Mcfarlandomar1296

The degree of fear during baseline OCD symptoms did not predict outcome. If replicated under controlled conditions, these results suggest that incompleteness and disgust may act as barriers to improvement in pediatric OCD and that treatment modifications that target these emotion-related motivators may improve outcome for a subset of youth.Behavioral activation (BA) is a well-supported treatment approach, but little research has been conducted on the effectiveness of this treatment within publicly funded community mental health settings. We examined the feasibility of conducting a randomized trial examining the effectiveness of nine sessions of BA as a treatment for major depressive disorder (MDD) in a community mental health clinic (CMHC) setting. Following adaptation of a BA manual and training of BA therapists, 80 patients seeking treatment at a CMHC were randomized, with a 31 randomization rate of BA to nine sessions of treatment as usual (TAU). learn more Feasibility assessments indicated that only one eligible patient refused randomization and, of patients who attended at least one session, the median number of sessions was six for the BA group and eight for the TAU group. Of three postbaseline monthly assessments, 71.3% (171/240) were successfully obtained. On average, patients in the BA condition completed homework assignments 83.9% of the time. Treatment fidelity ratings indicated that substantially more BA techniques were delivered in the BA group compared to the TAU group (d = 2.11). Measures of BA mechanisms improved significantly over time and these changes were significantly associated with change in depressive symptoms. These results indicate that it is feasible to conduct a randomized study of BA for MDD in a CMHC setting. In addition, the study reconfirmed the potential importance of theory-relevant BA mechanism variables. Following these findings, further investigation into the effectiveness of BA in this setting is needed.In parent-child interaction therapy (PCIT), therapists encourage parents to imitate child behaviors in order to convey approval of the child's actions and promote the development of linguistic and social-cognitive skills. However, the Dyadic Parent-Child Interaction Coding System (DPICS-IV), used to measure skills taught during PCIT, does not include guidelines for coding parent-child imitation, making it difficult to determine how PCIT affects it. The current study addresses this problem by developing guidelines for coding imitation, which were then used to code DPICS-IV segments from 58 Mexican American families that participated in a past clinical trial. Results suggest that these coding guidelines can be used to reliably measure parent and child imitation. A series of additional analyses supported the construct validity of the codes. Specifically, there was a trend for parent imitation, but not child imitation, to increase more from pre-post treatment in PCIT relative to treatment as usual. In addition, parents who imitate their children were found to have children who imitate them more in return. Finally, improvement in parent imitation, but not child imitation, was significantly related to a decrease in child behavior problems. Further study is needed to determine the optimal frequency of imitation, and findings suggest that additional attention to coaching imitation may be warranted.The co-occurrence of depression with posttraumatic stress disorder (PTSD) is common and associated with greater severity and impairment than PTSD alone, but the effects on PTSD treatment outcomes are unclear. This study investigated the impact of baseline depression on PTSD symptom change and dropout in a meta-analysis of 44 randomized controlled trials (N = 4,866) of trauma-focused psychotherapies for PTSD. Analyses included 107 active (k = 71) and control (k = 36) conditions. Baseline depression was indexed within samples as (a) continuous symptom severity (e.g., Beck Depression Inventory), standardized across depression measures and (b) proportion of patients with comorbid depressive disorder diagnosis. Among active conditions reporting continuous depression scores (k = 62), greater depression severity predicted smaller PTSD treatment effect sizes (ß = -.36, p = .002), but not dropout (ß = .25, p = .18). Categorical depressive diagnosis rates (k = 29)-reported less frequently-were not associated with treatment effects or dropout in active conditions. Greater depression severity may reflect a risk factor for attenuated response in PTSD psychotherapies, potentially demanding complementary strategies within trauma-focused interventions. Variability between trials in baseline depression symptoms may suggest the need to consider this sample characteristic when comparing treatment outcomes across studies.Prolonged grief disorder, characterized by severe, persistent, and disabling grief, has recently been included in the International Classification of Diseases-11 (ICD-11). Emotional disturbances are central to such complicated grief responses. Accordingly, emotion regulation is assumed critical in the development, persistence, and treatment of complicated grief. Yet, a comprehensive review on this topic is lacking. We conducted a systematic review (PROSPERO CRD42017076061) searching PsycInfo, Web of Science, and PubMed to identify quantitative research examining relationships between emotion regulation and complicated grief. link2 Sixty-four studies on 7,715 bereaved people were identified, focusing on a variety of emotion regulation strategies (i.e., experiential avoidance, behavioral avoidance, expressive suppression, rumination, worry, problem solving, cognitive reappraisal, positive thought, and mindfulness). Our synthesis showed strong evidence that experiential avoidance and rumination play a role in the persistence of complicated grief. More generally, surveys support positive associations between putative maladaptive emotion regulation strategies and complicated grief, and negative associations between putative adaptive emotion regulation strategies and complicated grief. Laboratory research yielded mixed results. Emotion regulation is critical in complicated grief, and in particular experiential avoidance and rumination form important targets in complicated grief treatments. We advise expanding current knowledge, by employing more advanced, intensive data collection methods and experiments across diverse samples. Increasing knowledge in this domain will improve clinical practice.Body image disturbances are widespread in highly populated, rapidly developing Asian nations such as China, but there are severe shortages of practitioners qualified to treat these issues. In such contexts, validated online interventions offer a potentially viable approach for addressing the lack of treatment resources. In this study, we evaluated effects of the eBody Project, an online, dissonance-based eating disorder prevention program, on functioning among body-dissatisfied young Chinese women. Participating women were randomly assigned to the 6-week eBody Project intervention (n = 191) versus an education brochure control condition (n = 181). Self-report assessments of eating disorder risk factors (body dissatisfaction, thin ideal internalization, depressive symptoms, restrained eating), self-esteem, body appreciation, and disordered eating were completed at baseline, posttreatment, and a 6-month follow-up. There were no intervention differences on outcomes before treatment but eBody Project women experienced significantly larger improvements on all outcomes following treatment and/or at follow-up compared to controls; corresponding effect sizes were small to medium. Results indicated the eBody Project program is a promising intervention for young women at risk for eating disorders in China and provide foundations for broad implementation in low- and middle-income countries where resources for in-person therapy and supervision are limited or unavailable altogether.Experiential avoidance, a trait-like construct referring to the tendency to rigidly avoid or change unpleasant internal experiences stemming from an unwillingness to experience them, is believed to contribute to the development and maintenance of various forms of psychopathology. Despite significant research on this construct, it remains unclear whether experiential avoidance is dimensional or categorical at the latent level. The current study examined the latent structure of experiential avoidance using three taxometric analytic approaches (MAXimum Eigenvalue, Mean Above Minus Below A Curve, Latent-Mode Factor Analysis) applied to data from two independent samples and using three widely used measures of experiential avoidance. The first sample (n = 922) completed the Multidimensional Experiential Avoidance Questionnaire (Gámez, Chmielewski, Kotov, Ruggero, & Watson, 2011), while the second sample (n = 615) completed the Brief Experiential Avoidance Questionnaire (Gámez et al., 2014) and Acceptance and Action Questionnaire-II (Bond et al., 2011). Across both samples and all three measures, experiential avoidance exhibited a dimensional structure. The clinical and research implications of this finding for experiential avoidance are discussed.Approximately half of individuals with binge eating disorder (BED) fail to improve when treated with cognitive behavioral therapy; thus, better treatments are needed. Cue exposure and response prevention (CERP) may be one option, but its full potential for reducing binge eating remains unknown because prior applications for binge eating have not utilized the broad range of strategies believed to optimize exposure therapy. The current single-subject AB design investigated the acceptability and effectiveness of a comprehensive CERP treatment among 8 women who met DSM-5 criteria for binge eating disorder. Changes in the number of binges were measured from baseline to the end of treatment, and desire to eat, salivation, and idiographic expectancies of aversive outcomes to food-cue exposure (idiographic CS-US expectancies), including expectancies about ability to tolerate distress when exposed to food cues were measured across the course of treatment. Statistical analysis revealed a significant reduction in the number of binges from baseline to the end of treatment. Across the course of treatment, desire to eat and idiographic CS-US expectancies reduced, and distress tolerance expectancies increased. No participants dropped out and all reported being maximally satisfied with the treatment. Based on these findings, future randomized-control trials with larger samples should examine the efficacy of CERP and mechanisms underlying change with the aim of establishing a more effective treatment for binge eating disorder.Previous studies have found that social anxiety and experiential avoidance (EA) are significantly associated, but the directionality of this relationship has not been firmly established. The present study examined momentary EA and social anxiety using repeated measurements during an opposite-sex interaction. Participants were 164 individuals (50% female) 42 were diagnosed with social anxiety disorder (SAD) and the remaining 122 were non-socially-anxious individuals (NSAs). Participants formed 42 experimental dyads including 1 individual with SAD and 1 NSA individual, and 40 control dyads including 2 NSA individuals. Lower-level mediational modeling indicated that for individuals with SAD, a reciprocal relationship was observed in which changes in both EA and social anxiety mediated changes in each other. link3 However, changes in EA explained approximately 89% of changes in social anxiety whereas changes in social anxiety explained approximately 52% of changes in EA throughout the interaction. For NSA individuals, only social anxiety predicted EA.