Rachel Hershenberg

Medical University of South Carolina, Charleston, South Carolina, United States

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Publications (13)17.52 Total impact

  • Rachel Hershenberg, Marvin R. Goldfried
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    ABSTRACT: The field of psychotherapy is at an important juncture. Recent changes in the field include (1) the skeptical reception of the Fifth Edition of the Diagnostic and Statistical Manual and (2) the National Institute of Mental Health (NIMH)’s prioritization of an alternative classification system to guide translational and intervention research. Moreover, (3) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroad. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development.
    Behavior Therapy. 10/2014;
  • Rachel Hershenberg, Daniel F Gros, Olga Brawman-Mintzer
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    ABSTRACT: Evidence-based treatment approaches for generalized anxiety disorder (GAD) comprise psychotherapy, pharmacotherapy, or a combination of the two. First-line pharmacotherapy agents include selective serotonin reuptake inhibitors, selective serotonin-norepinephrine reuptake inhibitors, and, in certain European guidelines, pregabalin, which gained European Commission approval. Although short- and long-term efficacy have been established for these agents in controlled trials, response rates of 60-70 % are insufficient, remission rates are relatively modest, and relapse rates considerable. Moreover, questions increasingly arise regarding tolerability and side-effect profiles. As an alternative, antipsychotics have long been of interest for the treatment of anxiety disorders, but investigation had been tempered by their potential for irreversible side effects. With the improved side-effect profiles of atypical antipsychotics, these agents are increasingly being investigated across Axis I disorders. Atypical antipsychotics such as quetiapine, aripiprazole, olanzapine, and risperidone have been shown to be helpful in addressing a range of anxiety and depressive symptoms in individuals with schizophrenia and schizoaffective disorders, and have since been used in the treatment of a range of mood and anxiety disorders. In this article, we review the efficacy and tolerability of atypical antipsychotics as adjunctive therapy and/or monotherapy for individuals with GAD, a currently off-label indication. The most evidence has accumulated for quetiapine. Findings suggest that approximately 50 % of participants tolerate the side effects, most commonly sedation and fatigue. Among this subset, those who continue treatment demonstrate significant reductions in anxiety when used as adjunctive therapy or monotherapy. The appropriateness of the use of antipsychotics in the treatment of GAD is discussed.
    CNS Drugs 05/2014; · 4.38 Impact Factor
  • Rachel Hershenberg, Daniel Paulson, Daniel F Gros, Ron Acierno
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    ABSTRACT: Background: Accumulating evidence supports behavioral activation (BA) as an effective stand-alone treatment for improving depression and related conditions, though little is known about the factors that influence positive outcomes. Such research is ripe for future dissemination and implementation efforts, particularly among vulnerable older adult populations in need of such efficacious and transportable treatments. Aims: Given the central but largely unexamined role that increasing activities plays in BA, we investigated the association between participation in weekly activities and treatment outcome. Method: As a preliminary study of this research question, we report on a sample of 20 older adults with symptoms of depression and complicated bereavement who completed 5 weeks of BA, pre- and posttreatment measures, and weekly planners of BA activities. All activities were coded as either functional or pleasurable (by participants) and if they were social in nature (by trained coders). Results: Overall, BA was associated with reductions in symptomatology. However, participants' total number of reported activities, and their relative proportion of functional, pleasurable, and social activities, did not significantly relate to their improvement in symptoms. Conclusion: One interpretation of the findings suggests that countering avoidance more generally, potentially independent of the specific type or total amount of activation activities, may be associated with amelioration of symptomatology.
    Behavioural and Cognitive Psychotherapy 03/2014; · 1.69 Impact Factor
  • Daniel F Gros, Melissa E Milanak, Rachel Hershenberg
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    ABSTRACT: Despite psychometric rationale to include multiple informants, psychological assessment typically involves data collected from the patient (target) only, particularly with regard to depressive and anxious symptomatology. This study addressed this gap in the literature by assessing convergence between targets and their close friends (informants) in an ethnically diverse sample of young adults. One hundred and thirty-nine friendship dyads completed a packet of questionnaires including different versions administered to the targets and informants, with targets completing the standard questionnaire battery focused on their own symptoms and informants completing questionnaires on their view of the target participants' symptoms, rather than their own characteristics. Measures were included to assess a wide range of symptomatology, including behavioral, cognitive, and physiological symptoms of anxiety and depression. The target-informant correlations were largely significant and of small-to-medium magnitude. In addition, target-informant agreement was higher in more visible symptoms (e.g., behavioral) than in less visible symptoms (e.g., physiological) of anxiety and depression. Interestingly, level of closeness in the relationship did not influence the magnitude of correlations. Implications for future research and integration into clinical assessment practices are discussed.
    Journal of social and clinical psychology. 12/2013; 32(10):1061-1074.
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    ABSTRACT: Recent research demonstrates that it is the quality rather than the frequency of social networking experiences that places individuals at risk for negative mental health outcomes. However, the mechanisms that account for this association have yet to be examined. Accordingly, this study examined whether the tendency to negatively compare oneself with others while using Facebook leads to increases in depressive symptoms, and whether this association is mediated by increases in rumination. A sample of 268 college-age young adults completed an initial online survey and a 3-week follow-up. Path analysis was used to test the hypothesized model, wherein negative social comparison on Facebook was predicted to be associated with increases in rumination, which, in turn, was predicted to be associated with depressive symptoms. The model controlled for general social comparison to test the specific effect of social comparison on Facebook over and above the tendency to engage in social comparison in general. Results indicated that the hypothesized mediation effect was significant. In sum, in the context of social networking, negatively comparing oneself with others may place individuals at risk for rumination and, in turn, depressive symptoms. Findings increase understanding of the mechanisms that link social networking use to negative mental health outcomes and suggest a continued emphasis on examining the specific processes that take place in the context of social networking that may be pathogenic.
    Psychology of Popular Media Culture. 01/2013; 2:161-170.
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    ABSTRACT: We propose a four-level, recursive Research-Practice Integration framework as a heuristic to (a) integrate and reflect on the articles in this Special Section as contributing to a bidirectional bridge between research and practice, and (b) consider additional opportunities to address the research-practice gap. Level 1 addresses Treatment Validation studies and includes an article by Lochman and colleagues concerning the programmatic adaptation, implementation, and dissemination of the empirically supported Coping Power treatment program for youth aggression. Level 2 translation, Training in Evidence-Based Practice, includes a paper by Hershenberg, Drabick, and Vivian, which focuses on the critical role that predoctoral training plays in bridging the research-practice gap. Level 3 addresses the Assessment of Clinical Utility and Feedback to Research aspects of translation. The articles by Lambert and Youn, Kraus, and Castonguay illustrate the use of commercial outcome packages that enable psychotherapists to integrate ongoing client assessment, thus enhancing the effectiveness of treatment implementation and providing data that can be fed back to researchers. Lastly, Level 4 translation, the Cross-Level Integrative Research and Communication, concerns research efforts that integrate data from clinical practice and all other levels of translation, as well as communication efforts among all stakeholders, such as researchers, psychotherapists, and clients. Using a two-chair technique as a framework for his discussion, Wolfe's article depicts the struggle inherent in research-practice integration efforts and proposes a rapprochement that highlights advancements in the field.
    Psychotherapy Theory Research Practice Training 06/2012; 49(2):143-51. · 0.84 Impact Factor
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    ABSTRACT: This Special Section, developed by the American Psychology Association's Division 12 (Clinical) 2011 Committee on Science and Practice, highlights different ideas to help bridge the gap between clinical research and clinical practice, and notes recent innovations that help make research-practice integration feasible. The articles consider how to break down the barriers to enhance researcher-practitioner dialogue, as well as how to make ongoing outcome assessment feasible for clinicians. Moreover, the articles address how to promote training in evidence-based practice, and how to translate efficacy research into clinical practice and clinical insight into empirical study to better establish a two-way bridge between research and practice. Ultimately, we hope this series can speak to many different types of psychologists, whether they work mainly as researchers or practitioners, so they can see new ways to integrate and learn from both research and practice.
    Psychotherapy Theory Research Practice Training 06/2012; 49(2):97-100. · 0.84 Impact Factor
  • Rachel Hershenberg, Deborah A G Drabick, Dina Vivian
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    ABSTRACT: Clinical researchers and clinical practitioners share a goal of increasing the integration of research and clinical practice, which is reflected in an evidence-based practice (EBP) approach to psychology. The EBP framework involves the integration of research findings with clinical expertise and client characteristics, values, and preferences, and consequently provides an important foundation for conducting clinically relevant research, as well as empirically based and clinically sensitive practice. Given the critical role that early training can play in the integration of science and practice and in promoting the future of the field, the present article addresses predoctoral training programs as a context for adopting an EBP approach to clinical work. We address training in the three components of EBP and provide suggestions for curriculum development and practicum training that we hope will contribute to bridging the gap between research and practice.
    Psychotherapy Theory Research Practice Training 06/2012; 49(2):123-34. · 0.84 Impact Factor
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    ABSTRACT: Two studies examined associations between social networking and depressive symptoms among youth. In Study 1, 384 participants (68% female; mean age = 20.22 years, SD = 2.90) were surveyed. In Study 2, 334 participants (62% female; M age = 19.44 years, SD = 2.05) were surveyed initially and 3 weeks later. Results indicated that depressive symptoms were associated with quality of social networking interactions, not quantity. There was some evidence that depressive rumination moderated associations, and both depressive rumination and corumination were associated with aspects of social networking usage and quality. Implications for understanding circumstances that increase social networking, as well as resulting negative interactions and negative affect are discussed.
    Psychology of popular media culture. 04/2012; 1(2):72-86.
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    ABSTRACT: OBJECTIVE: Research has linked adolescent romantic and sexual activities to depressive symptoms. The current study examines whether such activities are uniquely linked to depressive symptoms versus symptoms of other disorders (including anxiety, externalizing, and eating disorders), and whether co-occurring symptoms more precisely account for the association between depressive symptoms and romantic involvement. METHOD: Early adolescent girls (N = 83; mean age = 13.45) participated in baseline and 1-year follow up data collection. RESULTS: Romantic (i.e., dating and sexual) activities were longitudinally related to numerous types of symptoms. The association between depressive symptoms and romantic variables remained when considering co-occurring symptoms. Girls with more comorbid disorders reported more romantic activities. CONCLUSIONS: Results suggest that the maladaptive consequences and precipitants of adolescent romantic activities extend beyond depression, but also imply that this association is not secondary to comorbid symptoms. Future work should clarify causal pathways.
    Journal of Clinical Psychology 02/2012; · 2.12 Impact Factor
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    ABSTRACT: Because the ability to flexibly experience and appropriately express emotions across a range of developmentally relevant contexts is crucial to adaptive functioning, we examined how adolescent attachment security may be related to more functional emotional behavior during a relationship promoting interaction task. Data were collected from 74 early adolescent girls (Mean age 13.45 years; SD = 0.68; 89% Caucasian) and their primary caregiver. Results indicated that, regardless of the parent's interaction behavior and the level of stress in the parent-adolescent relationship, greater adolescent security was associated with more positive and less negative behavioral displays, including greater positivity, greater coherence of verbal content and affect, less embarrassment, and less emotional dysregulation in response to a situational demand for establishing intimacy with the parent. Implications for encouraging and fostering adolescents' capacity to respond to interpersonal contexts in ways that promote the relationship are discussed.
    Journal of Adolescence 10/2011; 34(5):1017-24. · 2.05 Impact Factor
  • Rachel Hershenberg, Joanne Davila
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    ABSTRACT: Building on the growing body of research that supports the relationship between depressive symptoms and sexual activities in adolescence, we examined how individual differences in interpersonal avoidance and anxiety might moderate this association. Data were collected from 71 early adolescent girls (M age 13.45 years; SD = 0.68; 89% Caucasian) concurrently and 1 year later. Results indicated that greater depressive symptoms predicted a greater frequency of sexual intercourse both concurrently and 1-year later, particularly among more interpersonally avoidant girls. However, greater depressive symptoms predicted a greater frequency of non-intercourse activities 1-year later among less avoidant girls. Implications for understanding how individual differences in interpersonal style may serve as risk or protective factors in dysphoric girls' sexual experiences are discussed.
    Journal of Youth and Adolescence 09/2009; 39(8):967-76. · 2.72 Impact Factor
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    ABSTRACT: Building on evidence that romantic experiences are associated with depressive symptoms in adolescence, we examined their bidirectional association, as well as the role of sexual activity and parent-adolescent stress in their association. Data were collected from 71 early adolescent girls (M age 13.45 years; SD=0.68) and their primary caregiver initially and one year later. Results indicated that adolescents who engaged in more romantic activities experienced increases in depressive symptoms over time. Second, greater depressive symptoms predicted romantic involvement and sexual activities, including intercourse, one year later. Third, dysphoric adolescents who were experiencing higher parent-adolescent stress were the most likely to engage in subsequent sexual intercourse. Implications for understanding how the association between depressive symptoms and romantic and sexual experiences develops and the course of this association are discussed.
    Journal of Adolescence 12/2008; 32(4):909-24. · 2.05 Impact Factor