditions in clinical research, (c) emphasizing common mechanisms underlying co-occurring problems, and (d) providing integrated treatment for comorbid disorders. The ultimate goal is to increase our ability to provide treatment that is both effective and efficient for individuals with multiple comorbidities.

Lunsford-Avery, Jessica R.; Mittal, Vijay A.

doi: 10.1111/cpsp.12041pmid: N/A

Sleep dysfunction is a pervasive symptom in schizophrenia, yet little is known regarding the extent to which problematic sleep is present prior to illness onset. Results from an online database search targeting genetic high-risk, clinical high-risk, and retrospective studies of patients with schizophrenia prior to onset suggest that abnormalities in sleep dysfunction precede schizophrenia onset. Further, a host of proximal factors such as neural structures, endocrine function, and cognitive performance holds promise for improving our conceptualization of sleep dysfunction. However, support is preliminary, and extensive new research in this area is essential. Drawing from this review, a neurodevelopmental diathesis–stress model is posited to highlight potential research targets and mechanisms through which vulnerability, biological/psychosocial stress, and adolescent neuromaturational factors may contribute to both sleep dysfunction and development of psychosis in at-risk youth.

Kewley, Andrew James

doi: 10.1111/cpsp.12042pmid: N/A

Clinical trials of cognitive behavioral therapy and graded exercise therapy have consistently demonstrated improvement in self-reported quality of life and improvement of symptoms. However, due to the nature of these therapies, it is not possible to carry out a double-blinded trial design or fully control for reporting biases. Therefore, to make strong claims about efficacy and reductions in disability, objective methods should be used such as neuropsychological testing, actigraphy, and repeat exercise testing.

Pinto-Gouveia, José; Castilho, Paula; Matos, Marcela; Xavier, Ana

doi: 10.1111/cpsp.12044pmid: N/A

Research has shown that the centrality of shame memories is related to psychopathological symptoms. However, little is known about the role of self-criticism on this association. The current study explored a mediator model in which self-criticism was hypothesized to mediate the relationship between centrality of shame memories and depressive symptoms, and between centrality of shame memories and paranoid beliefs. A battery of self-report instruments measuring centrality of shame memory (CES), forms (FSCRS) and functions (FSCS) of self-criticism, depressive symptoms (DASS-42), and paranoid beliefs (GPS) was administered to 204 participants from the general community population. Results showed did centrality of shame memories played an important role in depressive symptoms and paranoid beliefs. Only in depression did measures of self-criticism act as a mediator between centrality of shame and depressive symptomatology. These findings point to the distinct role that self-criticism plays on the relationship between shame memories and depressive and paranoid symptoms, adding to current evolutionary approaches on these two psychopathological features.

Wainer, Allison; Ingersoll, Brooke

doi: 10.1111/cpsp.12045pmid: N/A

Previous research has explored the efficacy and effectiveness of autism spectrum disorder (ASD) parent training interventions. Recent trials of such programs have not replicated earlier compelling outcomes, yet the reasons for the failure of such programs to produce desired effects are unclear. The purpose of the current article is to discuss the role of intervention fidelity in elucidating the relationships between a parent training program, the implementation and sustainability of an intervention, and important child outcomes. The article will discuss the importance of assessing intervention fidelity for the identification and successful use of effective treatment strategies and will propose an integrative conceptual framework for approaching the study and evaluation of intervention fidelity with respect to ASD parent training programs.