Clinical Psychological Science Research Articles

35.2 PARTNERSHIP AND ADAPTATION TO IMPLEMENT TRAUMA-FOCUSED CBT (TF-CBT) IN A LOW-RESOURCED AND POSTDISASTER CONTEXT: THE CASE OF PUERTO RICO

Clinical psychological science has developed efficacious treatments for trauma-related disorders in youth. However, randomized trials investigating these treatments have disproportionally been conducted by American, university-based research labs. Dissemination and implementation of trauma-focused treatment in broader global and lower-resourced settings are needed. The current presentation describes efforts to adapt trauma-focused CBT (TF-CBT) for successful deployment in Puerto Rico after undergoing multiple natural disasters (Hurricanes Irma and Maria, and earthquakes) and a global pandemic.

Applying the Science of Habit Formation to Evidence-Based Psychological Treatments for Mental Illness

Habits affect nearly every aspect of our physical and mental health. Although the science of habit formation has long been of interest to psychological scientists across disciplines, we propose that applications to clinical psychological science have been insufficiently explored. In particular, evidence-based psychological treatments (EBPTs) are interventions targeting psychological processes that cause and/or maintain mental illness and that have been developed and evaluated scientifically. An implicit goal of EBPTs is to disrupt unwanted habits and develop desired habits. However, there has been insufficient attention given to habit-formation principles, theories, and measures in the development and delivery of EBTPs. Herein we consider whether outcomes following an EBPT would greatly improve if the basic science of habit formation were more fully leveraged. We distill six ingredients that are central to habit formation and demonstrate how these ingredients are relevant to EBPTs. We highlight practice points and an agenda for future research. We propose that there is an urgent need for research to guide the application of the science of habit formation and disruption to the complex “real-life” habits that are the essence of EBPTs.

Which symptoms of depression and anxiety are most strongly associated with happiness? A network analysis of Indian and Kenyan adolescents

BackgroundNetwork analyses have been applied to understand the relationships between individual symptoms of depression and anxiety. However, little is known about which symptoms are most strongly associated with “positive” indicators of mental health, such as happiness. Furthermore, few studies have examined symptom networks in participants from low- and middle-income countries. MethodsTo address these gaps, we applied network analyses in a sample of Indian adolescents (Study 1; n=1080) and replicated these analyses in a pre-registered study with Kenyan adolescents (Study 2; n=2176). Participants from both samples completed the same measures of depressive symptoms, anxiety symptoms, and happiness. ResultsFeeling sad and feeling like a failure had the strongest (negative) associations with happiness items. These two symptoms, as well as worrying and feeling nervous, had the strongest associations with other symptoms of depression and anxiety. Symptoms of depression and anxiety formed a single cluster, which was distinct from a cluster of happiness items. Main findings were consistent across the two samples, suggesting a cross-culturally robust pattern. LimitationsWe used cross-sectional data, and we administered scales assessing a limited subset of symptoms and happiness items. ConclusionsOur findings support the idea that some symptoms of depression and anxiety are more strongly associated with happiness. These findings contribute to a body of literature emphasizing the advantages of symptom-level analyses. We discuss how efforts to understand associations between individual symptoms and “positive” mental health indicators, like happiness, could have theoretical and practical implications for clinical psychological science.

Racism and Poverty are Barriers to the Treatment of Youth Mental Health Concerns

ABSTRACT Objective Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological scientists. Method We conducted a narrative review of literature on racial and economic inequities and their impact on youth mental health. Results First, systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Second, attitudinal barriers, such as mistrust associated with treatments provided by researchers and government agencies, decrease the likelihood that minoritized groups will engage with or benefit from evidence-based treatments. Third, minoritized and underserved communities are especially unlikely to receive evidence-based treatment. Conclusion Clinical psychological science has unique insights that can help address systemic inequities that can decrease treatment efficacy for youth mental health treatment. Psychological scientists can help eliminate disparities in accessing evidence-based treatment and help end violent policies in underserved minoritized communities by at the very least (1) building and supporting scalable community-based treatments as well as (2) publicly advocating for an end to violent policies that impose negative social costs.

Critical Appraisal of Curriculum Content for Bachelor of Science in Clinical Psychology Under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University), as Against Learner Centricity

Background: The discipline of clinical psychology is the one that deals with assessment, diagnosis, treatment, and prevention of psychological illnesses and disorders with the aim to improve mental health. It is highly vital that the learner interested in faring for the said subject of clinical psychology must be subjected to competencies which are targeted around the learner himself/herself. These may include those which grant the learner the right to choose the direction of his further studies or the topics of their choice combining all the domains of learning with special emphasis on the affective domain therein. In the academic year 2020–2021, an undergraduate course curriculum on clinical psychology was launched in the Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University), the curricular inclusions for which were the document of interest for the present study. It is vital to determine the standing of the curriculum prepared for a new course for undergraduates with regard to its centricity – learner based, subject based, or problem based. Here, the cognitive domain can be viewed in the subject-based inclusions. The present study attempts to delineate the curricular inclusions for the said curriculum of Bachelor of Science in Clinical Psychology under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be university), as against typing of curriculum based on subject centricity. Materials and Methods: Rapid review of literature with reference to curriculum of Bachelor of Science in Clinical Psychology under faculty of Allied Health Sciences, Datta Meghe Institute Of Medical Sciences (Deemed to be University) in the academic year 2020–2021 for purpose of their “Typing” with principles of curriculum design was done. Results: The total number of curricular inclusions was 236. Ideally taking the ratio of curricular inclusions as 6:3:1, there should be 142 subject-centered inclusions, 71 problem-centered inclusion, and 23 learner–centered inclusions. Out of this, there were 184 inclusions which were observed to be subject centered, 40 inclusions were problem centered, and 12 were centered upon the learner. Thus, the overall percentage of typing of the inclusions was 77.96% subject centricity, 16.94% problem centricity, and 5.08% learner centricity. There was observed surplus of 42 objectives for subject centricity, deficit of 31 was observed for problem centricity and learner centricity showed a deficit of 11. Conclusion: The undergraduate course curriculum of Bachelor of Science in Clinical Psychology under Faculty of Allied Health Sciences included in the present study for typing of included curricular inclusions has been typed on the basis of their centricity upon the learner.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Scott O. Lilienfeld (1960–2020).

Memorializes Scott O. Lilienfeld (1960-2020), one of the most influential figures in contemporary clinical psychology. His contributions were prodigious and spanned psychopathy and personality disorders, psychiatric classification and di agnosis, dissociation, memory and trauma, neuroscience, and cultural sensitivity. He authored, coauthored, and coed ited more than 500 articles and book chapters and 20 books, including the Encyclopedia of Clinical Psychology. His in tellectual reach extended to writing introductory psychology and graduate textbooks, to op-eds and coverage in major news outlets, TV appearances, radio programs, podcasts, and lectures across the world. He made his mark in editorial roles including as editor-in-chief of Clinical Psychological Science, and as past editor and founder of the Scientific Review of Mental Health Practice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction to the Special Issue on Homework in Cognitive Behavioral Therapy: New Clinical Psychological Science

This article introduces the Special Issue in Cognitive Therapy and Research that presents advances in clinical psychological science for homework in behavior and cognitive behavioral therapies (CBTs). Studies include sophisticated evaluations of homework adherence, moving beyond simplistic assessments of quantity and quality of completion to more complete assessments of engagement (i.e., perceived difficulty, obstacles, and helpfulness). Studies advance the clinical psychological science by examining therapist behavior as a predictor of homework adherence, by testing homework as a vehicle for specific treatment processes in behavior therapy (e.g., context engagement via exposure), and also by quantifying relational patterns within longitudinal data from mindfulness-based cognitive therapy. The Special Issue also includes two studies on mobile health delivery of CBT interventions and point to advances in gathering objective data on client engagement with homework.

Hal Arkowitz (1941-2019).

Memorializes Hal Arkowitz (1941-2019). Arkowitz was an integrator, with a contagious curi osity for merging seemingly disparate ideas like science and practice. He joined the faculty at the University of Oregon, later moving to the University of Arizona in 1977. He studied self-help treatment as well as resistance and impasses in psychotherapy, and he worked to humanize conditions and reduce violence in prisons. Arkowitz was fascinated by integrating concepts and methods from various theoretical orientations and was involved in forming the Society for the Exploration of Psychotherapy Integra tion, becoming the founding editor of the society's Journal of Psychotherapy Integration. He also enjoyed writing for general audiences about the science of clinical psychology and myths of mental illness, witness his 2017 book with Scott Lilienfeld Facts and Fictions in Mental Health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Pornography Use and Psychological Science: A Call for Consideration

Pornography use is both ubiquitous and controversial in developed nations. Although research related to pornography use has flourished in topical and special-interest journals for several decades, much of this work has remained in the periphery of mainstream interests. The current article reviews how pornography use is likely relevant to various domains within psychological science, particularly emphasizing its significance in relationship research, adolescent-development research, and clinical science. Specifically, pornography use is likely salient to research examining both sexual and romantic satisfaction. Additionally, it is also likely relevant to understanding adolescent sexual development, particularly among sexual-minority populations. Finally, a large body of research suggests that pornography use may become problematic, either because of excessive use or moral incongruence about such use, illustrating its salience in clinical psychological science. Collectively, the current research related to pornography use suggests that it is of interest to multiple domains in psychological science and that its effects can range from positive to neutral to negative.

NETfacts: a community intervention integrating trauma treatment at the individual and collective level

ABSTRACT The aim of this article is to present a research-based rationale for NETfacts, a newly developed integrated approach at the individual and the community level in order to mitigate the mental and social sequelae of war and crisis. To this end, we provide a selective review of relevant literature from neuroscience, clinical psychology, and social science. In psychotraumatology, individual avoidance describes the effort to prevent exposure to trauma reminders. Among patients with post-traumatic stress disorder (PTSD), this becomes pathological, exacerbating distress and preventing recovery. This silence resonates in traumatized communities and consequently taboo builds – ultimately to the advantage of the perpetrators. The resulting collective avoidance leads to a fragmented collective memory about trauma or human rights violations in the community so that a shared account of the group’s history becomes impossible. The deficient collective memory promotes ambiguous truths and anxiety, enabling a reactive construction of safety based on selective information that leads to an endorsement of extreme opinions. Ongoing insecurity, violence and crime lead to increasing anxiety and fear. The self-interest of the perpetrators and the abnormal behaviour of survivors leads to an escalation in stigma and social exclusion resulting in the prevention or limitation of community exposure to traumatic material, i.e., to reduce tension and protect the construction of safety. The exposure to and recognition of traumatic facts subject to avoidance is key to a coherent collective memory and sense of communion, and to prevent further cycles of violence. The NETfacts health system combines individual and community-based intervention to treat the structure of memory at both the individual and collective levels. Abbreviations: NET: narrative exposure therapy; FORNET: narrative exposure therapy for forensic offender rehabilitation; NETfacts: facts derived from narrative exposure therapy

The difference between trait disinhibition and impulsivity-and why it matters for clinical psychological science.

In the psychological science field, there is substantial interest in quantifying individual differences in self-regulatory capacity because of its transdiagnostic relevance to various forms of psychopathology. Trait disinhibition and impulsiveness are popular conceptualizations of dispositions reflecting self-regulation of behavioral and emotional responding. In the literature, these constructs are often treated interchangeably because of their shared focus on general disconstraint and a lack of direct comparisons between measures of each. The current work used structural modeling to examine conceptual and empirical differences between 2 popular operationalizations of these traits in 2 samples (Ns = 400, 308), and employed regression and dominance analyses to compare their predictive relations with criterion measures of externalizing problems and negative affectivity (NA). Impulsigenic traits were related both to externalizing problems and NA, whereas trait disinhibition was selectively associated with externalizing. In a dominance analysis, trait disinhibition exhibited complete dominance over all impulsigenic traits in predicting externalizing problems. Conversely, multiple impulsigenic traits evidenced complete dominance over trait disinhibition in prediction of NA. The current work provides evidence that (a) disinhibition and impulsigenic traits are not interchangeable, (b) disinhibition specifically indexes propensity for externalizing problems, and (c) impulsigenic traits reflect a blend of externalizing and NA that appears relevant to diverse forms of psychopathology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Assessing the Toxic Levels in Parenting Behavior and Coping Strategies Implemented During the COVID-19 Pandemic

Assessing the Toxic Levels in Parenting Behavior and Coping Strategies Implemented During the COVID-19 Pandemic

Combined transcranial direct current stimulation and psychological interventions: State of the art and promising perspectives for clinical psychology

Recent literature shows great heterogeneity in the reported efficacy of transcranial direct current stimulation (tDCS) as a stand-alone psychiatric treatment. Aiming to increase its efficacy, tDCS has been combined with psychological interventions. Our state-of-the-art overview of such combined treatment trials indicates, however, that these usually do not elicit synergistic clinical effects. We therefore explored more basic mechanisms related to the brain state-dependency of tDCS. Importantly, based on our overview, the efficacy of combined interventions may depend on whether individual patients present with endophenotypes that are implicated in the development and maintenance of psychopathology, such as prefrontal-mediated cognitive dysfunction. We discuss how future studies may contribute to the development of personally-tailored dual active treatments by adhering to the Research Domain Criteria (RDoC) framework. RDoC-based mechanistic research may reveal alternative neural circuits that should be functionally targeted by both tDCS and psychological interventions, with promising avenues for clinical psychological science and practice.

Introduction to the Special Issue on Clinical Psychology and Behavioral Science: Processes, Principles, and Analytic Strategies

Introduction to the Special Issue on Clinical Psychology and Behavioral Science: Processes, Principles, and Analytic Strategies

Supplemental Material for The Difference Between Trait Disinhibition and Impulsivity—and Why It Matters for Clinical Psychological Science

Supplemental Material for The Difference Between Trait Disinhibition and Impulsivity—and Why It Matters for Clinical Psychological Science

Listen, don't tell: Partnership and adaptation to implement trauma-focused cognitive behavioral therapy in low-resourced settings.

Clinical psychological science has developed many efficacious treatments for diverse emotional and behavioral difficulties encountered by children and adolescents, although randomized trials investigating these treatments have disproportionally been conducted by American, university-based research labs. The subsection of the world population involved in these studies, however, represents very few people among those in need of psychological services whose voices, perspectives, and orientations to therapy have not generally been reflected in well-funded research trials. Dissemination and implementation of evidence-based services designed to meet the needs of this broader global population, therefore, may require cultural and contextual adaptation to be successful. The current article describes the implementation of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in 3 separate low-resourced settings (rural South Carolina, Puerto Rico, and El Salvador) utilizing the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and guided by a community-based participatory research framework. Emphasis is placed on description of program development, building collaborative and responsive partnerships, and the use of implementation strategies to guide continuous quality improvement. Program evaluation data comparing baseline to posttreatment trauma symptoms and treatment completion rates for all sites are also presented, which suggests that treatment was associated with a large reduction in symptoms, exceeding that noted in many TF-CBT randomized trials. The implications of attention to context, adaptation, and methods of building partnerships with global communities are discussed, with a particular focus on propelling more refined models and controlled studies in the future. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Using Evaluative Criteria to Review Youth Anxiety Measures, Part I: Self-Report

Evidence-based assessment serves several critical functions in clinical child psychological science, including being a foundation for evidence-based treatment delivery. In this Evidence Base Update, we provide an evaluative review of the most widely used youth self-report measures assessing anxiety and its disorders. Guided by a set of evaluative criteria (De Los Reyes & Langer, 2018), we rate the measures as Excellent, Good, or Adequate across their psychometric properties (e.g., construct validity). For the eight measures evaluated, most ratings assigned were Good followed by Excellent, and the minority of ratings were Adequate. We view these results overall as positive and encouraging, as they show that these youth anxiety self-report measures can be used with relatively high confidence to accomplish key assessment functions. Recommendations and future directions for further advancements to the evidence base are discussed.

"Best research practices in clinical science: Reflections on the status quo and charting a path forward": Correction to Gruber and Joormann (2020).

Reports an error in "Best research practices in clinical science: Reflections on the status quo and charting a path forward" by June Gruber and Jutta Joormann (Journal of Abnormal Psychology, 2020[Jan], Vol 129[1], 1-4). In the article, an incomplete sentence in the abstract read "This special section aims to take stock of current practices in our field and to reflect on them by providing user-friendly articles on common practices across a variety of methodologies in." The complete sentence is as follows: "This special section aims to take stock of current practices in our field and to reflect on them by providing user-friendly articles on common practices across a variety of methodologies in clinical science." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2019-79779-001.) Clinical psychological science is a rapidly evolving field using a diverse set of methods in various populations. Many of our common research practices and everyday decisions on how and when to use certain methods are described with little detail and formal guidelines and open discussion of those (formal and informal) guidelines is often missing. This special section aims to take stock of current practices in our field and to reflect on them by providing user-friendly articles on common practices across a variety of methodologies in clinical science. The articles cover 4 broad areas: (a) diagnostic and clinical assessment including the importance of interrater reliability, the challenges of extreme group designs, and transdiagnostic approaches; (b) clinical neuroscience research including clinical psychophysiology work and translational neuroscience; (c) research conducted outside the laboratory setting including experience sampling and online studies; and (d) daily research practices. A particular focus is on how the discussed practices apply specifically to psychiatric and at-risk clinical populations and the unique methodological challenges that arise when working with these sensitive populations. The contributors to this special issue represent a diverse group whose efforts target a variety of settings and processes with the ultimate goal of increasing transparency surrounding our everyday decisions about designs, methods, and data analysis. We hope that each of the pieces in this section offer inspiration and provide a resource as well as a starting point for further discussion. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Ambulatory assessment in psychopathology research: A review of recommended reporting guidelines and current practices.

The use of ambulatory assessment (AA; Trull & Ebner-Priemer, 2013) in psychopathology research, which includes experience-sampling methods as well as ecological momentary assessment, has increased dramatically over the last several decades. Previously, methodological and reporting guidelines have been presented to outline best practices and provide input on methodological issues and decisions that are faced when planning and conducting AA studies (e.g., Bolger & Laurenceau, 2013; Mehl & Conner, 2012; Stone & Shiffman, 2002). However, despite the publication of these important resources and guidelines, it remains an open question as to how much uniformity or consistency is evident in the design and reporting of AA studies of psychopathology. To address this, we reviewed the reported practices of published studies using AA in major psychopathology journals (Journal of Abnormal Psychology, Psychological Medicine, Clinical Psychological Science) over the last 7 years (2012-2018). Our review highlights (a) sample selection and size; (b) sampling design; (c) selection and reporting of measures; (d) devices used and software; (e) compliance; (f) participant training, monitoring and remuneration; and (g) data management and analysis. We conclude with recommendations for reporting the features of future AA studies in psychopathology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).