Browsing by Author "Curry, John F"

Substance use disorders are one of the most common psychiatric diagnoses among adolescents; marijuana is the illicit drug used most frequently by youth. Treatment dropout and relapse following treatment are common; innovative strategies are needed to improve treatment outcomes for youth substance abusers. The aim of this study was to develop and evaluate the feasibility of a virtual reality (VR) cue reactivity paradigm for adolescent cannabis abusers and to compare it to a video cue reactivity paradigm. Forty-two treatment-seeking youth with a cannabis use disorder completed the study, which incorporated three parts. During Part 1, drug and neutral video clips were shown to 11 youth and five substance-abuse experts who provided craving/usefulness ratings for each video clip. During Part 2, five youth met in a focus group and then individually to provide input on the development of the VR paradigm. During Part 3, 26 youth completed a laboratory procedure involving neutral and drug-related video clips and VR presentations. Heart rate, skin conductance, and skin temperature were measured as well as craving. Higher levels of craving and skin conductance were observed during drug-related presentations. The presentations did not significantly differ in their ability to elicit craving and arousal. Results suggest that youth can experience subjective and physiological reactivity to VR drug cues warranting further study with a larger, more diverse sample. Implications are discussed.

The overarching goal of this study is to enhance the current understanding of how college students with disordered eating experience alcohol. The study focuses on negative consequences, drinking behaviors, alcohol expectancies, and outcomes to a high-risk drinking prevention program. Taking a novel perspective to examine these problem behaviors, the current study uses a national sample of college students (N=8,095) who participated in an internet-based alcohol prevention program (AlcoholEdu for College, www.outsidetheclassoom.com). Multiple multivariate analyses were conducted. The results found that male and female college students with disordered eating are a high-risk drinking population. They reported higher rates of binge drinking, experienced more negative alcohol consequences, and engaged in more risky drinking behaviors and less protective drinking behaviors than college students without disordered eating. Additionally, most but not all, college students with disordered eating endorsed higher alcohol expectancies. College students with mild disordered eating also reported slightly worse outcomes to the program than students without disordered eating. The results suggest that college students with disordered eating should be targeted as a high-risk drinking population.

Among some researchers, there is an emerging conceptualization of chronic tic disorders (CTDs) as conditions that are partially rooted in avoidance of tic-related private experiences (i.e., painful or difficult thoughts and feelings) and internal sensations (i.e., premonitory urges to tic). The first specific aim of the present research was to investigate the possibility that experiential avoidance is related to tic severity and perceived quality of life in individuals with CTDs. The second aim was to determine whether the efficacy of Habit Reversal Training (HRT), the most prevalent and effective behavioral intervention for CTDs to date, might be enhanced by combining it with Acceptance and Commitment Therapy (ACT), an intervention that directly targets experiential avoidance. These aims were addressed by conducting two related studies. Study I, an online survey, included 239 adults (M = 37.6 years; SD = 13.8 years) who reported having been previously diagnosed with a CTD. Results showed that levels of premonitory urges, as well as both general and tic-specific experiential avoidance, were significantly positively related to tic severity. General and tic-specific experiential avoidance were also significantly negatively related to perceived quality of life. Psychometric analyses of two novel measures developed for Study I (i.e., the Yale Global Tic Severity Scale-Self-Report Version and the Acceptance and Action Questionnaire-Tic-Specific Version) demonstrated excellent internal consistency and convergent validity. Study II, a multi-site pilot investigation, involved 13 adolescents (M = 15.4 years; SD = 1.3 years) who were treated with either HRT alone or a novel HRT+ACT intervention. Results suggest that the HRT+ACT treatment is feasible, highly acceptable to both patients and parents, and as effective as HRT alone at reducing tic severity from pre-treatment through week 22 follow-up. Participants in both groups reported clinically significant post-treatment decreases in general and tic-specific experiential avoidance and improvements in overall functioning. Researchers concluded that experiential avoidance plays an important role in tic expression and overall functioning for individuals with CTDs. Results support additional development and testing of the promising HRT+ACT intervention, to evaluate its efficacy alone and in comparison to other relevant psychosocial and pharmacological interventions.

After the committing of an error or transgression, some people are prone to experience shame (they feel badly about themselves) and some are prone to experience guilt (they tend to feel badly about their action or inaction). Although a sizable number of researchers have examined how shame and guilt relate to distress or health, the field knows very little about whether persons are more prone to shame or whether shame is more strongly associated with distress when the error is particularly relevant to the offender's sense of self. The current research aims to address this significant gap in the literature.

One domain in which people's self-view and sense of worth is often heightened is their work or vocation. Clergy have been shown to collapse who they are with what they do or are called to do in their role as pastor. Therefore, a measure that uses failures that clergy may experience in their role was created to examine how this domain specific shame and guilt relate to general shame and guilt, positive and negative affect, and clergy burnout.

Student pastors generated items for the new scale of domain specific shame and guilt. Seminary students completed questionnaires online and were asked to complete the new measure again one month later to establish test-retest reliability. Factor analyses were run to examine the structure of the shame and guilt scales. A secondary factor analysis found that the four guilt factors all loaded onto one second-order factor and the three shame factors all loaded onto another second-order factor. Cronbach's alpha and test-retest reliability were strong. Construct validity was established. Next, United Methodist clergy completed measure by pen and paper or online.

Overall the data demonstrate that higher shame, both in ministry situations and in secular situations, was significantly associated with higher negative affect among seminarians and less satisfaction and more emotional exhaustion in ministry among clergy. Contrary to expectations, seminarians and clergy were not more prone to ministry shame nor was ministry shame more strongly associated with clergy burnout than was general proneness to shame.

NEED TO GO BACK AND ENTER WHEN I AM SURE IT IS COMPLETE

During adolescence, both boys and girls confront a period of heightened risk for dissatisfaction with weight and shape and engagement in unhealthy appearance-related behaviors. For many adolescents, this risk coincides with involvement in a range of romantic partnerships. Although a considerable body of empirical work has investigated same-gender peer influences on weight- and shape-related attitudes and behaviors, very little research has examined the role of romantic partners in this socialization process. Derived from social norms and social rewards theories of influence, this study examined several distinct modes through which romantic partners may influence changes in gender-specific behaviors and attitudes over a 6-month period. Participants included 214 (56% female) male and female adolescents ages 16-17 who reported having a romantic partner (of varying seriousness and relationship length) at Time 1. Results from multiple group (by gender) longitudinal path analyses revealed that both boys and girls experienced weight-related influence from a romantic partner. The seriousness and length of a romantic partner relationship moderated some, but not all, influence effects. Findings suggest that romantic relationships are important contexts for changes in adolescents' appearance-related health. Future research should examine romantic partners as contributors to both health-risk and health-promoting behaviors and attitudes.

Over the last three decades, there has been a precipitous rise in curiosity regarding the clinical use of mindfulness meditation for the self-management of a broad range of chronic health conditions. Despite the ever-growing body of evidence supporting the use of mindfulness-based therapies for both medical and psychological concerns, data on the active ingredients of these mind-body interventions are relatively scarce. Regular engagement in formal mindfulness practice is considered by many to be requisite for generating therapeutic change; however, previous investigations of at-home practice in MBIs have produced mixed results. The equivocal nature of these findings has been attributed to significant methodological limitations, including the lack of standardized, systematic practice monitoring tools, and a singular focus on practice time, with little attention paid to the nature and quality of one’s practice. The present study used a prospective, observational design to assess the effects of home-based practice on dispositional mindfulness, self-compassion, and psychological functioning in twenty-eight people enrolled in an MBSR or MBCT program. To address some of the aforementioned limitations, the present study collected detailed weekly accounts of participants’ home-based practice engagement, including information about practice time (i.e., frequency and duration), exercise type, perceived effort and barriers to participation, and practice quality. Hierarchical multiple regression was used to examine the relative contribution of practice time and practice quality on treatment outcomes, and to explore possible predictors of adherence to at-home practice recommendations. As anticipated, practice quality and perceived effort improved with time; however, rather unexpectedly, practice quality was not a significant predictor of treatment-related improvements in psychological health. Home practice engagement, however, was predictive of change in dispositional mindfulness, in the expected direction. Results of our secondary analyses demonstrated that employment status was predictive of home practice engagement, with those who were unemployed completing more at-home practice on average. Mindfulness self-efficacy at baseline and previous experience with meditation or other contemplative practices were independently predictive of mean practice quality. The results of this study suggest that home practice helps generate meaningful change in dispositional mindfulness, which is purportedly a key mechanism of action in mindfulness-based interventions.

Despite the prominence of cognitive theories of anxiety disorders, which posit that thoughts can affect the expression of psychopathology, empirical investigation of the origins of such thoughts is scant. In the study of obsessive-compulsive disorder (OCD), a number of cognitive factors, deemed obsessive beliefs, have been identified as correlates of the disorder. Although both parenting behaviors and obsessive beliefs have demonstrated associations with obsessive-compulsive symptoms, research exploring the relations between all three of these constructs has been heretofore limited. Moreover, given the moral content of some obsessions and compulsions (e.g. praying, harm prevention techniques), it is possible that specific moral socialization techniques serve to promote obsessive beliefs. This study investigated parenting, obsessive beliefs, moral socialization and obsessive-compulsive symptoms in a large non-clinical sample (N=288). Thirty-four students who were measured as relatively high or low on obsessive beliefs subsequently completed an additional procedure in which they were interviewed about moral socialization. Results provided support for a model in which obsessive beliefs served as a mediator of the relations between parenting behaviors and symptom levels. Adding self-conscious emotions to the model as a covariate significantly improved overall fit statistics. With respect to moral socialization, few differences emerged in the moral socialization histories of individuals relatively high or low on obsessive beliefs. However, those in the high obsessive beliefs group were more likely to report relationship-centered discipline (i.e. the parent using damage to the parent-child relationship as a vehicle for punishment) than those in the low obsessive beliefs group.