State and Trait Disgust Uniquely Predict Avoidance in Contamination Fear: Specificity of Disease-Specific and Nonspecific Individual Differences.

Although behavioral avoidance is observed among those with heightened contamination concerns, the extent to which such avoidance is best predicted by state and/or trait characteristics is unclear. Furthermore, while disgust proneness is a disease-specific trait that has been shown to predict avoidance among those with symptoms of contamination-based obsessive-compulsive disorder (OCD), it is unclear if other disease-specific traits may also serve a similar function. In the present study, contamination-fearful participants (N = 89) first completed self-report measures of disease-specific (disgust proneness, health anxiety, perceived vulnerability to disease) and disease-nonspecific (intolerance of uncertainty, trait anxiety) traits.

Changes in hoarding-related beliefs and associated neural changes during a simulated discarding task after cognitive-behavioral treatment for hoarding disorder.

Hoarding disorder (HD) is maintained by maladaptive beliefs about possessions, and recent research has demonstrated that changes in these beliefs partially mediate improvement in cognitive-behavioral therapy (CBT) for hoarding. It is not yet known whether changes in neural activity, particularly when discarding possessions, are associated with cognitive change during CBT for HD. Adults who completed group CBT for HD (N = 58) participated in a simulated discarding task before and after CBT.

The relationship between momentary experiential avoidance and anxiety symptoms.

Background: Experiential avoidance (EA) may serve as a risk factor for a wide range of anxiety-related psychopathology. Anxiety is thought to trigger the use of EA, while also serving as a consequence of EA efforts. Previous ecological momentary assessment (EMA) studies found that EA was associated with greater anxiety in nonclinical undergraduates and patients with social anxiety disorder.

Availability and consumption of hyper-palatable foods in an all-you-can-eat cafeteria among college freshmen.

Introduction: College campuses provide an expansive food environment, which may contribute to elevated risk of excess energy intake and weight gain among college students. All-you-can-eat style cafeterias often expose students to hyper-palatable foods (HPF), which may promote overeating. This study aimed to examine the availability of HPF in an all-you-can-eat college cafeteria, and to examine HPF intake during meals among undergraduates.

Cognitive-Behavioral Therapy Enhancement Strategies.

We review the literature on various strategies to augment cognitive-behavioral therapy (CBT). Although traditional pharmacotherapy has only a small additive effect, research demonstrates that it is possible to select interventions that potentiate known mechanisms of CBT. D-cycloserine appears to potentiate activity at the N-methyl D-ethyl aspartate receptor and thereby facilitates fear extinction.

Reductions in Anxiety are Associated with Decreased Expressive Suppression and Increased Cognitive Reappraisal After Cognitive-Behavioral Treatment: A Naturalistic Study in Youth.

Broad deficits in emotion regulation skills have been observed in children with anxiety-related disorders. These deficits typically improve during cognitive-behavioral therapy (CBT), but few studies have examined changes in expressive suppression and cognitive reappraisal in youth with anxiety disorders and/or obsessive-compulsive disorder (OCD) during CBT, especially in real-world settings. In a naturalistic treatment-seeking sample, 123 youth completed measures of anxiety, depression, and emotion regulation strategy use before and after 15 sessions of CBT.

Linking a latent variable trait-state-occasion model of emotion regulation to cognitive control.

Emotion dysregulation (ED) is a vulnerability factor for affective disorders that may originate from deficits in cognitive control (CC). Although measures of ED are often designed to assess trait-like tendencies, the extent to which such measures capture a time-varying (TV) or state-like construct versus a time-invariant (TI) or trait-like personality characteristic is unclear. The link between the TV and TI components of ED and CC is also unclear.

Psychometric properties of a daily obsessive-compulsive symptom scale for ecological momentary assessment.

Despite growing interest in ecological momentary assessment (EMA) in psychopathology and clinical observation of day-to-day fluctuations in obsessive-compulsive disorder (OCD) symptoms, there is not a standardized EMA measure of such symptoms that can guide systematic research. In the absence of such a measure, prior EMA research in OCD has utilized heterogeneous approaches to sampling momentary and daily OCD symptoms, which limits the ability to compare results between studies. The present study sought to examine the psychometric properties of a daily OCD symptom (d-OCS) measure that assesses common OCD symptom themes (e.

Intolerance of Uncertainty as a Cognitive Vulnerability for Obsessive-Compulsive Disorder: A Qualitative Review.

Intolerance of uncertainty (IU) is the tendency to react negatively to uncertain situations. In this review, we critically evaluate the evidence for IU as a cognitive vulnerability for obsessive-compulsive disorder (OCD), including (a) evidence for a robust association between IU and OCD symptoms, (b) evidence that IU is stable and trait-like, (c) evidence for IU as a causal risk factor that influences the development of OCD directly or indirectly, and (d) evidence that IU is malleable to intervention. The available evidence suggests that IU is likely a candidate cognitive vulnerability factor for OCD, though additional research is needed to determine if increasing tolerance for uncertainty is a mechanism of effective OCD treatment.

Linking repetitive negative thinking and insomnia symptoms: A longitudinal trait-state model.

Sleep disturbance is highly debilitating, and an abundance of research suggests that repetitive negative thinking (i.e., rumination, worry) may contribute to the development and maintenance of maladaptive sleep patterns, such as insomnia symptoms.

Facing Uncertainty: A Comparison of Hierarchical and Variable Exposure Interventions for Contamination Fear.

Consistent with the inhibitory retrieval approach, one proposed modification to improve the effectiveness of exposure-based interventions is to maximize variability by not proceeding linearly up an exposure hierarchy. Accordingly, the present study compares hierarchical and variable exposure interventions for contamination-fearful individuals and examines the role of uncertainty to predict intervention outcomes. Participants (=73) were randomly assigned to complete a single-session exposure intervention using a standard hierarchy or a variable exposure intervention in which hierarchy items were randomly presented.

Linking the Estimation of Threat and COVID-19 Fear and Safety Behavior Use: Does Intolerance of Uncertainty Matter?

Research has shown threat overestimation is significantly associated with intolerance of uncertainty (IU), and both processes predict higher anxiety and safety behavior usage. However, the extent to which threat overestimation predicts subsequent COVID-19-related distress may vary as a function of IU. The present study examined IU as a moderator of the relationship between COVID-19 threat estimation and subsequent COVID-19 fear and safety behavior use.

Mechanisms of Action in Exposure Therapy.

Purpose Of Review: Exposure therapy is an effective treatment for anxiety-related disorders, but many individuals do not achieve full symptom relief, and return of fear is a common occurrence. Understanding how exposure therapy works enables further development of strategies to improve its effectiveness.

Recent Findings: Recent studies have examined mechanisms of exposure-based interventions across multiple levels of analysis, from cognitive and behavioral changes that occur during treatment to the neurobiological mechanisms underlying fear extinction.

Obsessive-Compulsive Disorder and Illness Anxiety: Examining Commonalities and Comorbidity.

Obsessive-compulsive disorder (OCD) and illness anxiety disorder (IAD) often co-occur. Cognitive-behavioral models of both disorders overlap and include maladaptive attentional processes, misinterpretation of thoughts and physical sensations, and engagement in repetitive behaviors in an attempt to reduce associated distress. Given commonalities in their presentation and their common co-occurrence, it is important to understand how illness anxiety affects the presentation and treatment of OCD.

Time-Varying and Time-Invariant Dimensions in Intolerance of Uncertainty: Specificity in the Prediction of Obsessive-Compulsive Symptoms.

Intolerance of uncertainty (IU) is the tendency to respond negatively toward uncertain situations. IU consists of a Prospective factor (desire for predictability) and an Inhibitory factor (uncertainty paralysis) and is central to theoretical approaches to obsessive-compulsive disorder (OCD). However, time-invariant (TI) and time-varying (TV) components of IU and their association with OCD symptoms are not yet understood.

A longitudinal trait-state model of attentional control: Implications for repetitive negative thinking.

Background: Attentional control refers to the ability to direct, focus, and shift attention voluntarily, and poor attentional control may confer risk for various affective disorders by increasing repetitive negative thinking. Although attentional control has been described as a trait, it is unclear if it is a time-varying (TV) or state-like factor versus a time-invariant (TI) or trait-like personality characteristic.

Methods: In a 6-wave, 5-month longitudinal study, community participants (n = 1,251) completed the Attentional Control Scale (Derryberry & Reed, 2002), the most commonly used measure of attentional control that includes two components: Focusing and Shifting.

Anxiety and safety behavior usage during the COVID-19 pandemic: The prospective role of contamination fear.

The coronavirus (COVID-19) pandemic has broadly increased anxiety and changed individual behavior. However, there is limited research examining predictors of pandemic-related changes, and the majority of existing research is cross-sectional in nature, which limits causal inference. Given functional links with disease avoidance processes, individual differences in contamination fear may be especially relevant in predicting responses to COVID-19.

Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory.

The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses.

Anger Rumination is not Uniquely Characteristic of Obsessive-Compulsive Disorder.

Although anger has been observed in obsessive-compulsive disorder (OCD), it remains unclear if rumination about anger is characteristic and/or unique to OCD. The present study examines whether types of anger rumination are endorsed more strongly by OCD patients compared to clinical and nonclinical controls. Patients with OCD ( = 30), generalized anxiety disorder (GAD; = 29), and non-clinical controls (NCC; = 30) completed measures of OCD symptoms, anger rumination, and trait anxiety.

Enhancing Inhibitory Learning: The Utility of Variability in Exposure.

Exposure therapy has strong empirical support as a treatment for anxiety and related disorders, yet not all participants see clinically meaningful reduction in symptoms, and some experience return of fear. In this review, we examine the theoretical models of exposure therapy, from early precursors to the contemporary inhibitory learning model. The inhibitory learning model is applied to examine one potential method of improving outcomes in exposure therapy: increasing variability in the progression of the exposure hierarchy.

Disgust in Anxiety and Obsessive-Compulsive Disorders: Recent Findings and Future Directions.

Purpose Of Review: In the past 20 years, the role of disgust in anxiety disorders and obsessive-compulsive disorder (OCD) has been investigated with increasing precision. In this review, we examine recent evidence implicating disgust in anxiety and OCD, highlighting recent measurement and methodological improvements. Specific emphasis is placed on understanding the mechanisms that may account for the role of disgust in OCD and related disorders.

Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans.

Objective: Comorbidity is the rule and not the exception among veterans with posttraumatic stress disorder (PTSD). Examining comorbidities in a veteran population allows us to better understand veterans' symptoms and recognize when mental health treatment may need to be tailored to other co-occurring issues. This article evaluates comorbid mood and anxiety disorders and PTSD symptom severity in a large sample of veterans from multiple eras of service, including the recent wars in Iraq and Afghanistan.

Effects of exposure to erotica on disgust: A preliminary test among contamination-fearful individuals.

Disgust has been implicated in the fear of contamination that is commonly observed in obsessive-compulsive disorder (OCD). However, basic and treatment-oriented research has shown that disgust is resistant to extinction among those with a fear of contamination. Consequently, there is growing interest in discovering novel approaches to targeting heightened disgust responding among those with OCD.

Cognitive mechanisms of disgust in the development and maintenance of psychopathology: A qualitative review and synthesis.

A growing body of research has implicated disgust in various psychopathologies, especially anxiety-related disorders. Although the observed role of disgust in many disorders is robust, the mechanisms that may explain this role are unclear. Cutting-edge research in cognitive science has the potential to elucidate such mechanisms and consequently improve our understanding of how disgust contributes to the etiology and maintenance of psychopathology.

Temporal Sequencing of Change in Posttraumatic Cognitions and PTSD Symptom Reduction During Prolonged Exposure Therapy.

Prolonged exposure (PE) effectively reduces negative cognitions about self, world, and self-blame associated with posttraumatic stress disorder (PTSD), with changes in posttraumatic cognitions being associated with reductions in PTSD symptoms (Foa & Rauch, 2004). Further, recent research has demonstrated that cognitive change is a likely mechanism for PTSD symptom reduction in PE (Zalta et al., 2014).