New Research From Clinical Psychological Science

Anxiety-Symptom Severity and Implicit and Explicit Self-as-Anxious Associations in a Large Online Sample of U.S. Adults: Trends From 2011 to 2022
Noah J. French, René Freichel, Sercan Kahveci, et al.

Some studies have suggested a rise in anxiety prevalence and severity over the past decade, particularly among emerging adults, whereas others have reported stable rates. In this preregistered study, we examine trends in anxiety-symptom severity and explicit (self-reported) and implicit (using the Brief Implicit Association Test) associations about the self as anxious versus calm. Using continuous cross-sectional data from 99,973 U.S. adults who visited the Project Implicit Health website between 2011 and 2022, we compared trends in anxiety outcomes between emerging adults (ages 18–25) and adults ages 26+, including during the COVID-19 pandemic. Contrary to hypotheses, average anxiety severity and strength of implicit/explicit self-as-anxious associations did not spike at the start of the pandemic, and rates of change did not significantly differ by age from 2011 to 2020 except for explicit, nonrelative self-as-anxious ratings. Instead, anxiety mostly remained stable; emerging adults exhibited consistently higher anxiety-symptom severity and stronger implicit/explicit self-as-anxious associations than adults ages 26+.

The Relationship Between Environmental Sensitivity and Common Mental-Health Problems in Adolescents and Adults: A Systematic Review and Meta-Analysis
Tom Falkenstein, Luke Sartori, Margherita Malanchini, Kristin Hadfield, Michael Pluess

Environmental sensitivity is a personality trait reflecting individual differences in response to environmental influences. Although the link between common personality traits and psychopathology is well established, trait sensitivity is often overlooked despite its association with mental health. In this study, we systematically reviewed literature on sensitivity and mental-health outcomes and conducted a meta-analysis to quantify the relationship of sensitivity with depression and anxiety. The review included 33 studies (N = 12,697; 62.51% female; age: M = 25.35 years) and revealed positive correlations between sensitivity and depression, anxiety, psychosomatic symptoms, obsessive compulsive disorder, posttraumatic stress disorder, agoraphobia, and social phobia; correlations ranged from r = .05 to r = .65. The overall effect size was substantial for depression (r = .36, 95% confidence interval [CI] = [.30, .42], p < .001) and anxiety (r = .39, 95% CI = [.34, .44], p < .001). Findings confirm a robust association with mental health, and we explore its potential to inform treatment and prevention.

Longitudinal Clustering of Psychopathology Across Childhood and Adolescence: An Approach Toward Developmentally Based Classification
Connor Lawhead, Jamilah Silver, Thomas M. Olino, et al.

Current classification systems of psychopathology focus on cross-sectional symptoms rather than continuity, discontinuity, and comorbidity across development. Here, a community sample of 600 youths was assessed every 3 years from early childhood through late adolescence using semistructured diagnostic interviews. We used longitudinal k -means clustering of joint-diagnostic trajectories to identify six distinct clusters (healthy, childhood anxiety, childhood/adolescent attention-deficit/hyperactivity disorder, adolescent depression/anxiety, adolescent depression/substance use, and early childhood disruptive behavior). Comparing psychopathology clusters with the healthy cluster on age-3 predictors (parental education and psychopathology, early environment, temperament, cognitive and social functioning) and age-18 functional outcomes, we found that the clusters captured developmental patterning of psychopathology not apparent in cross-sectional nosology. The study serves as a proof of principle in applying a longitudinal clustering approach to common mental disorders, affording a rich perspective on the unfolding of sequential comorbidity and heterotypic continuity and identifying transdiagnostic subgroups with meaningful clinical, family, and temperamental correlates.

Emotion Identification and Emotion Sensitivity Following Interpersonal and Noninterpersonal Traumatic Experiences: Results From the AURORA Study
Chloe C. Hudson, Lauren Rutter, Jutta Joormann, et al.

Social cognition is an important mechanism linking trauma to psychopathology; however, current models fail to explain individual differences in social cognition after trauma exposure. We investigated whether the interpersonal nature of trauma exposure helps to explain variability in social-cognitive outcomes. Our sample was derived from the AURORA study, a national initiative involving intensive follow-up of trauma survivors for 1 year. We analyzed data from 2,241 participants (age: M = 35.12 years; 64% female; 54% Black) who experienced an assault (n = 262) or a motor vehicle collision (n = 1,979). Social cognition was assessed with the Multiracial Emotion Identification Task and the Belmont Emotion Sensitivity Test. Overall emotion-identification accuracy declined over time among participants who experienced interpersonal trauma (β = −0.10, p = .03) but not noninterpersonal trauma (β = 0.00, p = .83). These results may help to enhance the prediction of psychopathological outcomes following trauma exposure.

Longer Single-Session Interventions May Not Be Better: Evidence From Two Randomized Controlled Trials With Online Workers Facing Mental-Health Struggles
Benjamin Kaveladze, Arka Ghosh, Carter J. Funkhouser, Stephen M. Schueller, Jessica L. Schleider

Online, self-guided single-session interventions (SSIs), which provide a complete mental-health intervention in one brief experience, promise to increase global access to evidence-based support. One way to expand current SSIs’ reach is to shorten them, but doing so could also compromise their effectiveness. We conducted two randomized trials to test if shortening evidence-based SSIs reduces their efficacy among adult online workers facing mental-health struggles. In Study 1 (N  = 262), the 8-min Overcoming Loneliness SSI reduced loneliness over 8 weeks more than a 23-min version of it (b  = 2.64; d  = 0.22, 95% confidence interval = [0.02, 0.41]; p  = .03). In Study 2 (N  = 1,145), 15-min, 9-min, 5-min, and 3-min versions of the Action Brings Change SSI did not significantly differ in how much they affected depression 8 weeks later (p s > .14). Our results suggest that longer digital SSIs are not necessarily more helpful than shorter ones.

A Formal Theory of Mood Instability
Orestis Zavlis, Richard P. Bentall, Peter Fonagy, Francesco Rigoli

Despite empirical progress, theoretical understanding of mood instability remains stagnant. A major reason for this stagnation concerns the field’s reliance on narrative theories that cannot integrate disparate quantitative perspectives on mood dynamics. Here, we address the limitations of narrative theorizing by developing a formal theory of mood instability. Our theory is predicated on the computational process of “evaluation”: the process of appraising the value of stimuli, which has long been theorized to be central to mood dynamics. Building on reinforcement-learning models of evaluation, we propose a dynamic framework, which we use to simulate various evaluative situations. Our simulations can generate and thereby formally integrate three well-known types of mood instability: emotional rigidity/inertia, transience/instability, and sensitivity/reactivity. We discuss how this formal perspective could enhance the theory, clinical utility, and measurement of mood instability.

Differences in Resting-State Functional Connectivity of Temperament-Based Profiles Among Youths With Attention-Deficit/Hyperactivity Disorder in the Adolescent Brain Cognitive Development Study
Jaden A. Sangoi, Michael B. Kozlowski, Kathleen E. Feeney, et al.

Diagnostic criteria from the fifth edition of theDiagnostic and Statistical Manual of Mental Disordersdoes not fully address behavioral and clinical heterogeneity inherent to attention-deficit/hyperactivity disorder (ADHD); however, temperament-based profiles may help explain biological heterogeneity within the disorder. Temperament profiles have been defined and replicated among youths with ADHD and have demonstrated unique patterns of resting-state functional connectivity within a small sample. Two temperament profiles were identified by Kozlowski et al. in the Adolescent Brain Cognitive Development Study, and in the present study, we sought to replicate and validate documented resting-state patterns. Functional connectivity between bilateral amygdalae and 12 Gordon networks was compared between profiles and typically developing (TD) youths. Surgent youths demonstrated stronger right amygdala-dorsal attention network connectivity (β = 0.0434) and right amygdala-retrosplenial temporal network connectivity (β = 0.0442) compared with TD youths. Irritable youths demonstrated unique connectivity patterns compared with TD and surgent youths; however, effects did not survive correction for multiple comparisons. Findings provide support for future research examining temperament profiles among ADHD youths.

Longer Single-Session Interventions May Not Be Better: Evidence From Two Randomized Controlled Trials With Online Workers Facing Mental-Health Struggles
Benjamin Kaveladze, Arka Ghosh, Carter J. Funkhouser, Stephen M. Schueller, Jessica L. Schleider

Online, self-guided single-session interventions (SSIs), which provide a complete mental-health intervention in one brief experience, promise to increase global access to evidence-based support. One way to expand current SSIs’ reach is to shorten them, but doing so could also compromise their effectiveness. We conducted two randomized trials to test if shortening evidence-based SSIs reduces their efficacy among adult online workers facing mental-health struggles. In Study 1 (N = 262), the 8-min Overcoming Loneliness SSI reduced loneliness over 8 weeks more than a 23-min version of it (b = 2.64;d = 0.22, 95% confidence interval = [0.02, 0.41];p = .03). In Study 2 (N = 1,145), 15-min, 9-min, 5-min, and 3-min versions of the Action Brings Change SSI did not significantly differ in how much they affected depression 8 weeks later (ps > .14). Our results suggest that longer digital SSIs are not necessarily more helpful than shorter ones.

The Prevalence of Dissociative Disorders and Spirit Possession in the General Population: A Systematic Review and Meta-Analysis With the Moderating Effect of Individualism–Collectivism on Prevalence Rates
Fabio Carraturo, Roberto Santonicola, Stefania Cella

Drawing on culturally sensitive approaches to the study of dissociation, in the present meta-analysis, we aimed to obtain pooled prevalence estimates for dissociative disorders and spirit possession and to test for the effect of nation-level individualism scores on the occurrence of pathological dissociation. Pooled odds ratios (ORs) for the probability of women presenting with a dissociative disorder or with spirit possession relative to men were also computed. Individualism was positively associated with the prevalence of dissociative disorders: b= 0.712, 95% confidence interval [CI] = [0.274, 1.538], p= .015, n= 11. Women showed higher odds of having pathological dissociation, OR= 2.43, 95% CI = [1.18, 5.01], p= .03, n= 7, and spirit possession, OR= 4.31, 95% CI = [1.55, 11.99], p= .02, n= 5. A reliable prevalence estimate could be computed only for depersonalization disorder, for which, a predicted 1-month prevalence of 1.12% was obtained (95% CI = [0.61, 2.05],n= 6). These findings are discussed within a transtheoretical framework in an attempt to bridge the gap between the trauma and sociocultural models of dissociation.

Do Stress, Depression, and Anxiety Lead to Beliefs in Conspiracy Theories?
Nick D. Fox, Matt N. Williams, Stephen R. Hill

Previous research has found positive correlations between manifestations of psychological distress, such as anxiety, depression, and stress, and belief in conspiracy theories. However, it remains unclear whether these relationships represent causal effects. We therefore tested whether anxiety, depression, and stress affect (and are affected by) belief in conspiracy theories in a preregistered longitudinal study. We sampled participants from Australia, New Zealand, and the United Kingdom (N = 970) in seven monthly waves (October 2022–March 2023). Using multiple-indicator random-intercept cross-lagged panel models, we found support for only one of 15 preregistered hypotheses: a small cross-lagged effect of anxiety on belief in conspiracy theories. We also found no evidence of belief in conspiracy theories itself provoking psychological distress. Our findings provide grounds for skepticism of the notion that beliefs in conspiracy theories are often motivated by psychological distress or feelings of “existential threat.”

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