9:30–9:40: Welcome and Introduction -Philip C. Kendall, Ph.D., ABPP

Hosts for the day:  Lauren Ellman, Ph.D. & Michael McCloskey, Ph.D.

9:40–10:00: Weight Perception, Substance Use, and Weight Control Behavior in High-School Students

Dawn Eichen (Fauber)

 
The present study examined the association between misperception of weight and the use of substances (cigarettes, binge drinking and cocaine) on disordered eating behaviors (fasting, diet product use and vomiting or laxative use).  Data were from 11,103 adolescents from the Youth Risk Behavior Surveillance System, a nationally representative sample of high school students in the United States.  Overestimation of weight among normal weight adolescents, and accurate perception of weight among overweight adolescents was associated with disordered eating behaviors.  In normal weight individuals, use of all three substances was associated with each disordered eating behavior.  However, there was some differentiation between substance use and disordered eating behavior among overweight individuals.  This study demonstrates the need for universal prevention programs in adolescents aimed at reducing disordered eating behaviors as well as substance use.

10:00–10:20: Role of Comorbid Depression and Co-occurring Depressive Symptoms in Outcomes for Anxiety Disordered Youth Treated with Cognitive-Behavioral Therapy

Kelly A. O’Neil (Kendall)

This study examined the role of (a) comorbid depressive disorders and (b) co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia). Results indicated that higher levels of child-reported depressive symptoms predicted less favorable treatment outcome. Higher levels of mother-reported depressive symptoms predicted less favorable treatment maintenance at one-year follow-up. Comorbid depressive disorders and teacher-reported depressive symptoms did not predict treatment outcome or maintenance. Results suggest that co-occurring depressive symptoms play a role in effective treatment for anxiety-disordered youth and further suggest the need for treatment adaptations for these youth.

10:20–10:40: Characterizing Planning Behavior in Everyday Action

Colette Seter (Giovannetti)

This study examined evidence for planning and planning failures in participants with schizophrenia and healthy controls engaged in everyday tasks.  Forty-six inpatients with schizophrenia (SZ) and 26 healthy controls (CT) were administered the Naturalistic Action Test (NAT), a performance-based test of everyday functioning.  NAT performance was scored for errors, accomplishment, and overall ability according to the test manual.  In addition, planning was coded as proactive planning behaviors (PB; e.g. gathering items before engaging in a subtask), planning inefficiencies (PI; e.g. performing task steps in an inefficient sequence), and planning time (PT; time elapsed before beginning a task).  Planning variables were reliably coded but were not significantly correlated.  Therefore, planning variables were analyzed separately.  SZ participants performed worse than CT on all NAT performance variables.  The CT group demonstrated more PB than the SZ group; however, this difference was accounted for by education.  The SZ group demonstrated a trend for more PIs, and this difference remained after controlling for education.  Differences in PT were observed when analyzed as a proportion of the total time on tasks.  Planning variables were related to performance variables, as participants with more PBs also had higher overall NAT scores, and participants with more PIs made more errors on the NAT.  In sum, planning behaviors may be reliably coded, but different planning measures may reflect independent aspects of everyday planning.  Planning behaviors and planning time differentiate people with schizophrenia from controls and are related to overall functioning. Thus, rehabilitation strategies that emphasize planning time and proactive planning behaviors may facilitate everyday functioning in people with schizophrenia.

10:40–11:00: BREAK

11:00–11:20: A Further Test of the Cognitive Vulnerability – Stress Model of Depression Within the Context of the Kindling Hypothesis

Shimrit K. Black (Alloy)

A prospective multi-wave study tested Hopelessness theory’s and Beck’s cognitive vulnerability-stress models of depression. At an initial assessment, participants were determined to be at high or low cognitive vulnerability for depression based on their scores on measures of negative inferential style and dysfunctional attitudes. Throughout a 2-year span, participants completed measures of negative life events and depressive symptoms at 6-week intervals. In support of the vulnerability-stress model, hierarchical linear modeling (HLM) analyses showed that cognitive risk status moderated the relationship between biweekly negative events and changes in levels of depressive symptoms, with individuals at high cognitive risk exhibiting significantly greater increases in their depressive symptoms when experiencing high levels of stress. Supplementary analysis assessing the kindling model suggested that the moderation of the relationship between stress and depression by cognitive style changed over time. In the second year of participation, individuals at both high and low cognitive risk for depression showed no significant changes in depressive symptomatology in response to increased stress.

11:20–11:40: Differences between African Americans and European Americans with Social Anxiety Disorder Seeking Treatment in an Anxiety Specialty Clinic

Judy Wong (Heimberg)

Few studies have examined treatment-seeking behaviors of clinically-impaired African Americans, despite evidence that they underutilize mental health services. We hypothesized that African Americans with social anxiety disorder seeking treatment in an anxiety specialty clinic (N = 60) would exhibit greater symptom severity, greater impairment, and lower quality of life compared to European Americans with social anxiety disorder (N = 217). Results did not support study hypotheses. However, significantly fewer African American men than women sought treatment, compared to European Americans. African American men had the highest life satisfaction in the sample and European American men the lowest, suggesting that cultural factors may influence the relationship between life satisfaction and tendency to seek treatment among individuals with social anxiety disorder.

11:40–12:00: Externalizing Comorbidity, In-Session Externalizing Behavior, and Outcome in Youth Treated for Anxiety Disorders

Julie M. Edmunds (Kendall)

The present study examined comorbid externalizing disorders and in-session externalizing behavior (ISEB) as predictors of treatment outcome for 46 youth (M age = 10.24) who received family or individual cognitive-behavioral therapy for their principal anxiety disorder.  Externalizing and non-externalizing children were matched on gender, treatment condition, and principal anxiety disorder.  Outcome was defined continuously as clinical severity ratings (CSRs) and categorically as the presence or absence of the principal anxiety disorder.  Multiple regression analyses found no association between comorbid externalizing disorders and anxiety CSRs at posttreatment or 1-year follow-up.  Higher rates of ISEB coded during early treatment sessions were associated with greater decreases in the severity of the principal anxiety disorder at posttreatment, though not at 1-year follow-up.  Logistic regression analyses found no association between comorbid externalizing disorders or ISEB and the presence or absence of the principal anxiety disorder at posttreatment or 1-year follow-up.  The findings lend some support to the generalizability of anxiety treatment to youth with comorbid externalizing disorders and behaviors.

12:00–1:30: BREAK FOR LUNCH

1:30–1:50: Autistic Features in Anxiety disordered Youth and Differential Responsiveness to Cognitive-Behavioral Therapy

Connor Puleo (Kendall)

Autistic symptoms were assessed in principally anxiety-disordered children (N = 50) using (a) the Social Responsiveness Scale – Parent Version (SRS-P) and (b) observational coding of in-session behavior based on the Autism Diagnostic Observation Schedule. Identified symptoms were examined as predictors of differential treatment response in a randomized clinical trial of individual (ICBT) and family cognitive behavioral therapy (FCBT) via multiple and logistic regression analyses. According to SRS-P reports, children with moderate autistic symptomology were significantly more likely to improve from FCBT than ICBT (odds ratio 2.56). Coded behavior was not correlated with SRS-P scores or predictive of treatment outcome. Results suggest that ICBT, but not FCBT, is less effective for anxious children with moderate levels of parent-reported autistic symptoms.

1:50–2:10: The Specific Importance of Communicating About Sex to Couples’ Sexual and Overall Relationship Satisfaction

Jennifer L. Montesi  (Fauber)

Communication about sexual issues is an important aspect of communication between partners, and one that is particularly sensitive for couples. As such, its importance to relationship satisfaction may be in some ways distinct from the importance of general communication soundness. The purpose of this study was to examine the impact of both general communication and sexual communication on couples’ overall and sexual satisfaction. We predicted that positively viewed sexual communication between partners would be associated with both sexual and relationship satisfaction above and beyond their association with general communication soundness. Data on general communication soundness, sexual communication, overall relationship satisfaction, and sexual satisfaction were collected from 115 heterosexual, monogamous, committed couples in relationships of at least 3 months duration. Results supported the prediction that positively-viewed sexual communication between partners would be related to both overall happiness and sexual satisfaction. Furthermore, satisfaction with sexual communication accounted for unique variance in both sexual and overall relationship satisfaction; general communication quality did so only for overall relationship satisfaction.

2:10–2:30: Social Anxiety, Loneliness, and Depression: Do Romantic Relationships Make a Difference?

Elizabeth A. Gordon (Heimberg)

High rates of comorbidity between social anxiety and depression suggest that social anxiety may foster a set of interpersonal conditions, including lower social support and increased isolation, which generate depression. Based on the hypothesis that loneliness mediates the relationships between social anxiety and both depression and lower quality of life, the current study explored the potential of romantic relationships to mitigate these negative outcomes.  Undergraduate student involvement in a romantic relationship was associated with better psychological functioning for individuals across the social anxiety spectrum, as indicated by measures of depression, loneliness, social support, and quality of life. Loneliness partially mediated the relationship between social anxiety and depression and fully mediated the relationship between social anxiety and lower quality of life in both single and partnered samples. Although there was a greater association between social anxiety and social support dissatisfaction among single individuals than partnered individuals, involvement in a romantic relationship moderated neither the relationship between social anxiety and loneliness nor the relationship between social anxiety and depression.  Among partnered individuals, one’s own social anxiety was associated with higher levels of partner social anxiety and depression. Further, partner depression, but not partner social anxiety, moderated the relationship between one’s own social anxiety and depression, so that this relationship intensified with more depressed partners. In contrast, relationship satisfaction had no impact on the relationship between social anxiety and depression. Finally, the self-reported tendency of a partner to help his or her mate avoid social situations contributed unique variance to the prediction of one’s own depression.  In contrast to our hypotheses, partner depression but not social anxiety was associated with reports of helping one’s partner avoid social situations. Implications of these findings are discussed.

2:30–2:50: Frontal EEG Asymmetry in Individuals with Bipolar Spectrum Disorders as a Predictor of Substance and Alcohol Use Problems

Kim Goldstein (Alloy)

Considerable evidence demonstrates an association between bipolar disorder and substance use disorders (SUDs). Nonetheless, the neurophysiological mechanisms underlying their co-occurrence remain unclear. Affective processing and mood regulation play a significant role in both disorders, and research suggests that lateralized frontal brain activity may account for individual differences in affective traits linked to vulnerability to psychopathology, including risk for mood disorders and SUDs. The present study tested a prospective model of bipolar disorder/substance use co-occurrence involving resting frontal EEG asymmetry, mood, and drug/alcohol use. We evaluated this model in right-handed individuals with a bipolar spectrum diagnosis and right-handed individuals with no major affective psychopathology. It was hypothesized that a right-lateralized pattern of frontal EEG activity would be associated with prospective drug/alcohol use problems among the bipolar disorder participants but not the controls, and that increased depressive symptoms would mediate this relation. In line with our model, a right-lateralized pattern of frontal EEG asymmetry predicted drug use problems in bipolar participants, and higher levels of depressive symptoms mediated this relation. Results provide one potential risk trajectory for bipolar individuals who develop substance use problems, suggesting that frontal EEG asymmetry has consequences for mood, which may increase vulnerability for SUDs.

2:50-3:00 Closing Remarks