Why Does Therapy Work? An Idiographic Approach to Explore Mechanisms of Change Over the Course of Psychotherapy Using Digital Assessments.

BACKGROUND AND OBJECTIVES: While psychotherapy treatments are largely effective, the processes and mechanisms underlying such positive changes remain somewhat unknown. Focusing on a single participant from a treatment outcome study that used a modular-based cognitive behavior therapy protocol, this article aims to answer this question by identifying changes in specific symptomatology over the course of the treatment. Using quantitative data derived from digital health methodology, we analyzed whether a given therapeutic intervention was related to downstream effects in predicted symptom domains, to assess the accuracy of our interventions. METHODS: This case study employed an observational N-of-1 study design. The participant (n = 1) was a female in the age range of 25-35 years. Using digital health data from ambulatory assessment surveys completed prior to and during therapy, separate linear regression analyses were conducted to assess if hypothesized treatment targets reduced after a given module, or intervention. RESULTS: Support was found for some of the hypothesized quantitative changes (e.g., decreases in avoidance after exposures module), yet not for others (e.g., decreases in rumination following the mindfulness module). CONCLUSION: We present data and results from our analyses to offer an example of a novel design that may allow for a greater understanding of the nature of symptom changes with increased granularity throughout the course of a psychological treatment from the use of digital health tools.

Deviant Peers and Adolescent Risky Behaviors: The Protective Effect of Nonverbal Display of Parental Warmth.

This study examines whether nonverbal displays of parents' warmth during an in-lab conflict discussion mitigate the links between affiliation with deviant peers and risky behaviors. A sample of 107 youth and their parents participated in a study spanning from mid-adolescence (T1) to late adolescence (T2). At T1, family members discussed a contentious issue, which was coded for parents' nonverbal warmth. At T1 and T2, youth reported on their friends' and their own risky behaviors. Fathers' warmth moderated each prospective association between deviant peers and risky behaviors. Mothers' warmth did not emerge as a significant moderator. Girls, in particular, benefitted from fathers' warmth as a buffer in the trajectory from T1 risky behaviors to T2 risky behaviors and deviant peers.

Growing up wired: social networking sites and adolescent psychosocial development.

Since the advent of social networking site (SNS) technologies, adolescents' use of these technologies has expanded and is now a primary way of communicating with and acquiring information about others in their social network. Overall, adolescents and young adults' stated motivations for using SNSs are quite similar to more traditional forms of communication-to stay in touch with friends, make plans, get to know people better, and present oneself to others. We begin with a summary of theories that describe the role of SNSs in adolescents' interpersonal relationships, as well as common methodologies used in this field of research thus far. Then, with the social changes that occur throughout adolescence as a backdrop, we address the ways in which SNSs intersect with key tasks of adolescent psychosocial development, specifically peer affiliation and friendship quality, as well as identity development. Evidence suggests that SNSs differentially relate to adolescents' social connectivity and identity development, with sociability, self-esteem, and nature of SNS feedback as important potential moderators. We synthesize current findings, highlight unanswered questions, and recommend both methodological and theoretical directions for future research.

Positive and Negative Interactions Observed Between Siblings: Moderating Effects for Children Exposed to Parents' Conflict.

This study investigated links between interparental conflict appraisals (specifically threat and self-blame), sibling relationship quality (positive and negative dimensions), and anxiety in sibling pairs comprised of an adolescent and a younger sibling close in age. Sibling relationship quality was measured through behavioral observation. Links between self-blame and anxiety were moderated by sibling relationship quality. In older siblings, positive behavior with a sibling was associated with an attenuated relation between self-blame and anxiety. A paradoxical moderating effect was found for negative interactions; for both younger and older siblings, a relation between self-blame and anxiety was weakened in the presence of sibling negativity. Results offered support for theorized benefits of sibling relationship quality in helping early adolescents adjust to conflict between parents.

Does dampened physiological reactivity protect youth in aggressive family environments?

Is an attenuated physiological response to family conflict, seen in some youth exposed to early adversity, protective or problematic? A longitudinal study including 54 youth (average age 15.2 years) found that those with higher cumulative family aggression exposure showed lower cortisol output during a laboratory-based conflict discussion with their parents, and were less likely to show the normative pattern of increased cortisol reactivity to a discussion they rated as more conflictual. Family aggression interacted with cortisol reactivity in predicting youth adjustment: Adolescents from more aggressive homes who were also more reactive to the discussion reported more posttraumatic stress symptoms and more antisocial behavior. These results suggest that attenuated reactivity may protect youth from the negative consequences associated with aggressive family environments.

I'm outgoing and she's reserved: the reciprocal dynamics of personality in close friendships in young adulthood.

Close college-age friendships provide differential opportunities for reinforcing dispositional tendencies and fostering accommodation or change. This finding was obtained from a cross-sectional study of 66 pairs of same-sex college-age friends (58% female). Each pair of friends was extreme and either very similar or different with regard to extraversion-introversion. Interviews with each friend were analyzed for references to each other's role in various friendship domains, including the setting of the friendship and position with regard to chatting, disclosing, expressing opinions about peers, and energizing the friendship. Matched friends mutually reinforced each other's similar dispositional tendencies. Friends with contrasting personalities showed patterns of personality accommodation as well as complementary reinforcement. Implications are discussed for embedding reciprocal theories of personality development in close friendships.