This study examined the efficacy of a 2-year anxiety management intervention integrated with a reading intervention for struggling readers in upper-elementary grades on anxiety outcomes. The study randomly assigned 128 struggling readers to one of three conditions: (a) reading intervention with anxiety management intervention (RANX), (b) reading intervention with math fact practice, an attention control, (RMATH), and (c) business-as-usual comparison (BaU). Findings demonstrated promising results for students in the RANX condition, particularly compared with the BaU condition. However, findings were not always statistically significant suggesting the need for additional adequately powered trials. Secondary analyses among students beginning with average anxiety showed significant reductions in physical symptoms of anxiety at year 1 posttest favoring RANX over RMATH and BAU, as well as between RANX and BAU on reading anxiety at year 2 posttest. Among students beginning with elevated anxiety, significant reductions in social anxiety were found at year 2 posttest favoring RANX over RMATH and BaU. The findings underscore the promise of integrating anxiety management and reading interventions.

Hopelessness is a painful cognitive state that is related to depression and suicide. Despite its importance, only unsystematic efforts have been made to specifically target hopelessness in interventions, and no comprehensive review is currently available to guide future clinical studies. In this narrative review, we first analyze the phenomenon of hopelessness, by highlighting its components (e.g., dismal expectations, blocked goal-directed processing, and helplessness), antecedents (e.g., inferential styles), and contextual factors (e.g., loneliness and reduced social support). Then, we review the currently available interventions and manipulations that target these mechanisms, either directly or indirectly, and we highlight both their strengths and lacunae. Finally, we propose possible avenues to improve our clinical toolbox for breaking the vise of hopelessness.

Experiential avoidance (EA) is associated with posttraumatic stress disorder (PTSD) and self-injurious thoughts and behaviors (SITBs) across different populations, and extant literature has demonstrated a strong relationship between PTSD and SITBs. However, no study has explored the potential moderating role EA plays in the association of PTSD with nonsuicidal self-injury (NSSI), suicidal ideation, and suicide attempts. The objective of the present study was to determine if EA would moderate the association with PTSD and SITBs such that the association between PTSD and individuals SITBs would be stronger among individuals with higher EA. In a large national sample of Gulf War Era veterans ( = 1,138), EA was associated with PTSD, lifetime and past-year NSSI, current suicidal ideation, and lifetime suicide attempts in bivariate analyses. Multivariate analyses detected a significant EA by PTSD interaction on lifetime NSSI ( = 0.96), past-year NSSI ( = 1.03), and suicide attempts ( =1.03). Probing of the interactions revealed that the respective associations between PTSD, lifetime and past-year NSSI, and suicide attempts were stronger at lower levels of EA (i.e., better), counter to our hypotheses. These preliminary findings contextualize the relationship between these variables in a Gulf War veterans sample and signal the need to further investigate these relationships. Further, these findings highlight the need for advancement in assessment and intervention of EA and SITBs.

Increased quality of life (QoL) is rated by patients as a primary factor in determining recovery from psychopathology. Cognitive-behavioral therapies (CBTs) are the most well-researched psychotherapies for internalizing disorders and appear effective at reducing symptoms even when delivered by trainees. Existing research suggests that the effects of CBTs on QoL are more modest than their effects on symptoms. However, little is known about the effects of trainee-delivered CBT on life satisfaction, a subjective measure of QoL. We analyzed data from 93 clients treated by students (n=23) in a graduate-level training clinic using an intent-to-treat approach, completers case analyses, and random forest imputation. Across methods of handling missing data, improvements in anxiety, depression, and CBT skills were more marked than improvements in QoL. Exploratory analyses suggested baseline life satisfaction was the strongest predictor of end-of-treatment life satisfaction. Future research should explore alternatives to "standard" CBT for clients with low life satisfaction.

We examined interpersonal variables as moderators of the relation between therapists' use of cognitive change (CC) strategies and CC in a sample of 125 adults who participated in cognitive behavioral therapy for depression. We measured self-reported maladaptive personality characteristics, interpersonal problems, and social skills at intake. Observers rated therapist adherence to cognitive methods for the first five sessions. Patients reported in-session CC following each session. Cognitive methods predicted greater CC. The relation between cognitive methods and CC was moderated by maladaptive personality traits; this relation was stronger for patients with greater maladaptive personality traits. We encourage future research investigating moderators of therapist interventions of putative therapeutic mechanisms.

[This corrects the article DOI: 10.1007/s41811-021-00123-9.].

Research on the psychosocial impact of COVID-19 has found significant levels of distress among the general population, and among those especially vulnerable due to chronic social or health challenges. Among these are individuals aging with HIV infection, who are encountering COVID-19 as a new infectious threat to their health and wellbeing. In a longitudinal observational study of the psychosocial impact of COVID-19 in middle-aged and older people living with HIV, we identified a subset of participants who expressed heightened levels of distress and were referred for clinical intervention. This paper describes the supportive and contemporary cognitive-behavioral interventions that were provided and presents data on changes in distress in this case series. This work provides a model for identifying people in at-risk groups in acute need of psychological intervention and for implementing an individualized clinical response that can be safely delivered in the context of COVID-19 and future crisis situations.

The COVID-19 pandemic may exacerbate common symptoms of obsessive-compulsive disorder, such as fears of contamination or causing harm to others. To investigate the potential impact of COVID-19 on obsessive-compulsive (OC) symptoms, we utilized a frequent sampling prospective design to assess changes in OC symptoms between April 2020 and January 2021. We examined in a broad clinical and non-clinical sample whether baseline risk (e.g., emotion dysregulation, anxiety sensitivity, intolerance of uncertainty) and protective (e.g., resilience) factors would predict OC symptom changes, and whether coping strategies would mediate week-to-week changes in COVID-19 impact and OC symptoms. Emotion dysregulation was associated with greater likelihood of OC symptom worsening, whereas resilience was associated with lower likelihood. Longitudinal mediation analyses revealed that coping strategies were not significant mediators; however, changes in adaptive coping were associated with subsequent-week OC symptom reductions. Regardless of perceived COVID-19 impact, implementing adaptive coping strategies may prospectively reduce OC symptoms.

The COVID-19 pandemic triggered increased rates of depression, especially among college students. Due to social distancing guidelines, loneliness has been suspected as a prominent factor in depression during the pandemic. Research is needed to identify possible mechanisms through which loneliness conveys risk for pandemic-era depression. Two potential mechanisms are boredom and repetitive negative thinking (RNT). This study examined cross-sectional associations between depression, loneliness, boredom, and RNT in a sample of college students ( = 199) in April 2020 immediately following campus closure. Results showed a serial indirect effect of loneliness on depression through boredom then RNT. Moreover, specific indirect effects of loneliness on depression were found through boredom and RNT, individually. Though limited by the cross-sectional design, these data align with cognitive-behavioral theory and identify boredom and RNT as possible mechanisms of the association between loneliness and depression in college students during the COVID-19 pandemic.

Rumination and worry are vulnerability factors involved in the early development of depression and anxiety during adolescence, particularly in girls. Current views conceptualize rumination and worry as transdiagnostic forms of repetitive negative thinking (RNT). However, most of research has analyzed them separately, without considering gender differences. We analyzed common and specific roles of rumination and worry in accounting for depressive and anxiety symptom levels overall and as a function of gender in adolescents ( = 159). Rumination and worry items were loaded into separate RNT factors. Girls showed a higher use of rumination and worry and higher levels of depression and anxiety than boys. Structural equation modeling supported that both RNT factors accounted for gender differences in symptom levels: rumination was the strongest mediator for depression and worry the strongest mediator for anxiety. Our findings support both general and specific contributions of RNT to account for affective symptomatology during adolescence, particularly in girls.

Suicide is a public health concern which warrants considerable attention, especially with the onset of the COVID-19 pandemic. The current study sought to examine the relationship between behavioral, psychological, and economic impacts of COVID-19 on suicidal ideation severity in a sample of 90 undergraduate students who completed a comprehensive survey on mental health in January 2020 and were re-assessed in April, June, and July of 2020. Multiple regression analyses showed that changes in experience of loneliness, loneliness due to social distancing, pandemic-related concerns, COVID contagion anxiety, and quarantining alone positively and significantly correlated with peri-pandemic suicidal ideation severity after accounting for pre-pandemic suicidal ideation and sexual orientation, while time spent talking to romantic partner and time spent talking to friends and family were negatively correlated. Findings provide insights into the psychological and behavioral effects of social distancing measures and the pandemic, but further research is needed to generalize findings.

Dusseldorf Illustrated Schema Questionnaire for Children (DISC) measures early maladaptive schemas (EMS) in childhood. EMS are emotional and cognitive rules and patterns formed in childhood and adolescence because of unmet emotional needs which are maintained throughout life and negatively affect one's potential. The first aim of the current study is to adapt DISC to the Turkish language and examine its psychometric properties to facilitate preventive intervention during early childhood. The second aim of the study is to investigate the relationship between schemas and childhood difficulties. The sample consisted of 771 (419 females, 352 males) children of first graders (8-year-old) to twelfth graders (14-year-old) from 54 of the 81 cities in Turkey. Cronbach's value for the total of 36 items was calculated as .89 and values for subscales ranged between .42 and .83. The test-retest reliability coefficient of the total of the scale was .79 at 1 month and subscales' test-retest values ranged between .31 and .91. Confirmatory factor analysis showed a good fit for the purported 18-factor model of the original DISC in the Turkish version within a sample of children from diverse socio-economic and cultural backgrounds from Turkey. The Turkish version of the DISC indicated a reliable and valid instrument to assess maladaptive schemas in children.

The COVID-19 pandemic has resulted in increased distress and uncertainty. Understanding the progression of mental health and factors underlying the perpetuation of distress during the pandemic is pivotal in informing interventions and public health messaging. This current study examined longitudinal effects of two cognitive vulnerabilities, looming cognitive style, and intolerance of uncertainty, as well as coping styles on anxiety and depression through online questionnaires at two time points in the pandemic, May 2020 ( = 1520) and August 2020 ( = 545). Depression, but not anxiety, significantly increased across time, which was moderated by coping style. Serial mediation modeling using path analysis demonstrated a significant pathway illustrating increased looming cognitive style in the beginning of the pandemic leads to increased intolerance of uncertainty, avoidant coping, and anxiety later in the pandemic. Results suggest a novel model in conceptualizing anxiety during the pandemic, namely highlighting looming cognitive style as an underlying cognitive vulnerability factor and antecedent of intolerance of uncertainty and illuminating the temporal directionality between looming cognitive style and intolerance of uncertainty. These findings provide important implications regarding intervention and public health messaging with modifiable behavioral and cognitive factors to improve mental health during a pandemic.

We previously found that rumination maintains obsessive-compulsive (OC) symptoms. Our goal was to explore the moderating roles of three characteristics in the immediate and intermediate effects of rumination on OC symptoms: trait rumination, severity of comorbid depressive symptoms, and the tendency to misinterpret the occurrence of unwanted intrusive thoughts as meaningful. We reanalyzed our previous study's data and explored in a sample of 145 individuals diagnosed with obsessive-compulsive disorder (OCD) whether any of the three characteristics moderated the observed immediate and intermediate effects of rumination on OC symptoms. Only the tendency to misinterpret unwanted intrusive thoughts moderated the immediate and intermediate effects of rumination on OC symptoms. If this result is confirmed in future studies, individuals with OCD and a high tendency to misinterpret unwanted intrusive thoughts might benefit particularly from supplemental interventions targeting the reduction of excessive rumination.

This study was aimed at exploring the possible roles of the cognitive attentional syndrome (CAS) and metacognitive beliefs in moderating the relationships between fear of coronavirus during the pandemic and health anxiety. Because some symptoms of health anxiety may overlap with symptoms of other anxiety disorders, we also tried to ascertain whether our hypothesized relations would be maintained when taking other anxiety disorder symptoms into account. We hypothesized that CAS strategies and meta-beliefs would play a role in the progression from fears of the coronavirus to coronavirus health anxiety. The method done was a cross-sectional study with  = 783 participants who completed questionnaires on fear of coronavirus, coronavirus-specific health anxiety, CAS, and symptoms of anxiety disorders. Fear of coronavirus and coronavirus health anxiety are correlated with medium effect size. CAS and metacognitive beliefs moderate the relationship between fear of coronavirus and symptoms of coronavirus-specific health anxiety. CAS predicts a unique part of health anxiety symptoms variance above symptoms of other anxiety disorders. The results of this cross-sectional study preclude causal inferences but tentatively suggest that CAS strategies may play a role in moderating the relationship between fear of coronavirus and coronavirus-related health anxiety. These relationships were obtained after controlling for variance shared with agoraphobia, social phobia, and general physical symptoms of anxiety.

Research has shown threat overestimation is significantly associated with intolerance of uncertainty (IU), and both processes predict higher anxiety and safety behavior usage. However, the extent to which threat overestimation predicts subsequent COVID-19-related distress may vary as a function of IU. The present study examined IU as a moderator of the relationship between COVID-19 threat estimation and subsequent COVID-19 fear and safety behavior use. Between February 27 and March 26, 2020, participants ( = 57) completed a self-report measure of IU and estimated the number of people they believed had died from COVID-19. Four weeks later, participants completed measures of COVID-19 fear and safety behavior use. Results revealed IU significantly predicted subsequent COVID-19 fear and safety behavior use. IU also moderated the effect of threat estimation on COVID-19 fear such that those who underestimated threat and experienced low to moderate levels of IU reported experiencing lower levels of COVID-19 fear 1 month later.

Current models suggest health anxiety as a fundamental variable associated with fear and anxiety related to COVID-19. The investigation was carried out in separate two studies on the Iranian population. The first study aims to test the COVID-19 Anxiety Inventory ( = 202). The findings indicate a two-factor structure of the scale. Participants ( = 1638) completed the online survey anonymously in the second study, including the COVID-19 Anxiety Inventory, Short Health Anxiety Inventory, The Intolerance of Uncertainty Scale, Anxiety Sensitivity Index-3, Body Vigilance Scale, Depression Anxiety Stress Scales 21, and Contamination Cognitions Scale. Results showed that health anxiety, anxiety sensitivity, and body vigilance would significantly contribute to fears of contracting COVID-19. Moreover, the findings support a central role of intolerance of uncertainty in predicting COVID-19 anxiety. The study results provided both theoretical and practical implications for understanding psychosocial predictors during the COVID-19 pandemic.

The COVID-19 epidemic, which spread rapidly around the world, has had a significant negative impact on mental health. Obsessive-compulsive disorder (OCD) issues are among the main mental health effects of COVID-19. The purpose of this study is to develop a brief measurement tool that reliably and validly measures obsessive-compulsive (OC) symptoms in people with COVID-19. A total of 483 people took part in the research online. Individuals with aberrant item scores were excluded, and a series of validity and reliability analyses were performed to determine the psychometric properties of the COVID-19-specific obsessive compulsive symptoms scale (C19-OCS). C19-OCS was found to be a valid and reliable measure for assessing OC symptoms in relation to COVID-19. Mental health professionals could use C19-OCS to develop evidence-based intervention strategies and programs.

Group cognitive behavioral therapy (CBT) is an effective treatment for adolescent depression, but outcomes vary. Our goal was to examine interpersonal factors that predict response to group CBT for adolescent depression using a broad range of outcomes, including depressive symptoms, session attendance, treatment completion, engagement, and improvement. Seventy adolescents (age 14-18) with depression completed self-report measures of social support and parental conflict and were offered an established 16-session group CBT program. Correlation and regression analyses were conducted for interpersonal predictors and CBT outcomes. Accounting for pre-treatment depressive symptoms, fewer social supports predicted lower likelihood of finishing treatment and less clinician-rated improvement. Greater pre-treatment parental conflict predicted fewer sessions attended, lower clinician-rated engagement, and less clinician-rated improvement. Results highlight the need to consider interpersonal difficulties in CBT, as they may present a barrier to treatment attendance, engagement, and improvement.

Anxiety and uncertainty are common during pandemics. The present study extended previous pandemic research by investigating the role of two transdiagnostic risk factors - anxiety sensitivity (AS: fear of physiological anxiety or "fear of fear"; Reiss & McNally, 1985) and intolerance of uncertainty (IU; Buhr & Dugas, 2009) - in explaining relations between mental distress symptoms and behavioural responding during the COVID-19 pandemic. Student and community-based participants (N=457; 87.6% female) were recruited between May and July 2020 to complete measures of anxiety (health, panic, general), depression, and stress. Anxiety and related symptoms were found to be higher than in previous studies. Parallel mediation analyses showed that clinically meaningful levels of mental distress symptoms influenced safety behaviours and medical care utilization but also influenced the latter (vs. former) through AS-physical concerns (vs. IU). CBT interventions, targeting AS-physical concerns, may reduce mental distress symptoms during pandemic and prevent overuse of healthcare.

Chronic worry and generalized anxiety disorder (GAD) symptoms are associated with infrequent savoring, and high dampening, of positive emotions. The goal of the present study was to investigate the indirect role of GAD-relevant processes, including intolerance of uncertainty (IU), fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation, in the relationship between GAD symptom severity and the tendency to engage in dampening and not savor positive emotions. Community participants ( = 233) completed questionnaires online. In separate models, IU, fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation fully mediated the relationships between GAD symptom severity and greater dampening and lower savoring. However, controlling for depression, only IU remained a significant mediator. A post hoc latent analysis of the mediators provided support for an underlying construct that may reflect intolerance of uncomfortable states. Intolerance of uncomfortable states was found to significantly mediate the relationship between GAD symptoms and greater dampening and lower savoring. Difficulty withstanding uncertainty may be particularly relevant in understanding why people with elevated GAD symptoms engage in efforts to avoid experiencing positive emotions. Further, the findings suggest that there may be a common factor underlying a variety of GAD-associated constructs reflecting a broad intolerance of uncomfortable inner states. Theoretical and clinical implications are discussed.