Remembering or knowing how we felt: Depression and anxiety symptoms predict retrieval processes during emotional self-report.

Researchers and clinicians routinely rely on patients' retrospective emotional self-reports to guide diagnosis and treatment, despite evidence of impaired autobiographical memory and retrieval of emotional information in depression and anxiety. To clarify the nature and specificity of these impairments, we conducted two large online data collections (Study 1, N = 1,983; Study 2, N = 900) examining whether depression and/or anxiety symptoms would uniquely predict the use of self-reported episodic (i.e., remembering) and/or semantic (i.e., knowing) retrieval when rating one's positive and negative emotional experiences over different time frames. Participants were randomly assigned to one of six time frames (ranging from at this moment to last few years) and were asked to rate how intensely they felt each of four emotions, anxious, sad, calm, and happy, over that period. Following each rating, they were asked several follow-up prompts assessing their perceived reliance on episodic and/or semantic information to rate how they felt, using procedures adapted from the traditional "remember/know" paradigm (Tulving, 1985). Across both studies, depression and anxiety symptoms each uniquely predicted increased likelihood of remembering across emotion types, and decreased likelihood of knowing how one felt when rating positive emotion types. Implications for the theory and treatment of emotion-related memory disturbances in depression and anxiety, and for dual-process theories of memory retrieval more generally, are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Implicit health associations across the adult lifespan.

OBJECTIVE: Explicit reports of one's health self-concept (e.g. rate your overall health) are commonly used in research and clinical practice. These measures predict important health outcomes, but rely on conscious introspection so may not fully capture the different components of the health self-concept (e.g. more automatic components) that relate to actual health. This study examined the health-implicit association test (health-IAT), and how it may add to our prediction of health from self-reports. DESIGN: 1004 participants (ages 18-85) completed this web-based study with the health-IAT (assessing self-healthy implicit associations) and explicit assessments of health. MAIN OUTCOME MEASURES: Self-reported measures of physical functioning. RESULTS: The health-IAT was valid and reliable. Older age was correlated with stronger self-healthy implicit associations. Although the health-IAT did not incrementally predict self-reported markers of physical functioning when only controlling for explicit health self-concept, it was an incremental predictor once age was entered for all four models tested. CONCLUSIONS: The health-IAT appears to be a valid and reliable new measure that assesses implicit self-concept relating to physical health. Results reveal the potential value of assessing implicit health self-concept in both research and practice, especially when taking into account age.

Suicide and self-injury-related implicit cognition: A large-scale examination and replication.

Suicide and self-injury are difficult to predict because at-risk individuals are often unable or unwilling to report their intentions. Therefore, tools to reliably assess risk without reliance on self-report are critically needed. Prior research suggests that people who engage in suicidal and nonsuicidal self-injury (NSSI) often implicitly (i.e., outside conscious control) associate themselves with self-harm and death, indicating that self-harm-related implicit cognition may serve as a useful behavioral marker for suicide risk. However, earlier studies left several critical questions about the robustness, sensitivity, and specificity of self-harm-related implicit associations unaddressed. We recruited a large sample of participants (N = 7,015) via a public web-based platform called Project Implicit Mental Health (PIMH) to test several hypotheses about self-harm-related implicit associations using the Implicit Association Test (IAT). Participants were randomly assigned to complete 1 of 3 self-harm IATs (Self + Cutting using picture stimuli, Self + Suicide using word stimuli, Self + Death using word stimuli). Results replicated prior studies demonstrating that self-harm-related implicit associations were stronger among individuals with (vs. without) a history of suicide attempt and NSSI. Results also suggested that self-harm-related implicit associations are robust (based on internal replication), are sensitive to recency and severity of self-harm history (e.g., stronger associations for more recent and more lethal prior suicide attempts), and correlate with specific types of self-harm behaviors. These findings clarify the nature of self-harm-related implicit cognition and highlight the IAT's potential to track current risk for specific types of self-harm in ways that more fixed risk factors cannot. (PsycINFO Database Record

Moderators of age effects on attention bias toward threat and its association with anxiety.

OBJECTIVE: The current study used a research domain criteria (RDoC) approach to assess age differences in multiple indicators of attention bias and its ties to anxiety, examining stimulus domain and cognitive control as moderators of older adults' oft-cited positivity effect (bias towards positive and away from negative stimuli, when compared to younger adults). METHOD: 38 Younger adults and 38 older adults were administered a battery of cognitive control and trait and state anxiety measures, and completed a dot-probe task to assess attention bias, during which reaction time and fixation duration (using eye-tracking) were recorded for negative and neutral social (a salient threat domain for younger adults) and physical (a salient threat domain for older adults) stimuli. RESULTS: Mixed-effects models demonstrated that older adults were faster to react to dot-probe trials when the probe appeared in the place of negative (vs. neutral) physical stimuli, but displayed no difference in reaction time for social stimuli. Also, older (vs. younger) adults with lower levels of cognitive control were less negatively biased in their visual fixation to social stimuli. A negative reaction time attention bias on the dot-probe task predicted greater trait anxiety among participants with low levels of cognitive control, with a more complex pattern predicting state anxiety. CONCLUSION: Older adults do attend to social and physical stimuli differently. When stimuli concern a social threat, older adults do not preferentially attend to either neutral or negative stimuli. However, when stimuli concern physical threat, older adults preferentially attend to negative stimuli. Threat biases are associated with anxiety at all ages for those with low cognitive control.

Towards greater understanding of addiction stigma: Intersectionality with race/ethnicity and gender.

BACKGROUND: In spite of the significant burden associated with substance use disorders, especially among persons who inject drugs (PWIDs), most affected individuals do not engage with any type of formal or informal treatment. Addiction stigma, which is represented by negative social attitudes toward individuals who use alcohol and/or other drugs, is one of the barriers to care that is poorly understood. The current study: a) assessed implicit (indirect and difficult to consciously control) and explicit (consciously controlled) beliefs about PWIDs among visitors to a public web site; and b) experimentally investigated the effects of ethnicity/race and gender on those implicit and explicit beliefs. METHODS: N=899 predominantly White (70%) and women (62%) were randomly assigned to one of six target PWIDs conditions: gender (man/woman) x race/ethnicity (White, Black, Latino/a). Participants completed an Implicit Association Test and explicit assessment of addiction stigma. RESULTS: Participants implicitly associated PWIDs (especially Latino/a vs. White PWIDs) with deserving punishment as opposed to help (p=0.003, d=0.31), indicating presence of addiction stigma-related implicit beliefs. However, this bias was not evident on the explicit measure (p=0.89). Gender did not predict differential implicit or explicit addiction stigma (p=0.18). CONCLUSIONS: Contrary to explicit egalitarian views towards PWIDs, participants' implicit beliefs were more in line with addiction stigma. If replicated and clearer ties to behavior are established, results suggest the potential importance of identifying conditions under which implicit bias might influence behavior (even despite explicit egalitarian views) and increase the likelihood of discrimination towards PWIDs.

Characterizing implicit mental health associations across clinical domains.

BACKGROUND AND OBJECTIVES: Implicit associations are relatively uncontrollable associations between concepts in memory. The current investigation focuses on implicit associations in four mental health domains (alcohol use, anxiety, depression, and eating disorders) and how these implicit associations: a) relate to explicit associations and b) self-reported clinical symptoms within the same domains, and c) vary based on demographic characteristics (age, gender, race, ethnicity, and education). METHODS: Participants (volunteers over age 18 to a research website) completed implicit association (Implicit Association Tests), explicit association (self + psychopathology or attitudes toward food, using semantic differential items), and symptom measures at the Project Implicit Mental Health website tied to: alcohol use (N = 12,387), anxiety (N = 21,304), depression (N = 24,126), or eating disorders (N = 10,115). RESULTS: Within each domain, implicit associations showed small to moderate associations with explicit associations and symptoms, and predicted self-reported symptoms beyond explicit associations. In general, implicit association strength varied little by race and ethnicity, but showed small ties to age, gender, and education. LIMITATIONS: This research was conducted on a public research and education website, where participants could take more than one of the studies. CONCLUSIONS: Among a large and diverse sample, implicit associations in the four domains are congruent with explicit associations and self-reported symptoms, and also add to our prediction of self-reported symptoms over and above explicit associations, pointing to the potential future clinical utility and validity of using implicit association measures with diverse populations.

Correlates of public support toward federal funding for harm reduction strategies.

BACKGROUND: Historically, US federal policy has not supported harm reduction interventions, such as safe injection facilities (SIFs) and needle and syringe programs (NSPs), which can reduce the burden associated with injection drug use. Given recent increases in abuse of both legal and illegal opioids, there has been a renewed debate about effective ways to address this problem. The current study (1) assessed participants' support for SIFs and NSPs, and (2) evaluated several demographic factors (e.g., age, gender, race, education, political ideology, and religiosity) and individual differences in stigmatizing beliefs about people who inject drugs (PWID) that might relate to support for these interventions. METHODS: U.S. adults (N = 899) completed a web-based study that assessed self-reported support for NSPs and SIFs, and stigma about PWID. RESULTS: The majority of participants were at least somewhat supportive of both NSPs and SIFs. Regression analyses indicated greater support for NSPs and SIFs was predicted by more liberal political ideology, more agreement that PWID deserve help rather than punishment, older age, and male gender. Also, participants who endorsed lower stigma about PWID were more supportive of NSPs and SIFs. Race, religiosity, and education did not predict support for NSPs and SIFs. CONCLUSIONS: Most participants tended to report support for harm reduction strategies. Age, political ideology, and individual differences in stigmatizing beliefs about PWID were significantly associated with support. Given the potential malleability of stigmatizing beliefs, efforts that seek to shift stigma about PWID could have important implications for public policy towards harm reduction strategies for PWID.

Evaluating age differences in coping motives as a mediator of the link between social anxiety symptoms and alcohol problems.

The goal of this study is to evaluate whether coping motives mediate the relationship between self-reported symptoms of social anxiety and alcohol problems across different age groups, building on previous research conducted among emerging adults. This study focuses on adult drinkers, including emerging adults (aged 18-25 years; n = 148), young adults (aged 26-39 years; n = 68), and middle-aged adults (aged 40-65 years; n = 51). All participants completed measures of social anxiety symptoms, alcohol problems, and coping motives, administered via the Web. Invariance tests using structural equation modeling suggested that among emerging adults (and to some degree middle-aged adults), coping motives mediated the positive relationship between symptoms of social anxiety and alcohol problems. Interestingly, coping motives appeared to suppress a negative relationship between social anxiety and alcohol problems in young adults. Results suggest that it is critical to consider age differences when attempting to understand the relationships between symptoms of social anxiety, alcohol problems, and coping motives.

Wounds that can't be seen: implicit trauma associations predict posttraumatic stress disorder symptoms.

BACKGROUND AND OBJECTIVES: Prominent theories suggest that explicit and implicit cognitive biases are critical in the development and maintenance of posttraumatic stress disorder (PTSD). However, studies evaluating implicit PTSD-related cognitive biases are rare, and findings are mixed. We developed two adaptions of the Implicit Association Test (IAT), the "traumatized self" IAT (evaluations of the self as traumatized vs. healthy) and the "dangerous memory" IAT (evaluations of remembering as dangerous vs. safe), and investigated their psychometric properties and relations to PTSD symptoms and trauma exposure. METHODS: Participants were visitors to the Project Implicit research website (Study 1: N = 347, Study 2: N = 501). They completed the IATs (Study 1: both IATs; Study 2: traumatized self IAT only), a trauma exposure measure, a PTSD symptom inventory, and explicit cognitive bias measures (Study 2 only). RESULTS: Both IATs had good internal consistency, but only the traumatized self IAT was correlated with PSTD symptoms and identified participants meeting clinical cutoffs for PTSD symptoms. Study 2 focused on the traumatized self IAT and included explicit cognitive bias measures. The IAT correlated with PTSD symptoms and explicit cognitions, and predicted variance in PSTD symptoms above and beyond trauma exposure and explicit cognitions. LIMITATIONS: Study designs were cross-sectional; samples were unselected; and PTSD symptoms were self-reported. CONCLUSIONS: Despite these limitations, these studies provide preliminary validation of an implicit measure of PTSD-related cognitive bias - the traumatized self IAT - that is consistent with PTSD theories and may ultimately improve the identification and treatment of individuals with PTSD.