Components of Attentional Bias to Threat in Clinically Anxious Children: An Experimental Study Using the Emotional Spatial Cueing Paradigm Abstract Attentional bias to threat is believed to play a key role in the development and maintenance of anxiety disorders. However, the underlying attentional mechanisms related to anxiety are not well understood. The aim of the present study was to investigate the effect of cognitive therapy on the engagement and disengagement components of attentional bias to threat in clinically anxious children using the emotional spatial cueing paradigm. Anxiety was diagnosed using the Anxiety Disorders Interview Schedule and the Revised Child Anxiety and Depression Scale. Results from 27 clinically anxious children and 27 control children (7–13 years old) indicated that clinically anxious children showed significantly faster engagement to angry faces than control children. Results also indicated that clinically anxious children showed significantly faster disengagement from angry faces before treatment in comparison to control children and significantly slower disengagement from angry faces after treatment than they did before treatment. Findings suggests that cognitive therapy reduces attentional avoidance of threat in clinically anxious children and challenges the assumption that results can be generalized from subclinical to clinical samples.

Gaze-contingent Attention Bias Modification Training and its Effect on Attention, Interpretations, Mood, and Aggressive Behavior Abstract Cognitive theories propose that aggression is associated with specific patterns of attention to social cues, and suggest that cognitive biases in attention and interpretation are interrelated, The current study tested whether these attention patterns can be altered using a single session of a novel gaze-contingent cognitive bias modification paradigm (CBM-A) and assessed the impact of this on interpretation bias, aggressive behavior and mood. University students (18–31 years) were randomly assigned to either a single session of positive training (n = 40) aimed at increasing attention to pro-social cues, or negative training (n = 40) aimed at increasing attention to negative cues. Results showed that the positive training indeed resulted in an increase in pro-social attention bias, while the negative training seemed not to have an effect on attention to negative cues. Both groups did not differ on their interpretations, mood levels, self-reported aggression and behavioral aggression. Findings suggest that this novel gaze-contingent CBM-A paradigm can indeed alter biased gaze processes, but may not impact interpretations, aggression and mood. The current study was conducted in a non-clinical sample, further research with a clinical aggressive sample, such as forensic patients is necessary to further explore these issues.

Dynamic Changes in a Desire to Escape from Interpersonal Adversity: A Fluid Experimental Assessment of the Interpersonal Theory of Suicide Abstract Given suicide risk is dynamic, research needs to identify the factors responsible for these changes. This can be achieved through experimentally manipulating putative causal risk factors. Two studies experimentally manipulated a change in interpersonal risk factors (thwarted belongingness and perceived burdensomeness) to assess the influence on participants’ desire to escape. Study 1 (N = 74) found manipulating simultaneous changes in burdensomeness and belongingness rapidly changed participants’ desire to escape. In Study 2 (N = 54), a change in only thwarted belongingness was still effective in quickly changing participants’ desire to escape from the task, even in the presence of heightened feelings of burdensomeness. The findings speak to the causal role that changes in the levels of interpersonal risk factors may play in influencing a desire to escape from adverse life circumstances.

Reactivation and Evaluation of Mastery Experiences Promotes Exposure Benefit in Height Phobia Abstract The retrieval of personal mastery experiences has been linked to adaptive functions, such as increased perceived self-efficacy and coping capability. Successful exposure leads to an increased mastery experience with respect to anxiety provoking situations, possibly due to a violation of expected negative outcomes. We investigated whether the reactivation and evaluation of mastery experiences after a brief virtual reality exposure (VRE) training can enhance self-efficacy and promote exposure therapy benefit in patients with acrophobia. Acrophobic participants (N = 56) were randomly assigned to a memory reactivation and evaluation (= VRE–MRE) intervention, a control (= memory reactivation; VRE–MR), or no intervention (= VRE) after VRE. The VRE–MRE condition involved the evaluation of mastery experiences associated with exposure and related events from the past. The effects of the VRE–MRE intervention were assessed on the level of behavioral avoidance and subjective fear at post-treatment and one-month follow-up. Relative to both the VRE–MR and VRE conditions, the VRE–MRE group showed an increase in self-efficacy and exhibited more pronounced reductions in behavioral avoidance, subjective fear at the initial approach distance, as well as scores on the acrophobia questionnaire (AQ) from pre- to post-treatment. The superior effects of the VRE–MRE intervention remained evident on the level of behavioral avoidance and associated subjective fear at the initial approach distance, but not on the AQ, from pre-treatment to follow-up. These findings indicate that the reactivation and evaluation of mastery experiences could be used as a strategy to increase exposure-based therapy in anxiety disorders.

Cognitive Moderation of CBT: Disorder-Specific or Transdiagnostic Predictors of Treatment Response Abstract Cognitive vulnerability research has focused on cognitive variables that are hypothesized to confer risk to specific disorders within the mood and anxiety spectrum, while transdiagnostic research has emphasized common risk factors across disorders. The purpose of the present study was to test specific versus common cognitive predictors of treatment response across three treatment groups. Participants (N = 373) with major depressive disorder (MDD; N = 187, panic disorder with/without agoraphobia (PD/A; N = 85), and obsessive compulsive disorder (OCD; N = 101) completed measures of cognitive vulnerability (performance-oriented dysfunctional attitudes, anxiety sensitivity, and obsessive beliefs) and disorder-specific symptom measures at pre- and post CBT treatment. Based on latent difference score analysis, pre-treatment performance-oriented dysfunctional attitudes alone predicted improvement in depressive symptoms in the MDD group; pre-treatment anxiety sensitivity alone predicted reductions in anxious arousal symptoms in the PD/A group; and pre-treatment obsessive beliefs alone predicted change in OCD symptoms in the OCD group. These findings provide support for disorder-specific cognitive factors in the prediction of CBT treatment outcomes and provide guidance towards ways in which current CBT approaches may benefit from augmentation or adjustment.

Post-event Processing and Alcohol Intoxication: The Moderating Role of Social Anxiety Abstract To resolve the mixed findings on the link between social anxiety (SA) and alcohol use, studies have examined the role of post-event processing (PEP), i.e., negative thinking about past social events. In a sample of 18–30 year olds (82% female) high (n = 40) and low (n = 49) in SA, the current 21-day study assessed the effect of PEP after social drinking events on subjective intoxication at the next social event. The moderating role of SA severity was tested. Compared to the low SA group, the high SA group reported overall more PEP but similar intoxication levels. Multilevel models supported a SA by PEP interactive effect on next-event intoxication, but for the high SA group only. Conditioned slopes revealed that within the high SA group, at − 1 SD elevated PEP predicted increased next-event intoxication. Thus, for those ‘moderate/high’ in SA, PEP after social drinking may increase risk for alcohol misuse.

Transdiagnostic Mechanisms of Psychopathology in Youth: Executive Functions, Dependent Stress, and Rumination Abstract Executive function (EF) deficits have been proposed as transdiagnostic risk factors for psychopathology, and recent research suggests EF impairments are associated with what is shared across forms of psychopathology (p factor). However, most research has not employed methods that differentiate between EF components, and little is known about the mediating mechanisms linking EF and psychopathology dimensions. The current study tested associations between the latent unity/diversity model of EF and latent dimensions of psychopathology and investigated mediating mechanisms in a community sample of 292 youth age 13–22. The results confirmed the finding that poor EF is associated with internalizing psychopathology in older youth via higher dependent stress and rumination, and showed that this pathway was transdiagnostic, predicting the p factor rather than internalizing specifically. Links with psychopathology were specific to the common EF factor, rather than updating- or shifting-specific EF.

Client Motivation and Engagement in Transdiagnostic Group Cognitive Behavioral Therapy for Anxiety Disorders: Predictors and Outcomes Abstract Client motivation is regarded as a key factor in cognitive behavioral therapy (CBT) for anxiety disorders. To date, client motivation has only been measured during individual-CBT, with little known about the predictive capacity of motivation in group settings. The current study aimed to explore the role of client motivation in group-CBT. Measuring motivation during individual-CBT has proven somewhat difficult with many self-report measures providing weak and inconsistent results. For this reason observational measures of motivation, such as rating client change (CT) language during CBT, have been trialled with some success. The current study aimed to measure motivation using an observational coding system of CT and counter change talk (CCT) during two components of group CBT: cognitive restructuring and exposure sessions. The study explored the predictive capacity of CT and CCT in determining treatment outcomes, and baseline characteristics that predicted in session CT and CCT. Results indicated that CT and CCT predicted different treatment outcomes depending on the stage of therapy. CT and CCT predicted symptom severity at post-treatment and slope of improvement in cognitive restructuring sessions. During exposure sessions only CCT was predictive of poorer treatment outcomes but CT determined client attendance and treatment drop out. Furthermore, baseline characteristics including symptom severity, education, and age were predictive of CT and CCT throughout treatment. These findings are discussed and comparisons are drawn to the role of motivation in individual-CBT. Limitations and implications of this research are explored, specifically the utility of coding motivational language using observational methods in group settings.

4/20 Cannabis Use is Greater than Other High-Risk Events: Identification of Psychosocial Factors Related to 4/20 Use Abstract Cannabis is the most commonly used federally illicit drug, yet little research has identified risk factors for high-risk use. Although April 20 (“4/20”) has been identified as a day on which cannabis users use more cannabis than they typically do, it remains unknown whether 4/20 is a high-risk event for greater use than other heavy use days (e.g., other holidays) and whether use on 4/20 is related to greater use-related problems. Such information has important implications for event-specific prevention efforts. Thus, the present study tested whether 4/20 is associated with greater cannabis use than other high-risk cannabis use events (e.g., Spring Break), whether 4/20 cannabis use is associated with event-specific use-related problems and subjective intoxication, and whether event-specific psychosocial factors (i.e., motives, normative beliefs) influence 4/20 use among 68 past-year cannabis using undergraduates who reported using cannabis on 4/20 (in a state where cannabis is legal for medical but not recreational purposes). A majority reported experiencing problems related to their 4/20 use and use was greater on 4/20 than on all other high-risk days. Quantity of 4/20 use was significantly, positively correlated with 4/20 cannabis use-related problems and subjective intoxication. 4/20-specific descriptive norms were a stronger predictor of 4/20 cannabis use and use-related problems than 4/20-specific cannabis use motives whereas 4/20-specific enjoyment motives were stronger predictors of subjective intoxication on 4/20. The current study identifies 4/20 as an especially high-risk cannabis use event and is the first to test psychosocial factors related to 4/20 use and use-related problems. Event-specific descriptive norms and enjoyment motives may be important targets for campus-wide efforts to prevent risky use on this high-use day.

Depressive Suppression: Effects of Emotion Suppression on Multiple Emotions for Depressed Versus Nondepressed Individuals Abstract Clinical theory from multiple psychological perspectives, including cognitive therapies, have long suggested that the maladaptive use of strategies to regulate emotion play a central role in the development and maintenance of psychopathology. This consideration may be particularly salient for depressive symptoms, given the prevalence of multiple negative emotions in the context of depression and the recently established tendency for depressed individuals to suppress emotions. We experimentally tested whether emotional and physiological effects of emotion suppression in response to separate sadness and anxiety inductions are moderated by depressive symptoms. Results indicated no effect of suppression on self-reported sadness compared to control condition for depressed or nondepressed participants (total N = 113). However, suppressing anxiety led to a reduction in self-reported anxiety compared to control condition for nondepressed participants, but there was no effect of suppression on anxiety among depressed participants. A similar pattern emerged for cardiac responding during both inductions. Results suggest that the effects of suppression depend on the emotion suppressed and on one’s level of depressive symptoms. Depressed participants’ difficulty mitigating state anxiety also suggests that depressed individuals have difficulty regulating certain emotions, but not others. Further implications for theoretical understanding, assessment of psychopathology, and clinical practice are discussed.