Transdiagnostic Risk Factor Research Articles

Transdiagnostic Risk Factors for Reasons for Smoking: Evaluating the Concurrent Role of Distress Tolerance and Anxiety Sensitivity.

Although rates of cigarette smoking have declined in the US, many individuals report experiencing significant barriers to quitting smoking, including poor mental health. Two prominent affective vulnerability factors that independently underlie both smoking behavior and processes and mental health include distress tolerance and anxiety sensitivity. However, limited work has examined the concurrent role of these factors on motivational reasons for smoking. The current study is a secondary analysis of baseline data from a nationally recruited sample of individuals (N = 156; Mage = 29.74, SD = 7.72; 69.2% female) interested in participating in a digitally delivered intervention for comorbid smoking and low distress tolerance. Two-step hierarchical linear regression was used to examine the unique role of self-reported distress tolerance and anxiety sensitivity in relation to reasons for smoking (i.e., habitual, negative affect reduction, addictive, pleasurable/relaxation, stimulation, and sensorimotor manipulation). Results indicated that lower levels of distress tolerance and greater levels of anxiety sensitivity were associated with greater sensorimotor manipulation reasons for smoking. Only distress tolerance was related to addictive, negative affect reduction, and stimulation reasons for smoking, whereas only anxiety sensitivity was related to habitual reasons for smoking. The current findings suggest that there is an explanatory utility for unique and multi-risk effects for distress tolerance and anxiety sensitivity for understanding smoking motives.

Intolerance of uncertainty and psychosis: A systematic review.

Intolerance of uncertainty, the tendency to interpret and react negatively to uncertainty, is a transdiagnostic risk factor for anxiety, depression and eating-related disorders. Given the high comorbidity between anxiety, depression and schizophrenia-spectrum diagnoses (SSDs), there is potential for intolerance of uncertainty to play a role in modulating psychosis symptoms. To address this gap in our understanding, we conducted the first prospectively registered systematic review on intolerance of uncertainty and psychotic symptoms in both people with SSDs and in the general population. Four databases were searched (PsycINFO, Medline, Web of Science and PubMed), which identified ten studies with a total of 1503 participants that measured intolerance of uncertainty and psychosis symptoms. Key findings suggest the following: (1) Intolerance of uncertainty was associated with total negative psychotic symptoms with small-medium effect sizes; (2) intolerance of uncertainty was higher in individuals with an 'at-risk' mental state for psychosis compared to controls; (3) higher intolerance of uncertainty was associated with more individual psychotic symptoms related to delusions and paranoia within clinical and nonclinical samples; and (4) there was mixed evidence for a relationship between intolerance of uncertainty and auditory hallucinations and intolerance of uncertainty and total positive symptoms in clinical samples. Overall, these findings highlight that intolerance of uncertainty may be an important transdiagnostic dimension and potential treatment target for psychotic symptoms such as delusions and paranoia in people with SSDs.

The relations between impulsivity, opioid use, and nonmedical prescription opioid use motives: An examination within three large urban emergency departments.

Impulsivity is a transdiagnostic risk factor for multiple disorders, including opioid use disorders (OUDs). However, scant work has examined if impulsivity facets distinguish individuals reporting nonmedical opioid use from those who use opioids as prescribed, particularly in important settings such as emergency departments (EDs). Further, no studies, to our knowledge, have examined the relations between impulsivity facets and motives for nonmedical prescription opioid use (NMPOU). Using data from EDs, this study examined if impulsivity facets (assessed via the [negative] urgency, premeditation, perseverance, sensation seeking, and positive urgency) related to nonmedical opioid use and if these facets related to OUD severity among individuals reporting past-year opioid use. Among patients reporting past 3-month NMPOU, the relation between motives for use and impulsivity was examined. Results indicated all facets (except lack of perseverance) distinguished patients reporting nonmedical opioid use from individuals abstaining from opioid use and those who used opioids as prescribed, with particularly large effect sizes for positive and negative urgency. Similarly, among patients reporting past 12-month opioid use, all facets (except lack of perseverance) significantly distinguished individuals who were OUD negative from those with severe OUD, with positive and negative urgency showing the strongest relations. Multiple motives were associated with certain UPPS-P facets, particularly positive urgency, negative urgency, and sensation-seeking. Results suggest that the relation between impulsivity and opioid use characteristics varies across facets of impulsivity, with emotion-based impulsivity being the most relevant. Implications for screening and interventions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A new way to conceptualize intolerance of uncertainty among adolescents: Embracing the network perspective.

Intolerance of uncertainty (IU), a pivotal transdiagnostic risk factor in psychopathology, is defined as a dispositional incapacity to withstand uncertainty distress, driving maladaptive cognitive, emotional and behavioural reactions to uncertainty. However, the intricate interplay among these components, particularly in adolescents, remains underexplored; yet understanding this interplay is crucial for supporting mental health. To address this gap, we employed a network approach to conceptualize IU in 5672 non-clinical Chinese adolescents (Mage = 14.13 years, SDage = 1.96 years, range = 10-19 years, 46.6% boys), combining graphical Gaussian models (GGM) and directed acyclic graphs (DAG). Our analyses revealed a tripartite network comprising cognitive, behavioural and emotional components. Notably, 'frustration' and 'work with hindrance' emerged as key drivers, while 'catastrophizing belief' served as a critical bridge linking different components. These findings underscore the importance of alleviating uncertainty-induced frustration and enhancing coping skills for behavioural impediments to mitigate adolescent IU. Additionally, therapeutic interventions should prioritize modifying and re-evaluating catastrophizing beliefs related to uncertainty.

The relationship between emotion regulation difficulties and eating disorder outcomes: a longitudinal examination in a residential eating disorder treatment facility

ABSTRACT Eating disorders (EDs) are associated with numerous comorbidities and deleterious outcomes (e.g. medical complications, high rates of death by suicide). The complexities of EDs are further compounded by treatment dropout, poor treatment outcomes, and relapse. One way to better understand these complexities is to investigate broad, transdiagnostic risk factors that contribute to the etiology and maintenance of EDs, such as emotion regulation (ER) difficulties. We longitudinally tested the relationship between ER difficulties and ED outcomes in a sample of 101 female ED patients in a southeastern U.S. residential ED treatment facility. Consistent with hypothesis, there were significant improvements in both ER difficulties and eating pathology from admission to discharge. Further, improvement in ER difficulties was associated with improvements in eating pathology. These findings further substantiate the role of ER difficulties in eating disorders and provide further evidence for the relationship between ER difficulties and eating pathology among residential eating disorder patients.

Alexithymia: A Defense of the Original Conceptualization of the Construct and a Critique of the Attention-Appraisal Model.

Our goal was to compare the original conceptualization of the alexithymia construct with the attention-appraisal model, focusing primarily on the removal of the reduced imaginal activity component, a seminal aspect of the construct in the original model. We also examined associations between alexithymia and emotional distress and emotion regulation, attachment, and trauma, and whether alexithymia is a transdiagnostic risk factor. We discuss differences between the models in the treatment of alexithymia and also differences in measurement. We conducted a narrative review of the scientific literature validating the original model of alexithymia and examined the comparatively few empirical studies evaluating the attention-appraisal model. Articles describing contemporary theoretical ideas about the relationship between imagination and emotion were reviewed, as well as studies exploring associations between alexithymia and imaginal activity. The attention-appraisal model of alexithymia is theoretically derived and examined empirically in studies using correlation/measurement-based methods that employed self-report measures with mostly non-clinical samples and conducted primarily by researchers led by developers of the model. The original model of alexithymia is derived from observations of patients in clinical settings; its validity is supported by findings from hundreds of empirical investigations spanning nearly four decades with nonclinical and a variety of clinical samples using both correlation-based and experimental studies and methods of measurement other than self-report, and by independent teams of researchers. The reduced imaginal activity component of the alexithymia construct is mostly supported by these studies. Because of the dearth of studies with clinical samples, the absence of investigations by independent researchers, and the limited range of methods and measurements to evaluate and assess the model, there is insufficient evidence to warrant removal of the imaginal activity component of the alexithymia construct and for replacing the original conceptualization of the construct with the attention-appraisal model.

Pilot implementation of an evidence-based online cognitive behavioural therapy for perfectionism in university students: Lessons learnt.

Higher Education Institutes (HEIs) have been met with an unprecedented demand on their student counselling and wellbeing services in recent years with the impacts of COVID-19 and high rates of mental health concerns amongst student populations. Online mental health programs offer one solution by providing students with quick and easy access to effective therapeutic content. The Focused Minds Program is an evidence-based eight-module online self-guided cognitive behavioural intervention that targets the transdiagnostic risk factor of perfectionism and has been shown to decrease depression, anxiety, and disordered eating. The program was implemented at a UK university between 2021 and 2023. Recruitment occurred via departmental emails, academic staff, and the university's counselling staff and website. Participants were provided with access to the intervention for 6-weeks and completed weekly surveys of psychosocial measures. The trial's implementation was assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework: reach (uptake via the recruitment channels), effectiveness (outcomes on psychometric measures of mental wellbeing), adoption (staff and organisational support), implementation (intervention engagement and attrition), and maintenance (continued implementation across the trial period). Key barriers to successful implementation, as well as proposed solutions, are discussed to guide future online mental health interventions provided in HEIs.

Alexithymia and Personality Pathology.

Alexithymia is an important transdiagnostic risk factor for many psychopathologies. To explore its relevance for personality disorders, we examined the association between alexithymia and maladaptive personality traits, as conceptualized within the DSM-5-TR Alternative Model for Personality Disorders (i.e., negative affect, detachment, antagonism, disinhibition, psychoticism). Participants (N = 651) completed a battery of psychometric questionnaires. Regressions revealed that alexithymia facets accounted for a significant 15% of the variance in negative affect, 22% in detachment, 11% in antagonism, 18% in disinhibition, and 25% in psychoticism. Latent profile analysis showed that profiles with more severe personality pathology were generally characterized by more severe levels of alexithymia. Overall, our data highlight that alexithymia is important in understanding personality dysfunction. All facets of alexithymia, across both positive and negative emotions, are linked to each maladaptive personality trait. The assessment and targeting of alexithymia may therefore be of high relevance for the treatment of personality pathology.

B - 22 Self-Reported Traumatic Brain Injury and its Biopsychosocial Risk Factors in Siblings of Individuals with Neurodevelopmental Conditions

Abstract Objective Siblings of individuals with neurodevelopmental conditions (NDCs) are situated within a complex system of transdiagnostic risk and resilience factors for poor psychosocial, cognitive and behavioral outcomes. Many such factors experienced by NDC siblings overlap with risk for traumatic brain injury (TBI) and correlate with poorer recovery trajectories. Method With data from an online self-report survey, the present study used Bayesian analyses to characterize and compare TBI and biopsychosocial risk factors amongst 632 siblings (207 NDC, 425 controls; mean age 20.54 years, range 10–30, 78.48% female), and examine correlations between clinical, biological, and social determinant of health variables. Results NDC siblings had a higher self-reported lifetime history of TBI compared to controls (14.98% versus 6.35%), with most NDC siblings reporting more than one TBI, and at an earlier mean age. TBI history was associated with psychiatric diagnoses and subclinical NDC features, including hyperactivity and impulsivity, inattention, conduct problems, and autistic traits. Family and structural factors related to TBI included poorer parent–child relationship, NDC diagnoses of autism or fetal alcohol spectrum disorder, minority ethnicity and lower income. Conclusions Findings have important clinical and policy implications for health literacy, TBI education and screening, development of prevention and intervention strategies, and implementation of family support to target social and structural determinants of health impacting NDC sibling wellbeing.

Induced ruminative and mindful self-focus in daily life across the menstrual cycle in women with and without premenstrual dysphoric disorder

Rumination and mindfulness are transdiagnostic risk and protective factors while their role in Premenstrual Dysphoric Disorder (PMDD) is unclear. Thus, we aimed to investigate the cycle-phase-specific effects of rumination and mindful self-focus on momentary mood and cognitions in women with and without PMDD. This study involved brief ambulatory inductions of ruminative and mindful self-focus along with ambulatory assessments of negative (NA) and positive affect (PA), and rumination, present-moment-awareness (PMA) and self-acceptance on two days during both the follicular and late luteal phase in women with and without PMDD (n = 60 each). Compared to healthy controls, women with PMDD showed stronger increases in PA in response to mindful self-focus inductions during the late luteal phase, whereas no such group differences were identified during the follicular phase. Independent of clinical status and cycle phase, induced ruminative self-focus immediately increased momentary NA and rumination and decreased PMA, whereas induced mindful self-focus inductions increased momentary self-acceptance. Overall, higher PA-reactivity toward mindful self-focusing during late luteal phase in women with PMDD points to the potential of cycle-phase-specific mindfulness interventions for PMDD. Irrespective of cycle phase, rumination and mindfulness appear to represent targets for brief prevention and intervention measures for both non-clinical and clinical groups.

Child maltreatment as a transdiagnostic risk factor for the externalizing dimension: a Mendelian randomization study.

Observational studies suggest that child maltreatment increases the risk of externalizing spectrum disorders such as attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), antisocial personality disorder (ASPD), and substance use disorder (SUD). Yet, only few of such associations have been investigated by approaches that provide strong evidence for causation, such as Mendelian Randomization (MR). Establishing causal inference is essential given the growing recognition of gene-environment correlations, which can confound observational research in the context of childhood maltreatment. Evaluating causality between child maltreatment and the externalizing phenotypes, we used genome-wide association study (GWAS) summary data for child maltreatment (143,473 participants), ADHD (20,183 cases; 35,191 controls), CD (451 cases; 256,859 controls), ASPD (381 cases; 252,877 controls), alcohol use disorder (AUD; 13,422 cases; 244,533 controls), opioid use disorder (OUD; 775 cases; 255,921 controls), and cannabinoid use disorder (CUD; 14,080 cases; 343,726 controls). We also generated a latent variable 'common externalizing factor' (EXT) using genomic structural equation modeling. Genetically predicted childhood maltreatment was consistently associated with ADHD (odds ratio [OR], 10.09; 95%-CI, 4.76-21.40; P = 1.63 × 10-09), AUD (OR, 3.72; 95%-CI, 1.85-7.52; P = 2.42 × 10-04), and the EXT (OR, 2.64; 95%-CI, 1.52-4.60; P = 5.80 × 10-04) across the different analyses and pleiotropy-robust methods. A subsequent GWAS on childhood maltreatment and the externalizing dimension from Externalizing Consortium (EXT-CON) confirmed these results. Two of the top five genes with the strongest associations in EXT GWAS, CADM2 and SEMA6D, are also ranked among the top 10 in the EXT-CON. The present results confirm the existence of a common externalizing factor and an increasing vulnerability caused by child maltreatment, with crucial implications for prevention. However, the partly diverging results also indicate that specific influences impact individual phenotypes separately.

A Transdiagnostic Network Analysis of Childhood Trauma and Psychopathology.

Psychiatric comorbidities suggest that symptoms overlap across different diagnoses; the transdiagnostic network approach is valuable for studying psychopathology. Childhood trauma is a common transdiagnostic risk factor for psychiatric disorders, but the complex relationship between childhood trauma and psychopathology has seldom been investigated using a large cross-sectional transdiagnostic sample. This study recruited 869 patients with different diagnoses, including 418 schizophrenia, 215 bipolar disorder, and 236 major depressive disorder. Participants completed psychiatric interviews and self-report questionnaires. We constructed dimension- and item-level Least Absolute Shrinkage and Selection Operator-based (LASSO) networks to explore the relationship between childhood trauma, psychopathology, and duration of illness. Moreover, we constructed directed acyclic graphs (DAGs) to tentatively clarify the potential directions of associations among these variables. Network Comparison Tests (NCTs) were conducted for different diagnostic groups and gender-stratified groups. The transdiagnostic LASSO networks showed that different types of childhood trauma exerted distinct impacts on various psychopathological dimensions. Emotional abuse was linked to depressive symptoms, physical abuse to excited symptoms, sexual abuse to positive and disorganized symptoms, emotional neglect to depressive symptoms and motivation and pleasure (MAP) deficits factor of negative symptoms, and physical neglect to MAP factor. The DAG findings generally concurred with the LASSO network. The NCT showed comparable networks. Our findings suggest that childhood trauma is significantly associated with the development of psychopathology across different diagnostic groups. The affective pathway model suggests that early identification and tailored interventions would be needed for people with a history of childhood trauma.

Personality disorders and their association with adverse childhood events.

Theoretical models of personality disorders (PDs) highlight the role of adverse childhood experiences (ACEs) in the development and maintenance of personality pathology. This review presents recent studies on the associations between childhood adversity and PDs, while discussing mechanisms and factors that impact these relationships. Studies point to small to moderate associations between childhood adversity and cluster A, cluster B and cluster C PDs, and some research suggests that childhood adversity could be a predictor for the onset and development of personality pathology. Most research focuses on borderline PD, while research on other PDs is limited. Some mechanisms that explain these associations have been proposed, with the literature investigating emotion dysregulation, dissociation, avoidance or psychosocial dysfunction as mediators. The consistent associations between ACEs and PDs seems to point that childhood adversity could be a transdiagnostic risk factor for PDs, but research warrants further prospective investigations for causal conclusions, and calls for future research to investigate potential mediators and moderators more thoroughly.

Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic

BackgroundEfforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertainty (IU), a transdiagnostic risk factor for anxiety, may be a particularly relevant vulnerability factor. MethodN = 641 adults with pre-pandemic anxiety data reported their anxiety, IU, and other pandemic and mental health-related variables at least once and up to four times during the COVID-19 pandemic, with assessments beginning in May 2020 through March 2021. ResultsIn preregistered analyses using latent growth models, higher IU at the first pandemic timepoint predicted more severe anxiety, but also a sharper decline in anxiety, across timepoints. This finding was robust to the addition of pre-pandemic anxiety and demographic predictors as covariates (in the full sample) as well as pre-pandemic depression severity (in participants for whom pre-pandemic depression data were available). Younger age, lower self/parent education, and self-reported history of COVID-19 illness at the first pandemic timepoint predicted more severe anxiety across timepoints with strong model fit, but did not predict anxiety trajectory. ConclusionsIU prospectively predicted more severe anxiety but a sharper decrease in anxiety over time during the pandemic, including after adjustment for covariates. IU therefore appears to have unique and specific predictive utility with respect to anxiety in the context of the COVID-19 pandemic.

Bidirectional associations between prolonged grief symptoms and depressive, anxiety, and posttraumatic stress symptoms: A systematic review.

Prolonged grief symptoms frequently co-occur with symptoms of depression, posttraumatic stress, and anxiety; however, little is known about how prolonged grief symptoms temporally relate to symptoms of neighboring stress-related and affective disorders. Clarifying such associations can help elucidate which symptoms to prioritize during treatment for distressed bereaved adults. We conducted a systematic review to provide a comprehensive overview of the empirical research on the bidirectional temporal associations between prolonged grief symptoms and symptoms of depression, posttraumatic stress, and anxiety. A search of the PsycInfo, Web of Science, and Scopus databases (final search: December 2023) identified eight relevant empirical longitudinal studies utilizing lower-level mediation (two studies), cross-lagged panel modeling (CLPM; four studies), or random-intercept CLPM (RI-CLPM; two studies). The studies included a total of 2,914 bereaved adult participants. Studies showed considerable methodological heterogeneity, including different sample characteristics, study designs (e.g., measurement moments, time frames), statistical analyses, and measures. Temporal associations between prolonged grief symptoms and different types of symptoms appeared intertwined. Prolonged grief symptoms more consistently predicted symptoms of depression and posttraumatic stress across measurement waves than vice versa, tentatively suggesting that prolonged grief may be a transdiagnostic risk factor for depressive and PTS symptoms. However, this pattern was not observed in the two studies utilizing RI-CLPM. Future research should aim to decrease methodological heterogeneity by using validated measures to capture prolonged grief symptoms, appropriate timeframes, and RI-CLPM to clarify associations between temporal within-person fluctuations of prolonged grief, depressive, posttraumatic stress, and anxiety symptoms.

Executive Function as an Underlying Mechanism of Alcohol Use, Aggression, and ADHD.

Executive functioning (EF) has been proposed as a transdiagnostic risk factor for externalizing disorders and behavior more broadly, including attention-deficit/hyperactivity disorder (ADHD), aggression, and alcohol use. Previous research has demonstrated both phenotypic and genetic overlap among these behaviors, but has yet to examine EF as a common causal mechanism. The current study examined reciprocal causal associations between EF and several externalizing behaviors using a Mendelian randomization (MR) approach. Two-sample MR was conducted to test causal associations between EF and externalizing behaviors. Summary statistics from several genome-wide association studies (GWASs) were used in these analyses, including GWASs of EF, ADHD diagnostic status, drinks per week, aggressive behavior, and alcohol use disorder (AUD) diagnostic status. Multiple estimation methods were employed to account for horizontal pleiotropy (e.g., inverse variance weighted, MR-PRESSO, MR-MIX). EF demonstrated significant causal relationships with ADHD (P < 0.01), AUD (P < 0.03), and alcohol consumption (P < 0.01) across several estimation methods. Reciprocally, ADHD showed a significant causal influence on EF (P < 0.03). Nonetheless, caution should be used when interpreting these findings as there was some evidence for horizontal pleiotropy in the effect of EF on ADHD and significant heterogeneity in variant effects in the other relations tested. There were no significant findings for aggression. Findings suggest that EF may be a causal mechanism underlying some externalizing behaviors, including ADHD and alcohol use, and that ADHD may also lead to lower performance on EF tasks.

Comparing Transdiagnostic Risk Factors: Predicting Emergence of Significant Depressive, Anxiety, and Substance Abuse Symptoms Among Juvenile Delinquents.

In a 7-year 11-wave study of low-SES adolescents (N = 856, age = 15.98), we compared multiple well-established transdiagnostic risk factors as predictors of first incidence of significant depressive, anxiety, and substance abuse symptoms across the transition from adolescence to adulthood. Risk factors included negative emotionality, emotion regulation ability, social support, gender, history of trauma, parental histories of substance abuse, parental mental health, and socioeconomic status. Machine learning models revealed that negative emotionality was the most important predictor of both depression and anxiety, and emotion regulation ability was the most important predictor of future significant substance abuse. These findings highlight the critical role that dysregulated emotion may play in the development of some of the most prevalent forms of mental illness.

Impulsivity and reward and punishment sensitivity among patients admitted to a specialized inpatient eating disorder treatment program.

Eating disorders (EDs) are conceptualized as disorders of under- and over-control, with impulsivity reflecting under-control. Extant research indicates that impulsivity and related factors such as reward sensitivity and punishment sensitivity may serve as trait-level transdiagnostic risk and/or maintenance factors in EDs. Findings on impulsivity and reward and punishment sensitivity by diagnosis are mixed and research on the relationship between these factors and ED symptoms, hospital course, and treatment outcomes is limited. Participants (N = 228) were patients admitted to a specialized inpatient behavioral treatment program for EDs who agreed to participate in a longitudinal study and completed self-report measures of impulsivity, reward sensitivity, and punishment sensitivity at admission. Weight and ED symptomatology were measured at admission and discharge. Hospital course variables included length of stay and premature treatment dropout. Impulsivity was lower in individuals with anorexia nervosa (AN) restricting type compared to those with AN binge/purge type or bulimia nervosa; no other group differences were observed. Higher impulsivity was associated with greater bulimic symptoms on the Eating Disorder Inventory 2 (EDI-2) at admission. Impulsivity was not related to ED symptoms, weight outcomes, length of hospital stay, or treatment dropout at program discharge. Impulsivity may help distinguish restrictive versus binge/purge EDs, but does not necessarily relate to discharge outcomes in an intensive inpatient ED program. Findings from this study provide novel contributions to the literature on personality traits in EDs and have important clinical implications. Results suggest that patients with higher levels of impulsivity or reward and punishment sensitivity can be expected to respond to inpatient treatment. Suggestions for future research are discussed.

Attentional bias to uncertainty-based information: a conceptual replication of Fergus et al. (2013)

Attentional biases to negative information are often observed in emotional disorders such as anxiety and depression. Recently, Fergus et al. (Cognitive Therapy and Research 37:735-741, 2013) demonstrated that participants scoring high in Intolerance of Uncertainty (IU), a transdiagnostic risk factor for emotional disorders, were faster at identifying targets with uncertainty-based information (e.g., word stimuli such as ‘maybe’), relative to neutral information (e.g. word stimuli related to household items). Moreover, this effect was specific to IU over other anxious traits such as worry. This report aimed to conceptually replicate the results of Fergus et al. (Cognitive Therapy and Research 37:735-741, 2013). The current experiment was conducted with a student sample (n = 126). As in the original study, a visual search task with uncertainty-based and neutral information (e.g., word stimuli) was used. Reaction times were collected. IU and trait anxiety was measured via self-report. We partially replicated the results of Fergus et al. (Cognitive Therapy and Research 37:735-741, 2013). We found that higher IU was significantly associated with faster identification of uncertainty-based information, relative to neutral information. However, we also observed a similar pattern of results for trait anxiety. Additionally, we observed no specificity of IU or trait anxiety in predicting faster identification of uncertainty-based information, relative to neutral information. Despite the lack of specificity of IU or trait anxiety in predicting attentional bias to uncertainty-based information, these findings highlight that negative emotionality may be generally associated with attentional biases to uncertainty-based information in the absence of direct threat.

Perspective taking as a transdiagnostic risk factor for interpersonal dysfunction

ObjectiveNumerous psychiatric populations have demonstrated reduced tendency to adopt others’ perspectives relative to those without psychiatric illness; yet, the clinical implications of these deficits remain unclear. We examined whether impairments in perspective-taking are prospectively associated with symptom severity and functional outcomes in an acute psychiatric sample. We hypothesized that poorer perspective-taking would prospectively predict more severe depressive symptoms, functional impairment, and relationship problems. MethodParticipants were 421 adults seeking psychiatric treatment at a partial hospital program. Participants completed the following self-report questionnaires at admission and discharge: Interpersonal Reactivity Index, Patient Health Questionnaire, Work and Social Adjustment Scale, and Behavior and Symptom Identification Scale. We conducted cross-lagged panel models to estimate directional effects. ResultsConsistent with hypotheses, more frequent perspective-taking was significantly and prospectively associated with less overall functional impairment (β = −0.08, p = 0.04) and fewer relationship problems (β = −0.11, p = 0.02). When modelled together, perspective-taking remained a significant and bidirectional predictor of relationship problems, but not overall functional impairment. Inconsistent with hypotheses, perspective-taking did not prospectively predict depressive symptoms. ConclusionsResults suggest that perspective-taking deficits are uniquely associated with relationship problems among adults with severe mental illness and highlight a potential target for future intervention.