Self-efficacy is a key construct in behavioral science affecting mental health and psychopathology. Here, we expand on previously demonstrated between-persons self-efficacy effects. We prompted 66 patients five times daily for 14 days before starting cognitive behavioral therapy (CBT) to provide avoidance, hope, and perceived psychophysiological-arousal ratings. Multilevel logistic regression analyses confirmed self-efficacy's significant effects on avoidance in daily life (odds ratio [] = 0.53, 95% confidence interval [CI] = [0.34, 0.84], = .008) and interaction effects with anxiety in predicting perceived psychophysiological arousal ( = 0.79, 95% CI = [0.62, 1.00], = .046) and hope ( = 1.21, 95% CI = [1.03, 1.42], = .02). More self-efficacious patients also reported greater anxiety-symptom reduction early in treatment. Our findings assign a key role to self-efficacy for daily anxiety-symptom experiences and for early CBT success. Self-efficacy interventions delivered in patients' daily lives could help improve treatment outcome.

Difficulty knowing when to switch emotion regulation (ER) strategies is theorized to be a key pathway to emotion dysregulation, but relatively few studies have empirically examined this. We applied a new order-based metric to quantify how =109 socially anxious people switched between 19 different ER strategies (or chose not to regulate at all) throughout a 5-week ecological momentary assessment study yielding 12,616 observations. We tested whether state and trait anxiety reports, and their interaction, predicted differences in ER strategy switching. Results indicated that people with relatively higher social anxiety symptoms switch more often between ER strategies during periods of high average state anxiety but less often during periods of high variability in state anxiety than less socially anxious people. Interventions focused on helping socially anxious people learn how ER strategies are connected to variations in state anxiety might hold promise to increase adaptive ER switching decisions. More broadly, expanding ER switching interventions to consider the role of changing situations is an important next step.

We used Swedish national register data ( = 2,828,777) to examine divorce and its associated patterns of family genetic risk scores (FGRS; personalized measures of genetic risk inferred from diagnoses in relatives) across ten psychiatric disorders: major depression, anxiety disorders, obsessive-compulsive disorder, bipolar disorder, schizophrenia, anorexia nervosa, alcohol use disorder, drug use disorder, ADHD, and autism-spectrum disorder. Individuals who divorced had elevated FGRS across all disorders compared to those who were stably married or never married. FGRS for all disorders were higher among divorced females compared to divorced males; among those who did not go on to have a stable second marriage compared to those who had a stable second marriage; and increased as the cumulative number of divorces increased. In summary, genetic predispositions for psychiatric disorders are associated with the propensity to divorce, and with several differences as a function of sex, remarriage, and the cumulative number of divorce transitions.

In psychotic disorders, motivation and pleasure (MAP) deficits are associated with decreased affiliation and heightened functional impairment. We leveraged a transdiagnostic sample enriched for psychosis and a multi-method approach to test the hypothesis that MAP deficits undermine the stress-buffering benefits of affiliation. Participants completed the Social Affiliation Enhancement Task (SAET) to cultivate affiliation with an experimental partner. Although the SAET increased perceived affiliation and mood, individuals with greater negative symptoms derived smaller emotional benefits from the partners, as indexed by self-report and facial behavior. We then used the Handholding fMRI paradigm, which combines threat-anticipation with affiliative physical contact, to determine whether MAP deficits undermine the social regulation of distress. Individuals with greater MAP deficits showed diminished neural 'benefits'-reduced dampening of threat-elicited activation-from affiliative touch in key frontoparietal nodes of the Dorsal Attention Network. In short, MAP symptoms disrupt the emotional and neuroregulatory benefits of affiliation.

Algorithmically defined aspects of reinforcement learning correlate with psychopathology symptoms and change with symptom improvement following cognitive-behavioral therapy (CBT). Separate work in nonclinical samples has shown that varying the structure and statistics of task environments can change learning. Here, we combine these literatures, drawing on CBT-based guided restructuring of thought processes and computationally defined mechanistic targets identified by reinforcement-learning models in depression, to test whether and how verbal queries affect learning processes. Using a parallel-arm design, we tested 1,299 online participants completing a probabilistic reward-learning task while receiving repeated queries about the task environment (11 learning-query arms and one active control arm). Querying participants about reinforcement-learning-related task components altered computational-model-defined learning parameters in directions specific to the target of the query. These effects on learning parameters were consistent across depression-symptom severity, suggesting new learning-based strategies and therapeutic targets for evoking symptom change in mood psychopathology.

Adversity that exhibits continuity across the life course has long-term detrimental effects on physical and mental health. Using 920 participants from the Dunedin Study, we tested the following hypotheses: (1) children (ages 3-15) who experienced adversity would also tend to experience adversity in adulthood (ages 32-45), and (2) interim personality traits in young adulthood (ages 18-26) would help account for this longitudinal association. Children who experienced more adversity tended to also experience more stressful life events as adults, β=.11, 95% CI [.04, .18], =.002. Negative emotionality-particularly its sub-facet alienation, characterized by mistrust of others-helped explain this childhood-to-midlife association (indirect effect: β=.06, 95% CI [.04, .09], <.001). Results were robust to adjustment for sex, socioeconomic origins, childhood IQ, preschool temperament, and other young-adult personality traits. Prevention of early-life adversity and treatment of young-adult negative emotionality may reduce vulnerability to later life stress and thereby promote the health of aging adults.

Internalizing (e.g., anxiety, depression) and disordered eating (DE; e.g., binge eating, dietary restraint) are highly comorbid, but the mechanisms underlying their comorbidity remain unknown. This was the first twin study to examine whether their co-occurrence may be driven by genetic and/or environmental influences on emotion regulation (ER; ability to modulate duration/intensity of emotions). Analyses included 688 adult female twins from the MSU Twin Registry. Cholesky decomposition twin models showed comorbidity between dimensionally-modeled internalizing and DE was due to overlapping genetic ( = .55; 69.3% of shared variance) and nonshared environmental influences ( = .26; 30.7% of shared variance). When ER was added into the model, all genetic influences shared between internalizing and DE were attributable to ER, suggesting genetic influences on ER are the primary driver of comorbidity between internalizing and DE. Shared genes may shape affective processing, interoceptive sensitivity, or other brain-based processes (e.g., cognitive control) implicated in ER.

Some children socially transition genders by changing their pronouns (and often names, hairstyles, clothing) from those associated with their assigned sex at birth to those associated with their gender identity. We refer to children who have socially transitioned as transgender children. In a prospective sample of children who socially transitioned during childhood (at or before the age of 12; = 6.82), we tested whether the parent-reported internalizing symptoms of transgender children were different before vs. after they socially transitioned. The children were predominantly white (70.6% white) and girls (76.5% transgender girls, 23.5% transgender boys). Their parents tended to have high levels of education (74.5% Bachelor's degree or above) and lived in families with high household incomes (62.7% with household incomes of $75,000 or above). On average, youth showed lower levels of internalizing symptoms after socially transitioning vs. before, suggesting a possible mental health benefit of these transitions.

Individual differences in self-control predict many health and life outcomes. Building on twin literature, we used genomic structural equation modeling to test the hypothesis that genetic influences on executive function and impulsivity predict independent variance in mental health and other outcomes. The impulsivity factor (comprising urgency, lack of premeditation, and other facets) was only modestly genetically correlated with low executive function ( =.13). Controlling for impulsivity, low executive function was genetically associated with increased internalizing ( =.15), externalizing ( =.13), thought disorders ( =.38), compulsive disorders ( =.22), and chronotype ( =.11). Controlling for executive function, impulsivity was positively genetically associated with internalizing ( =.36), externalizing ( =.55), body mass index ( =.26), and insomnia ( =.35), and negatively genetically associated with compulsive disorders ( = -.17). Executive function and impulsivity were both genetically correlated with general cognitive ability and educational attainment. This work suggests that executive function and impulsivity are genetically separable and show independent associations with mental health.

Do people with social anxiety (SA) benefit from positive memory retrieval that heightens self-relevant meaning? In this preregistered study, an analog sample of 255 participants with self-reported clinically significant symptoms of SA were randomly assigned to retrieve and process a positive social-autobiographical memory by focusing on either its self-relevant meaning (deep processing) or its perceptual features (superficial processing). Participants were then socially excluded and instructed to reimagine their positive memory. Analyses revealed that participants assigned to the deep processing condition experienced significantly greater improvements than participants in the superficial processing condition in positive affect, social safeness, and positive beliefs about others during initial memory retrieval and in negative and positive beliefs about the self following memory reactivation during recovery from exclusion. These novel findings highlight the potential utility of memory-based interventions for SA that work by "hooking" self-meaning onto recollections of positive interpersonal experiences that elicit feelings of social acceptance.

Extending a recent parent mediation efficacy trial, we identified parent reinforcement and relationship behaviors as setting boundary conditions, or moderators, of youth anxiety outcome in 254 youths and their parents, who were randomized to: (1) Cognitive Behavioral Treatment (CBT) with parent reinforcement behavior training (CBT + Reinf); (2) CBT with parent relationship behavior training (CBT + Relat); or (3) individual youth CBT - a comparator control arm. Findings revealed that parents with high baseline negative reinforcement levels and acceptance levels (i.e., above the mean) report their children as having lower anxiety at outcome, when assigned to CBT + Reinf, and CBT + Relat, respectively, versus CBT. No moderation effects were found for either parent positive reinforcement or parent psychological control. Implications for treating anxiety disorders and moving toward precision treatment approaches in youth are discussed, and the importance of research replication and extension.

Elevated levels of Neuroticism/Negative Emotionality (N/NE) and, less consistently, lower levels of Extraversion/Positive Emotionality (E/PE) confer risk for pathological depression and anxiety. To date, most prospective-longitudinal research has narrowly focused on traditional diagnostic categories, creating uncertainty about the precise nature of these prospective associations. Adopting an explicitly hierarchical-dimensional approach, we examined the association between baseline variation in personality and longitudinal changes in broad and narrow internalizing-symptom dimensions in 234 emerging adults followed for 2.5 years, during the transition from older adolescence to early adulthood. N/NE was uniquely associated with increases in broadband internalizing-the core cognitive and affective symptoms that cut across the emotional disorders-and unrelated to the narrower dimensions of positive affect and anxious arousal that differentiate specific internalizing presentations. Variation in E/PE and several other Big Five traits was cross-sectionally, but not prospectively, related to longitudinal changes in specific internalizing symptoms. Exploratory personality-facet-level analyses provided preliminary evidence of more granular associations between personality and longitudinal changes in internalizing symptoms. These observations enhance the precision of models linking personality to internalizing illness; highlight the centrality of N/NE to increases in transdiagnostic internalizing symptoms during a key developmental chapter; and set the stage for developing more effective prevention and treatment strategies.

Trauma and posttraumatic stress disorder (TR/PTSD) are implicated in deleterious alcohol outcomes, yet the processes that undergird these associations remain elusive. Affective (i.e., emotionally laden) cognitions may play key roles in TR/PTSD-related drinking that could inform prevention and intervention. The present review synthesized extant literature ( = 58) on affective cognitions and their role in negative and positive reinforcement TR/PTSD-related drinking, including alcohol-specific (e.g., drinking motives, alcohol expectancies) and non-alcohol-specific (e.g., emotion regulation cognitions, perception and attentional biases) cognitions. Findings generally supported the importance of alcohol-specific cognitions in negative more so than positive reinforcement drinking. Non-alcohol-specific affective cognitions were considerably less researched. Several gaps in the knowledge base emerged; studies were overwhelmingly cross-sectional, conducted mainly within homogenous college samples, and often did not disaggregate effects of trauma exposure from those of PTSD. Future research is needed to address these gaps to optimally inform clinical efforts to reduce TR/PTSD-related drinking risk.

Most health disparities originate in childhood and extend across the lifespan. However, studies on health disparities have been predominately focused on adults. This study evaluated the biological and psychosocial consequences of exposure to chronic adversity among 491 low-income children 8 to 12 years old (52.1% male; = 9.73, = 1.0; 68.2% Black/African American; 21.2% Latinx; 267 maltreated and 224 nonmaltreated). Latent profile analyses revealed six distinct profiles of cumulative socioeconomic risk, allostatic load, and mental health functioning. Childhood maltreatment, emotion regulation, affect, and personality characteristics were differentially associated with these latent profiles. Consistent with resilience theory, findings indicate differential effects of chronic adversity on adaptation. These findings also offer evidence that signs of physiological dysregulation emerge at earlier ages in development and suggest there may be a window of opportunity in childhood for interventions to reduce the detrimental effects of chronic adversity on health outcomes in children.

The expression of personality pathology differs between people and within a person in day-to-day life. Personality pathology may reflect, in part, dysregulation in basic behavioral processes. Thus, a useful approach for studying maladaptive trait expression comes from literature on stress and daily hassles, which provide dynamic accounts for the relations between individual differences and maladaptive dysregulation. This study sought to integrate maladaptive traits and dynamic stress processes to further dynamic models of personality pathology. In a combined clinical/community sample (=297) oversampled for interpersonal problems, we used ecological momentary assessment (observation =19,968) to investigate how maladaptive traits moderated the processes of stress generation, stress reactivity, and affective spillover/inertia. Tests of our preregistered hypotheses provided a mix of supportive and null findings for stress processes identified in past research, and mixed support for the moderating role of personality. The results provide insights into the relations between everyday stressors and personality pathology.

Chronic low back pain (CLBP) is a biopsychosocial phenomenon involving complex relationships between pain and psychosocial factors. In preregistered analyses, we examined dynamic relationships between pain and negative affect among individuals with CLBP ( 87). We found that increased negative affect was concurrently and prospectively associated with increased pain for individuals on average. However, there was significant and meaningful between-persons variability in these effects such that risk for future opioid-related problems was positively associated with the within-persons correlation between pain and negative affect (β 0.290, 95% credible interval [CI] [0.071, 0.485]), the degree to which pain predicted increased negative affect (β 0.439, 95% CI [0.044, 0.717]), and the autoregressive effect of negative affect over 4-hr lags (β 0.255, 95% CI [0.007, 0.478]). These results suggest that variability in within-persons symptom dynamics may help identify chronic pain patients who are at greater risk of opioid-related problems.

This study describes a hierarchical dimensional model of eating-disorder (ED) classification based on the Hierarchical Taxonomy of Psychopathology (HiTOP). Participants were community-recruited adults with an ED (=252; 81.9% female). We used a modified version of Goldberg's (2006) method, which involved sequentially extracting latent factors using exploratory structural equation modeling, resulting in a 10-factor hierarchical-dimensional model. Dimensions predicted 92.4% and 58.7% of the variance in recovery outcomes at six-month and one-year, respectively. Compared to other illness indicators (e.g., diagnoses, dimensional ED impairment scores, weight/shape overvaluation, and ED severity specifiers), hierarchical dimensions predicted .88 to 334 times more variance in ED behaviors at baseline and 1.95 to 80.8 times more variance in psychiatric impairment at one-year follow-up. Results suggest that reducing within-disorder heterogeneity for EDs within the broader context of internalizing symptoms provides a powerful framework from which to predict outcomes and understand symptoms experienced by those with EDs.

Children who experience environmental adversities are at increased risk of both internalizing and externalizing disorders. Epigenetic mechanisms may regulate the influence of environmental adversities on mental health. We examined the hypothesis that salivary DNA-methylation patterns of pace of biological aging (DunedinPoAm) and inflammation (DNAm-CRP) are socially stratified and associated with mental health in 1,183 children (609 female, age M=13.6y) from the Texas Twin Project. Analyses were preregistered. Participants' DNA-methylation algorithms and psychiatric symptoms differed by socioeconomic contexts and race/ethnicity. Children with more parent-reported internalizing symptoms had higher DunedinPoAm and DNAm-CRP scores, and children with more aggression problems had higher DNAm-CRP. DunedinPoAm partially mediated advantage of White racial identity on internalizing. Similarly, DNAm-CRP partially mediated advantage of higher family socioeconomic contexts and, in a separate model, White racial identity on reduced internalizing symptoms. Children's epigenetic measures of pace of biological aging and inflammation are associated with social inequalities and mental health.

Although intraminority gay community stress has been theorized to affect sexual minority men's body dissatisfaction, this association has not been evaluated quantitatively. In two samples of sexual minority men-one sample recruited from a population-based study of U.S. adults (=424; =54.29), the other a sample meeting diagnostic criteria for depressive, anxiety, or trauma-/stressor-related disorders (=251; =26.52)-this study investigated associations between gay community stress and body dissatisfaction. In both samples, gay community stress was significantly associated with sexual minority men's greater body dissatisfaction in models that controlled for demographic and minority stress variables. In terms of specific domains of gay community stress, perceptions of the gay community's focus on sex, social status, and social competition were significant correlates of greater body dissatisfaction. Future research can determine the impact of routinely addressing gay community stress in body image and eating disorder treatments for this population.

Elevated threat appraisal is a postulated neurodevelopmental mechanism of anxiety disorders. However, laboratory-assessed threat appraisals are task-specific and subject to measurement error. We utilized latent variable analysis to integrate youth's self-reported threat appraisals across different experimental tasks; we next examined associations with pediatric anxiety as well as behavioral and psychophysiological task indices. Ninety-two youth ages 8-17 years ( age=13.07, 65% female), including 51 with a primary anxiety disorder and 41 with no Axis I diagnosis, completed up to eight threat-exposure tasks. Anxiety symptoms were assessed using questionnaires and ecological momentary assessment. Appraisals both prior to and following threat exposures evidenced shared variance across tasks. Derived factor scores for threat appraisal were associated significantly with anxiety symptoms and variably with task indices; findings were comparable to task-specific measures and had several advantages. Results support an overarching construct of threat appraisal linked with pediatric anxiety, providing groundwork for more robust laboratory-based measurement.

Natural language processing (NLP) is a subfield of machine learning that may facilitate the evaluation of therapist-client interactions and provide feedback to therapists on client outcomes on a large scale. However, there have been limited studies applying NLP models to client outcome prediction that have (a) used transcripts of therapist-client interactions as direct predictors of client symptom improvement, (b) accounted for contextual linguistic complexities, and (c) used best practices in classical training and test splits in model development. Using 2,630 session recordings from 795 clients and 56 therapists, we developed NLP models that directly predicted client symptoms of a given session based on session recordings of the previous session (Spearman's rho =0.32, p<.001). Our results highlight the potential for NLP models to be implemented in outcome monitoring systems to improve quality of care. We discuss implications for future research and applications.