Feeling safe: Judgements of safety and anxiety as a function of worry and intolerance of uncertainty.

Safety perspectives of generalized anxiety disorder (GAD) propose that safety perception is critical to regulating anxiety. Reduced safety processing may contribute to persistent worry and anxiety that extend to recognizably safe contexts. We explored whether individuals higher in worry and intolerance of uncertainty (IU), central characteristics of GAD, display poorer recognition and use of safety cues, and whether safety perception is related to anxiety. One hundred and eighty-two adults were presented with unfolding potentially threatening scenarios, half of which contained safety information. Participants rated how safe and anxiety-provoking each scenario was as they received new information, as well as overall. Using multilevel modeling, results showed that individuals higher in worry and IU recognize safety information and use it to appraise the safety of a situation. A moderate correlation between safety and anxiety ratings, and inconsistent correspondence between ratings of safety and anxiety, suggest this relationship is complicated by additional factors. Individuals higher in worry and IU may have difficulty accepting their safety appraisals in order to inhibit their anxiety. The implications of the findings and future avenues of research are discussed.

A randomized experimental analysis of the attention training technique: Effects on worry and relevant processes in individuals with probable generalized anxiety disorder.

CONTEXT: The Attention Training Technique (ATT, Wells, 1990) is an intervention guiding individuals to focus, shift, and divide their attention in response to sounds presented in an audiorecording. The ATT has long been recommended for generalized anxiety disorder (GAD); however, there is insufficient research on its effects on excessive worry and related processes. OBJECTIVES: This experiment examined whether the ATT is more efficacious than a control intervention at reducing worry and modifying worry-related processes (e.g., attention control, negative metacognitive beliefs, attention bias, mindfulness). PARTICIPANTS: 78 adults with probable GAD. DESIGN: Participants completed measures of worry and worry-related processes at the lab. They then monitored worry and attention daily for a week. Following this baseline, participants recompleted the lab measures and were randomly assigned to ATT or control. Participants listened to their assigned recording once/day for a week while again monitoring worry and attention daily. Participants then recompleted the lab measures. RESULTS: The ATT did not perform better than the control condition on any measure. A variety of improvements were seen over the intervention period in both conditions. CONCLUSIONS: ATT may not have meaningful effects on excessive worry and worry-related processes. Explanations for null findings are offered. CLINICALTRIALS. GOV REGISTRATION: NCT03216382.

Family and Couple Integrated Cognitive-Behavioural Therapy for Adults with OCD: A Meta-Analysis.

Reprinted with permission from Elsevier.

Family and couple integrated cognitive-behavioural therapy for adults with OCD: A meta-analysis.

BACKGROUND: Integrating family into the treatment of obsessive-compulsive disorder (OCD) is standard in pediatric populations; however, in adult populations, patients are typically treated independent of their family. Yet, there is compelling evidence to suggest that family members exacerbate OCD symptoms, and thus there is a strong rationale for integrating family members into the treatment of adult OCD. The present meta-analysis examined whether family treatment is effective for OCD in adult populations as well as moderators of treatment outcome. METHODS: Fifteen studies were reviewed (16 independent samples). RESULTS: Family treatment for adult OCD was found to improve patient OCD symptoms, depression, anxiety, and functional impairment. There was also improvement in patient and family-reported general relationship satisfaction, antagonism, accommodation, and family member's mental health. Individual treatment format and targeting family accommodation were especially beneficial for improving patient depression. Family members reported greater relational improvements than patients. Fewer patient treatment sessions were associated with greater improvement in antagonism, as was female gender. Fewer sessions for family members was associated with greater improvement in family member mental health. FIT outperformed controls with individual ERP on reduction of OCD and depression symptoms, accommodation, and improvement in functional impairment. LIMITATIONS: Limitations of the present review include a relatively small sample size, lenient study inclusion criteria, and the subjectivity of some moderator categories. CONCLUSIONS: Family-integrated treatment appears to be effective for adult OCD, related symptoms, and relationship factors. There is preliminary support that family-integrated treatments lead to better outcomes than individual treatment. Clinical recommendations are discussed.

Field Evaluation of Low-Cost Particulate Matter Sensors for Measuring Wildfire Smoke.

Until recently, air quality impacts from wildfires were predominantly determined based on data from permanent stationary regulatory air pollution monitors. However, low-cost particulate matter (PM) sensors are now widely used by the public as a source of air quality information during wildfires, although their performance during smoke impacted conditions has not been thoroughly evaluated. We collocated three types of low-cost fine PM (PM2.5) sensors with reference instruments near multiple fires in the western and eastern United States (maximum hourly PM2.5 = 295 µg/m3). Sensors were moderately to strongly correlated with reference instruments (hourly averaged r2 = 0.52-0.95), but overpredicted PM2.5 concentrations (normalized root mean square errors, NRMSE = 80-167%). We developed a correction equation for wildfire smoke that reduced the NRMSE to less than 27%. Correction equations were specific to each sensor package, demonstrating the impact of the physical configuration and the algorithm used to translate the size and count information into PM2.5 concentrations. These results suggest the low-cost sensors can fill in the large spatial gaps in monitoring networks near wildfires with mean absolute errors of less than 10 µg/m3 in the hourly PM2.5 concentrations when using a sensor-specific smoke correction equation.

Genomic structure and diversity of Plasmodium falciparum in Southeast Asia reveal recent parasite migration patterns.

Estimates of Plasmodium falciparum migration may inform strategies for malaria elimination. Here we elucidate fine-scale parasite population structure and infer recent migration across Southeast Asia using identity-by-descent (IBD) approaches based on genome-wide single nucleotide polymorphisms called in 1722 samples from 54 districts. IBD estimates are consistent with isolation-by-distance. We observe greater sharing of larger IBD segments between artemisinin-resistant parasites versus sensitive parasites, which is consistent with the recent spread of drug resistance. Our IBD analyses reveal actionable patterns, including isolated parasite populations, which may be prioritized for malaria elimination, as well as asymmetrical migration identifying potential sources and sinks of migrating parasites.

Can Self-Report Measures of Readiness for Change and Treatment Ambivalence Predict Outcomes in Cognitive Behavioral Therapy for Generalized Anxiety Disorder?

Clients with generalized anxiety disorder (GAD) that demonstrate observer-coded treatment ambivalence benefit from the addition of motivational interviewing (MI) to cognitive behavioral therapy (CBT; Button, Westra, Constantino, & Antony, 2016). While observer-coded assessment of ambivalence and readiness for change is resource-intensive, the present study investigates the use of more efficient self-report measures to predict treatment outcomes. Participants (N = 85) with GAD received CBT or MI-CBT and completed self-report measures of readiness for change (Change Questionnaire, Miller & Johnson, 2008) and ambivalence (Treatment Ambivalence Questionnaire, Purdon, Rowa, Gifford, McCabe, & Antony, 2012). Greater self-reported baseline readiness for change was associated with lower posttreatment worry and symptom severity and faster reduction in worry. Self-reported ambivalence was not associated with outcomes. Patients with less concern about adverse consequences of treatment who received CBT experienced greater increases in readiness for change than those receiving MI-CBT. We discuss implications for using these measures in clinical settings.

Clinical Perfectionism, Dissatisfaction With Standards, and Raising the Bar: Validation of the Response to Goal Achievement Scale.

OBJECTIVES: To examine the factor structure and psychometrics of a new self-report scale measuring cognitive and behavioral reactions to goal achievement (Reactions to Goal Achievement Scale; RGAS), and to examine its relationship to other measures of clinical perfectionism in two samples. Self-reported reasons for setting higher standards following successful goal achievement were also examined. METHODS: The RGAS, Clinical Perfectionism Questionnaire (CPQ) and Frost Multidimensional Perfectionism Scale (FMPS) were administered to a sample on Amazon Mechanical Turk (N = 264) and to a sample of overweight individuals (N = 65). RESULTS: Exploratory and confirmatory factor analyses suggested two factors, entitled dissatisfaction with success (DS) and increase in standards (IS). The RGAS was associated with subscales of the CPQ and FMPS. In addition, participants indicated many reasons for setting higher standards following success. CONCLUSION: The RGAS is a new instrument for measuring both cognitive and behavioral responses to success in clinical perfectionism. Setting higher standards may not be an indication of perfectionism, as there appear to be many reasons people set higher standards.