Psychology

Permanent URI for this collectionhttps://digital.lib.washington.edu/handle/1773/4959

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Behavioral and Cognitive Avoidance as Predictors of Session-by-Session Change During Prolonged Exposure Therapy
(2026-04-20) Pandey, Shivani; Zoellner, Lori A; King, Kevin M
Avoidance of trauma-related stimuli and feelings can provide short term relief. However, long-term avoidance can become pervasive, hindering new learning that is necessary for therapeutic change. This study investigated the role of both pre-treatment and in-session measures of behavioral avoidance and rumination, conceptualized as a cognitive avoidance strategy, on PTSD and depression symptom change during a course of prolonged exposure (PE) therapy. We hypothesized that higher pre-treatment and in-session avoidance would be predictive of flatter reductions in both PTSD and depression symptom change from pre-to-post treatment. Data from a randomized control trial (N = 149) were used to investigate study questions. Pre-treatment behavioral avoidance and rumination were measured with self-report measures. Avoidance and unproductive processing, a form of rumination, during PE sessions was measured using an observational coding system (CHANGE). Structural equation models were used to investigate study questions. Contrary to hypotheses, analyses revealed higher pre-treatment behavioral avoidance, but not rumination, was associated with steeper decreases in PTSD symptoms (β = -.373; p = .004) throughout treatment. Higher baseline rumination, but not behavioral avoidance, was associated with steeper decreases in depression symptoms (β = -.221; p = .032) from pre-to-post treatment. Higher in-session avoidance was associated with less declines in PTSD symptom trajectories (β = .327; p = .026). Taken together, individuals with high baseline rumination and avoidance can still make clinically meaningful shifts during PE. Mid-point of treatment seems to be an important time during which therapeutic stagnation may occur, indicating that clinicians should pay special attention to avoidance and emotional engagement at this time to ensure therapeutic gains.
Psychological Responses to and Acceptance of Medical AI: Comparing Human Provider, AI Provider, and their Collaboration
(2026-02-05) Han, Jee Hoon; Joslyn, Susan
Advances in medical artificial intelligence (AI) have accelerated the development of diagnostic tools designed to support or replace human clinicians, yet public acceptance of these systems remains uncertain. This dissertation examines how psychological responses vary depending on the type of diagnostic provider: Human, AI, or a Human + AI collaboration. In a between-groups experiment inspired by Longoni et al. (2019), participants viewed a skin-cancer screening scenario that involved one of the three providers. Willingness to use the service differed only between the Human and AI conditions, but substantial differences emerged in underlying psychological reactions. Trust and confidence followed a consistent pattern where the Human condition had the highest ratings followed by Human + AI, then AI last, indicating that lack of trust in AI persists and collaboration only partially restores the trust associated with human providers. Diagnostic-worry analyses revealed stronger worry about under-diagnosis (miss) than over-diagnosis (false alarm), particularly when AI was involved. Participants were also more likely to seek a second opinion when the provider was AI or Human + AI rather than Human, and when the diagnosis was Cancer-Positive. These findings demonstrate that acceptance of medical AI is multifaceted and that merely adding a human reviewer may not sufficiently address patients’ concerns. Targeted communication strategies that address provider-specific worries, such as concerns for under-diagnosis with AI diagnosis, may be necessary to support effective and trustworthy integration of AI in medical decision-making.
Who is 'Asian'? Challenging Essentialist Categorization Through Scientific Communication.
(2026-02-05) RAY, ISHIKA; Shoda, Yuichi
Research on racial categorization has largely treated 'Asian' as a monolithic category, despite substantial heterogeneity in national origins, phenotypic features, and cultural practices within this population. This dissertation examines how the category 'Asian' is represented in human cognition, artificial intelligence systems, and psychological research practices, with particular attention to systematic bias toward East Asian prototypes that renders South Asian, Southeast Asian, and Central Asian populations less visible. Study 1 investigated how differences in (i) categorization instructions and (ii) response categories provided would affect face-sorting behavior with 139 participants across three independent tasks. When provided with disaggregated Asian subgroup categories (East Asian, Southeast Asian, South Asian, Central Asian), participants recognized a substantially broader range of individuals as belonging to some Asian subgroup compared to conventional binary Asian/non-Asian choices, with increases of up to 46 percentage points for faces with the lowest baseline categorization proportions. Study 2 examined whether AI image generators exhibit similar biases. Forty images generated using prompts with varying diversity reminders were categorized by 191 participants. Results revealed that AI systems default to East Asian representations, with substantial between-platform differences. Critically, diversity-focused prompts did not significantly alter AI outputs, suggesting surface-level prompt engineering cannot override deeply embedded patterns in training data. Study 3 conducted a scoping review of 408 studies across eight psychology journals. Among 91 studies mentioning Asian participants, 89.0% used only the broad label 'Asian' without ethnic disaggregation, and 58.8% failed to specify whether identity was self-reported or researcher-assigned. Study 4 examined how 336 participants perceived the accuracy of different identity measurement formats. Pan-ethnic umbrella terms received the lowest accuracy ratings, while formats allowing participants to select self-descriptive labels received higher ratings. Collectively, these findings reveal systematic biases in how 'Asian' identity is operationalized across racial categorization behavior, AI systems, and research practices – suggesting that categorization patterns reproduce essentialist boundaries historically encoded in legal and bureaucratic definitions, and that these patterns can be challenged through methodological transparency and disaggregated measurement approaches.
The Color of Foreignness: Distinct Consequences for Black Groups in the United States
(2026-02-05) Hailu, Fasika; Cheryan, Sapna
The majority of the social psychology literature to date suggests that being perceived as culturally foreign is a significant cause of discrimination (Tuan, 1998; Yogeeswaran & Dasgupta, 2010; L. X. Zou & Cheryan, 2017). In three studies (N = 1,188), we investigate the uniquely positive effect of perceived foreignness on Black groups in the United States. In Study 1, we establish that the relationship between negative stereotyping and perceived foreignness operates differently for Black and Asian groups. Consistent with current literature, we find that stereotypes of Asian immigrants are more negative than those of Asian Americans. However, we find the reverse effect for Black groups: stereotypes of Black immigrants are less negative than those of Black Americans. Study 2 finds that Black immigrants are perceived as higher status, warmer, and less progressive than Black Americans. In Study 3, we examine the mediating role of status stereotypes in an educational context. Undergraduate students anticipate higher work quality on a final project when paired with a Black immigrant partner compared to a Black American partner, and this effect is driven by perceptions that Black immigrants are higher status than Black Americans. Findings reveal that the consequences of perceived foreignness may take a unique form for Black individuals in the U.S. Understanding how groups are differentially affected by perceptions of foreignness is crucial for identifying when and why groups are most likely to encounter discrimination.
Organization-Level Determinants for Low Secondary Traumatic Stress in Lay Counselors Delivering Trauma-Focused Cognitive Behavioral Therapy in Kenya
(2026-02-05) Dahiya, Priya; Dorsey, Shannon
Eighty percent of the world’s youth live in low- and middle-income countries (LMICs), yet access to trauma-focused mental health care in these settings remains limited despite a high burden of mental health disorders and trauma exposure among youth. Task-shifting models that train lay counselors to deliver evidence-based treatments can expand access to care, yet delivering trauma-focused treatment may increase counselors’ vulnerability to secondary traumatic stress (STS). Organization-level support may play an important role in sustaining counselor well-being, yet little is known about which organizational factors are protective (i.e., contribute to low STS) in resource-limited settings. Data came from an implementation-effectiveness trial for an adapted trauma-focused cognitive behavioral therapy in western Kenya, to examine organizational factors linked to low STS among two groups of lay counselors: community health volunteers (CHVs; N = 120) and teachers (N = 117). Counselors completed surveys following training and treatment delivery that assessed supervisory relationships, leadership, implementation climate, feasibility, and organizational climate. We applied Coincidence Analysis, a configurational method, to identify organization-level determinants of low STS. Among CHVs, a solution with three pathways was identified for low STS: high supervision relationship; high implementation climate with high implementation leadership; and high feasibility with high transactional leadership. Among teachers, a different solution with three pathways emerged: high implementation climate; high supervisory relationship with a positive perceived work environment; and low transactional leadership with high transformational leadership. No single organizational factor was necessary for low STS. Instead, multiple configurations were sufficient, and these differed across provider roles and their organizational contexts. These findings suggest that organizational strategies to prevent or mitigate STS should be tailored to provider roles and settings. As task-shifting models expand in LMICs, centering lay counselors’ well-being within organizational management and treatment development will be critical to sustaining the workforce and ensuring quality trauma-focused care.
The Impact of Sign Language on Visual Attention and the Development of the American Sign Language Test Battery
(2026-02-05) Awad, Jasmine F; Fine, Ione
This dissertation presents two projects aimed at advancing accessibility in research and education for D/deaf individuals. The first applied a dual task paradigm to American Sign Language (ASL) letter signs to examine whether deafness or ASL experience alters divided attention. Deaf signers, Children of Deaf Adults (CODAs), and Hearing Non-Signers all showed moderate costs when dividing attention between two letters, with no group differences. This divided attention cost, observed equally across all groups, highlights the need to incorporate what is known about attention in D/deaf individuals when designing classrooms and other learning environments to ensure they are accessible. The second project developed the American Sign Language Test Battery (ASLTB), a low-cost, self- administered online screening tool that minimizes reliance on English and does not require ASL-fluent experimenters. Strong correlations with self-reported fluency and validated measures of ASL receptive skills support its effectiveness for inclusive participant recruitment. By lowering logistical and expertise barriers, the ASLTB enables more representative sampling and supports research that better reflects the diversity of ASL users. Together, these projects advance understanding of divided attention in a diverse deaf group and provide the beginnings of a practical tool for more inclusive ASL research.
Alcohol-related perceived parental approval: The moderating role of identity exploration
(2026-02-05) Pandya, Urmi Sumit; Larimer, Mary E; Foster, Katherine T
Perceived parental approval plays a key role in influencing college student alcohol use outcomes. However, much remains unknown about how it varies over time, whether there are within-person associations with alcohol use, and whether identity exploration moderates its influence. To address this gap, we estimated cross-sectional (Aim 1 N = 2767 college students, 62.8% female, Mage = 19.94) and longitudinal (Aim 2 N = 1494 students, 63.2% female, Mage = 20.13) associations between perceived parental approval and four alcohol use indices: number of weekly drinks, peak estimated blood alcohol concentration, alcohol-related negative consequences, and alcohol-related attitudes. As hypothesized, all cross-sectional associations were significant and, at the within-person level, students reported elevated weekly drinking when perceiving their parents as more approving than usual. Identity exploration enhanced associations between perceived parental approval and negative consequences both cross-sectionally (b = -0.21, p < .01, 95% CI [-0.35, -0.07]) and at the between-person level from the longitudinal model, the latter of which was probed using finite differences: at an identity exploration of a standard deviation below the mean, a one-unit increase moving from a mean of parent-approval grand-mean centered to a standard deviation above the mean corresponds with a 0.96 increase (95% CI [0.76, 1.22]). in alcohol-related negative consequences. By contrast, at a one standard deviation above the mean of identity exploration, a one-unit increase moving from a mean of parent-approval grand-mean centered to a standard deviation above the mean corresponds with a 0.42 point increase (95% CI [0.3, 0.6]) in alcohol-related negative consequences. These findings highlight need for further study of within-person effects and emphasize that parental disapproval is less protective for students who have a strong commitment to exploring their own personal identity.
Microdosing Hallucinogens/ Psychedelics: Trends and Practices Among College Students and Young Adults
(2025-10-02) Szydlowski, Victoria; Larimer, Mary E
The emerging behavior of microdosing hallucinogens/psychedelics is, at minimum, broadly defined as the act of taking a low dose of a hallucinogen/psychedelic. Interest in microdosing hallucinogens/psychedelics generally stems from the promising clinical trial results of "full" dose hallucinogen/psychedelic use as well as legalization efforts and corporate investment in hallucinogens/psychedelics. Increasingly, interest in microdosing includes as a wellness practice for enhancing mood and cognition as well as a treatment for mental health and substance use symptoms, however research is sparse. As part of two large ongoing studies, we recruited participants who were generally screened for lifetime microdosing. Through a brief web survey, we aimed to document the frequency of microdosing, including concurrent use of other substances (Aim 1); to examine associations between etiological risk factors (e.g., use patterns, normative perceptions, motivations, expectancies, openness, consequences, and other substance use) as they relate to microdosing frequency and consequences (Aim 2); and to provide preliminary psychometric validation of measures of microdosing expectancies and motives (Aim 3). A purposive sample of survey respondents with variability in constructs of interest to understanding microdosing was then invited to participate in a qualitative interview to provide a more nuanced understanding of patterns of use, perceived benefits, and perceived consequences of microdosing (Aim 4). Results indicate microdosing hallucinogens/psychedelics among college students and young adults is a variable and heterogenous behavior. Increased cannabis use is significantly associated with a slightly higher microdosing frequency, though alcohol and NMPS use are nonsignificant. Both descriptive and injunctive microdosing norms for close friends are associated with greater microdosing frequency as well as injunctive norms for close friends associated with more microdosing consequences. Greater microdosing frequency is significantly associated with more microdosing consequences, and a more positive evaluation of microdosing consequences. Neither microdosing frequency nor consequences are significantly associated with greater openness to experience. Increased insomnia symptoms, described in some qualitative interviews as a stimulant-like energy disrupting sleep, are associated with more microdosing consequences. Increased anxiety symptoms are associated with lower microdosing frequency. There is no significant association with depression symptoms and either microdosing frequency or consequences. Preliminary psychometric validation of two cognitive microdosing constructs, found neither identified factor structure for microdosing motives (Factor 1: "Fun Without Tripping", Factor 2: Perception Shift, Factor 3: Cognitive Enhancement, and Factor 4: Improve Mood/Mental Health) nor expectancies (Factor 1: Creativity and Connectedness, Factor 2: Improving Affect/Reducing Unwanted Affect, and Factor 3: Undesired Outcomes) is a strong fit. Nevertheless, microdosing motives Factors 1-3 are partially associated with microdosing frequency and consequences, yet all associations with microdosing expectancies factors are nonsignificant. In sum, among college students and young adults, findings from this exploratory study suggest microdosing hallucinogens/psychedelics is a low frequency, variable, and heterogenous behavior that may be considered as part of a larger polysubstance context. Microdosing trends in some associations with several etiologic risk factors (i.e., perceptions of social norms, motives, etc.) similar to other forms of substance use, which suggests it is not completely categorically different from other forms of substance use. Microdosing is associated with consequences, varying from its public perception as a risk-free means of enhancing health. Though this study did not recruit a clinical sample, microdosing was associated with some clinical symptoms (i.e., insomnia and anxiety). This exploration of microdosing associations and measurement psychometrics may inform future empirically supported mental health and substance use interventions for college students and young adults during a period of a rapidly shifting hallucinogen/psychedelic landscape.
‭ A Longitudinal Study of Speculative Trading Activities and Health Correlates in Young Adults
(2025-10-02) Song, Frank; Larimer, Mary
Problem gambling is a significant public health concern linked to profound behavioral health consequences, particularly for young adults who are affected by higher vulnerability to‬ risky behaviors. In the backdrop of online gambling's growing popularity, speculative short-term‬ trading of stocks and cryptocurrencies (e.g., Bitcoin) have seen major gains in popularity among‬ young adults. Emerging evidence suggests speculative trading entails many of the same risks and‬ harms as traditional gambling, warranting efforts to explore and minimize trading-related health‬ harms. The present study investigated behavioral health and substance use correlates of young‬ adult speculative trading through a longitudinal study design utilizing generalized linear mixed‬ models (GLMMs). The study aimed to 1) evaluate between-person associations between trading‬ and health indices, 2) assess within-person associations between trading and health indices, and‬ 3) explore moderators of the relationship between trading and health indices based on‬ theoretically supported links. We hypothesized that greater speculative trading activity would‬ predict greater depression, anxiety, and substance use behaviors at both between-person and‬ within-person levels. The results demonstrated a positive between-person association between‬ trading frequency and nicotine use intensity. They also highlighted the roles of financial stress,‬ sensation seeking, perceived norms and attitudes towards trading in moderating trading's‬ connections to behavioral health and substance use. Descriptive statistics from the study yielded‬ additional key insights into trading behaviors and related harms in our cohort of young adults.‬ Theoretically and empirically supported explanations and potential implications are discussed.‬ The current study serves as the first of its kind known to assess the longitudinal associations‬ between speculative trading activities and health correlates among young adults.‬
Racial Bias in Telemedicine: A Within-Subjects Study of Medical Student Attitudes and Affect
(2025-10-02) Manbeck, Katherine; Kanter, Jonathan W
Health disparities are a matter of grave public health significance. Racial health disparities have complex etiologies and correlates but remain when controlling for other social determinants of health and patient factors such as treatment refusal. Residual disparities reflect differences in provider treatment of White and minority patients. One factor contributing to disparate treatment of minority patients is provider implicit bias—non-conscious biases that alter behavior. However, research suggests that intervening directly on implicit bias may not be effective, indicating that novel directions are needed to understand and address health disparities. Effects of implicit bias on disparities may be clarified by articulating and examining the constructs underlying implicit bias. This dissertation examines intergroup anxiety (anxiety that manifests in interracial interactions in response to negative expectations) as a mediator of the relationship between implicit bias and provider behavior. I first conduct a narrative review to understand the literature related to implicit bias and intergroup behavior. Then, I report on a within-subjects study in which medical student participants (N = 71) interacted with Black and White standardized patients in a telemedicine context. In Aim 1, I conducted preliminary video review in hopes of developing a coding scheme to assess nonverbal behaviors indicative of anxiety. In Aim 2, I used regression analysis to examine the associations between intergroup anxiety and communication behaviors. In Aim 3, I used regression analysis and the Baron and Kenny mediation approach to assess the relationships between implicit bias and intergroup anxiety and the direct and indirect effects of implicit bias on communication behaviors. I report that one of six mediation models tested was significant; observer-rated nervousness was negatively associated with observer-rated warmth. However, as I explore in the results and discussion, low interrater reliability and concerns related to model assumptions indicate that readers should exercise caution in interpreting results. Despite methodological concerns, our preliminary findings indicate weak support for intergroup anxiety as a construct that contributes to disparate provider behaviors. While many health disparities researchers hope that further research will improve health disparities, it is the opinion of this author that most research exploring provider factors that contribute to racial health disparities lacks real-world impact and external validity, and that researchers should focus their work on connecting with communities in deep and intimate ways.
Gender prototypicality shapes self-perceptions of and bystander responses to women's sexual harassment
(2025-10-02) Schachtman, Rebecca; Kaiser, Cheryl
Nonprototypical women (e.g., masculine, transgender, Black, etc.) are especially vulnerable to sexual harassment but face greater credibility discounts relative to prototypical women (e.g., feminine, cisgender, White, etc.). In three parts and across thirteen pre-registered studies (total N = 4,922), we examine the consequences of this prototype bias for women's self-perceptions (Part 1) of and bystander responses (Parts 2 and 3) to their sexual harassment. We advance the literature on the prototype bias by testing these novel outcomes and manipulating gender prototypicality in different ways within and across studies. In Part 1, six studies show that wearing more masculine vs. feminine clothing, but not possessing more masculine vs. feminine traits, leads women to perceive the same experiences as less sexually harassing. In Part 2, a meta-analysis across four experiments shows that bystanders intervene less readily for women who possess more stereotypically masculine vs. feminine traits and are transgender vs. cisgender. In Part 3, unexpectedly, Black vs. White women receive similar support from bystanders across three experiments, suggesting the prototype bias may not extend to this form of between-group prototypicality. Taken together, this work highlights the pervasiveness and limits of the prototype bias in how women perceive their own sexual harassment and bystanders respond to women's sexual harassment.
Workplace Sexual Harassment of Non-Prototypical Women: Cognitive Processes and Legal Outcomes
(2025-10-02) Ferguson, Z E; Kaiser, Cheryl R
Sexual harassment is widespread in the workplace, yet people do not equally perceive all women as victims. Grounded in intersectionality theory and prototype models of social perception, this dissertation explores whether people are less likely to see women who deviate from the dominant cultural prototype (White, young, straight, feminine) as legitimate when claiming sexual harassment and advances research on sexual harassment by (a) examining new forms of intersectional prototypicality, (b) testing the boundaries of prototype bias in legal professionals using realistic case materials, and (c) evaluating an intervention to reduce reliance on biased prototypes in victim judgments. Chapter 1 uses MouseTracker to test whether participants are less likely to categorize Black (vs. White), lesbian (vs. straight), and middle-aged (vs. young-adult) women as harassment victims. Chapter 2 tests this bias in a legal context by asking civil rights attorneys to evaluate cases involving prototypical and nonprototypical women. Chapter 3 introduces an educational intervention that aims to reduce prototype bias in both laypeople and legal professionals.
Memory and the #MeToo Movement: Understanding Cognitive Mechanisms of Risk for Posttraumatic Psychopathology Following Sexual Assault
(2025-10-02) PeConga, Emma; Zoellner, Lori
Background: Sexual assault exposure and posttraumatic psychopathology have been linked to a range of biases in general memory (e.g., Aupperle et al., 2012; Ono et al., 2016) and in the trauma memory itself (e.g., Brewin et al., 2014). These memory biases have been implicated in theoretical models of post-assault psychopathology (e.g., Rubin, 2016; Williams et al., 2007): working memory deficits may potentially impact the creation of new, positive memories (Vasterling et al.,1998), inhibitory deficits may impact normal forgetting processes (Storm & Levy, 2012), and lower autobiographical memory specificity may buffer emotional pain (Williams, 2006). However, it is not clear whether memory deficits reflect a pre-trauma risk factor (Parslow & Jorm, 2007; Gilberston et al., 2007), are a consequence of trauma exposure, or are exacerbated by psychopathology. Few longitudinal studies have been conducted to understand the dynamic associations among sexual assault, general memory processing, event-related memory, and psychopathology (PeConga, 2023). Method: This quasi-experimental study systematically examined variation in memory trajectories and psychopathology over time in university-age women (N = 216) at high risk for assault exposure (National Sexual Violence Resource Center, 2017). Sexual assault exposure was measured using a binary variable that combined endorsement of sexual assault on the Sexual Experiences Survey (SES-V; Koss, & Gidycz, 1985) and the trauma symptom checklist (PDS-5; Foa et al., 2016). Participants completed online versions of the digit span task (Wechsler, 1997), retrieval-induced forgetting task (Storm and Levy, 2012), and the autobiographical memory task (AMT; Williams & Broadbent, 1986). Participants also provided brief narratives of the most negative and positive events in the last year. Standardized questions about those events were coded for consistency over time and narratives were coded for emotionality (VADER; Hutto & Gilbert, 2014). Psychopathology was assessed using the Posttraumatic Stress Diagnostic Scale (PDS-5; Foa et al., 2016), Quick Inventory of Depressive Symptomatology (QIDS-SR; Rush et al., 2003), and Daily Drinking Questionnaire (DDQ; Collins et al., 1985). It was hypothesized that sexual assault exposure would predict next-session changes in general memory processing (working memory, retrieval-induced forgetting, autobiographical memory specificity). Second, general memory processing deficits would increase prior to decreases in emotional event memory consistency. Finally, psychopathology would increase prior changes in general memory processing (working memory, retrieval-induced forgetting, autobiographical memory specificity) and emotional event memory (consistency, emotionality). Results: The mean age of the sample was 19.54 (SD = 2.47, 18-35). About half (50.46%) reported lifetime experience of sexual assault at baseline (n = 109). Cross-lagged, longitudinal multilevel models with disaggregated within- and between-person effects found that the occurrence of sexual assault predicted next-assessment reductions in autobiographical memory specificity (SAt  AMTt+1: ES = -0.26, 95% credible interval [CI] = -0.45, -0.09), with a small effect. Further, higher retrieval-induced forgetting (RIFt  Consistencyt+1: ES = 0.19, 95% CI [0.29, 0.87]) and higher memory specificity (AMTt  Consistencyt+1: ES = 0.29, 95% CI [0.09, 0.31]) predicted higher next-assessment event memory consistency, with a small effect. Only higher emotionality of negative and positive emotional life event narratives predicted higher PTSD next assessment (e.g., Negativityt  PTSDt+1: ES = -.12, 95% CI [-0.17, 0.00]; Positivityt  PTSDt+1: ES = .14, 95% CI [0.00, 0.01]). Conclusion: These findings extend cross-sectional literature regarding associations between post-traumatic psychopathology and memory biases but raise questions about the causal role of memory processing biases on psychopathology. Temporal associations of retrieval-induced forgetting and autobiographical memory specificity predicting higher consistency of emotional event memories align with theories highlighting the mechanistic role general memory styles play in how highly emotional life events are remembered.
Depressed and Drinking: A Daily Diary Study of Mood, Alcohol, and Behavioral Activation
(2025-10-02) Gasser, Melissa; George, William
Young adults, compared to other age cohorts, are more likely to develop and experience depression and alcohol use disorders, singly or concurrently. Some interventions, including behavioral activation, have shown promise as potential concurrent treatment models for these concerns. Studies examining theorized behavioral activation treatment mechanisms alongside alcohol consumption and related factors, especially across multiple timepoints, are limited. We hypothesized that increased alcohol consumption (across timepoints) would be predicted by increased depression symptomatology, alcohol-related problems, and drinking to cope, as well as by decreased engagement with theorized behavioral activation treatment mechanisms. The current study (N = 109) explores these behavioral activation-, depression-, and alcohol-related factors in a college student sample through 22 daily online surveys. Results: alcohol-related problems and engagement with behavioral activation targets were both associated with alcohol consumption at baseline and only alcohol-related problems were predictive in longitudinal models of daily alcohol consumption, while in the weekly model, only the previous week's alcohol consumption and previous week's alcohol-related consequences were significant. These findings help to extend our understanding of the relation between depression, behavioral activation targets, and alcohol, and may help to refine mHealth or other interventions for this population.
Emotional and behavioral regulation as mediators of the association between adversity and dysregulated drinking
(2025-10-02) Smith, Michele R; King, Kevin M.; Lengua, Liliana J.
Young adult alcohol misuse results in over 1,500 deaths per year; thus, understanding contributing factors is crucial. Childhood adversity (CA) has been a demonstrated predictor of alcohol use, and behavioral and emotional dysregulation may be mechanisms for this association. Using ecological momentary assessment (EMA) of young adults aged 18-22 (N=496), this dissertation investigated how experiences of CA contribute to dysregulated drinking through effects on behavioral and emotional dysregulation in three studies. Study 1 investigated how different categorizations of CA relate to young adult behavioral and emotional dysregulation. Study 2 examined behavioral and emotional dysregulation as mediators of the associations between CA and daily dysregulated drinking. Finally, Study 3 used idiographic modeling to explore relations between negative affect, emotion dysregulation, and binge drinking in a high CA subsample. Overall results suggested that CA, specifically experiences characterized by threat, is associated with increased emotional dysregulation. Although there is limited support for behavioral dysregulation as a process linking CA and dysregulated drinking, emotion dysregulation appears to be a more likely pathway.
Hierarchical Drift Diffusion Modeling of Self-Referential Processing in Social Anxiety and Body Dysmorphic Disorder
(2025-10-02) Zhao, Yuchen; Fang, Angela
Body dysmorphic disorder (BDD) and social anxiety disorder (SAD) share hallmark features of heightened self-consciousness and maladaptive self-referential processing (SRP), yet the cognitive mechanisms underlying SRP in these disorders remain poorly understood. This study employed hierarchical drift diffusion modeling (HDDM) to examine SRP during a self-referential encoding task (SRET) among individuals with BDD, SAD, and healthy controls (HC). Drift rate, a model parameter indexing the efficiency of evidence accumulation, served as a proxy for SRP, with lower drift rates indicating greater decisional inefficiency in processing self-relevant information. A total of 58 participants (15 BDD, 15 SAD, 28 HC) judged positive and negative trait adjectives in self- and other-referential contexts. Both clinical groups endorsed fewer positive and more negative self-descriptors than HC, with no group differences in other-referential trials. Critically, both BDD and SAD showed reduced drift rates relative to HC in both self- and other-referential trials regardless of valence, although deficits were substantially larger for self-referential decisions. Within-group analyses showed marked self–other drift rate reductions in clinical groups. Across patients, disorder‑specific symptom severity predicted lower drift rates in self-referential trials even after controlling for depression. No drift rate differences emerged between BDD and SAD groups, suggesting a shared cognitive process. Together, these findings integrate computational modeling with experimental task data to reveal that BDD and SAD involve a generalized inefficiency in evaluating social information, most pronounced for self-relevant content, highlighting drift rate as a potential transdiagnostic marker of cognitive impairment.
Inter-leg Coordination and Static Stability of Walking Drosophila in Courtship
(2025-10-02) Zhang, Yuqing; Ahmed, Osama
Animals use different gaits (leg coordination patterns) to move at different speeds. Abundant research examines the step characteristics and leg coordination of walking Drosophila under controlled conditions, where individual flies exhibit straight forward walking. It remains unclear what walking patterns flies choose under a more complex, naturalistic behavior paradigm, such as courtship. During courtship, male flies exhibit a repertoire of walking behaviors, including following, turning, and circling. These behaviors require precise, flexible temporal and spatial coordination of limb movements. Here I explore how male flies position their legs in courtship context. Using high-speed videography and pose estimation, we tracked male Drosophila during engaged (active courtship) and disengaged walking. We found that while stepping kinematics (stance duration and step length) were broadly similar across social contexts, static stability of the leg coordination diverged. Specifically, engaged males exhibited greater use of more stable coordination patterns, particularly at low to intermediate speeds. These findings indicate that while locomotor parameters remain stereotyped, static stability is flexibly modulated during social interactions. We conclude that social goals, such as tracking or signaling to a mate, shape locomotor strategy. This study highlights how internal and external context shape motor output and raises the question of how neural circuits integrate social cues to influence movement in natural behaviors.
Identifying Mechanisms of Change in Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD): A Mixed Methods Examination of Mediators of Substance Use Reduction
(2025-10-02) Kwon, Diana Mi-Jung; Forsythe Cox, Vibh
Substance use disorders (SUDs) often co-occur with other mental health disorders, such as borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), and eating disorders. Historically, treatment systems have struggled to treat both substance use and other co-occurring mental health symptoms concurrently, often requiring abstinence before access to therapy is offered. Such approaches miss the mark in how to meet the needs of these complex individuals with co-occurring SUD and other mental health disorders. Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD) offers an integrated model tailored to address the needs of this population, combining evidence-based strategies to address emotion dysregulation and foster behavioral changes, such as moderation or abstinence from substances, as well as targeting suicidal and non-suicidal self-injurious behaviors. However, the mechanisms through which DBT-SUD achieve behavioral changes, particularly reductions in substance use, are not well understood. This study utilized an exploratory sequential mixed methods design to identify and test potential mechanisms of substance use change in DBT-SUD. Phase 1. Traditional ethnographic methods were used to analyze video-recorded therapy sessions from an RCT of DBT-SUD. Using both inductive and deductive coding strategies, four themes emerged that appeared to support reductions in substance use: reducing experiential avoidance, developing strong therapeutic alliance, cultivating self-validation and self-efficacy, and adopting dialectical thinking. Reduction in opioid use appeared to occur not through isolated skill use, but through dynamic interactions between therapist and client where trust and safety were paramount. This therapeutic alliance and safe environment seemed to allow for more willingness to experience emotions and engage in behavior change. Phase 2. Informed by the qualitative findings, this phase tested three longitudinal path models to examine whether these hypothesized mechanisms predicted reductions in opioid use across the treatment year. Data included repeated assessments of experiential avoidance, emotional ambivalence, emotion regulation, therapeutic alliance, and reduction in opioid use (via UA). While the hypothesized mediation pathways were not supported by the models, therapeutic alliance emerged as a significant predictor of reduction in opioid use and increased emotion regulation. These findings provide emerging evidence for the therapeutic alliance as a potential mechanism of change in DBT-SUD and underscore the need for more nuanced and precise ways of operationalizing alliance within complex treatments.
Psychosocial Support Needs and Preferences Among Family Caregivers of ICU Patients with Severe Acute Brain Injury: A Qualitative Thematic Analysis
(2025-10-02) Reichman, Mira; Foster, Katherine
Family caregivers of patients with severe acute brain injury (SABI) are at risk for clinically significant chronic emotional distress, including depression, anxiety, and posttraumatic stress. Existing psychosocial interventions for caregivers of intensive care unit (ICU) patients are not tailored to the unique needs of caregivers of patients with SABI, do not demonstrate long-term efficacy, and may increase caregiver burden. In this study, we explored the needs and preferences for psychosocial services among SABI caregivers to inform the development and adaptation of interventions to reduce their emotional distress, during and after their relative's ICU admission. In this multicenter, longitudinal, qualitative study, we conducted semi-structed interviews with SABI caregivers at two time points: during their relative's ICU admission (n=30) and 2-months later (n=20). We analyzed qualitative data using a hybrid of inductive and deductive analytic techniques. We recruited family caregivers of patients with SABI from 14 U.S. neuroscience ICUs. We conducted interviews over live video. Our convenience sample of SABI caregivers (n=30) was recruited through referral by medical teams and nursing staffs across participating neuroscience ICUs. Caregivers included spouses, children, parents, and siblings to patients with SABI. We identified themes and subthemes related to participants' preferences for 1) the content of psychosocial support services, and 2) the delivery and implementation of psychosocial support services. Findings revealed a significant unmet need for psychosocial support around the time of ICU discharge and 2 months later, including: information to understand their loved one's condition and guide difficult decision-making, education regarding how best to communicate with the patient's care team and other family members, and emotional and behavioral coping skills. Our findings provide specific recommendations to justify and inform the development and adaptation of psychosocial support services for SABI caregivers in the ICU and post-discharge.
Comparison of Estimation Algorithms for Latent Class Models
(2025-10-02) Yu, Jessica; Flaherty, Brian
Latent class models are used to identify unobserved subgroups in a population, but estimation ischallenged by multimodal likelihood surfaces that can produce local solutions. This study employed Monte Carlo simulations of four-class models with varying sample sizes, class prevalences, and measurement error to investigate the prevalence, proximity, and interpretability of local optima, as well to compare the behavior of two estimation algorithms: Expectation- Maximization and Newton-Raphson. Local solutions often emerged in difficult conditions and yielded qualitatively different class interpretations, highlighting potential instability in parameter recovery. In addition, the two algorithms exhibited different estimation behavior despite being initialized with the same sets of starting values. These findings support the use of exploring local solutions and employing multiple estimation strategies to ensure robust and reliable inference in latent class analysis.

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