Brief family involvement enhances veteran homework quality during trauma-focused psychotherapy.

OBJECTIVE: Homework has been shown to improve outcomes in cognitive-behavioral therapy, though less is known about the importance of homework during trauma-focused psychotherapy. Similarly, prior research suggests family context plays a key role in posttraumatic stress disorder (PTSD)-related distress and treatment engagement. One potential way that families can facilitate better treatment outcomes is by promoting homework engagement. This study examined the impact of a brief family intervention (BFI) for PTSD toward this aim. We hypothesized that veterans with PTSD whose family members (FMs) received the BFI would have better homework completion and quality than those who did not receive the BFI. METHOD: This mixed-methods analysis examined 24 veteran-family dyads enrolled in a randomized clinical trial examining the BFI. All veterans were currently engaged in trauma-focused psychotherapy. Each veteran's clinician rated their homework quality and completion after each therapy session. A subset of dyads also completed semistructured interviews posttreatment. A rapid qualitative analysis approach was used to examine themes in shifting family behavior post-BFI. RESULTS: Quantitative analyses yielded partial support for our hypotheses: those in the BFI condition had significantly higher clinician-rated homework quality. While participants in the BFI condition had a higher homework completion rate, this difference did not reach statistical significance. Qualitative analyses suggested that the BFI prompted meaningful discussions about PTSD and increased FMs' use of supportive (rather than accommodative) behavior when responding to PTSD-related distress. CONCLUSIONS: Involving FMs in PTSD treatment appears to shift the family context in a manner that improves homework quality in veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Transitioning to college: Testing cognitive bias modification for interpretations as an inoculation tool for social anxiety in college first-years.

BACKGROUND AND OBJECTIVES: Reducing social anxiety development among incoming college students may improve college adjustment and mental health outcomes. This study tested whether cognitive bias modification for interpretations (CBM-I) reduces social anxiety and increases adjustment during the transition to college, and whether changes in outcomes would be mediated by changes in interpretation biases. METHODS: Participants (N = 73) were randomly assigned to a 3-session weekly CBM-I condition or symptom tracking (ST) control condition. Multilevel models were used to estimate within-person trajectories from baseline to one week post-intervention and to test whether trajectories differed by condition. RESULTS: Those in the CBM-I condition (vs. ST) reported higher increases in social adjustment across time. There were not significant differences between conditions for changes in social anxiety, academic adjustment, and personal adjustment. CBM-I was indirectly linked to improvements in outcome variables via more adaptive interpretation biases. LIMITATIONS: CBM-I was administered in a laboratory setting, requiring more resources than some computerized interventions. CONCLUSIONS: Data tentatively support CBM-I for first-year students to increase social adjustment. Further, mediation findings provide support for targeting interpretation biases to improve social anxiety and adjustment outcomes. Yet, CBM-I did not outperform ST in improving social anxiety symptoms or other areas of college adjustment, and effect sizes were small, suggesting that more work is needed to amplify the potential of CBM-I as a therapeutic tool.

Why am I craving? The role of elaboration on ambiguous desire states.

Objective: We examined how attributions of broad ambiguous desire symptoms (eg, irritability) and elaborations on specific substances (ie, caffeine/food) influence subsequent self-reported cravings for these substances. Participants: 346 undergraduates were randomized to attribute their ambiguous desire symptoms to a lack of caffeine, food, or a vacation (active control), and then elaborate on the assigned stimulus. There was also a no-elaboration control group. Methods: Generalized Linear Models were used to test whether elaborating on one substance would increase cravings for that substance and decrease craving for the unelaborated substance relative to controls. Results: Participants who elaborated in terms of food reported increased food cravings, whereas participants who elaborated in terms of caffeine reported increased caffeine cravings. Conclusions: Findings suggest that food and caffeine cravings are malleable, and point to the importance of elaboration in polysubstance contexts. Food and caffeine elaborations may matter for heightening craving and determining the targets of craving.

Do you believe in magical thinking? Examining magical thinking as a mediator between obsessive-compulsive belief domains and symptoms.

BACKGROUND: Despite substantial research attention on obsessive beliefs, more research is needed to understand how these beliefs serve as aetiological or maintaining factors for obsessive-compulsive (OC) symptoms. Magical thinking may allow individuals to gain a sense of control when experiencing intrusive thoughts and corresponding obsessive beliefs, potentially accounting for why OC belief domains are often related to OC symptoms. AIMS: This study examines magical thinking as a mediating variable in the relationship between OC belief domains and symptoms. METHOD: Undergraduate students (n = 284) reported their obsessive beliefs, magical thinking, and OC symptoms. RESULTS: As expected, there were significant indirect effects for the belief domain of inflated responsibility and over-estimation of threat on OC symptoms via magical thinking. There was also an indirect effect for the belief domain of importance and control of thoughts on OC symptoms via magical thinking. Unexpectedly, there was no indirect effect involving the belief domain of perfectionism and intolerance of uncertainty. CONCLUSIONS: Magical thinking may be one mechanism through which certain OC beliefs lead to OC symptoms. It may be that magical thinking serves as a coping mechanism in response to elevated beliefs. Future studies should extend these findings across time and clinical samples.