Psychoeducational and Skill-building Interventions for Emotion Dysregulation.

Family psychoeducation plus skill building is a class of interventions considered to be well-established for youth with mood disorders or emotion dysregulation. Psychoeducational psychotherapy (PEP) is an example of this class of interventions. PEP provides psychoeducation for parents and children, skill building to help children better regulate emotions and behaviors, and strategies for parents to better facilitate school-based interventions, develop specific symptom management techniques, and generate coping strategies for the entire family. Evidence is summarized supporting the efficacy of PEP for reducing rage, overall mood symptom severity, disruptive behavior, and executive functioning deficits in youth. Long-term benefits of PEP are discussed.

Anhedonia and the Relationship Between Other Depressive Symptoms and Aggressive Behavior.

Depression has been linked to multiple forms of aggressive behavior in college students; however, it is unclear which aspects of depression explain this connection. Anhedonia, defined as the loss of interest and/or pleasure in previously enjoyed activities, may provide unique information about relationships between depression and aggression. Using cross-sectional data from two independent samples of college students (N = 747 and N = 736 for Study 1 and Study 2, respectively), we examined whether anhedonia helped explain the relationship between broader depressive symptoms and different forms of aggressive and antisocial behavior. Anhedonia accounted for variance in both self-directed aggression and antisocial behavior independent of gender, hostility, anger, other depressive symptoms, and cognitive distortions (Study 2). In addition, there were significant indirect effects of depressive symptoms on self-directed aggression (Studies 1 and 2) and antisocial behavior (Study 2) via anhedonia. Hypotheses involving other-directed aggression received mixed support, with anhedonia atemporally associated with other-directed aggression independent of broader depressive symptoms in Study 1, but not in Study 2. The current findings suggest that anhedonia is an important individual difference that helps explain the relationship between depression and aggressive and antisocial acts and that anhedonia may be differentially associated with various types of aggressive and antisocial behavior.

The current status of temporal network analysis for clinical science: Considerations as the paradigm shifts?

OBJECTIVE: Network analysis in psychology has ushered in a potentially revolutionary way of analyzing clinical data. One novel methodology is in the construction of temporal networks, models that examine directionality between symptoms over time. This paper provides context for how these models are applied to clinically-relevant longitudinal data. METHODS: We provide a survey of statistical and methodological issues involved in temporal network analysis, providing a description of available estimation tools and applications for conducting such analyses. Further, we provide supplemental R code and discuss simulations examining temporal networks that vary in sample size, number of variables, and number of time points. RESULTS: The following packages and software are reviewed: graphicalVAR, mlVAR, gimme, SparseTSCGM, mgm, psychonetrics, and the Mplus dynamic structural equation modeling module. We discuss the utility each procedure has for specific design considerations. CONCLUSION: We conclude with notes on resources for estimating these models, emphasizing how temporal networks best approximate network theory.

Affective Processing Biases in Relation to Past, Current, and Future Depression in Children and Adolescents.

BACKGROUND: The affective go/no-go (AGN) task has been used to assess affective biases in attention set-shifting and deficits in inhibitory control of emotional information among depressed youth, but results have been inconsistent. We aimed to test AGN robustness and clarify temporal relationships between depressive symptoms and affective processing in youth. METHODS: We evaluated AGN performance twice (Time 1 N = 306; Time 2 N = 238) in relation to current, previous, and future depression in the same children/adolescents with depression and those without diagnoses who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Mixed repeated ANCOVAs were powered to detect small-medium group by valence interactions in response latency and errors. Supplemental regression analyses examined depressive symptoms as a continuous variable in relation to AGN performance. RESULTS: No clear pattern emerged, mirroring the broader AGN literature. In primary analyses, group by valence interactions were only observed at one AGN administration; none replicated across administrations. Similarly, in regression analyses depressive symptoms had no relation to affective processing biases/deficits at AGN Time 1, though some relationships were detected between symptoms and AGN Time 2. LIMITATIONS: Relatively few youth met criteria for a depressive disorder, though analyses were appropriately powered and supplemental analyses examined depressive symptoms continuously. Comparison groups were not healthy controls at recruitment but were free from any Axis I disorder at AGN administration. CONCLUSIONS: Given the inconsistency of AGN findings, attention should be focused on tasks that provide more sensitive, robust measures of emotional information processing in depressed youth.

Combined behavioural markers of cognitive biases are associated with anhedonia.

Biases towards negative information, as well as away from positive information, are associated with psychopathology. Examining biases in multiple processes has been theorised to be more predictive than examining bias in any process alone. Anhedonia is a core symptom of psychopathology and predictive of future psychopathological symptoms. Finding that combined biases are associated with anhedonia would advance knowledge of the nature of emotional processing biases and the value of objective performance-based measures for identifying early risk markers. Participants (N = 139) completed tasks that assess latency bias (dot probe) and biased recognition (two-alternative forced-choice) of emotional information, as well as an anhedonia measure. An index was computed for each task's performance reflecting biased processing of positive and negative words. Only combined biases on both tasks were associated with anhedonia. Attentional bias was positively associated with anhedonia, but only when recognition bias for emotional words was high. Thus, assessing biases in multiple domains increased sensitivity to uncover relationships between emotional processing biases and anhedonic symptoms.

Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms.

Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon's Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.

Struggling toward reward: Recent experience of anhedonia interacts with motivation to predict reward pursuit in the face of a stressful manipulation.

Anhedonia, or the loss of interest and/or pleasure, is a core symptom of depression. Individuals experiencing anhedonia have difficulty motivating themselves to pursue rewarding stimuli, which can result in dysfunction. Action orientation is a motivational factor that might interact with anhedonia to potentially buffer against this dysfunction, as action-oriented individuals upregulate positive affect to quickly motivate themselves to complete goals in the face of stress. The Effort-Expenditure for Rewards Task (EEfRT) is a promising new method for examining differences in motivation in individuals experiencing anhedonia. In the EEfRT, participants choose either easier tasks associated with smaller monetary rewards or harder tasks associated with larger monetary rewards. We examined the relationship between action orientation and EEfRT performance following a negative mood induction in a sample with varying levels of anhedonia. There were two competing hypotheses: (1) action orientation would act as a buffer against anhedonia such that action-oriented individuals, regardless of anhedonic symptoms, would be motivated to pursue greater rewards despite stress, or (2) anhedonia would act as a debilitating factor such that individuals with elevated anhedonic symptoms, regardless of action orientation, would not pursue greater rewards. We examined these hypotheses via Generalized Estimating Equations and found an interaction between anhedonia and action orientation. At low levels of anhedonia, action orientation was associated with effort for reward, but this relationship was not present at high levels of anhedonia. Thus, at low levels of anhedonia, action orientation acted as a buffer against stress, but at high levels, anhedonia debilitated action orientation so that it was no longer a promotive factor.

Reward devaluation: Dot-probe meta-analytic evidence of avoidance of positive information in depressed persons.

Cognitive theories of depression and anxiety have traditionally emphasized the role of attentional biases in the processing of negative information. The dot-probe task has been widely used to study this phenomenon. Recent findings suggest that biased processing of positive information might also be an important aspect of developing psychopathological symptoms. However, despite some evidence suggesting persons with symptoms of depression and anxiety may avoid positive information, many dot-probe studies have produced null findings. The present review used conventional and novel meta-analytic methods to evaluate dot-probe attentional biases away from positive information and, for comparison, toward negative information, in depressed and anxious individuals. Results indicated that avoidance of positive information is a real effect exhibiting substantial evidential value among persons experiencing psychopathology, with individuals evidencing primary symptoms of depression clearly demonstrating this effect. Different theoretical explanations for these findings are evaluated, including those positing threat-processing structures, even-handedness, self-regulation, and reward devaluation, with the novel theory of reward devaluation emphasized and expanded. These novel findings and theory suggest that avoidance of prospective reward helps to explain the cause and sustainability of depressed states. Suggestions for future research and methodological advances are discussed.

Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender.

STUDY OBJECTIVES: The purpose of the study was to examine whether insomnia symptoms and nightmares mediated the relation between alcohol use and suicide risk. Further, we examined whether this mediation was moderated by gender. DESIGN: The study consisted of questionnaires administered online examining insomnia symptoms, nightmares, alcohol use, and suicide risk. SETTING: University. PATIENTS OR PARTICIPANTS: 375 undergraduate students at a large, public university in the southeastern United States. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Results indicated that insomnia symptoms significantly mediated the relation between alcohol use and suicide risk; however, this mediation was moderated by gender. For women, there was both a direct effect of alcohol use on suicide risk as well as an indirect effect of alcohol use through insomnia symptoms increasing suicide risk. For men, there was no direct effect of alcohol use on suicide risk, but there was a significant indirect effect of alcohol use increasing suicide risk through insomnia symptoms. Nightmares were not related to alcohol use, and the association between nightmares and suicide risk was found to be independent of alcohol use. CONCLUSIONS: Insomnia symptoms are an important factor in explaining the mechanism by which alcohol use increases suicide risk.

Anhedonia predicts suicidal ideation in a large psychiatric inpatient sample.

This study examined the relationship among symptoms of anhedonia and suicidal ideation at baseline, at termination, and over time in 1529 adult psychiatric inpatients. Anhedonia was associated with suicidality cross-sectionally at baseline and at termination. In addition, change in anhedonia from baseline to termination predicted change in suicidality from baseline to termination, as well as level of suicidality at termination; moreover, anhedonia remained a robust predictor of suicidal ideation independent of cognitive/affective symptoms of depression. Symptom-level analyses also revealed that, even after accounting for the physical aspect of anhedonia (e.g., loss of energy), loss of interest and loss of pleasure were independently associated with higher levels of suicidal ideation at baseline, over time, and at discharge. Loss of interest was most highly predictive of suicidal ideation, providing support for recent differential conceptualizations of anhedonia. Taken together, these findings indicate that the manner in which anhedonia is conceptualized is important in predicting suicidal ideation, and that anhedonia symptoms warrant particular clinical attention in the treatment of suicidal patients.