New Research From Clinical Psychological Science

Alcohol and Cannabis Use Predicted by Affect-Urgency Interactions in Everyday Life
Jonas Dora, Connor J. McCabe, Megan E. Schultz, et al.

The hypothesis that urgency, a trait quantifying individual differences in impulsive behaviors driven by intense emotions, moderates associations between affect and alcohol use has received inconsistent support in ecological-momentary-assessment research. In this Registered Report, we tested whether trait- and state-level urgency moderate affect-substance use (alcohol and cannabis use) associations in young adults. Four hundred ninety-six adults (ages 18–22) completed ecological-momentary-assessment surveys five times daily across 32 days over 8 weekends. Positive affect was associated with increased alcohol-use probability, and negative affect was associated with decreased alcohol-use probability; cannabis use showed minimal associations with daily affect. Contrary to hypotheses, we found minimal evidence that urgency moderated daily affect-substance-use associations. Interaction effects were consistently estimated around the null value with narrow credible intervals. Results challenge theoretical predictions about urgency’s role in emotion-driven substance use and support simpler affect-substance-use models.

Heightened Affective Reactivity Is Associated With More-Severe Symptoms of Emotional Disorders
Ashleigh Fulton, Laura Forbes, Suresh Sundram, Daniel Bennett

Disturbances of emotion are a core feature of psychological disorders generally and mood and anxiety disorders in particular. However, it remains unclear what specific patterns of affective disturbance are shared across different symptom domains. Here, we examined correlations between emotional-disorder symptom severity (anxiety, depression, hypomania, and anhedonia) and affective reactivity to gain and loss outcomes in a decision-making task with embedded sampling of emotional valence (Experiment 1: N = 329; preregistered replication in Experiment 2: N = 524). Using hierarchical Bayesian computational modeling of emotion self-reports, we found that greater affective reactivity to gains and losses in the task was associated with more-severe symptoms of both anxiety and hypomania. This suggests that heightened reactivity to both appetitive and aversive outcomes indexes emotional-disorder severity across multiple symptom domains of psychopathology, in line with theoretical frameworks that conceptualize affective disturbance as a generalized risk factor for psychopathology.

Interpretation Biases in Anxiety: A Three-Level Meta-Analysis
Felix Würtz, Marius Kunna, Simon E. Blackwell, et al.

Interpretation biases (IBs) play a central role in cognitive models of anxiety disorders and are considered a transdiagnostic feature across anxiety disorders and severity levels. However, the magnitude of this bias in anxiety and modulating factors are largely unknown. In this three-level meta-analysis, we investigated the associations between IBs and symptoms of anxiety. Database searches (PsycINFO, PubMed, ProQuest Dissertations) led to 295 samples with 1,450 contrasts. An overall medium effect size (g = 0.48, 95% confidence interval = [0.43, 0.52]) was found. Equivalent effect sizes were found for youths and adults and different disorder categories and clinical statuses. Effect sizes were larger for studies using direct measures, verbal stimuli, disorder-specific stimuli, and negative (as opposed to positive) stimuli. Overall, results are consistent with the view that anxiety is associated with IBs across different disorders and severity levels. These findings have implications for cognitive theories of anxiety and clinical interventions.

Distinct Event-Related-Potential Biomarkers of Broad Versus Specific Dimensions of the Hierarchical Taxonomy of Psychopathology Externalizing Spectrum
Christopher J. Patrick, Pablo Ribes-Guardiola, Bruce D. Bartholow, et al.

The Hierarchical Taxonomy of Psychopathology (HiTOP) provides a dimensional framework for connecting psychological disorders to neural systems/processes. We examined how neurophysiological measures of cognitive-attentional (oddball P300) and perceptual-emotional processing (fear-face N170/P200) relate to dimensions of the HiTOP externalizing spectrum. Employing 666 community participants, we fit a model in which antagonistic externalizing and substance-problems subfactors, defined via symptom and questionnaire-scale measures, loaded with a disinhibitory trait scale onto a higher-order externalizing factor. Hierarchical regression was used to evaluate how much observed relations of each neural measure with the two subfactors reflected their unique variance versus their covariance (reflected in the general factor). P300’s relations were fully accounted for by the general factor, suggesting that impaired cognitive processing characterizes broad risk for externalizing problems. Neural indicators of sensitivity to others’ distress (N170, P200) were uniquely related to antagonistic externalizing. Findings highlight the HiTOP framework’s potential to advance biobehavioral understanding of psychopathology.

Hippocampal Volume Moderates the Link Between Racial-Ethnic Discrimination and Early Adolescent Depression
Shanting Chen, Beiming Yang, Zeix Zhou, et al.

Adolescent depression has risen sharply, especially among racial-ethnic minority youths. Although racial-ethnic discrimination is known to be linked with depression, there is limited understanding of how individual differences in brain development contribute to this process. Drawing on the framework of adolescent neurobiological susceptibility, in this study, we examined the moderating role of hippocampal volume in the longitudinal association between racial-ethnic discrimination and adolescent depression. Using longitudinal data of racial-ethnic minority youths from the Adolescent Brain Cognitive Development Study (N= 5,061; age:M= 9.93 years; 52% female), we found that racial-ethnic discrimination was associated with adolescents’ increased depression 2 years later. A larger left hippocampal volume amplified the link between discrimination and depression. These findings highlight the detrimental role of racial-ethnic discrimination on adolescents’ psychological well-being and suggest that hippocampal volume may serve as a neurobiological marker of susceptibility, amplifying the negative impact of racial-ethnic discrimination among racial-ethnic minority youths.

Executive Dysfunction and Depression Risk in Adolescence: Functional-MRI Analysis of Transient Network States During a Working Memory Task
Elena C. Peterson, Jenna Jones, Sofia Barnes-Horowitz, et al.

Executive-function (EF) deficits are a putative risk factor for adolescent depression, but neural correlates of this association remain unclear. Imbalances between externally and internally oriented attention underlying depression risk may be reflected in altered temporal dynamics of large-scale functional brain networks. In this longitudinal study, we evaluated neural correlates of EF-related depression risk in an adolescent sample (N = 154, ages 13–19). We applied coactivation pattern analysis to identify transient network states occurring during a working memory (WM) task and dynamic structural equation modeling to model depressive-symptom trajectories over 2 years. Results failed to support general EF as predictor of symptoms, but exploratory analyses revealed that WM deficits during low-load conditions predicted greater depression variability. WM-related risk for depression was partially mediated by longer persistence of a transient network involving coactivation of frontoparietal regions. Findings suggest that WM deficits and related temporal dynamics of frontoparietal regions may contribute to depression risk.

Does Dissociation Have an Emotion-Regulation Function? Evidence From Daily Life and the Laboratory
Johannes B. Heekerens, James J. Gross, Sylvia D. Kreibig, et al.

Dissociation has long been thought to regulate distressing emotions. However, empirical findings are mixed. To test the purported regulatory effects of dissociation, we examined 88 participants with borderline personality disorder, posttraumatic stress disorder, and/or derealization/depersonalization disorder who experienced frequent dissociation. Specifically, we collected dense experience-sampling and continuous electrocardiogram data 1 week in daily life and additional electrodermal data, blood pressure, and salivary cortisol data during the Trier Social Stress Test. Results from dynamic-structural-equation and latent-change-score models showed a strong contemporaneous link between negative affect and dissociation in both daily life and the laboratory. However, we found no reduction in negative affect following dissociation and no consistent alteration in physiological responses during or after dissociation. These findings challenge traditional views of the emotion-regulatory functions of dissociation, highlighting the maladaptive nature of recurrent dissociation.

Embracing Complexity in Clinical Practice: Operationalizing a Systems-Based Perspective in Mental-Health Diagnostics
Jim Driessen, Rutger Goekoop, Sander A. Voerman, et al.

The field of mental-health care continues to face the challenge of translating conceptual approaches into the idiographic reality of everyday clinical practice. For any framework to be both meaningful and useful to individual cases, it must account for the contextual, interconnected, temporal, and granular nature of such problems and prioritize clinical utility by design. In this narrative review, we aim to bridge this gap by proposing a workable framework building on these premises. Our proposal centers on the concept of “problem-sustaining patterns,” which aligns with the ongoing trend toward complexity thinking while offering sufficient clinical utility in practice. We advocate for a collaborative approach in which professionals and help-seeking individuals co-construct these models. Furthermore, we discuss the need for new digital tools to facilitate the procedural steps while also enabling development of generative models as clinical decision-making support tools, which could significantly enhance the feasibility of embracing complexity in clinical practice.

Daily Life Assessment of Seven Alcohol-Use-Disorder Symptoms
Dahyeon Kang, Ashley L. Watts, Cassandra L. Boness, et al.

Understanding how alcohol-use-disorder (AUD) symptoms unfold in daily life is key to improving assessment and intervention. In this study, we examined the retrospective and prospective validity of repeated daily assessments of AUD symptoms compared with retrospective self-reports. A community sample of young adults (N= 496) completed daily reports over an 8-week period assessing a subset of AUD symptoms: hazardous use, social/occupational problems, failure to fulfill obligations, craving, tolerance, larger/longer consumption, and time spent obtaining/using alcohol. Retrospective self-reports were collected at baseline and 6-month follow-up. Several symptoms (e.g., hazardous use, social/occupational problems, time spent) showed strong convergence between daily and baseline reports, and others (e.g., craving, tolerance) showed weaker associations. Daily symptom totals predicted 6-month retrospective AUD severity, particularly for symptoms with greater convergence. Daily measures of total AUD symptoms were associated with both baseline and follow-up AUD severity. Findings support the value of daily assessment and underscore discrepancies in retrospective recall.

Predictors of State and Trait Components of Depression From Early Adolescence Into Emerging Adulthood
Pascal Schlechter, Tamsin Ford, Paul O. Wilkinson, Sharon A. S. Neufeld

Disaggregating depression into stable trait-like and fluctuating state-like components provides insights into potential mechanisms underlying depression; predictors of these components can point to potentially tractable risk factors for depression onset. Using latent-trait-occasion modeling, we extracted state- and trait-depression components from the Short Mood and Feelings Questionnaire obtained in young people ages 11 to 26 from a population-based study in England (Avon Longitudinal Study of Parents and Children;N= 7,364). The proportion of state variance ranged from 91.9% (age 11) to 36.8% (age 26), decreasing during adolescence and stabilizing from age 22. The proportion of trait variance increased correspondingly. Female sex correlated with trait variance and with state variance only during adolescence (ages 12–19). Life events, school enjoyment, maternal depression, and parent–child relationship quality predicted state variance during adolescence, whereas anxiety was the main predictor during emerging adulthood. The greater role of state factors in early adolescesuggests that depression is more modifiable at younger ages.

When Joy Feels Wrong: Identifying Key Dampening Features Predicting Depressive Symptoms Using Machine Learning and Network Analysis
Liesbeth Bogaert, Barnaby D. Dunn, David J. Hallford, Jonas Everaert, Filip Raes

Dampening of positivity is implicated in increased depression risk, yet research traditionally overlooks dampening’s and depression’s multifaceted natures and differential relations between dampening features and depressive symptoms. In this preregistered study, we pooled data from 13 studies, yielding four cross-sectional (N = 4,015; 13–86 years) and four longitudinal (N = 1,457; 14–86 years) data sets grouped by measures. Random-forest (RF) and network analyses examined the predictive utility of individual dampening features for specific symptoms. Across both analytic approaches, dampening features most strongly predicted core cognitive-affective symptoms, such as negative self-perceptions, pessimism, pervasive negative emotions, and to a lesser extent, fearful feelings. Concurrently, both approaches showed that the features on not deserving positivity, positivity not being long-lasting, and positivity being likely to end soon had consistently high predictive utility. The latter two emerged as longitudinal predictors in the RF analyses. Findings refine the relation of dampening to depressive symptoms and highlight intervention targets.

Comparative Thinking and Clinical Social Anxiety: Within- and Between-Person Effects in a Daily Ecological Momentary Assessment Study and a Four-Wave Longitudinal Study
Pascal Schlechter, Thomas Meyer, Lianna E. Kerneck, et al.

Comparisons with social, expectation-based, counterfactual, and temporal standards may play a significant role in the maintenance of social anxiety disorder (SAD). The general comparative-processing model outlines the comparison process, encompassing comparison frequency, discrepancy, and affective/behavioral impact. For instance, an individual may frequently compare their performance to their colleagues’, perceive themselves as less competent, and consequently experience negative emotions that lead to avoidance. Two studies examined these processes across different time frames. In a 10-day ecological momentary assessment with 133 individuals with probable SAD, daily stressors and all comparison components (frequency, discrepancy, impact) were positively linked to social anxiety both between and within individuals. Additionally, comparison affective and behavioral impact were significant within-person mediators. In Study 2, which had 376 participants and included four assessments over 1 year, stable between-person effects and less consistent within-person effects were found. These findings advance our understanding of comparative thinking in SAD and may inform related therapeutic interventions.

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