Moral Elevation Online Intervention for Veterans Experiencing Distress Related to Posttraumatic Stress Disorder and Moral Injury (MOVED): Pilot Trial of a 4-Week Positive Psychology Web-Based Intervention.

Background: Veterans with posttraumatic stress disorder (PTSD) and moral injury can encounter several barriers to treatment, including limited access to care and low engagement with therapy. Furthermore, most treatment approaches focus on alleviating distress rather than cultivating positive experiences that could facilitate trauma recovery. A potential way to address these issues is through moral elevation: feeling uplifted and inspired by others' virtuous actions.

Interpersonal contrast avoidance as a mechanism for the maintenance of worry.

Despite consistent links between interpersonal problems and worry, mechanisms explaining this relationship remain unknown. The Contrast Avoidance Model (CAM; Newman & Llera, 2011) posits that individuals at risk for chronic worry and generalized anxiety disorder (GAD) fear sudden negative mood shifts, using worry to perpetuate negative moods and avoid these negative emotional contrasts. We propose interpersonal (IP) contrast avoidance (e.

Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts.

Introduction: Generalized anxiety disorder (GAD) is common and disabling. Different versions of cognitive behavioral therapy (CBT) have been tested, but no treatment works for everyone. Therefore, researchers have attempted approaches to enhance CBT.

Big five traits and interpersonal goals during stressors as predictors of hair cortisol.

Background: Hair cortisol concentrations (HCC) provide a biomarker for stress adaptation, which has downstream health consequences. Personality traits (e.g.

Character virtues prospectively predict responses to situational stressors in daily life in clinical and subclinical samples.

Background: Character strengths and virtues may shape responses to stressors and risk for anxious and depressive distress. However, most studies have relied on cross-sectional designs, and it remains unclear whether virtues directly predict distress in daily life or buffer context-specific stressors. We tested whether higher-order (inquisitiveness), (self-control), and virtues (caring) prospectively predicted coping responses and lower symptoms, and moderated effects of specific stressors on distress.

Disgust uniquely predicts coping and interpersonal processes beyond anxiety and dysphoria in the context of naturalistic stressors.

Background: Disgust is theorized to serve a unique function of motivating avoidance of noxious stimuli and setting interpersonal boundaries to prevent contamination. Research has established the relevance of disgust to OCD, posttraumatic stress, and phobias, suggesting transdiagnostic features. However, research has not always accounted for overlap of disgust with other negative emotions, obscuring unique contributions.

Does depression in multiple sclerosis mediate effects of cognitive functioning on quality of life?

Purpose: Patients with multiple sclerosis (MS) are at significant risk for decreased quality of life (QoL), in part due to factors such as cognitive impairment and depression. However, objective versus subjective assessments of cognitive functioning may differentially predict QoL, and it remains unknown whether they each impact QoL through levels of depression. The aims of the present study included (1) testing the effects of cognitive impairment on MS-related QoL via depression symptoms and (2) examining whether perceived and objective cognitive functioning differentially predict QoL through depression.

Gratitude is positively associated with quality of life in multiple sclerosis.

Purpose/objective: Individuals diagnosed with multiple sclerosis (MS) often experience decreased quality of life (QoL), in part attributable to fatigue, depression (Benedict et al., 2005), and cognitive dysfunction (Cutajar et al., 2000).

Direct and Indirect Effects of Trait and State Gratitude on Health-Related Quality of Life in a Prospective Design.

Gratitude has been consistently linked to well-being, but its influence on health-related functioning is not well understood. Furthermore, research suggests the need to differentiate between-person and within-person effects of personality characteristics, and research on gratitude and health has not typically done so. This prospective study aimed to (1) differentiate the unique effects of trait and state gratitude on health-related quality of life (HRQoL) and (2) test state gratitude as a mediator between baseline trait gratitude and subsequent HRQoL.

Compassionate and self-image goals as interpersonal maintenance factors in clinical depression and anxiety.

Objective: Interpersonal models of depression and anxiety have not examined the role of interpersonal goals in shaping relationships and symptoms. Striving to promote/protect desired self-images (self-image goals) may undermine relationships and increase symptoms, whereas striving to support others (compassionate goals) may be protective, but clinical relevance is unknown.

Method: We tested effects of compassionate versus self-image goals on interpersonal functioning and symptoms in clinically depressed and/or anxious participants (N = 47) during 10 days of experience sampling, over a 6-week follow-up, and in a dyadic relationship.

Mediators of compassionate goal intervention effects on human neuroendocrine responses to the Trier Social Stress Test.

Objectives: The hypothalamic-pituitary-adrenal (HPA) axis is thought to mediate the effects of stress on illness. Research has identified a limited number of psychological variables that modulate human HPA responses to stressors (e.g.

Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry.

The factors that maintain generalized anxiety disorder (GAD) symptoms and worry over time are not entirely clear. The Contrast Avoidance Model (CAM) postulates that individuals at risk for pathological worry and GAD symptoms uniquely fear emotional shifts from neutral or positive emotions into negative emotional states, and consequently use worry to maintain negative emotion in order to avoid shifts or blunt the effect of negative contrasts. This model has received support in laboratory experiments, but has not been investigated prospectively in the naturalistic context of daily life.

Interpersonal Problems Predict Differential Response to Cognitive Versus Behavioral Treatment in a Randomized Controlled Trial.

Objective: We examined dimensional interpersonal problems as moderators of cognitive behavioral therapy (CBT) versus its components (cognitive therapy [CT] and behavioral therapy [BT]). We predicted that people with generalized anxiety disorder (GAD) whose interpersonal problems reflected more dominance and intrusiveness would respond best to a relaxation-based BT compared to CT or CBT, based on studies showing that people with personality features associated with a need for autonomy respond best to treatments that are more experiential, concrete, and self-directed compared to therapies involving abstract analysis of one's problems (e.g.

Shifts in Attitudes, Knowledge, and Social Goals in Nursing Students Following Structured Contact With Community-Dwelling Older Adults.

Background: Traditional nursing pedagogies have not systematically addressed the ageist perspectives students bring into training that threaten competent care for older adults. The current study evaluated nursing students' shifts in attitudes, knowledge about aging, and social goals during a program of repeated and structured social interactions with community-dwelling older adults.

Method: Beginning nursing students in pairs met with high-functioning older adults four times over 8 months to provide brief health promotion activities.

Somatic Symptoms Mediate the Relationship Between Health Anxiety and Health-Related Quality of Life over Eight Weeks.

Previous research has indicated that at clinical levels, health anxiety is cross-sectionally correlated with both somatic symptoms and health-related quality of life (HRQOL). However, research has not tested mediational models of how health anxiety may lead to diminished HRQOL prospectively, and more broadly outside of clinical contexts. In the context of an eight-week prospective diary study of 118 subclinical adults, we examined whether somatic symptoms mediate the relationship between health anxiety and both same-week HRQOL and week-to-week change in HRQOL.

Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms.

Worry, social anxiety, and depressive symptoms are dimensions that have each been linked to heterogeneous problems in interpersonal functioning. However, the relationships between these symptoms and interpersonal difficulties remain unclear given that most studies have examined diagnostic categories, not accounted for symptoms' shared variability due to general distress, and investigated only interpersonal problems (neglecting interpersonal traits, interpersonal goals, social behavior in daily life, and reports of significant others). To address these issues, students (Study 1; N=282) endorsed symptoms and interpersonal circumplex measures of traits and problems, as well as event-contingent social behaviors during one week of naturalistic daily interactions (N=184; 7,036 records).

Ambivalence About Interpersonal Problems and Traits Predicts Cross-Situational Variability of Social Behavior.

Multiple theoretical perspectives suggest that maladjusted personality is characterized by not only distress, but also opposing or "ambivalent" self-perceptions and behavioral lability across social interactions. However, the degree to which ambivalence about oneself predicts cross-situational variability in social behavior has not been examined empirically. Using the interpersonal circumplex (IPC) as a nomological framework, the present study investigated the extent to which endorsing opposing or "ambivalent" tendencies on IPC measures predicted variability in social behavior across a range of hypothetical interpersonal scenarios (Part 1; N = 288) and naturalistic social interactions (Part 2; N = 192).

Brief cognitive intervention can modulate neuroendocrine stress responses to the Trier Social Stress Test: buffering effects of a compassionate goal orientation.

Background: The hypothalamic-pituitary-adrenal (HPA) axis is a critical mediator linking stress to health. Understanding how to modulate its reactivity could potentially help reduce the detrimental health effects of HPA axis activation. Social evaluative threat is a potent activator of this system.

A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD).

Background: "Mindfulness-based" interventions show promise for stress reduction in general medical conditions, and initial evidence suggests that they are accepted in trauma-exposed individuals. Mindfulness-based cognitive therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat posttraumatic stress disorder (PTSD).

Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment.

Generalized anxiety disorder (GAD) is associated with substantial personal and societal cost yet is the least successfully treated of the anxiety disorders. In this review, research on clinical features, boundary issues, and naturalistic course, as well as risk factors and maintaining mechanisms (cognitive, biological, neural, interpersonal, and developmental), are presented. A synthesis of these data points to a central role of emotional hyperreactivity, sensitivity to contrasting emotions, and dysfunctional attempts to cope with strong emotional shifts via worry.

Predicting unpredictability: do measures of interpersonal rigidity/flexibility and distress predict intraindividual variability in social perceptions and behavior?

Maladjusted individuals have been theorized to exhibit problematic intraindividual variability of social behavior across situations. This variability is either excessively high (i.e.

Effects of perceived control and cognitive coping on endocrine stress responses to pharmacological activation.

Background: The hypothalamic-pituitary-adrenal (HPA) axis may mediate negative health effects of stress. It is sensitive to cognitive/emotional factors like novelty, perceived control, and coping. Psychological intervention that reduces novelty and enhances cognitive coping and sense of control can reduce cortisol responses to pentagastrin, a pharmacological HPA activator.

Interpersonal and emotional processes in generalized anxiety disorder analogues during social interaction tasks.

Persons with chronic worry and generalized anxiety disorder (GAD) report maladaptive social cognitions, interpersonal behaviors, and emotional regulation. Because research has neither investigated these processes in actual social situations nor explored whether they take heterogeneous forms, the present study provides the first attempt to do so in a laboratory investigation. GAD analogue participants and nonanxious controls interacted with confederates in an unstructured collaborative story construction task and an emotional disclosure task with standardized confederate behavior.

Using Structural Analysis of Social Behavior (SASB) measures of self- and social perception to give interpersonal meaning to symptoms: anxiety as an exemplar.

Current symptom-based diagnosis, although important, lacks theoretical underpinning that might give meaning to psychiatric symptoms. The structural analysis of social behavior (SASB) fills this void, operationalizing interpersonal theory for investigation of relational aspects of psychopathology. To provide an example of how SASB may be utilized to this end, participants with (n = 40) and without (n = 40) uncontrollable worry and anxiety completed SASB Intrex Questionnaires to explore self-perceptions and perceptions of strangers in a social interaction task.

Cognitive behavioral psychotherapy for generalized anxiety disorder: a primer.

Generalized anxiety disorder is a highly debilitating psychologic disorder associated with cognitive, affective, behavioral and physiologic forms of rigidity and dysfunction. Chronic and uncontrollable worry, a future-oriented and highly negative form of verbal thought, is its hallmark symptom. Cognitive behavioral therapy, the most well-established psychologic treatment for generalized anxiety disorder, entails techniques designed to target and reduce dysfunction in each of these mutually interrelating domains.