Dave Haaga

American University | AU · Department of Psychology

Prior studies of behavior therapy for trichotillomania (TTM) have shown that response is variable, and relapse after treatment discontinuation is common. Little information is available concerning prognostic factors capable of predicting individual differences in response or maintenance of improvement. The present study is a secondary analysis of a...

Purpose Two methods of operationalizing readiness to quit smoking have been used extensively in prior research. An algorithm derived from the transtheoretical model classifies current smokers in distinct stages of precontemplation (not intending to quit in next 6 months), contemplation (serious intent to quit within 6 months), and preparation (seri...

Background Behavioral treatments of body-focused repetitive behaviors are effective, but access to expert therapists is limited. Access might be improved by use of web-based self-help, but nonadherence limits the efficacy of these programs. This trial tested an intervention derived from the “strength” model of self-control (Baumeister et al in Pers...

Nonclinical hair-pulling is much more prevalent than hair pulling associated with a diagnosis of trichotillomania (TTM). However, little is known about nonclinical pulling. The purpose of this exploratory research was to begin characterizing a subset of nonclinical hair pullers we refer to as "untroubled pullers," people who engage in recurrent, no...

Unconditional self-acceptance (USA) may be described as the ability of individuals to accept themselves, regardless of personal flaws, life achievements, being praised, valued or accepted by others. It reflects an ability to be truly in touch with oneself. However, cultural adaptation of this instrument to European Portuguese is lacking. This study...

Research has shown that outcome expectancies predict smoking behavior, and expectancy challenge interventions can reduce smoking. This study tested the hypothesis that supplementing expectancy challenge with a behavioral activation intervention promoting increased exposure to alternative reinforcers would help increase motivation to quit and induce...

The Comprehensive Behavioral (ComB) model of treatment for trichotillomania (TTM) organizes cues for, and perceived consequences of, hair pulling in terms of five modalities (Sensory, Cognitive, Affective, Motoric, Place - SCAMP). The model proposes that assessment based on the SCAMP domains facilitates treatment by guiding individualized conceptua...

The Comprehensive Behavioral (ComB) model of treatment for trichotillomania (TTM) and other body-focused repetitive behaviors offers a framework for individualized, flexible intervention based on functional analysis. This case report focuses on the treatment of a patient who enrolled in the first randomized clinical trial of ComB for TTM (Carlson e...

Objectives School-based interventions with parent-training components might improve access among lower-income families to effective help for children with neurodevelopmental disorders. This potential might be realized, however, only if parents perceive the interventions as acceptable and therefore engage with treatment. Methods Parents (N = 124) o...

This study provides the longest follow-up yet for comprehensive behavioral (ComB) treatment of trichotillomania (TTM) (M = 24.59 months after pre-treatment and 15.92 months after the last follow-up point in a recent clinical trial (CITATION MASKED), which had shown ComB to be significantly more efficacious than minimal attention at post-treatment)....

Objective This study is the first controlled trial of comprehensive behavioral (ComB) treatment of trichotillomania (TTM). ComB provides individualized treatment based on factors triggering and maintaining hair pulling. Method Participants (N = 36) were adults (M = 34.08 years old, SD = 12.26) meeting DSM5 criteria for TTM. A majority were female...

Introduction: The looming vulnerability model holds that people become anxious when they perceive threats as growing larger and accelerating toward them in space and time. Preliminary research suggested that a guided imagery induction designed to activate a sense that health consequences of smoking are a looming threat led more smokers to attempt...

Objective: Affective features of depression are uniquely involved in the depression-smoking relationship, and it follows that smokers with depression are likely to use cigarettes to alleviate negative affect. However, most ecological momentary assessment (EMA) studies demonstrate no relationship between mood and smoking, in general. Conversely, a...

In a motivational interviewing (MI) framework of decision-making, we consider potential outcomes for both a primary choice and an alternative choice (DiClemente & Velazquez, 2002). Thus, we would expect that motivation to quit smoking is related to expectancies for quitting smoking and expectancies for continuing to smoke. While smoking expectancie...

Introduction: Experimental manipulations intended to alter cognitive appraisals of smoking-related threats may affect cigarette smoking and motivation to quit. However, no previous measure has directly assessed perceptions of smoking-related threats as increasing and coming closer in space and/or time (i.e., "looming"). The current research develo...

Participants (N = 94) were randomly assigned to one of two experimental conditions, watching a brief video of a nature scene or of an urban scene. Following the video exposure, participants responded to subjective measures. Those who were exposed to the nature video showed higher scores on connectedness to nature, positive affect, state mindfulness...

Outcome expectancies for specific coping strategies may help explain why people vary in their choices of coping strategies (e.g., whether to smoke a cigarette or talk to a friend). These choices have relevance to both physical and mental health. The current study evaluated the psychometric properties of a new measure of mood regulation expectancies...

This study aimed to concretize and pilot test comprehensive behavioral (ComB) treatment of trichotillomania (TTM), to facilitate rigorous testing of its efficacy. ComB provides a conceptualization to develop individualized treatment and choose interventions for managing distinct factors that maintain the individual's hair pulling. It has been used...

Objective: This study investigated relationship functioning in trichotillomania (TTM) as well as specific interpersonal behaviors that have received little attention in TTM research, including by-proxy pulling, symptom accommodation, and self-disclosure. The objective was to contribute data for future development of components of treatment that fo...

Psychotherapists are in the challenging position of needing to (a) listen to traumatic self-disclosures well enough to form empathically accurate responses to clients and (b) keep such self-disclosures and their own emotional reactions to them private, without © becoming burned out or suffering excessively from compassion fatigue. To shed light on...

Numerous studies of trichotillomania (TTM) incorporate measures of the extent of alopecia (hair loss) resulting from hair pulling. This study used data from a clinical trial of stepped care for TTM to provide further evidence pertaining to a 1-7 alopecia rating scale (Tolin et al. 2002). Ratings were based on photographs of participants’ (N = 60) m...

Objective Treatment outcome was compared among non-Hispanic White and racial/ethnic minority participants with trichotillomania (TTM), or hair-pulling disorder.Method Symptom severity, quality of life, and TTM-related disability were compared in a behavior therapy trial with a stepped care approach: web-based self-help and then individual behavior...

Research has indicated that the “observing” facet of mindfulness fits a hierarchical factor structure in which specific facets relate to a general mindfulness factor, and correlates with well-being, only among meditators. We extended this research by testing whether observing functions differently among meditators in terms of buffering the effects...

Objective: This study sought to identify predictors of relapse in a behavior therapy trial for trichotillo- mania (TTM), or hair-pulling disorder. Relapse is common after treatment for TTM, and only a few studies have examined what might predict relapse. Method: Data was examined from a TTM treatment study with a stepped-care approach (Step 1. Web-...

Different studies of the treatment of trichotillomania (TTM) have used varying standards to determine the proportion of patients who obtain clinically meaningful benefits, but there is little information on the similarity of results yielded by these methods or on their comparative validity. Data from a stepped-care (Step 1: Web-based self-help; Ste...

Objective: There are effective treatments of trichotillomania (TTM), but access to expert providers is limited. This study tested a stepped care model aimed at improving access. Method: Participants were 60 (95% women, 75% Caucasian, 2% Hispanic) adults (M = 33.18 years) with TTM. They were randomly assigned to immediate versus waitlist (WL) condit...

To examine the relationship between self-related agency beliefs and observed eating behavior in adolescent girls with loss of control (LOC) eating. One-hundred eleven adolescent girls (14.5 ± 1.7 years; BMI: 27.1 ± 2.6 kg/m(2) ) were administered the General Self-Efficacy Scale and the Weight Efficacy Lifestyle Questionnaire (WEL). Adolescents then...

The theoretical conceptualization of self-acceptance has been in development for the last century. Early research focused on studying self-acceptance in relation to acceptance of others, whereas more recently researchers have emphasized trying to understand the association of self-acceptance with other aspects of psychological well-being, and the d...

Cognitive theory of depression (Beck, 1963) holds a prominent place in the history of clinical psychology as one of the first systematic statements of assumptions that have shaped the cognitive revolution in psychopathology (Clark and Steer, 1996). These tenets have since informed cognitive conceptualizations of many other disorders, as evidenced b...

Objective: Although there is extensive evidence of the efficacy of cognitive-behavioral therapy (CBT), it is less certain what potential mechanisms of change are specifically affected by CBT interventions. This study was intended to test the specific effects of CBT on compensatory coping skills, acceptance, and distress tolerance or persistence....

Objective: Cotherapy supervision has been hypothesized to enhance client outcomes and trainee effectiveness, but there is little empirical evidence relevant to either claim. This study tested both hypotheses, using data from the supervision of psychology doctoral students conducting cognitive behavioral therapy in a university-based clinic. Metho...

This chapter addresses principles and practices useful in designing and evaluating studies aimed at determining how well a particular psychotherapy method works. The authors' focus is on controlled research designs. Topics include: choice of comparison conditions (wait-list or no-treatment comparisons, treatment-as-usual comparisons, placebo comp...

Social support is related to mental health outcomes among battered women. It is unclear, however, whether researchers should measure social support as a unidimensional or multidimensional concept. Efforts to identify the latent dimensions underlying a common measure of social support, the Interpersonal Support Evaluation List (ISEL), have yielded i...

This study examined the association between cognitive vulnerability factors and seasonality. Students (N = 88), classified based on the Seasonal Pattern Assessment Questionnaire as experiencing moderate (n = 26) or mild (n = 32) seasonality, and nondepressed, low-seasonality controls (n = 30) completed explicit (i.e., dysfunctional attitudes, autom...

As group treatment becomes an increasingly used modality, it is imperative to investigate what factors contribute to successful treatment involvement and subsequent treatment outcome. The present study explored the impact of unanimous 1st session attendance on smoking cessation psychoeducational groups. Group members that attended the 1st session o...

The critical session hypothesis (Tang & DeRubeis, 1999) posits that patient changes in a single critical therapy session lead to sudden gains in psychotherapy outcome. This study examines if psychotherapy trainee raters can accurately differentiate critical sessions leading to sudden gains (called pregain sessions) from control sessions using sessi...

Postpartum depression (PPD) and postpartum psychosis (PPP) can impact mother, infant, and family. Obstetrician-gynecologists (ob-gyns) are often the most frequent medical contact for postpartum women, and so are in a position to identify women needing psychological care. This study assessed ob-gyns' knowledge, attitudes, and practices regarding dia...

Experiential avoidance and distress intolerance play a central role in novel behavior therapies, yet they appear to overlap considerably the REBT concept of low frustration tolerance. Using baseline data from 100 adult cigarette smokers enrolled in a clinical trial of smoking cessation therapies, the present study evaluated the convergent validity...

Sudden gains are abrupt and substantial improvements in symptoms. This study used the Outcome Questionnaire-45 (OQ-45; Lambert et al., 1996) to characterize sudden gains occurring in a cognitive-behavioral therapy training clinic. Also, gradual gainers were identified and used as a comparison group. Sudden gains were identified in 23% of patients a...

A randomized wait-list controlled trial (N = 295 university students) of the effects of the Transcendental Meditation program was conducted in an urban setting. Substance use was assessed by self-report at baseline and 3 months later. For smoking and illicit drug use, there were no significant differences between conditions. For alcohol use, sex X...

Several clinical trials have tested the hypothesis that smoking cessation treatments with a mood management component derived from cognitive behavior therapy (CBT) for depression would be specifically effective for depression-vulnerable smokers, with mixed results. This trial addressed methodological concerns with some of the previous studies to cl...

Regulatory focus theory (RFT; Higgins, 1997) may help to address the issue of motivation in cigarette smoking cessation. RFT suggests that individuals may be motivated to approach desired end-states (e.g., improved lung capacity) and/or avoid undesired end-states (e.g., illness). These motivations are referred to as promotion focus, in which people...

Despite widespread knowledge of the negative health consequences of cigarette smoking, in 2007 a majority (60%) of daily smokers in the USA did not make a quit attempt lasting at least 24 h. Drawing on Riskind's looming cognitive vulnerability model of anxiety, we developed a guided imagery induction intended to increase smokers' perceived suscepti...

Psychological distress contributes to the development of hypertension in young adults. This trial assessed the effects of a mind-body intervention on blood pressure (BP), psychological distress, and coping in college students. This was a randomized controlled trial (RCT) of 298 university students randomly allocated to either the Transcendental Med...

Activation of a default mode network (DMN) including frontal and parietal midline structures varies with cognitive load, being more active during low-load tasks and less active during high-load tasks requiring executive control. Meditation practices entail various degrees of cognitive control. Thus, DMN activation patterns could give insight into t...

This article introduces a special issue of the Journal of Rational-Emotive & Cognitive-Behavior Therapy on assessment and diagnostic issues in REBT. Contributions to the special issue include reviews of (a) the psychometric properties of irrational beliefs measures and (b) the potential utility for REBT research and practice of behavioral measures...

Mindfulness is associated with low levels of neuroticism, anxiety, and depressive symptoms, as well as high levels of self-esteem and satisfaction with life (Brown & Ryan, 2003). As part of a 3-month randomized waitlist-controlled trial of the effects of the Transcendental Meditation (TM) program on university students (N=295), we examined the impa...

Leykin and DeRubeis (2009) persuasively argue that, just as correlation does not prove causation, so too allegiance-outcome association does not prove that investigator allegiance biases reported treatment outcomes. This commentary notes that similarly ambiguous links between investigator allegiance and study outcomes may be found in other areas of...

This article: (1) describes and reviews evidence for hypothesized biological and psychological mechanisms of winter seasonal affective disorder (SAD), (2) advocates for an integrative approach to studying SAD etiology that incor-porates both biological and psychological mechanisms, and (3) delineates areas for future research from an integrative pe...

This randomized controlled trial investigated effects of Transcendental Meditation (TM) practice on Brain Integration Scale scores (broadband frontal coherence, power ratios, and preparatory brain responses), electrodermal habituation to 85-dB tones, sleepiness, heart rate, respiratory sinus arrhythmia, and P300 latencies in 50 college students. Af...

This study investigated intimate partner violence (IPV) victims' emotion-focused coping efforts, as well as their retrospective ratings of the perceived helpfulness of these efforts, in the context of a longitudinal study of battered women's experiences over time. Four hundred and six primarily African American, low-income battered women who had ex...

Advocates of the Open Access movement claim that removing access barriers will substantially increase the diffusion of academic research. If successful, this movement could play a role in efforts to increase utilization of psychotherapy research by mental health practitioners. In a pair of studies, mental health professionals were given either no c...

Smoking cessation programs might benefit from tailoring messages to individual differences in regulatory focus (see Higgins, 1997), but there is little evidence on the stability or convergent validity of regulatory focus measures. In two studies, smokers completed four measures of regulatory focus: (a) Regulatory Focus Questionnaire (RFQ); (b) actu...

Relapse to cigarette smoking after a quit attempt is often the result of inadequate coping. In a study of 72 cigarette smokers, relationships between neuroticism, depressive symptoms, and the use of engagement and disengagement coping strategies were explored, along with expectancies for the effectiveness of these different types of coping for regu...

Garratt, Ingram, Rand, and Sawalani (2007) comprehensively reviewed research on the specificity of effects of cognitive therapy on depression, as well as the mediating mechanisms of these effects. Comparing their findings with those of a similar review by Whisman (1993), it seems that progress in this area has been slow. Several suggestions are mad...

The high rates of cigarette smoking among depressed persons may be partially explained by increased positive expectancies for cigarette smoking among this population. In view of theoretical and empirical work on depressed people's negative views of the future, though, it would be expected that depressed smokers would hold particularly negative expe...

This study evaluated in several ways the concurrent and discriminant validity of measuring self-concept organization via Hierarchical Classes (HICLAS) analysis of interview-derived self-descriptions. College students (N=85) listed and then described using their own words various self-aspects, and they completed standardized measures of depressive s...

Seasonal affective disorder (SAD) frequently co-occurs with premenstrual dysphoric disorder. Explanations of this comorbidity highlighting the cyclical nature of female sex hormones imply that seasonal and premenstrual symptoms should correlate positively even in nonclinical samples. In a sample of 91 female college students, we found a sizable pos...

Cognitive behavior therapy for depression has been adapted for use in cigarette smoking cessation groups. CBT appears to be an effective treatment, though results are mixed as to whether it is especially helpful for smokers vulnerable to depression, and little is known about what mediates its effects. Based on the hypothesis that CBT works by way o...

To examine the frequency and recency of binge eating in relation to psychopathology in overweight, treatment-seeking adolescents. We investigated psychological correlates of the frequency and recency of reported loss of control (LOC) eating episodes in 160 overweight (body mass index [BMI]: 40.7 +/- 8.8 kg/m(2)) adolescents. On the basis of the res...

Research on lay beliefs about depression has shown that recovered-depressed people evaluate their own depressive experiences as more distressing than do those who have never experienced major depression. This study tested whether history of depression would influence beliefs about others' experiences of depression. Recovered-depressed (n = 63) and...

This article, based on B. McCrady, D. Haaga, and J. Lebow (2006), provides guidance for the treatment of substance use disorders by identifying empirically based principles that underpin effective treatment systems and effective treatments. To promote the flexible application of empirically based principles to individual clients, the authors (a) in...

Few studies have addressed the amount of training needed to obtain reliable ratings in behavioral observation data. The current study examined the effects of differing intensities of frame-of-reference (FOR) rater training on observers' ratings of anxiety, social skills, and alcohol-specific coping skills in community volunteers with and without so...

Several studies have linked posttraumatic stress disorder with heavy smoking. It is not known to what extent this association is specific, as opposed to being a function of a joint association of PTSD and heavy smoking with a third variable such as depression proneness. In a cross-sectional study of 157 current regular smokers, severity of nicotine...

In the context of a project examining depression vulnerability and cigarette smoking, the authors tested whether depression-vulnerable people differed from less vulnerable people in their reactions to a depressive stimulus. Regular smokers with a history of depression but not currently depressed (n = 63) and never-depressed smokers (n = 64) listene...

People with current or past depression are more likely to have been smokers at some point in their lives. Smokers with depression histories are also less likely to quit. Attempts to understand this relationship are important insofar as they can help treatment efficacy for this group of smokers. Prior research indicates that different genetic variat...

Patients and family members in a radiation oncology department participated in a study of a new education/orientation program. Information was presented in oral and in written form. After the intervention, orientation program participants did not differ significantly from control group members in state anxiety, general distress, treatment adherence...

Doss (this issue) makes many excellent suggestions for enhancing the conceptual precision and methodological rigor of psychotherapy research. His article argues convincingly for a need to be systematic and forward-looking in organizing sequential programs of therapy studies, in order that investigators may identify the most powerful change mechanis...

Some personality trait dimensions may not be equally applicable to all people. The degree of applicability of a given trait, or traitedness, is conceptually distinct from trait level. In this study, 3 ways of assessing traitedness--interitem variance (R. F. Baumeister & D. M. Tice, 1988), scalability (K. Lanning, 1988), and construct similarity (W....

"Psychology," like many abstract terms, is difficult to define precisely. Henriques' (this issue) argument that psychology, though unified and coherent, actually spans two realms-psychological formalism ("the science of mind," this issue) and human psychology ("the science of human behavior at the individual level," this issue)-seems likely to impr...

Cigarette smokers vulnerable to depression experience considerable difficulty in quitting smoking, possibly because they use smoking to manage negative affect and possess underdeveloped alternative coping skills for doing so. Efforts to adapt cognitive behavior therapy (CBT) of depression to the treatment of depression-vulnerable smokers have achie...

D. Westen, C. M. Novotny, and H. Thompson-Brenner identified many important concerns in their critique of methods typically used in randomized controlled trials (RCTs) of psychotherapy outcome and by extension in methods of identifying empirically supported therapies (ESTs). Some of the concerns would be mitigated if empirical support of treatments...

Previous research has shown that smokers progress through a series of stages of change as they attempt to quit their habit. This study evaluated smokers in the precontemplation and contemplation stages in order to explore how we can effectively facilitate positive stage transition. Precontemplators (n = 71) and contemplators (n = 30) were compared...

Doss (this issue) makes many excellent suggestions for enhancing the conceptual precision and methodological rigor of psychotherapy research. His article argues convincingly for a need to be systematic and forward-looking in organizing sequential programs of therapy studies, in order that investigators may identify the most powerful change mechanis...

Self-complexity (SC) theory proposes that a highly differentiated self-concept protects against the depressogenic impact of negative life events. Linville's influential prospective study appeared to support this proposition (P. W. Linville, 1987). Subsequent reports have raised questions about the construct validity of Linville's operationalization...

Previous descriptive and treatment studies imply that the association between depressed affect and cigarette smoking may be strongest among those with limited cognitive coping skills. This study, therefore, experimentally examined whether the combination of poor mood management skills and negative affect results in reduced self-efficacy and increas...

Identification of characteristics that predict entry into substance abuse treatment programs may facilitate efforts to make effective programs more attractive to people who could benefit from them. We examined dispositional hope as a predictor of entering a voluntary substance abuse treatment program for federal prison inmates. Controlling statisti...

The Life Orientation Test (LOT; Scheier & Carver, 1985) is a common measure of optimism. Previous studies of the convergent and discriminant (vis-à-vis neuroticism) validity of the LOT have relied solely on questionnaires. Our Study 1 was a multitrait, multimethod investigation of the LOT incorporating Gottschalk and Gleser's (1969) method of conte...

Although positive emotions undoubtedly confer benefits, one can have too much of it. There is probably a point beyond which enjoyment interferes with realism, yet it is unclear where that point is. The original States of Mind (SOM) model (Schwartz and Garamoni, 1986; 1989) proposed that a ratio of [positive] to [positive plus negative] affective/co...

Eighty-six university students with learning disabilities (LDs) completed measures of self-esteem and of perceptions of their LDs. In addition, they rated their willingness to seek help from academic services in response to two experimental manipulations: (a) they read vignettes about a student requesting help from professors or peers and receiving...

The reformulated balanced states of mind (BSOM) model (Schwartz, 1997) pro-posed new cognitive-affective set-point ratios based on a mathematical model of con-sciousness (Lefebvre, 1990) to differentiate among pathological, normal and optimal bal-ances. Using data derived from the Affects Balance Scale (Derogatis, 1975), the reformulated set-points...

Previous community programs have been unsuccessful in changing youths' attitudes toward police, and have thus far not addressed police attitudes toward youth. In this pilot study, police (n = 26) competed together with minority youths (n = 51) on heterogeneous basketball teams. Pre- and postintervention attitudes toward youths/officers and posttest...

This study examined coping responses and alcohol outcome expectancies in alcohol abusing and nonabusing social phobics. The sample consisted of social phobics with current alcohol abuse or dependence (SPAs, n = 19), social phobics without lifetime alcohol use disorders (SPs, n = 19), and normal controls (NCs, n = 21). As predicted, SPs reported les...

Previous research has established an association between depressive symptoms and self-rated insecure adult attachment styles. In this project we evaluated whether this association is an artifact of mood-dependent negative self-ratings. In Study 1 (N = 95, nonclinical sample), depressive symptoms correlated positively with Preoccupied and Fearful at...

Resolving whether subthreshold depressive symptoms exist on a continuum with unipolar clinical depression is important for progress on both theoretical and applied issues. To date, most studies have found that individuals with subthreshold depressive symptoms resemble cases of major depressive disorder along many important dimensions (e.g., in term...

Low self-esteem is usually considered unhealthy, but according to rational-emotive behavior therapy, any level of self-esteem reflects a dysfunctional habit of globally evaluating one's worth; it would be preferable to accept oneself unconditionally. This hypothesis was tested by examining several correlates of scores on a novel questionnaire measu...

Rational-emotive behavior therapy (REBT; Ellis, 1995) contends that esteeming oneself—favorably or unfavorably—is illogical (implying an objective basis for evaluating global worth) and counterproductive (making one prone to depression in the wake of setbacks, anxiety otherwise). A healthier outlook requires unconditional self-acceptance (USA). We...

We assessed perceptions of the impact of depression among two groups of currently nondepressed adults (Beck Depression Inventory score 9). The recovered-depressed (RD) participants (n = 25) had a history of major depressive disorder but had been recovered for at least 2 months since the most recent depressive episode. Never-depressed (ND) participa...