New Research From Clinical Psychological Science

Personality Pathology and Momentary Stress Processes
Colin Vize, Aleksandra Kaurin, and Aidan Wright

The expression of personality pathology differs between people and within a person in day-to-day life. Personality pathology may reflect, in part, dysregulation in basic behavioral processes. Thus, a useful approach for studying maladaptive trait expression comes from literature on stress and daily hassles, which provides dynamic accounts for the relations between individual differences and maladaptive dysregulation. In this study, we sought to integrate maladaptive traits and dynamic stress processes to further dynamic models of personality pathology. In a combined clinical/community sample (N = 297) oversampled for interpersonal problems, we used ecological momentary assessment (observation N = 19,968) to investigate how maladaptive traits moderated the processes of stress generation, stress reactivity, and affective spillover/inertia. Tests of our preregistered hypotheses provided a mix of supportive and null findings for stress processes identified in past research and mixed support for the moderating role of personality. The results provide insights into the relations between everyday stressors and personality pathology. 

Stereotypes and OCD-Symptom Presentations: A Mixed-Methods Evaluation Using Male-Character Vignettes
Gabriella Ponzini, Miranda Signorelli, Elizabeth Claydon, Christa Lilly, and Shari Steinman

Stereotypes toward symptom presentations of obsessive compulsive disorder (OCD) are poorly understood. A mixed-methods, multistudy analysis of OCD stigma was conducted. In Study 1 (N = 60), participants read one of five vignettes (symmetry/just right, contamination, sexual, harm/aggression, scrupulous OCD) before responding to open-ended questions. Inductive content analyses revealed anxiety-relevant stereotypes (e.g., trivialization) for symmetry/just right and contamination and serious mental-illness stereotypes (e.g., dangerous) for harm/aggression and sexual vignettes. In Study 2 (N = 698), participants read one of seven vignettes (OCD-symptom presentations, generalized anxiety disorder, schizophrenia) before responding to stigma measures. The sexual, harm/aggression, and schizophrenia vignettes were strongly associated with serious mental-illness stigma. The scrupulous vignette was associated with the most anxiety-relevant stigma. Together, these studies detail stereotype endorsement across OCD-symptom presentations. Stigma-reduction interventions should include psychoeducation and address macro-level stereotypes (i.e., stereotypes that exist across symptom presentations) while enhancing opportunities for contact to mitigate stigma. 

Exploring the Association Between Depression Symptoms and Emotional-Communication Dynamics
Amy Gregory, Melanie Dirks, Jonas Nitschke, Jessica Wong, Lauren Human, and Jennifer Bartz

Communicating emotional experiences effectively is critical for adaptive functioning and personal and interpersonal well-being. Here, we investigated whether variability in depression symptoms undermines people’s ability to express their emotions to others (“emotional expressive accuracy”) and how those communication dynamics influence other’s impressions. In Phase 1, 49 “targets” were videotaped describing significant autobiographical events; they then watched their videos and continuously rated how positive/negative they were feeling throughout the narrative. In Phase 2, 171 “perceivers” watched subsets of videos from targets and similarly rated each target’s affect. Results from 1,645 unique target–perceiver observations indicate a link between target’s depressive symptoms and impaired emotional expressive accuracy for positive events, B = −0.002, t(1,501) = −3.152, p = .002. Likewise, more depressive targets were rated less favorably by perceivers, again when sharing positive events, B = −0.012, t(1,511) = −10.145, p < .001. Given the beneficial effects of “capitalization”—sharing positive experiences with others—these findings may illustrate one link between depressive symptoms and impoverished relationships. 

Facing Emotions: Between- and Within-Sessions Changes in Facial Expression During Psychological Treatment for Depression
Hadar Fisher, Philip Reiss, Dovrat Atias, Michal Malka, Ben Shahar, Simone Shamay-Tsoory, and Sigal Zilcha-Mano

The main diagnostic criteria for major depressive disorder (MDD) are consistent experiences of high levels of negative emotions and low levels of positive emotions. Therefore, modification of these emotions is essential in the treatment of MDD. In the current study, we harnessed a computational approach to explore whether experiencing negative emotions during psychological treatment is related to subsequent changes in these emotions. Facial expressions were automatically extracted from 175 sessions of 58 patients with MDD. Within sessions, a U-shaped trajectory of change in valence was observed in which patients expressed an increase in negative emotions in the middle of the session. Between sessions, a consistent increase in valence was observed. A trajectory of within-sessions decrease followed by an increase in valence was positively associated with greater perceived positive emotions and subsequent decreases in depressive symptoms. These findings highlight the importance of targeting negative emotions during treatment to achieve more favorable outcomes.   

Heterogeneity in Temporal Dynamics of Pain and Affect Among Individuals With Chronic Back Pain and Associations With Risk for Future Opioid-Related Problems
Madelyn Frumkin, Ryan Carpenter, and Thomas Rodebaugh

Chronic low back pain (CLBP) is a biopsychosocial phenomenon involving complex relationships between pain and psychosocial factors. In preregistered analyses, we examined dynamic relationships between pain and negative affect among individuals with CLBP (N = 87). We found that increased negative affect was concurrently and prospectively associated with increased pain for individuals on average. However, there was significant and meaningful between-persons variability in these effects such that risk for future opioid-related problems was positively associated with the within-persons correlation between pain and negative affect (β = 0.290, 95% credible interval [CI] = [0.071, 0.485]), the degree to which pain predicted increased negative affect (β = 0.439, 95% CI = [0.044, 0.717]), and the autoregressive effect of negative affect over 4-hr lags (β = 0.255, 95% CI = [0.007, 0.478]). These results suggest that variability in within-persons symptom dynamics may help identify chronic pain patients who are at greater risk of opioid-related problems. 

The Longitudinal (Co)Development of Personality Traits and the Level of Personality Functioning After Negative Life Events
Peter Haehner, Chelsea Sleep, Joshua Miller, Donald Lynam, and Christopher Hopwood

Based on the evidence from cross-sectional studies, there is an ongoing debate whether personality traits and personality functioning are redundant (e.g., because these constructs are strongly correlated). However, some questions regarding their overlap can only be addressed using longitudinal data. In this Registered Report, we examined the (co)development of the Big Five personality traits and personality functioning using longitudinal data from individuals who had recently experienced a negative life event (N = 1,151). Personality functioning was less rank-order stable than conscientiousness and less mean-level stable than all Big Five traits except neuroticism. Furthermore, the developmental trajectory of the level of personality functioning was particularly similar to the developmental trajectory of neuroticism. Our results show that personality functioning and most Big Five personality traits differ in their longitudinal development in the context of negative life events and suggest the need for a clearer distinction between personality functioning and neuroticism. 

Threat Appraisal and Pediatric Anxiety: Proof of Concept of a Latent-Variable Approach
Rachel Bernstein, Ashley Smith, Elizabeth Kitt, Elise Cardinale, Anita Harrewijn, Rany Abend, Kalina Michalska, Daniel Pine, and Katharina Kircanski  

Elevated threat appraisal is a postulated neurodevelopmental mechanism of anxiety disorders. However, laboratory-assessed threat appraisals are task-specific and subject to measurement error. We used latent-variable analysis to integrate youths’ self-reported threat appraisals across different experimental tasks; we next examined associations with pediatric anxiety and behavioral- and psychophysiological-task indices. Ninety-two youths ages 8 to 17 (M = 13.07 years, 65% female), including 51 with a primary anxiety disorder and 41 with no Axis I diagnosis, completed up to eight threat-exposure tasks. Anxiety symptoms were assessed using questionnaires and ecological momentary assessment. Appraisals both before and following threat exposures evidenced shared variance across tasks. Derived factor scores for threat appraisal were associated significantly with anxiety symptoms and variably with task indices; findings were comparable with task-specific measures and had several advantages. Results support an overarching construct of threat appraisal linked with pediatric anxiety, providing groundwork for more robust laboratory-based measurement. 

Investigating a Common Structure of Personality Pathology and Attachment
Madison Smith and Susan South

Critical theoretical intersections between adult insecure attachment and personality disorders (PDs) suggest that they may overlap, but a lack of empirical analysis to date has limited further interpretation. The current study used a large sample (N = 812) of undergraduates (N = 355) and adults receiving psychological treatment (N = 457) to test whether a joint hierarchical factor structure of personality pathology and insecure attachment is tenable. Results suggested that attachment and PD indicators load together on latent domains of emotional lability, detachment, and vulnerability, but antagonistic, impulsigenic, and psychosis-spectrum factors do not subsume attachment indicators. This solution was relatively consistent across treatment status but varied across gender, potentially suggesting divergent socialization of interpersonal problems. Although further tests are needed, if attachment and PDs prove to be unitary, combining them has exciting potential for providing an etiologic-developmental substrate to the classification of interpersonal dysfunction. 

Neuroticism Is Prospectively Associated With 30-Month Changes in Broadband Internalizing Symptoms but Not Narrowband Positive Affect or Anxious Arousal in Emerging Adulthood
Christopher Conway, Shannon Grogans, Allegra Anderson, Samiha Islam, Logan Craig, Jazmine Wedlock, Juyoen Hur, Kathryn DeYoung, and Alexander Shackman

Elevated levels of Neuroticism/Negative Emotionality (N/NE) and, less consistently, lower levels of Extraversion/Positive Emotionality (E/PE) confer risk for pathological depression and anxiety. To date, most prospective-longitudinal research has narrowly focused on traditional diagnostic categories, creating uncertainty about the precise nature of these prospective associations. Adopting an explicitly hierarchical-dimensional approach, we examined the association between baseline variation in personality and longitudinal changes in broad and narrow internalizing-symptom dimensions in 234 emerging adults followed for 2.5 years, during the transition from older adolescence to early adulthood. N/NE was uniquely associated with increases in broadband internalizing—the core cognitive and affective symptoms that cut across the emotional disorders—and unrelated to the narrower dimensions of positive affect and anxious arousal that differentiate specific internalizing presentations. Variation in E/PE and several other Big Five traits was cross-sectionally but not prospectively related to longitudinal changes in specific internalizing symptoms. Exploratory personality-facet-level analyses provided preliminary evidence of more granular associations between personality and longitudinal changes in internalizing symptoms. These observations enhance the precision of models linking personality to internalizing illness, highlight the centrality of N/NE to increases in transdiagnostic internalizing symptoms during a key developmental chapter, and set the stage for developing more effective prevention and treatment strategies. 

The Association Between the Selection and Effectiveness of Emotion-Regulation Strategies and Psychopathological Features: A Daily Life Study
Marlies Houben, Elise Kalokerinos, Peter Koval, Yasemin Erbas, Jardine Mitchell, Madeline Pe, and Peter Kuppens

Emotion dysregulation is central to psychopathological conditions, including borderline personality disorder (BPD) and depression. However, the nature of emotion-regulation (ER) difficulties in the daily life of people with BPD or depressive features is still unclear. Therefore, in this study, we aimed to disentangle two different ER subprocesses in daily life, (a) selection of ER strategies and (b) the effectiveness of implementing strategies, in terms of their associations with subsequent emotional experience. We analyzed data from a three-wave, longitudinal, experience-sampling study of young adults with varying levels of psychopathological features (N = 202). BPD features were uniquely linked to the use but not altered effectiveness of several putatively adaptive and maladaptive ER strategies. Depressive features were uniquely associated with the use of putatively maladaptive strategies. These findings suggest that ER deficits in people with more BPD or depressive features may be primarily located in strategy selection rather than the implementation of those strategies.  

Executive Function and Impulsivity Predict Distinct Genetic Variance in Internalizing Problems, Externalizing Problems, Thought Disorders, and Compulsive Disorders: A Genomic Structural Equation Modeling Study
Daniel Gustavson, Claire Morrison, Travis Mallard, Mariela Jennings, Pierre Fontanillas, Sarah Elson, Abraham Palmer, Naomi Friedman, and Sandra Sanchez-Roige

Individual differences in self-control predict many health and life outcomes. Building on twin literature, we used genomic structural equation modeling to test the hypothesis that genetic influences on executive function and impulsivity predict independent variance in mental health and other outcomes. The impulsivity factor (comprising urgency, lack of premeditation, and other facets) was only modestly genetically correlated with low executive function (r = .13). Controlling for impulsivity, we found that low executive function was genetically associated with increased internalizing (β = 0.15), externalizing (β = 0.13), thought disorders (β = 0.38), compulsive disorders (β = 0.22), and chronotype (β = .011). Controlling for executive function, we found that impulsivity was positively genetically associated with internalizing (β = 0.36), externalizing (β = 0.55), body mass index (β = 0.26), and insomnia (β = 0.35) and negatively genetically associated with compulsive disorders (β = −0.17). Executive function and impulsivity were both genetically correlated with general cognitive ability and educational attainment. This work suggests that executive function and impulsivity are genetically separable and show independent associations with mental health.  

Does Major Depression Differentially Affect Daily Affect in Adults From Six Middle-Income Countries: China, Ghana, India, Mexico, Russian Federation, and South Africa?
Vanessa Panaite and Nathan Cohen

Much of the research on how depression affects daily emotional functioning comes from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. In the current study, we investigated daily positive affect (PA) and negative affect (NA) and PA and NA variability in a cross-cultural sample of adults with a depression diagnosis (N = 2,487) and without a depression diagnosis (N = 31,764) from six middle-income non-WEIRD countries: China, Ghana, India, Mexico, Russian Federation, and South Africa. Across countries, adults with depression relative to adults without depression reported higher average NA and NA variability and lower average PA but higher PA variability. Findings varied between countries. Observations are discussed within the context of new theories and evidence. Implications for current knowledge and for future efforts to grow cross-cultural and non-WEIRD affective science are discussed.

Depressive Symptoms and Their Mechanisms: An Investigation of Long-Term Patterns of Interaction Through a Panel-Network Approach
Asle Hoffart, Nora Skjerdingstad, René Freichel, Alessandra Mansueto, Sverre Johnson, Sacha Epskamp, and Omid V. Ebrahimi  

The dynamic interaction between depressive symptoms, mechanisms proposed in the metacognitive-therapy model, and loneliness across a 9-month period was investigated. Four data waves 2 months apart were delivered by a representative population sample of 4,361 participants during the COVID-19 pandemic in Norway. Networks were estimated using the newly developed panel graphical vector-autoregression method. In the temporal network, use of substance to cope with negative feelings or thoughts positively predicted threat monitoring and depressed mood. In turn, threat monitoring positively predicted suicidal ideation. Metacognitive beliefs that thoughts and feelings are dangerous positively predicted anhedonia. Suicidal ideation positively predicted sleep problems and worthlessness. Loneliness was positively predicted by depressed mood. In turn, more loneliness predicted more control of emotions. The findings point at the theory-derived variables, threat monitoring, beliefs that thoughts and feelings are dangerous, and use of substance to cope, as potential targets for intervention to alleviate long-term depressive symptoms. 

Hooking the Self Onto the Past: How Positive-Autobiographical-Memory Retrieval Benefits People With Social Anxiety
David Moscovitch, Kendra White, and Taylor Hudd

Do people with social anxiety (SA) benefit from positive memory retrieval that heightens self-relevant meaning? In this preregistered study, an analog sample of 255 participants with self-reported clinically significant symptoms of SA were randomly assigned to retrieve and process a positive social-autobiographical memory by focusing on either its self-relevant meaning (deep processing) or its perceptual features (superficial processing). Participants were then socially excluded and instructed to reimagine their positive memory. Analyses revealed that participants assigned to the deep processing condition experienced significantly greater improvements than participants in the superficial processing condition in positive affect, social safeness, and positive beliefs about others during initial memory retrieval and in negative and positive beliefs about the self following memory reactivation during recovery from exclusion. These novel findings highlight the potential utility of memory-based interventions for SA that work by “hooking” self-meaning onto recollections of positive interpersonal experiences that elicit feelings of social acceptance. 

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