A Pilot Randomized Controlled Trial of the Family Assessment and Feedback Intervention (FAFI): Effects on Mental Health Literacy and Attitudinal Engagement with Health Supports and Services.

This randomized controlled trial tested the Family Assessment and Feedback Intervention (FAFI), a new intervention to enhance family engagement with emotional and behavioral health services. The FAFI is a guided conversation with families about results of their multidimensional assessment that is set in the context of motivational enhancement. It differs from other assessment-with-feedback interventions by extending the focus of assessment beyond the target child to parents and the family environment, addressing parental emotional and behavioral problems and competencies, spanning a broad range of children's and parents' strengths and difficulties, and being generalizable to many settings and practitioners. Participants were 81 families in primary care pediatrics. The FAFI was associated with a significant increase in parental mental health literacy and with an increase in parental attitudinal engagement with health supports and services that closely approached statistical significance (p = .052), while controlling for children's age and gender and family socioeconomic status.

The Vermont Family Based Approach in Primary Care Pediatrics: Effects on Children's and Parents' Emotional and Behavioral Problems and Parents' Health-Related Quality of Life.

This randomized controlled trial tested the Vermont Family Based Approach (VFBA) in primary care pediatrics. The VFBA is a model of healthcare delivery that shifts the focus from the individual to the family, emphasizes emotional and behavioral health, and uses evidence-based health promotion/prevention along with the treatment of emotional and behavioral problems. Participants were 81 families of 3-15-year-olds. For children, the VFBA was associated with greater reductions than the Control condition on the Child Behavior Checklist Emotionally Reactive, Withdrawn, Sleep Problems, Aggressive Behavior and Total Problems scales. For parents, the VFBA was associated with greater reductions than the Control condition on the Adult Self-Report Anxious/Depressed, Rule-Breaking Behavior, Internalizing Problems and Total Problems scales. The VFBA was also associated with greater improvement than the Control condition in the parents' health-related quality of life, as indicated by all scales of the Medical Outcomes Study Health Survey.

Who is more willing to engage in social rejection? The roles of self-esteem, rejection sensitivity, and negative affect in social rejection decisions.

How do self-schemas and their consequences guide would-be-rejectors? When making decisions about whether to reject, individuals consider the difficulty and emotional consequences of rejecting, and both considerations are likely to involve self-schemas. In three preregistered studies, we examine the roles of self-esteem, rejection sensitivity, and symptoms of depression and anxiety in rejection decisions. In an initial set of studies (N1a = 214, N1b = 264), participants forecast their willingness to reject and their emotional responses in friendship (Study 1a) and romantic (Study 1a-1b) vignettes. In Study 2 (N2 = 259), participants who recently rejected rated that experience on the same measures. Correlates of negative self-schema were associated with negative emotions. Self-esteem, rejection sensitivity, and general distress were associated with forecasted difficulty rejecting, but only anxiety and general distress were associated with retrospectively reported increased difficulty. Taken together, psychological distress may decrease willingness to reject in a way that participants cannot predict.

Exploratory and Confirmatory Bayesian Networks Identify the Central Role of Non-judging in Symptoms of Depression.

OBJECTIVES: Depression is a highly heterogeneous disorder, and meta-analyses of mindfulness-based interventions show moderate efficacy for reducing depressive symptoms. However, the mechanisms governing their efficacy remain unclear, highlighting the need for hypothesis-generating analyses to guide future research. METHODS: We used Bayesian network analysis in three cross-sectional samples (N = 1135) of undergraduates and participants from the community to identify links between individual symptoms of depression and specific facets of mindfulness. In two exploratory studies, we assessed depression using the Patient Health Questionnaire (n = 384) or the Depression Anxiety and Stress Scale (n = 350) and mindfulness using the Five-Facet Mindfulness Scale. RESULTS: Across these samples and measures, exploratory analyses indicated that non-judging was a central bridge between facets of mindfulness and symptoms of depression. We confirmed this finding in a pre-registered replication (n = 401) using a recently developed confirmatory testing framework for network analysis. Non-judging was consistently a central bridge in the networks and specifically linked to the symptoms of depression related to feelings of failure and worthlessness. CONCLUSIONS: These findings provide strong evidence that non-judging is an essential feature of mindfulness in the context of depression and provides direction for future research testing mindfulness-oriented treatment prescriptions for depression. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12671-021-01726-1.

Association between negative cognitive bias and depression: A symptom-level approach.

Cognitive models of depression posit that negatively biased self-referent processing and attention have important roles in the disorder. However, depression is a heterogeneous collection of symptoms and all symptoms are unlikely to be associated with these negative cognitive biases. The current study involved 218 community adults whose depression ranged from no symptoms to clinical levels of depression. Random forest machine learning was used to identify the most important depression symptom predictors of each negative cognitive bias. Depression symptoms were measured with the Beck Depression Inventory-II. Model performance was evaluated using predictive R-squared (Rpred2), the expected variance explained in data not used to train the algorithm, estimated by 10 repetitions of 10-fold cross-validation. Using the self-referent encoding task (SRET), depression symptoms explained 34% to 45% of the variance in negative self-referent processing. The symptoms of sadness, self-dislike, pessimism, feelings of punishment, and indecision were most important. Notably, many depression symptoms made virtually no contribution to this prediction. In contrast, for attention bias for sad stimuli, measured with the dot-probe task using behavioral reaction time (RT) and eye gaze metrics, no reliable symptom predictors were identified. Findings indicate that a symptom-level approach may provide new insights into which symptoms, if any, are associated with negative cognitive biases in depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Effect of cognitive bias modification-memory on depressive symptoms and autobiographical memory bias: two independent studies in high-ruminating and dysphoric samples.

Memory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative memory bias and depressive symptoms was tested in vulnerable samples. We compared positive to neutral (control) CBM-Memory trainings in highly-ruminating individuals (N = 101) and individuals with elevated depressive symptoms (N = 100). In both studies, participants studied positive, neutral, and negative Swahili words paired with their translations. In five study-test blocks, they were then prompted to retrieve either only the positive or neutral translations. Immediately following the training and one week later, we tested cued recall of all translations and autobiographical memory bias; and also measured mood, depressive symptoms, and rumination. Retrieval practice resulted in training-congruent recall both immediately after and one week after the training. Overall, there was no differential decrease in symptoms or difference in autobiographical memory bias between the training conditions. In the dysphoric but not in the high-ruminating sample, the positive training resulted in positive autobiographical bias only in dysphoric individuals with positive pre-existing bias. We conclude that one session of positive retrieval-based CBM-Memory may not be enough to yield symptom change and affect autobiographical memory bias in vulnerable individuals.

Positive imagery training increases positive self-referent cognition in depression.

Depressed adults often show a bias towards negative self-referent processing at the expense of positive self-referent processing. The current study assessed whether a mental imagery intervention (Positive Self Reference Training-PSRT) delivered via the Internet could improve self-referent processing and depressive symptomatology among adults with moderate or greater depression symptoms. Participants were recruited via online methods and randomly assigned to one of two computerized interventions: active PSRT (n=44) or control training (NTC; n=43). The PSRT involved visualizing the self in response to different positive cues (e.g., an achievement) every other day for two weeks. The NTC provided neutral cues about objects. Self-referential processing of positive and negative adjectives and depression symptoms were measured at baseline, one week, and two weeks after initiating training. Over those two weeks, PSRT participants showed a greater increase in positive self-referent processing than did NTC participants. Negative self-referent processing and symptoms of depression declined comparably in both groups. Similarly, for both groups, increase in positive and decrease in negative self-referent processing was associated with a greater reduction in depression. These results indicate that mental imagery has the potential to improve self-referential processing, especially for positive stimuli, which may, in turn, help reduce depressive symptomatology.

Negative self-referential processing is associated with genetic variation in the serotonin transporter-linked polymorphic region (5-HTTLPR): Evidence from two independent studies.

The current research examined whether carriers of the short 5-HTTLPR allele (in SLC6A4), who have been shown to selectively attend to negative information, exhibit a bias towards negative self-referent processing. The self-referent encoding task (SRET) was used to measure self-referential processing of positive and negative adjectives. Ratcliff's diffusion model isolated and extracted decision-making components from SRET responses and reaction times. Across the initial (N = 183) and replication (N = 137) studies, results indicated that short 5-HTTLPR allele carriers more easily categorized negative adjectives as self-referential (i.e., higher drift rate). Further, drift rate was associated with recall of negative self-referential stimuli. Findings across both studies provide further evidence that genetic variation may contribute to the etiology of negatively biased processing of self-referent information. Large scale studies examining the genetic contributions to negative self-referent processing may be warranted.

Determining optimal parameters of the self-referent encoding task: A large-scale examination of self-referent cognition and depression.

[Correction Notice: An Erratum for this article was reported online in Psychological Assessment on Aug 2 2018 (see record 2018-38659-001). In this article, there was an error in how exclusions for one of the three samples were reported, which resulted in inaccurate reporting of how many participants did not have complete data. This error did not change the primary results of the article or the conclusions. However, in the second paragraph of the Participant Attrition and Data Filtering section, the number of exclusions for the adolescent sample should be 301, not 163. As a result, n=408 should read n=270 in the abstract; in paragraph 3 of the Method section; and in the Figure 1 legend. In addition, the correct values for the Adolescents sample reported in Tables 1 and 2 are provided in the erratum.] Although the self-referent encoding task (SRET) is commonly used to measure self-referent cognition in depression, many different SRET metrics can be obtained. The current study used best subsets regression with cross-validation and independent test samples to identify the SRET metrics most reliably associated with depression symptoms in three large samples: a college student sample (n = 572), a sample of adults from Amazon Mechanical Turk (n = 293), and an adolescent sample from a school field study (n = 408). Across all 3 samples, SRET metrics associated most strongly with depression severity included number of words endorsed as self-descriptive and rate of accumulation of information required to decide whether adjectives were self-descriptive (i.e., drift rate). These metrics had strong intratask and split-half reliability and high test-retest reliability across a 1-week period. Recall of SRET stimuli and traditional reaction time (RT) metrics were not robustly associated with depression severity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Specificity and overlap of attention and memory biases in depression.

BACKGROUND: Attentional and memory biases are viewed as crucial cognitive processes underlying symptoms of depression. However, it is still unclear whether these two biases are uniquely related to depression or whether they show substantial overlap. METHODS: We investigated the degree of specificity and overlap of attentional and memory biases for depressotypic stimuli in relation to depression and anxiety by means of meta-analytic commonality analysis. By including four published studies, we considered a pool of 463 healthy and subclinically depressed individuals, different experimental paradigms, and different psychological measures. RESULTS: Memory bias is reliably and strongly related to depression and, specifically, to symptoms of negative mood, worthlessness, feelings of failure, and pessimism. Memory bias for negative information was minimally related to anxiety. Moreover, neither attentional bias nor the overlap between attentional and memory biases were significantly related to depression. LIMITATIONS: Limitations include cross-sectional nature of the study. CONCLUSIONS: Our study showed that, across different paradigms and psychological measures, memory bias (and not attentional bias) represents a primary mechanism in depression.

Sustained engagement of attention is associated with increased negative self-referent processing in major depressive disorder.

This study investigated the link between self-reference and attentional engagement in adults with (n=22) and without (HC; n=24) Major Depressive Disorder (MDD). Event-related potentials (ERPs) were recorded while participants completed the Self-Referent Encoding Task (SRET). MDD participants endorsed significantly fewer positive words and more negative words as self-descriptive than HC participants. A whole-scalp data analysis technique revealed that the MDD participants had larger difference wave (negative words minus positive words) ERP amplitudes from 380 to 1000ms across posterior sites, which positively correlated with number of negative words endorsed. No group differences were observed for earlier attentional components (P1, P2). The results suggest that among adults with MDD, negative stimuli capture attention during later information processing; this engagement is associated with greater self-referent endorsement of negative adjectives. Sustained cognitive engagement for self-referent negative stimuli may be an important target for neurocognitive depression interventions.

Minds "at attention": mindfulness training curbs attentional lapses in military cohorts.

We investigated the impact of mindfulness training (MT) on attentional performance lapses associated with task-unrelated thought (i.e., mind wandering). Periods of persistent and intensive demands may compromise attention and increase off-task thinking. Here, we investigated if MT may mitigate these deleterious effects and promote cognitive resilience in military cohorts enduring a high-demand interval of predeployment training. To better understand which aspects of MT programs are most beneficial, three military cohorts were examined. Two of the three groups were provided MT. One group received an 8-hour, 8-week variant of Mindfulness-based Mind Fitness Training (MMFT) emphasizing engagement in training exercises (training-focused MT, n = 40), a second group received a didactic-focused variant emphasizing content regarding stress and resilience (didactic-focused MT, n = 40), and the third group served as a no-training control (NTC, n = 24). Sustained Attention to Response Task (SART) performance was indexed in all military groups and a no-training civilian group (CIV, n = 45) before (T1) and after (T2) the MT course period. Attentional performance (measured by A', a sensitivity index) was lower in NTC vs. CIV at T2, suggesting that performance suffers after enduring a high-demand predeployment interval relative to a similar time period of civilian life. Yet, there were significantly fewer performance lapses in the military cohorts receiving MT relative to NTC, with training-focused MT outperforming didactic-focused MT at T2. From T1 to T2, A' degraded in NTC and didactic-focused MT but remained stable in training-focused MT and CIV. In sum, while protracted periods of high-demand military training may increase attentional performance lapses, practice-focused MT programs akin to training-focused MT may bolster attentional performance more than didactic-focused programs. As such, training-focused MT programs should be further examined in cohorts experiencing protracted high-demand intervals.

Neural and behavioral measures of error-related cognitive control predict daily coping with stress.

This study tested the hypothesis that individual differences in cognitive control can predict individual differences in emotion regulation. Participants completed color-word and emotional Stroop tasks while an electroencephalogram was recorded, and then they reported daily stressful events, affect, and coping for 14 days. Greater posterror slowing in the emotional Stroop task predicted greater negative affect in response to stressors and less use of task-focused coping as daily stressors increased. Participants whose neural activity best distinguished errors from correct responses tended to show less stress reactivity in daily self-reports. Finally, depression levels predicted daily affect and coping independent of cognitive control variables. The results offer qualified support for an integrated conception of cognitive and emotional self-regulation.

Cognitive control in the intertrial interval: evidence from EEG alpha power.

This study used electroencephalogram (EEG) power spectrum analyses to characterize neural activity during the intertrial interval, a period during which online cognitive adjustments in response to errors or conflict are thought to occur. EEG alpha power was quantified as an inverse index of cerebral activity during the period between each response and the next stimulus in a Stroop task. Alpha power was significantly reduced following error responses compared to correct responses, indicating greater cerebral activity following errors. Reduced alpha power was also observed following Stroop conflict trials compared to no-conflict trials, suggesting that conflict engages processes of mental adjustment. Finally, hemispheric differences in alpha power during the intertrial interval supported the complementary roles of the left and right hemispheres in behavioral activation and inhibition.