Clinical Psychological Science

Assessing youth psychopathology involves collecting multiple informants’ reports. Yet multi-informant reports often disagree, which necessitates integrative strategies that optimize predictive power. The trait-score approach leverages principal components analysis to account for the context and perspective from which informants provide reports. This approach may boost the predictive power of multi-informant reports and thus warrants rigorous testing. We tested the trait score approach using multi-informant reports of adolescent social anxiety in a mixed clinical and community sample of adolescents (N = 127). The trait score incrementally predicted observed social anxiety (βs = 0.47–0.67) and referral status (odds ratios = 2.66–6.53) above and beyond individual informants’ reports and a composite of informants’ reports. The trait score predicted observed behavior at magnitudes well above those typically observed for individual informants’ reports of internalizing psychopathology (i.e., rs = .01–.15). Findings demonstrate the ability of the trait score to improve prediction of clinical indices and potentially transform widely used practices in multi-informant assessments.

The ability to identify and label one’s emotions is associated with effective emotion regulation, rendering emotional awareness important for mental health. We evaluated how emotional awareness was related to psychopathology and whether low emotional awareness was a transdiagnostic mechanism explaining the increase in psychopathology during the transition to adolescence and as a function of childhood trauma—specifically, violence exposure. In Study 1, children and adolescents (N = 120, age range = 7–19 years) reported on emotional awareness and psychopathology. Emotional awareness was negatively associated with psychopathology (p-factor) and worsened across age in females but not males. In Study 2 (N = 262, age range = 8–16 years), we replicated these findings and demonstrated longitudinally that low emotional awareness mediated increases in p-factor as a function of age in females and violence exposure. These findings indicate that low emotional awareness may be a transdiagnostic mechanism linking adolescent development, sex, and trauma with the emergence of psychopathology.

Childhood adversity is common and strongly associated with risk for psychopathology. Identifying factors that buffer children from experiencing psychopathology following adversity is critical for developing more effective intervention approaches. In the present study, we examined several behavioral metrics of reward processing reflecting global approach motivation for reward and the degree to which reward responses scaled with reward value (i.e., behavioral sensitivity to reward value) as potential moderators of the association of multiple dimensions of adversity—including trauma, caregiver neglect, and food insecurity—with depression and externalizing psychopathology in a sample of youths ages 8 to 16 (n = 132). Trauma exposure and externalizing problems were positively associated at low and moderate levels of reward reactivity, but this association became nonsignificant at high levels of reward reactivity. Our findings extend prior work by demonstrating that high behavioral sensitivity to reward value may buffer against externalizing problems following exposure to trauma.

Rumination has been consistently shown to play a critical role in the severity and course of depression. Relatively understudied, however, is the nature of rumination across time and how individual differences in the temporal dynamics of rumination may be related to depression. In this study, we investigated the association between ruminative inertia (the degree to which rumination levels are resistant to change from day to day) and both current and past depression in a clinical sample. Participants (N = 71) completed daily-diary surveys for 3 weeks. Ruminative inertia was positively associated with current depressive symptoms and negatively associated with the number of past depressive episodes. These findings suggest that more severe depressive symptoms are associated with rumination that is more resistant to change over time, whereas a greater number of past depressive episodes is related to less ruminative inertia. Additional research is needed to explore the directionality of these effects.

Trait impulsivity—defined by strong preference for immediate over delayed rewards and difficulties inhibiting prepotent behaviors—is observed in all externalizing disorders, including substance-use disorders. Many laboratory tasks have been developed to identify decision-making mechanisms and correlates of impulsive behavior, but convergence between task measures and self-reports of impulsivity are consistently low. Long-standing theories of personality and decision-making predict that neurally mediated individual differences in sensitivity to (a) reward cues and (b) punishment cues (frustrative nonreward) interact to affect behavior. Such interactions obscure one-to-one correspondences between single personality traits and task performance. We used hierarchical Bayesian analysis in three samples with differing levels of substance use (N = 967) to identify interactive dependencies between trait impulsivity and state anxiety on impulsive decision-making. Our findings reveal how anxiety modulates impulsive decision-making and demonstrate benefits of hierarchical Bayesian analysis over traditional approaches for testing theories of psychopathology spanning levels of analysis.

Repetitive negative thinking (RNT) is a transdiagnostic feature of psychiatric disorders. Women report greater RNT than do men, yet the association between uniquely female characteristics, such as fluctuating sex hormones during the menstrual cycle, and RNT has not been established. Here we examined changes in RNT and anxiety symptoms across the menstrual cycle in women with (n = 40) and without (n = 41) generalized anxiety disorder (GAD). Women with GAD reported an increase in RNT and negative affect from the follicular phase to the luteal phase; unexpectedly, this was not associated with changes in anxiety symptoms, estradiol, or progesterone. Nonanxious women reported no changes in RNT or anxiety symptoms over the menstrual cycle, but higher within-participants progesterone was associated with reduced RNT and negative affect. These results indicate that uniquely female biological processes may influence core cognitive processes that underlie anxiety disorders, but further investigations to determine the implications for symptom severity are required.

Cognitive deficits in chronic pain are often attributed to difficulties in attentional control. According to the deficit view, these difficulties stem from a reduction in attentional capacity driven by attentional focus on pain experience; alternatively, according to the motivated-attention view, attentional biases toward pain-relevant threats in the environment reduce attention available for everyday tasks and goals. We tested both accounts using a task in which 72 people with chronic pain and 72 without chronic pain performed a simple perceptual task while attempting to ignore pain-relevant images of body mutilations or neutral scenes. They also completed a common test of attentional control. Although people with chronic pain reported subjective difficulty with attentional control and were slower on both tasks, groups did not differ on behavioral measures of attentional control. Findings suggest that attentional control may not be an optimal target for interventions intended to improve cognitive function in chronic pain.

Dozens of studies have indicated that individuals more prone to experiencing disgust have stronger symptoms of anxiety disorders—especially contamination sensitivity. However, no work has informed the degree to which this relationship arises from genetic factors versus environmental factors. In the present study, we fill this gap by measuring disgust proneness and contamination sensitivity in a sample of 7,199 twins and siblings of twins, including 1,411 complete twin pairs. Disgust proneness was related to contamination sensitivity, r = .32. Multivariate twin modeling revealed that genetic factors accounted for 34% and 40% of the variance in disgust proneness and contamination sensitivity, respectively, and that the correlation between the two traits reflected overlapping genetic (54%) and unshared environmental (46%)—but not shared environmental—influences. Although consistent with work indicating that disgust proneness relates to contamination sensitivity, results suggest that prevailing parental-modeling hypotheses for explaining this relationship be reevaluated.

The March 2011 Great East Japan Earthquake, tsunami, and nuclear leak were complex traumas. We examined psychological distress in the years following the earthquake using growth mixture modeling to classify responses from 2,599 linked respondents (2012–2016). We identified four classes of trajectories following the disaster: resilient (76% of respondents), delayed distress (8%), recovery (8%), and chronic distress (7%). Compared with the resilient class, other class members were less likely to be female and had less social support. Survivors in the recovery group were more likely to live in prefabricated housing. Although distress has decreased over time, specific populations continue to require targeted intervention.