Assessment and Disruption of Ruminative Episodes to Enhance Mobile Cognitive Behavioral Therapy Just-in-Time Adaptive Interventions in Clinical Depression: Pilot Randomized Controlled Trial.

BACKGROUND: A just-in-time adaptive intervention (JITAI) is "designed to address the dynamically changing needs of individuals via the provision of the type or amount of support needed, at the right time when needed." If and how rumination-focused cognitive behavioral therapy (RFCBT), the gold standard, blocks emotional cascades underlying rumination is unclear. Furthermore, cognitive behavioral therapy has been successfully used as a mobile variant, but RFCBT has not been adapted for a mobile variant (mobile RFCBT [MRFCBT]) or for a JITAI variant. OBJECTIVE: This study aimed to pilot-test a fully automated JITAI leveraging RFCBT and ways to identify and block cascading depressive rumination. METHODS: Patients in therapy for clinical depression were recruited for a randomized controlled trial (RCT). After consenting to be part of the RCT, they were randomly assigned to either of the 2 mobile versions of the RFCBT conditions personalized to the individual's rumination timing patterns (JITAI-MRFCBT) or a no-treatment control condition through a double-blind procedure. Although the initial design was to have a 3-armed trial with 2 JITAI conditions (a JITAI and a narrative JITAI condition), we later opted to collapse those 2 conditions into 1 JITAI condition because of the low number of participants. All participants were recruited and participated through their smartphones, receiving 5 SMS text message reminders on each of the 35 days to self-report their rumination-related symptoms (eg, rumination episodes and duration). In the JITAI-MRFCBT condition, they also received treatment materials. The first 7 days provided a rumination baseline, and the last 7 days provided a postintervention rumination value. In total, 42% (25/59) of volunteers were eligible and provided their phone numbers, 20% (5/25) of whom never replied to the SMS text message reminding them to start the RCT. A total of 90% (18/20) of volunteers completed it (ie, finishing, as prespecified, 80% of the questionnaires and training tasks) and, therefore, were included in the analysis. RESULTS: Using independent 2-tailed t tests with bootstrapping, results showed that participants in the JITAI-MRFCBT condition, compared with those in the control condition, reported a greater reduction in counts of rumination episodes (mean -25.28, SD 14.50 vs mean 1.44, SD 4.12, P<.001) and greater reduced average time (minutes) spent in rumination (mean -21.53, SD 17.6 vs mean 1.47, SD 1.5; P=.04). Results also suggest that, compared with those in the control group, those in treatment reduced ruminative carryover from one episode to the next. CONCLUSIONS: The results suggest that JITAI-MRFCBT may reduce negative rumination by providing RFCBT just in time following rumination, thereby blocking the next rumination episode using the same trigger. This study supports a subsequent, full-scale JITAI and the importance of leveraging mobile smartphone technology with MRFCBT to curb depressive symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT04554706; https://clinicaltrials.gov/ct2/show/NCT04554706.

Behavioral regulation relies on interacting forces and predictive models.

OBJECTIVE: We discuss how our recent neural network model of personality and motivation can explain many aspects of the regulation of behavior. METHOD: Contrary to approaches that focus on a goal-corrected, set-point, and discrepancy-reducing mechanism, we argue that many aspects of regulation can be understood in terms of two other mechanisms. First, many aspects of the stability and coherence of personality, as well as the dynamics of personality, can be understood in terms of the interaction of forces within organized motivational systems, and their interaction with features of the environment and interoceptive states, that identify an individual's current needs. This has been described as a settling point or equilibrium of forces model, rather than a set-point architecture. Second, regulation has been shown to depend also on the use of predictive models of the world, either learned or innate. Such models can be thought of as feedforward models, in contrast to the feedback models characteristic of set-point, goal-corrected systems. RESULTS AND CONCLUSIONS: We describe a neural network model of these processes that simulates the behavior over time and situations of an individual and shows how important regulatory processes can operate through a process of interactive forces and predictive models of the world.

Artificial light at night correlates with seabird groundings: mapping city lights near a seabird breeding hotspot.

Artificial light at night (ALAN) is a growing conservation concern for seabirds, which can become disoriented and grounded by lights from buildings, bridges and boats. Many fledgling seabirds, especially Procellariiformes such as petrels and shearwaters, are susceptible to light pollution. The Hauraki Gulf, a seabird hotspot located near Tamaki Makaurau/Auckland, Aotearoa-New Zealand's largest urban city, with a considerable amount of light pollution and regularly documented events of seabird groundings. We aim to identify the characteristics of locations especially prone to seabird groundings. We used an online database of seabirds taken to a wildlife rescue facility by the public to map 3 years of seabird groundings and test for correlations between seabird groundings and the natural night sky brightness. We found that areas with lower amounts of natural night sky brightness and greater light pollution often had a higher number of seabirds grounded. Further, we identified important seasonal patterns and species differences in groundings. Such differences may be a by-product of species ecology, visual ecology and breeding locations, all of which may influence attraction to lights. In general, seabird groundings correlate with the brightness of the area and are species-specific. Groundings may not be indicative of human or seabird population abundance considering some areas have a lower human population with high light levels and had high amounts of seabird groundings. These findings can be applied worldwide to mitigate groundings by searching and targeting specific brightly lit anthropogenic structures. Those targeted structures and areas can then be the focus of light mitigation efforts to reduce seabird groundings. Finally, this study illustrates how a combination of community science, and a concern for seabirds grounded from light attraction, in addition to detailed animal welfare data and natural night sky brightness data can be a powerful, collaborative tool to aid global conservation efforts for highly-at-risk animals such as seabirds.

"I Want to Be Alone, but I Don't Want to Be Lonely": Uncertainty Management Regarding Social Situations among College Students with Social Anxiety Disorder.

Individuals with social anxiety disorder (iSAD) experience adverse outcomes in daily life due to the disorder (e.g., lower educational and work achievement compared to their healthy counterparts). They are prone to social isolation, even though they desire intimate interpersonal relationships. Yet, little research on iSAD is devoted to understanding in detail a) when they interpret social situations as social-anxiety-provoking, b) how this interpretation motivates their assessments of their efficacy and likely interaction outcomes, and c) how they choose specific information-seeking strategies in uncertain social situations. Leveraging the theory of motivated information management (TMIM) and the emotional systems (ES) model, we explored the lived experiences of iSAD. We conducted in-depth interviews (N = 27) and analyzed them using thematic analysis. iSAD perceived discrepancies in a) mutual goals, b) common ground, and c) self-image as social-anxiety-provoking. These interpretations motivated their assessments of a) socializing benefits, b) communication competency, and c) interactant partner's amiability, which led to a mix of information-seeking decisions in social situations. Practical and theoretical implications for future research are discussed.

Protean Kinematics: A Blended Model of VR Physics.

Avatar research largely focuses on the effects of the appearance and external characteristics of avatars, but may also warrant further consideration of the effects of avatar movement characteristics. With Protean kinematics, we offer an expansion the avatar-user appearances-based effects of the Proteus Effect to a systematic exploration into the role of movement in affecting social perceptions (about others) and idealized perceptions (about self). This work presents both a theoretical (typology) and methodological (physics-based measurement) approach to understanding the complex blend of physical inputs and virtual outputs that occur in the perceptual experience of VR, particularly in consideration of the collection of hippocampal (e.g., place cells, grid cells) and entorhinal neurons (e.g., speed cells) that fire topologically relative to physical movement in physical space. Offered is a novel method that distills the blend of physical and virtual kinematics to contribute to modern understandings of human-agent interaction and cognitive psychology.

User-Agent Bond in Generalizable Environments: Long-Term Risk-Reduction via Nudged Virtual Choices.

Avatars or agents are digitized self-representations of a player in mediated environments. While using agents to navigate through mediated environments, players form bonds with their self-agents or characters, a process referred to as identification. Identification can involve automatic, but temporary, self-concept "shifts in implicit self-perceptions" (Klimmt et al., 2010, p. 323) of the media user by adopting or emphasizing the action choices on behalf of the social expectation of the avatar in the mediated environment. In the current study, we test the possibility that users' identification with video game avatars-a bond built between avatars and players- would account for subsequent behavior changes. We did so by using 3-month longitudinal data involving a narratively-based serious game: Socially Optimized Learning in Virtual Environments (SOLVE), a 3D-interactive game designed to reduce risky sexual behaviors among young men who have sex with men (n = 444). Results show that video game identification predicts both the reduction of risky sexual behaviors over time, and reduction in the number of non-primary partners with whom risky sex occurs. And when players identify with the game character, they tend to make healthier choices, which significantly mediates the link between video game identification and reduction of risky behaviors.

The Structure of Social Support in Confidant Networks: Implications for Depression.

Social support differs for depressed and non-depressed individuals. However, the structural features of social supports, as represented via social networks and how they are related to depression, and its mitigation, are unclear. Here, we examine associations between personal support network structures and self-reports of depression and depression mitigation behaviors. Cross-sectional data were collected from participants (n = 1002 adults) recruited from a research volunteer website. Personal support networks were elicited by asking participants to nominate up to six people (i.e., confidants) that they talk to about interpersonal problems (e.g., unpleasant social encounters) and to indicate who knows whom among their confidants. Results show that the confidant networks of depressed and non-depressed participants did not differ in network size or in constraint-i.e., the degree to which confidants' ties overlap with the ties of the participant. However, depressed participants' confidants had significantly fewer average ties with one another (mean degree). Irrespective of depression diagnosis, lower network constraint and size predicted greater engagement in depression mitigation behaviors. That is, having relatively large confidant networks within which one can freely navigate one's personal information can contribute to improvement in depressive outcomes. Implications are further discussed in the discussion section.

The utilization of advance telemetry to investigate critical physiological parameters including electroencephalography in cynomolgus macaques following aerosol challenge with eastern equine encephalitis virus.

Most alphaviruses are mosquito-borne and can cause severe disease in humans and domesticated animals. In North America, eastern equine encephalitis virus (EEEV) is an important human pathogen with case fatality rates of 30-90%. Currently, there are no therapeutics or vaccines to treat and/or prevent human infection. One critical impediment in countermeasure development is the lack of insight into clinically relevant parameters in a susceptible animal model. This study examined the disease course of EEEV in a cynomolgus macaque model utilizing advanced telemetry technology to continuously and simultaneously measure temperature, respiration, activity, heart rate, blood pressure, electrocardiogram (ECG), and electroencephalography (EEG) following an aerosol challenge at 7.0 log10 PFU. Following challenge, all parameters were rapidly and substantially altered with peak alterations from baseline ranged as follows: temperature (+3.0-4.2°C), respiration rate (+56-128%), activity (-15-76% daytime and +5-22% nighttime), heart rate (+67-190%), systolic (+44-67%) and diastolic blood pressure (+45-80%). Cardiac abnormalities comprised of alterations in QRS and PR duration, QTc Bazett, T wave morphology, amplitude of the QRS complex, and sinoatrial arrest. An unexpected finding of the study was the first documented evidence of a critical cardiac event as an immediate cause of euthanasia in one NHP. All brain waves were rapidly (~12-24 hpi) and profoundly altered with increases of up to 6,800% and severe diffuse slowing of all waves with decreases of ~99%. Lastly, all NHPs exhibited disruption of the circadian rhythm, sleep, and food/fluid intake. Accordingly, all NHPs met the euthanasia criteria by ~106-140 hpi. This is the first of its kind study utilizing state of the art telemetry to investigate multiple clinical parameters relevant to human EEEV infection in a susceptible cynomolgus macaque model. The study provides critical insights into EEEV pathogenesis and the parameters identified will improve animal model development to facilitate rapid evaluation of vaccines and therapeutics.

Modeling mosquito-borne and sexual transmission of Zika virus in an enzootic host, the African green monkey.

Mosquito-borne and sexual transmission of Zika virus (ZIKV), a TORCH pathogen, recently initiated a series of large epidemics throughout the Tropics. Animal models are necessary to determine transmission risk and study pathogenesis, as well screen antivirals and vaccine candidates. In this study, we modeled mosquito and sexual transmission of ZIKV in the African green monkey (AGM). Following subcutaneous, intravaginal or intrarectal inoculation of AGMs with ZIKV, we determined the transmission potential and infection dynamics of the virus. AGMs inoculated by all three transmission routes exhibited viremia and viral shedding followed by strong virus neutralizing antibody responses, in the absence of clinical illness. All four of the subcutaneously inoculated AGMs became infected (mean peak viremia: 2.9 log10 PFU/mL, mean duration: 4.3 days) and vRNA was detected in their oral swabs, with infectious virus being detected in a subset of these specimens. Although all four of the intravaginally inoculated AGMs developed virus neutralizing antibody responses, only three had detectable viremia (mean peak viremia: 4.0 log10 PFU/mL, mean duration: 3.0 days). These three AGMs also had vRNA and infectious virus detected in both oral and vaginal swabs. Two of the four intrarectally inoculated AGMs became infected (mean peak viremia: 3.8 log10 PFU/mL, mean duration: 3.5 days). vRNA was detected in oral swabs collected from both of these infected AGMs, and infectious virus was detected in an oral swab from one of these AGMs. Notably, vRNA and infectious virus were detected in vaginal swabs collected from the infected female AGM (peak viral load: 7.5 log10 copies/mL, peak titer: 3.8 log10 PFU/mL, range of detection: 5-21 days post infection). Abnormal clinical chemistry and hematology results were detected and acute lymphadenopathy was observed in some AGMs. Infection dynamics in all three AGM ZIKV models are similar to those reported in the majority of human ZIKV infections. Our results indicate that the AGM can be used as a surrogate to model mosquito or sexual ZIKV transmission and infection. Furthermore, our results suggest that AGMs are likely involved in the enzootic maintenance and amplification cycle of ZIKV.

A road map for the future: An exploration of attitudes, perceptions, and beliefs among African Americans to tailor health promotion of cancer-related genetic counseling and testing.

African Americans (AA), the second largest racial/ethnic minority group in the United States (US), carry the largest mortality burden of cancer compared with other racial/ethnic groups (Cancer Facts & Figures for African Americans, 2019-2021, American Cancer Society).One solution to address this disparity is through cancer-related genetic counseling and testing (CGT). Although CGT is utilized among the general population, it remains underutilized among AA populations. Community-engaged and community-driven health promotion programs within faith-based organizations (FBOs) have been successfully implemented and delivered among AA populations (Israel et al., American Journal of Public Health, 100, 2010, 2094). FBOs are well positioned for cancer-related health promotion and equipped as conduits of health education and information distribution for cancer prevention. In the present pilot study, a community-based participatory approach (CBPR) was used to collect exploratory data on attitudes, perceptions, and beliefs toward CGT and uptake among an AA sample in the Midwest. Focus groups were conducted in two churches where respondents (N=34) answered a pre-focus group survey prior to a discussion. Respondents were largely unaware of CGT and thought of testing as primarily for ancestral discovery and not for an inheritable disease. Themes identified through qualitative analysis included emotional experiences with cancer; perception of cancer risk; different pictures of genetic testing; other things to worry about; trust in the healthcare system/faith in God and the healthcare system; and ideas and insights regarding promotion of CGT. These primary themes showed participants' perceptions of CGT were shaped by their experiences with cancer, faith, faith communities/FBOs, and cost and access to CGT. Overall, participants within these organizations had positive perceptions about the church as a conduit of genetic testing information but had mixed opinions about the rationale for completing CGT. These findings have implications for genetic counselors, medical providers, and health promotion personnel as to how AA faith populations view CGT and the utility of FBOs as promoters of CGT information.

Neurocognitive risk markers in pediatric obsessive-compulsive disorder.

BACKGROUND: Obsessive-compulsive disorder (OCD) has complex genetic underpinnings, particularly in its early-onset form, which places siblings at a 10-fold increased risk of developing the disorder. Examination for neurocognitive markers preceding pediatric OCD onset has not been conducted, although markers have been identified in adult OCD. This study compared neurocognition across groups of OCD-affected youth (n = 87), unaffected siblings of those with early-onset OCD (n = 67), and healthy controls (HC; n = 79). METHODS: A total of 233 participants aged 6-18 years old completed standardized neurocognitive tests of cognitive flexibility, decision making, planning, response inhibition, spatial working memory, attention, recognition nonverbal memory, and intelligence. They were administered the Anxiety Disorders Interview Schedule-Parent version (ADIS-P) and completed self-report anxiety and OCD questionnaires. Linear mixed-effects models tested for differences between groups, adjusting for age, gender, IQ, state anxiety, and ethnicity, and accounting for random effects of family membership. RESULTS: OCD-affected youth and unaffected siblings performed significantly worse on planning in comparison to HCs (Cohen's d = 0.74; 95% CI = [0.11, 1.36]; Cohen's d = 0.75; 95% CI = [0.12, 1.38], respectively; omnibus group effect p = .007). No other significant between-group differences were identified. CONCLUSIONS: Neurocognitive performance differences between groups identified planning as a preexisting trait marker of pediatric OCD, while no other domain presented as a marker of pediatric OCD. This differs from adult OCD, which is associated with broader cognitive impairments. Investigating longitudinal trajectories and predictive significance of neurocognition in those affected by, and at risk for, early-onset OCD is warranted. Ideally, this will enhance individualized risk stratification and inform future prevention and early intervention strategies.

Just-in-the-Moment Adaptive Interventions (JITAI): A Meta-Analytical Review.

A just-in-time, adaptive intervention (JITAI) is an emerging type of intervention that provides tailored support at the exact time of need. It does so using enabling new technologies (e.g., mobile phones, sensors) that capture the changing states of individuals. Extracting effect sizes of primary outcomes produced by 33 empirical studies that used JITAIs, we found moderate to large effect sizes of JITAI treatments compared to (1) waitlist-control conditions (k = 9), Hedges's g = 1.65 and (2) non-JITAI treatments (k = 21), g = 0.89. Also, participants of JITAI interventions showed significant changes (k = 13) in the positive direction (g = 0.79). A series of sensitivity tests suggested that those effects persist. Those effects also persist despite differences in the behaviors of interests (e.g., blood glucose control, recovering alcoholics), duration of the treatments, and participants' age. Two aspects of tailoring, namely: (1) tailoring to what (i.e., both people's previous behavioral patterns and their current need states; with these effects additive) and (2) approach to tailoring (i.e., both using a human agent and an algorithm to decide tailored feedback; with these effects additive), are significantly associated with greater JITAI efficacy.

Are insecure attachment styles related to risky sexual behavior? A meta-analysis.

OBJECTIVE: Attachment theory provides a powerful framework for understanding individual differences affecting interpersonal relationships and a range of health behavior outcomes. However, no meta-analyses have yet to examine the relationship between adult attachment styles and risky sexual behaviors. The purpose of this meta-analysis was to synthesize the results of the association between adult attachment and risky sexual behaviors. METHOD: Keywords were searched via PsycINFO, Web of Science, and Google Scholar. We used comprehensive meta-analysis (CMA) 3.0 to systematically synthesize and analyze the 42 effect sizes from 16 studies (total N = 7,233). RESULTS: Attachment anxiety has a small effect on having multiple partners (Fisher's Z = .09, 95% CI [0.021, 0.154]; I² = 80.4%) and engaging in condomless sex (Fisher's Z = .09, 95% CI [.006, 0.175]; I² = 82.5%), whereas attachment avoidance has a small effect on having multiple partners (Fisher's Z = .06, 95% CI [0.019, 0.109]; I² = 57.6%) but no effect on engaging in condomless sex (Fisher's Z = .05, 95% CI [-0.024, 0.117]; I2 = 73.9%). Furthermore, average age of participants in a study (z = 3.31, ß = .01, p = .001) and type of risk population (z = 3.03, ß = .12, p = .002) were found to be significant moderators. CONCLUSIONS: Insecure attachment styles are related to risky sexual behaviors and the correlation between attachment anxiety and having multiple partners is stronger as the average age of participant increases and when the study population is specifically an at-risk population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The relationship between social norms and sexual risk-reduction intentions and behavior among men who have sex with men: Findings from an eHealth intervention.

Normative-based research has found that norms are significant predictors of safe sex behavioral intentions and behavior. Research shows that group identity moderates the relationship between norms and intentions/behavior. The present study used the theory of normative social behavior to evaluate whether identification with characters in an HIV-prevention interactive video moderated the relationship between sexual risk-taking norms and risk reduction intentions/behavior. Participants included 540 men between the ages 18 and 30 enrolled in a randomized controlled trial with a 3-month follow-up. We found support for the hypothesized interaction. At low levels of character identification, the negative relationship between sexual risk-taking norms and risk reduction intentions was strong. However, as character identification increased, the link between norms and intentions became weaker. The mean intentions score of high-risk norm participants was elevated to the level reported by low risk norm participants, demonstrating the favorable effect of character identification on narrative persuasion in entertainment-education. The utility of a social norms approach to health behavior change is discussed in the context of eHealth interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Using Neural Networks as Models of Personality Process: A Tutorial.

This paper presents a tutorial for creating neural network models of personality processes. Such models enable researchers to create explicit models of both personality structure and personality dynamics, and to address issues of recent concern in personality, such as, "If personality is stable, then how is it possible that within subject variability in personality states can be as large as or larger than between subject variability in personality?" or "Is it possible to understand personality dynamics and personality structure within a common framework?" We discuss why one should want to use neural networks, review what a neural network model is, review a previous model we have constructed, discuss how to conceptualize issues in such a way that they can be computationally modeled, show how that conceptualization can be translated into a model, and discuss the utility of such models for understanding personality structure and personality dynamics. To build our model we use a neural network modeling package called emergent that is freely available, and a specific architecture called Leabra to build a runnable model that addresses one of the questions posed above: How can within subject variability in personality related states be as large as between subject variability in personality?

Virtual prognostication: When virtual alcohol choices predict change in alcohol consumption over 6-months.

Narrative games, in which users interact with virtual agents, are increasingly being used in health interventions to change targeted behaviors. In virtual social interactions, based on similar real-life contextual cues, past behavior can predict virtual choices. Here, based on theories in learning and interactivity, we examined the whether following a virtual intervention, choices in social interactions may be particularly diagnostic of future behavior changes. To test this, we needed to: (1) leverage a contextualized risk (e.g., involving alcohol consumption) scenario (e.g., having one more drink with my partner) given a target audience (e.g., sexually risky young men who have sex with men (YMSM)), (2) include within this context an evidence-based virtual intervention (e.g., promoting alcohol reduction), (3) instantiate and record a virtual choice (water or alcohol) in a virtual dating game scenario intervention with IA for that target audience, and (4) assess pre and 6-months post-intervention YMSM's alcohol use. Using a Socially Optimized Learning Environment (SOLVE) intervention game with IA and alcohol use measures, we found that virtual water choice (versus virtual alcohol choice) significantly predicted real-life alcohol consumption change. Furthermore, personality factors (e.g., Behavioral Approach System) predicted virtual choices and alcohol consumption change. Implications of these findings are discussed.

Neurocognitive decision-making processes of casual methamphetamine users.

Neuroadaptations caused by chronic methamphetamine (MA) use are likely major contributors to high relapse rate following treatment. Thus, focusing intervention efforts at pre-empting addiction in vulnerable populations, thereby preventing MA-use-induced neurological changes that make recovery so challenging, may prove more effective than targeting chronic users. One approach is studying casual/recreational users, not diagnosed with substance use disorder. This group may be at high risk for addiction due to their experience with MA. On the other hand, they may be resilient against addiction since they were able to maintain casual use over the years and not become addicted. Understanding their neuro-cognitive characteristics during decision-making and risk-taking would help solve this dilemma and, may help identify intervention strategies. Unfortunately, research on neuro-cognitive characteristics of casual MA users is currently lacking. In this work we begin to address this deficit. This study was part of a larger investigation of neural correlates of risky sexual decision-making in men who have sex with men. While undergoing functional magnetic resonance imaging, 31 casual MA users and 66 non-users performed the CUPS task, in which they decided to accept or refuse a series of mixed gambles. Convergent results from whole brain, region of interest and psychophysiological interaction (PPI) analyses are presented. Whole brain analysis identified an amygdala-striatal cluster with weaker activation in casual MA users compared to non-users during decision-making. Activity in that cluster inversely correlated with decisions to gamble: lower activation corresponded to higher risk taking. Using this cluster as a seed in PPI analyses, we identified a wide range of neural network differences between casual MA users and non-users. Parametric whole brain analyses identified clusters in the ventral striatum, posterior insula and precuneus where activations modulated by risk and reward were significantly weaker in casual MA users than in non-users. The striatal cluster identified in these analyses overlapped with the amygdala-striatal cluster. This work identified neural differences in casual MA users' reward processing and outcome learning systems which may underlie their increased real-world risk-taking. It suggests that while making decisions casual MA users focus primarily on potential gain unlike non-users who also take the riskiness of the choice into consideration.

"She Finally Smiles for Real": Reducing Depressive Symptoms and Bolstering Resilience Through a Camp Intervention for LGBTQ Youth.

While summer camps are a recognized evidence-based strategy for building social and emotional skills among youth (U.S. Centers for Disease Control and Prevention [CDC], 2009), no known studies have evaluated the effects of camp programming for LGBTQ youth in the United States. This pilot study evaluates a novel program (Brave Trails) for LGBTQ youth ages 12 to 20, using a pre-post camper survey (N = 56) and a post-camp parent survey (N = 54). Results show campers experienced increases in identity affirmation and hope and a reduction in depressive symptoms. Regression analyses found changes in identity affirmation predicted reductions in depressive symptoms and increases in resilience. Additionally, campers' experience of key camp programming features predicted changes in depressive symptoms. Findings from the parent survey were consistent with camper survey results. Theoretical and practical implications are discussed.

Causal Inference in Generalizable Environments: Systematic Representative Design.

Causal inference and generalizability both matter. Historically, systematic designs emphasize causal inference, while representative designs focus on generalizability. Here, we suggest a transformative synthesis - Systematic Representative Design (SRD) - concurrently enhancing both causal inference and "built-in" generalizability by leveraging today's intelligent agent, virtual environments, and other technologies. In SRD, a "default control group" (DCG) can be created in a virtual environment by representatively sampling from real-world situations. Experimental groups can be built with systematic manipulations onto the DCG base. Applying systematic design features (e.g., random assignment to DCG versus experimental groups) in SRD affords valid causal inferences. After explicating the proposed SRD synthesis, we delineate how the approach concurrently advances generalizability and robustness, cause-effect inference and precision science, a computationally-enabled cumulative psychological science supporting both "bigger theory" and concrete implementations grappling with tough questions (e.g., what is context?) and affording rapidly-scalable interventions for real-world problems.