Guided Self-Help Works: Randomized Waitlist Controlled Trial of Pacifica, a Mobile App Integrating Cognitive Behavioral Therapy and Mindfulness for Stress, Anxiety, and Depression.

Background: Despite substantial improvements in technology and the increased demand for technology-enabled behavioral health tools among consumers, little progress has been made in easing the burden of mental illness. This may be because of the inherent challenges of conducting traditional clinical trials in a rapidly evolving technology landscape.

Objective: This study sought to validate the effectiveness of Pacifica, a popular commercially available app for the self-management of mild-to-moderate stress, anxiety, and depression.

Increased startle potentiation to unpredictable stressors in alcohol dependence: Possible stress neuroadaptation in humans.

Stress plays a key role in addiction etiology and relapse. Rodent models posit that following repeated periods of alcohol and other drug intoxication, compensatory allostatic changes occur in the central nervous system (CNS) circuits involved in behavioral and emotional response to stressors. We examine a predicted manifestation of this neuroadaptation in recently abstinent alcohol-dependent humans.

Exclusion criteria in treatment research on alcohol, tobacco and illicit drug use disorders: A review and critical analysis.

Issues: High rates of exclusion in substance use disorder treatment studies reduce the external validity and clinical utility of research findings to an unknown extent. Accordingly, the current review examined commonly used exclusion criteria and their effect on study samples and outcomes.

Approach: English-language literature was identified by PubMed searches and review of identified articles' reference lists.

Alcohol stress response dampening during imminent versus distal, uncertain threat.

Research indicates that fear and anxiety are distinct processes with separable neurobiological substrates. Predictable versus unpredictable shock administration has been used to elicit fear versus anxiety, respectively. Recent research has demonstrated that alcohol may reduce anxiety but not fear.

Alcohol dose effects on stress response to cued threat vary by threat intensity.

Rationale: Clarification of alcohol's effect on stress response during threat is critical to understand motivation for alcohol use and related alcohol-use disorders. Evaluation of stress response dampening (SRD) effects of alcohol has been limited by nonsystematic use of varied experimental methods and measures.

Objectives: This experiment parametrically varied alcohol dose and shock threat intensity among social drinkers to examine their effects on startle potentiation, a physiological measure of the affective component of the stress response.

Alcohol selectively reduces anxiety but not fear: startle response during unpredictable versus predictable threat.

Recent theory and empirical research have suggested that fear and anxiety are distinct processes with separable neurobiological substrates. Furthermore, a laboratory procedure has been developed to manipulate fear versus anxiety independently via administration of predictable or unpredictable electric shock, respectively. Benzodiazepines appear to selectively reduce anxiety but not fear in this procedure.