Clinical Psychological Science Research Articles

Three principles for the utility of simple tasks that assess elemental processes in parsing heterogeneity.

As clinical psychological science and biological psychiatry push to assess, model, and integrate heterogeneity and individual differences, approaches leveraging computational modeling, translational methods, and dimensional approaches to psychopathology are increasingly useful in establishing brain-behavior relationships. The field is ultimately interested in complex human behavior, and disruptions in such behaviors can arise through many different pathways, leading to heterogeneity in etiology for seemingly similar presentations. Parsing this complexity may be enhanced using "simple" tasks-which we define as those assaying elemental processes that are the building blocks to complexity. Using eyeblink conditioning as one illustrative example, we propose that simple tasks assessing elemental processes can be leveraged by and enhance computational psychiatry and dimensional approaches in service of understanding heterogeneity in psychiatry, especially when these tasks meet three principles: (a) an extensively mapped circuit, (b) clear brain-behavior relationships, and (c) relevance to understanding etiological processes and/or treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Improving the Science of Adolescent Social Media and Mental Health: Challenges and Opportunities of Smartphone-Based Mobile Sensing and Digital Phenotyping

AbstractThe impact of social media (SM) use (‘screentime’) on adolescent mental health has been the focus of increasing concern, despite mixed findings from empirical research. Current methodological approaches rely on self-reported SM use, which has limited accuracy and obscure the dynamic interplay of SM use and mental health. Smartphone-based mobile sensing offers new opportunities to gain insights into adolescents’ SM use patterns and behaviors, particularly at an idiographic level. Considerations and challenges of smartphone sensing methods for capturing adolescents’ SM use patterns and behaviors in clinical psychological science are discussed in the context of a pilot study using smartphone-based sensing with adolescents. The pilot study included 19 adolescents (Mean age = 15.84; 68% boys; 79% White) who installed a passive monitoring application (AWARE) on their phones for 31 (SD = 5.6) days. Descriptive data of sensing acceptability and feasibility are presented based on participant ratings and data yield ratio of usable data (74.18%). Sensing yielded 10,038 hourly observations collected from the ‘application foreground’ sensor across all participants from social media apps, and a total of 645 applications used. Categorization of SM apps were coded (kappa >.90) into ‘social networking’ (N = 20 apps) and ‘broader SM’ (N = 41) and compared to both Play Store-defined SM apps (N = 26) and popular SM apps based on Common Sense Media Survey (N = 9). Descriptive data on extracted behavioral features (duration, checking) from SM use categories (binned hourly and daily) are presented. Challenges, opportunities, and future directions of sensing methods for SM use are discussed to inform our understanding of its impacts on mental health and to improve the rigor of SM research in clinical psychological science.

The utility of high-dosage experiments in everyday life to test theories in clinical science.

This viewpoint article discusses the utility of high-dosage experiments (HDEs) in everyday life to test theories in clinical science. HDEs involve experimental manipulations and assessments that occur over much longer periods of time than traditional experiments-generally days or even weeks. By nature, they also occur outside the lab, in the everyday environments of participants. Additionally, as with other experiments, the purpose of the study is concealed from participants. Experimental design is one of the most distinguishable characteristics of psychology that separates it from other behavioral sciences. Studies that rely on experiments are essential for theory testing and establishing the potential causal role of mechanisms that underlie psychopathology. Yet despite the value of experimental research, experimental studies are not currently given special prominence in clinical psychological science. For example, in the Journal of Psychopathology and Clinical Science, of all the empirical studies in the most recent year (2023), only three of 77 incorporated an experimental manipulation. Experimental research appears to be less popular in clinical psychology than in other fields, such as social psychology. What might account for this discrepancy? First, clinical samples are more difficult to recruit. This is important because experimental manipulations may produce small effects that require large samples for detection. Additionally, mechanisms hypothesized to underlie psychopathology are often chronic and intransigent. For example, cognitive factors (e.g., perfectionistic beliefs) could require an especially strong manipulation to modify in isolation. Researchers have argued that psychology has been experiencing a crisis in theory development. Eronen and Bringmann (2021) stated that one major reason for this crisis is the difficulty in establishing causal relationships between psychological constructs. The replication crisis has garnered even more attention (Open Science Collaboration, 2015). HDEs would help address these two crises and provide stronger and more replicable tests of theory. This could allow us to more precisely identify important mechanisms underlying psychopathology, potentially enhancing treatment efficacy, and enabling us to move the field forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Marketing mental health services: a mixed-methods analysis of racially and ethnically diverse college students’ engagement with and perspectives on U.S. university mental health clinics’ websites

BackgroundThe United States (U.S.) faces a significant mental health crisis, with around 52.9 million adults experiencing mental health disorders, with young adults (18–25 years old), such as college students, having the highest prevalence and lowest service utilization rates. While efforts to expand mental health services through “push” strategies are in place (e.g., training therapists in evidence-based therapies), limited initial engagement suggests a need for “pull strategies” and targeted marketing that make services attractive to college students and increase demand. This mixed-methods study identifies U.S. university mental health clinic websites and website characteristics that are attractive and engaging to college students interested in seeking mental health services (i.e., students were considering or actively looking for mental health support).MethodsEleven U.S. university websites were chosen (10 randomly and one from the university where students were attending) from a pool of 44 Psychological Clinical Science Accreditation System training clinics websites. Fifty-seven college students (Mage = 20.95, SD = 2.97; 81% female; 68% racial/ethnic minority) were videorecorded engaging with two U.S. university mental health clinic websites, completed self-report engagement measures, and gave detailed feedback about websites through semi-structured interviews.ResultsLikert scale scores revealed moderate engagement with all websites (e.g., they were interesting and helpful). Qualitative results indicated that websites that provided important and easily understood information about key features of services (e.g., types, evidence-base, and cost), therapist backgrounds, psychoeducation, used lay language, and had an appealing website layout (e.g., color, font, images, organization, and interactive components) generated greater consumer interest and trust in their mental health services.ConclusionsThis study emphasizes the importance of using marketing strategies to enhance college students’ engagement through mental health service websites. Salient features, psychoeducation, and effective promotional strategies (e.g., how information is presented) were identified as crucial for website engagement and subsequent mental health service uptake. Using marketing strategies, such as tailoring language to consumer literacy levels, describing the evidence-base of services, and improving website design may address college students’ needs and enhance initial mental health service engagement.

Open Science at Clinical Psychological Science: Reflections on Progress, Lessons Learned, and Suggestions for Continued Improvement

Open Science at <i>Clinical Psychological Science</i>: Reflections on Progress, Lessons Learned, and Suggestions for Continued Improvement

Clinical Psychology Graduate Programs: Falling Short in Cultural Humility Training.

Despite requirements by the American Psychological Association and the Psychological Clinical Science Accreditation System regarding training and education in cultural humility, questions remain regarding the presence and quality of the training in clinical psychology PhD and PsyD programs. This is a critical issue as inadequate training in diversity, cultural humility, and multiculturalism has substantial downstream effects on care for clients of color and may contribute to racial disparities and inequities in access to mental health services. We seek to explicitly evaluate key features of the conceptual model thought to improve the provision of mental health services for clients facing oppression and marginalization which includes perceptions of clinical psychology graduate programs' training in and assessment of cultural humility. We also assess self-efficacy related to the application of cultural humility as well as actual practice of actions associated with cultural humility. Each of these domains are evaluated among a sample of 300 graduate students and faculty, clinical supervisors, and/or directors of clinical training (DCTs) and differences across position and race of participants were tested. Study findings highlight significant gaps between what trainees need to develop cultural humility and what they may actually be receiving from their respective programs. While findings suggest that there is still a lot of work to be done, understanding the state of the field with regards to clinical training in cultural humility is an important first step towards change.

Diversity, equity, inclusion, justice, and antiracism statements by clinical psychological science programs: A mixed methods analysis of public commitments.

Diversity, equity, inclusion, justice, and antiracism statements by clinical psychological science programs: A mixed methods analysis of public commitments.

Parental Neglect and Childhood Obesity Amidst COVID-19: A Developmental Psychopathology Perspective on Health and Developmental Risks.

The COVID-19 pandemic has profoundly impacted the mental health and developmental trajectories of children and adolescents, catalyzing a range of psychological and behavioral issues due to enforced lockdowns and other restrictions. This text explores these impacts through the lens of developmental psychopathology, which integrates clinical psychology and developmental science to examine the emergence and evolution of psychological disorders across a lifespan. This paper highlights how pandemic-related disruptions have exacerbated conditions such as anxiety and depression and, notably, increased childhood obesity due to changes in lifestyle and reductions in physical activity. The analysis includes a discussion of how isolation has not only restricted access to educational and psychological resources but also increased the risk of parental mental illness and related familial stress, thereby intensifying issues of neglect and their consequent impact on child health. By employing a developmental psychopathology framework, this paper argues for the necessity of targeted interventions that address these complex interplays of genetic, environmental, and psychological factors. Such interventions aim to support children through structured educational and health-oriented strategies, ensuring their well-being amidst the ongoing challenges posed by the pandemic. This approach underscores the importance of early, multifaceted strategies involving parents, educators, and healthcare providers to foster healthier developmental outcomes for children facing unprecedented global health crises.

Major Problems in Clinical Psychological Science and How to Address them. Introducing a Multimodal Dynamical Network Approach

Abstract Background Despite impressive dissemination programs of best-practice therapies, clinical psychology faces obstacles in developing more efficacious treatments for mental disorders. In contrast to other medical disciplines, psychotherapy has made only slow progress in improving treatment outcomes. Improvements in the classification of mental disorders could enhance the tailoring of treatments to improve effectiveness. We introduce a multimodal dynamical network approach, to address some of the challenges faced by clinical research. These challenges include the absence of a comprehensive meta-theory, comorbidity, substantial diagnostic heterogeneity, violations of ergodicity assumptions, and a limited understanding of causal processes. Methods Through the application of multimodal dynamical network analysis, we describe how to advance clinical research by addressing central problems in the field. By utilizing dynamic network analysis techniques (e.g., Group Iterative Multiple Model Estimation, multivariate Granger causality), multimodal measurements (i.e., psychological, psychopathological, and neurobiological data), intensive longitudinal data collection (e.g., Ecological Momentary Assessment), and causal inference methods (e.g., GIMME), our approach could improve the comprehension and treatment of mental disorders. Under the umbrella of the systems approach and utilizing e.g., graph theory and control theory, we aim to integrate data from longitudinal, multimodal measurements. Results The multimodal dynamical network approach enables a comprehensive understanding of mental disorders as dynamic networks of interconnected symptoms. It dismantles artificial diagnostic boundaries, facilitating a transdiagnostic view of psychopathology. The integration of longitudinal data and causal inference techniques enhances our ability to identify influential nodes, prioritize interventions, and predict the impact of therapeutic strategies. Conclusion The proposed approach could improve psychological treatment by providing individualized models of psychopathology and by suggesting individual treatment angles.

Future Directions for Community-Engaged Research in Clinical Psychological Science with Youth

ABSTRACT Despite advances in clinical science, the burden of mental health problems among youth is not improving. To tackle this burden, clinical science with youth needs methods that include youth and family perspectives on context and public health. In this paper, we illustrate how community-engaged research (CEnR) methods center these perspectives. Although CEnR methods are well-established in other disciplines (e.g. social work, community psychology), they are underutilized in clinical science with youth. This is due in part to misperceptions of CEnR as resource-intensive, overly contextualized, incompatible with experimentally controlled modes of inquiry, or irrelevant to understanding youth mental health. By contrast, CEnR methods can provide real-world impact, contextualized clinical solutions, and sustainable outcomes. A key advantage of CEnR strategies is their flexibility—they fall across a continuum that centers community engagement as a core principle, and thus can be infused in a variety of research efforts, even those that center experimental control (e.g. randomized controlled trials). This paper provides a brief overview of this continuum of strategies and its application to youth-focused clinical science. We then discuss future directions of CEnR in clinical science with youth, as well as structural changes needed to advance this work. The goals of this paper are to help demystify CEnR and encourage clinical scientists to consider adopting methods that better consider context and intentionally engage the communities that our work seeks to serve.

Psychological Clinical Science: Meeting the Challenge of Public Mental Health.

The purpose of this article is to provide a brief overview of how clinical psychology evolved in the United States as a prelude to discussing the emergence of psychological clinical science in the closing years of the 20th century. Despite the growth of clinical psychology, mental disorders remain highly prevalent, compelling us to envision new ways to deliver services in an effective but efficient manner. Topics include the dissemination gap, the affordable access gap, and the Psychological Clinical Science Accreditation System (PCSAS). Examples of novel methods for addressing the problem of public mental health in the 21st century are discussed. Finally, I close by considering the potential relevance of our experience in America for European clinical psychology.

Generalized anxiety disorder and selective attention: An unsuccessful replication of Yiend et al., (2015) in a student population

ABSTRACT Generalized Anxiety Disorder (GAD) is an anxiety disorder that is believed to affect attention (Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine, 373(21), 2059–2068. https://doi.org/10.1056/NEJMcp1502514; Yiend, J., Mathews, A., Burns, T., Dutton, K., Fernández-Martín, A., Georgiou, G. A., Luckie, M., Rose, A., Russo, R., & Fox, E. (2015). Mechanisms of selective attention in generalized anxiety disorder. Clinical Psychological Science, 3(5), 758–771. https://doi.org/10.1177/2167702614545216). Previous literature has found that selective attention is changed when someone perceives threatening stimuli, such as an angry face, and that those with anxiety disorders, may have a heightened or delayed response to threatening stimuli (Richards, H. J., Benson, V., Donnelly, N., & Hadwin, J. A. (2014). Exploring the function of selective attention and hypervigilance for threat in anxiety. Clinical Psychology Review, 34(1), 1–13. https://doi.org/10.1016/j.cpr.2013.10.006; Stevens, C., & Bavelier, D. (2012). The role of selective attention on academic foundations: A cognitive neuroscience perspective. Developmental Cognitive Neuroscience, 2, S30–S48. https://doi.org/10.1016/j.dcn.2011.11.001), which may alter how fast a presented task is completed (Yiend et al., 2015). The present study aimed to reproduce findings by Yiend et al. (2015), which identified an unexpected pattern in those with GAD: faster disengagement from angry faces compared to positive (happy, neutral) faces. The present study recruited a larger (nonclinical) sample from a student population to achieve greater statistical power. None of the findings reported by Yiend and colleagues (Experiment 1; 2015) were replicated in a student sample. The implications are discussed.

Response to responsible research assessment I and II from the perspective of the DGPs working group on open science in clinical psychology

We comment on the papers by Schönbrodt et al. (2022) and Gärtner et al. (2022) on responsible research assessment from the perspective of clinical psychology and psychotherapy research. Schönbrodt et al. (2022) propose four principles to guide hiring and promotion in psychology: (1) In addition to publications in scientific journals, data sets and the development of research software should be considered. (2) Quantitative metrics can be useful, but they should be valid and applied responsibly. (3) Methodological rigor, research impact, and work quantity should be considered as three separate dimensions for evaluating research contributions. (4) The quality of work should be prioritized over the number of citations or the quantity of research output. From the perspective of clinical psychology, we endorse the initiative to update current practice by establishing a matrix for comprehensive, transparent and fair evaluation criteria. In the following, we will both comment on and complement these criteria from a clinical-psychological perspective.

Understanding Ethnoracial Disparities and Advancing Mental Health Equity Through Clinical Psychological Science: Introduction to Special Issue

Mental health disparities persist in countries such as the United States and across the world. Research with disparity populations is underrepresented in mainstream clinical psychological journals, and existing science has not focused on group specific lived experiences. Achieving mental health equity requires examination of determinants of psychopathology and health disparities and personal and cultural attributes that promote mental health. Clinical psychological science ideally also encourages and values research with underrepresented minority and underserved populations, novel and underused study designs, and research produced by diverse scholars. Our special issue highlights research that considers systematically culture specific processes, examines not only individual- but also community-level factors that relate to psychopathology and mental-health care, and challenges structural limitations in the current literature. We review these articles that incorporate innovative and community engaged approaches and showcase the importance of diversity in researcher and research participant demographics and perspectives in the advancement of equity in clinical psychological science.

Supplemental Material for Diversity, Equity, Inclusion, Justice, and Antiracism Statements by Clinical Psychological Science Programs: A Mixed Methods Analysis of Public Commitments

Supplemental Material for Diversity, Equity, Inclusion, Justice, and Antiracism Statements by Clinical Psychological Science Programs: A Mixed Methods Analysis of Public Commitments

Toward a Science of Clinical Psychology: A Tribute to the Life and Works of Scott O. Lilienfeld

Toward a Science of Clinical Psychology: A Tribute to the Life and Works of Scott O. Lilienfeld

From Allies of “Conversion Therapy” to Accomplices of Justice: Invited Concluding Comment to the C&BP Special Series

This special feature of Cognitive and Behavioral Practice serves to remind psychological scientists and other mental health clinicians of the importance of understanding our responsibilities in the field with specific reference to sexual orientation and gender identity “conversion therapy” efforts: from considering our ethical responsibilities in our practice (Davison) to understanding the widespread iatrogenic impacts of “conversion therapy” practice in all its subtleties (Anderson et al.), from staying abreast of the contemporary anti-LGBTQ+ talking points (Haldeman) to understanding how this rhetoric targets specific subpopulations in the U.S. currently (Hope & Puckett). We conclude this special series by reminding the reader that structures within our institutions and day-to-day functioning uphold and foster an unethical and iatrogenic practice. We point out the need to be alert. Clinical psychological science is not value-free. Pretending that it is serves the obfuscation of scientific findings and equips scholars who hold vested interests in seeing the dangerous practice of “conversion therapy” legitimized and disseminated in a larger scale.

Transparency and the Mindfulness Opacity Hypothesis

Abstract Many philosophers endorse the Transparency Thesis, the claim that by introspection one cannot become aware of one's experience. Recently, some authors have suggested that the Transparency Thesis is challenged by introspective states reached under mindfulness. We label this the Mindfulness Opacity Hypothesis. The present paper develops the hypothesis in important new ways. First, we motivate the hypothesis by drawing on recent clinical psychology and cognitive science of mindfulness. Secondly, we develop the hypothesis by describing the implied shift in experiential perspective, the scope of introspectable qualities, and the level of skill. Thirdly, we defend the hypothesis against various philosophical arguments. We conclude that the Mindfulness Opacity Hypothesis is empirically and theoretically well motivated and supported.

Challenges and ways forward in bridging units of analysis in clinical psychological science.

For decades, experiential measures (i.e., self- and informant-report) have dominated clinical psychological science as the primary methods of investigating the nature, causes, and consequences of psychopathology. Recent efforts to understand psychopathology in a comprehensive manner, bridging across measurement modalities and study designs, have yielded disappointing results and small cross-domain effect sizes. This problem has stymied progress in diagnosing and treating mental illness. We contend that we continue to struggle to link different units of analysis in psychopathology research because, as a field, we have not learned the lessons that have been detailed in the literature since at least the 1950s. We argue that our reliance on single units of analysis (e.g., only self-report or only neuroimaging) to conceptualize and operationalize psychological constructs lies at the heart of our struggles. Conflation of a construct with its operationalization in a single measurement modality fundamentally limits the ability to understand its manifestation in other units of analysis. To make progress toward a fine-grained understanding of the symptoms, signs, and mechanisms of psychopathology, we must move past the siloed reification of constructs and prioritize new, integrated research paradigms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

'Visible' compulsions: OCD and the politics of science in British clinical psychology, 1948-1975.

This article historicizes a single stage in how the contemporary obsessive-compulsive disorder (OCD) category was built. Starting from the position that the two central components which make up OCD are 'obsessions' and 'compulsions', it illustrates how these concepts were taken apart by a small group of clinical psychologists working at the Institute of Psychiatry and the Maudsley psychiatric hospital in south London in the early 1970s, and why compulsions were investigated whilst obsessions were ignored. The decision to distinguish the previously undifferentiated symptoms is attributed to the commitment amongst psychologists at the Maudsley, most notably Stanley Rachman, to an empirical conception of science which emphasized observability. Two aspects of this are discussed. First, compulsions were deemed 'visible' through their correspondence with animal behaviour. Second, the symptom was seen as open to an experimental modification procedure which privileged visible outcomes. Ultimately, the article concludes that the historical division between 'obsessions' and 'compulsions', and the extensive investigation of the latter, has had substantial implications for the development of OCD as a category centred on visible behaviours and treated through behavioural means.