David M. Fresco

David M. Fresco
University of Michigan | U-M · Department of Psychiatry

Ph.D.

About

142
Publications
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Publications

Publications (142)
Article
Full-text available
Decentering is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind, as opposed to reflections of the self that are necessarily true. The Experiences Questionnaire (EQ) was designed to measure both decentering and rumination but has not been empirically validated. The current study investigated th...
Article
Cognitive behavioral therapy (CBT) has a rich history of alleviating the suffering associated with mental disorders. Recently, there have been exciting new developments, including multicomponent approaches, incorporated alterna-tive therapies (e.g., meditation), targeted and cost-effective technologies, and integrated biological and behavioral fram...
Article
Rumination, worry, and other forms of negative self-referential processing are familiar to everyone, as reflecting on the self is perhaps our most human characteristic. However, for a substantial subgroup of patients, negative self-referential processing (NSRP) arises in response to intense emotionality, worsening the clinical presentation and dimi...
Article
The capacity to shift experiential perspective – from within one’s subjective experience, onto that experience – is fundamental to being human. Scholars have long theorized that this metacognitive capacity – that we refer to as decentering – may play an important role in mental health. To help illuminate this mental phenomenon and its links to ment...
Article
Full-text available
Objectives Mindfulness-based cognitive therapy (MBCT) can reduce anxiety and depression symptoms in adults with anxiety disorders, and changes in threat-related attentional bias may be a key mechanism driving the intervention’s effects on anxiety symptoms. Event-related potentials (ERPs) can illuminate the physiological mechanism through which MBCT...
Article
Full-text available
Study objectives The study had three primary goals. First, we estimated survey-assessed DSM-5 insomnia disorder rates in pregnancy, and described associated sociodemographics, and sleep-wake and mental health symptoms. Second, we derived cutoffs for detecting DSM-5 insomnia disorder using common self-report measures of sleep symptoms. Third, we ide...
Article
Objective: "Decentering" is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The present study sought to examine the role of decentering, and other related variables, in the effic...
Preprint
Full-text available
Objective: “Decentering” is defined as the ability to observe one’s thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The current study sought to examine the role of decentering, and other related variables, in the effica...
Article
While research identifies a growing list of risk factors for anxiety and depression, it is equally important to identify potential protective factors that may prevent or reduce vulnerability to developing internalizing psychopathology. We hypothesized that forms of perseverative thinking, such as rumination and worry, act as mechanisms linking nega...
Article
Full-text available
Objectives Mindfulness stress buffering theory (Creswell & Lindsay, 2014) posits that higher dispositional (trait) mindfulness can protect cardiovascular health by buffering physiological stress reactivity — a risk marker for hypertension and cardiac events. Yet, empirical evidence is mixed. This study used baseline data from the Serenity Study — a...
Article
Full-text available
This scoping review summarized the current literature on Internet-delivered MBIs for people with depression, stress, and anxiety and identified gaps to provide direction for future research in the area.
Article
Background: For the 720 000 Americans expected to experience a new acute cardiac event this year, cardiac rehabilitation is an important part of recovery. Symptoms of depression and anxiety undermine recovery efforts, leaving recovering patients at risk for diminished functional capacity and heightened risk of mortality. Poor emotion regulation ca...
Article
Approach and avoidance motivational changes over the course of Emotion Regulation Therapy (ERT) were assessed at pre-, mid-, and post-treatment using an Approach-Avoidance variant of the Implicit Association Test (AAIAT) that specifically targeted implicitly-held action tendencies about approach/avoidance in the context of positively and negatively...
Article
Background Being an informal caregiver (IC) of a cancer patient is often associated with psychological distress. We have recently, in a randomized controlled trial (RCT), demonstrated efficacy of Emotion Regulation Therapy for ICs (ERT-C), evidenced as lower levels of psychological distress. Such efficacy demonstration is important, but a crucial s...
Article
Background: Major depressive disorder (MDD) has been associated with difficulties in social and interpersonal functioning. Deficits in emotion processing may contribute to the development and maintenance of interpersonal difficulties in MDD. Although some studies have found that MDD is associated with deficits in recognition of emotion in faces, o...
Article
Background and objectives Emotion differentiation is considered adaptive because differentiated emotional experiences are believed to promote access to the information that emotions carry, enabling context-appropriate emotion regulation. In the present study, secondary analyses from a recent randomized controlled trial (O’Toole et al., 2019 O’Toole...
Article
Objective Generalized anxiety disorder (GAD) is characterized, in part, by physical symptoms such as muscle tension and gastrointestinal (GI) distress. To date, little research has examined how changes in psychological symptoms associated with GAD may impact physical symptoms. This study investigated if reductions in worry, anxiety, and depression...
Article
Full-text available
The purpose of this two-arm randomized controlled pilot study was to assess initial efficacy of the theoretically-based RENEwS intervention, designed to improve emotion regulation and thereby decrease depression and anxiety and increase moderate to vigorous physical activity (MVPA) following a cardiac event. Participants (n=30, 83% men) recruited f...
Article
Cardiac rehabilitation (CR) is an important part of overcoming an acute cardiac event, but can be undermined by debilitating levels of depression and anxiety, which can leave cardiac patients at risk for diminished functional capacity. The purpose of this randomized control trial was to evaluate the development and early efficacy testing of a theor...
Article
Introduction The World Health Organization recommends moderate to vigorous physical activity (MVPA) for 150 minutes per week to reduce the risk of primary or secondary cardiovascular diseases (CVD). Adherence to these recommendations is only around 30% in the US. Identifying reliable barriers or facilitators of time spent in MVPA is a critical comp...
Article
Full-text available
Depressive rumination is considered a prominent risk factor for the occurrence, severity, and duration of depressive episodes. A variety of treatment options have been developed to treat depressive rumination of which mindfulness based programs are especially promising. In the current study, we investigated the neural underpinnings of a short mindf...
Article
Cardiac rehabilitation is important to improve physical activity and reduce cardiovascular disease risk factors among people who have experienced a major cardiac event. However, poor emotion regulation can make it difficult to change cardiovascular risk factors. The purpose of this article was to assess the feasibility of the Regulating Emotions to...
Article
Full-text available
Background: Racial discrimination is one of many barriers experienced by African Americans that interfere with health self-care management. Discrimination stress may decrease the tendency for individuals to resonate with the social-emotional appeals embedded in persuasive health information, which are known to play a key role in producing behavior...
Article
Full-text available
Objectives Although mindfulness meditation is the familiar and researched form of mental training derived from Buddhism, it represents but one form of practice. Monastic debate is an interactive and dyadic analytical meditation practice that originates from the Tibetan Buddhist tradition where monastics seek to jointly deepen their understanding of...
Article
Inflexibility of the autonomic nervous system is relevant to depression vulnerability, but the downstream behavioral consequences of autonomic inflexibility are not well understood. Rumination, a perseverative thinking style that characterizes depression, is one candidate phenotype relevant to autonomic inflexibility. Undergraduates (N = 134) compl...
Article
Full-text available
Although stress is an inevitable part of everyday life, its chronicity, severity, and perceived burden can result in enduring distress, which may manifest as heightened emotionality, contributing to a number of self-regulatory failures. Specifically, distress disorders are characterized, in part, by heightened sensitivity to underlying motivational...
Article
Emotion Regulation Therapy (ERT) has demonstrated efficacy in both open and randomized trials for generalized anxiety disorder (GAD) with and without co-occurring depression. An important goal in ERT is to teach clients adaptive emotion regulation, including healthier metacognitive abilities such as decentering and cognitive reappraisal. A few stud...
Article
Full-text available
Background: Previous cognitive behavioral therapies for informal caregivers (ICs) have produced negligible effects. The purpose of this study was to evaluate, in a randomized controlled trial, the efficacy of Emotion Regulation Therapy adapted for caregivers (ERT-C) on psychological and inflammatory outcomes in psychologically distressed ICs and t...
Article
Theory and prior research suggests that decentering-an objective, distanced perspective on one's internal experiences-may vary based upon characteristics such as age, gender, race/ethnicity, and meditation experience. However, little is known about whether decentering measures are comparable in their meaning and interpretation when administered to...
Article
We previously proposed that three metacognitive processes – meta-awareness, disidentification from internal experience, and reduced reactivity to thought content – together constitute decentering. We review emerging methods to study these metacognitive processes and the novel insights they provide regarding the nature and salutary function(s) of de...
Article
Background: Although many of the proposed mediating processes of self-management interventions are operationally defined as cognitive processes (e.g., acquiring and using information, self-efficacy, motivation, decision-making), little is known about their underlying brain mechanisms. Brain biomarkers of how people process health information may be...
Article
Full-text available
Emotion regulation therapy (ERT) is an efficacious treatment for distress disorders (i.e., depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individual...
Article
People living with HIV (PLHIV) are increasingly diagnosed with comorbidities which require increasing self-management. We examined the effect of a self-management intervention on neurocognitive behavioral processing. Twenty-nine PLHIV completed a two-group, 3-month randomized clinical trial testing a self-management intervention to improve physical...
Preprint
Full-text available
Emotion Regulation Therapy (ERT) is an efficacious treatment for distress disorders (i.e. depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals...
Article
Analytical meditation and monastic debate are contemplative practices engaged in by Tibetan Buddhist monastics that have up to now been largely unexplored in Western contemplative science. The highly physical form of contemplative debating plays an important role in the monastic curriculum. Based on discussions and recorded interviews Tibetan monas...
Chapter
Although cognitive behavioral therapies (CBTs) have demonstrated efficacy in treating individuals with anxiety and depressive symptoms, recent meta-analytic findings indicate negligible effects of CBTs in treating emotional distress among informal caregivers of patients with cancer. Adapted from emotion regulation therapy (ERT), ERT for cancer care...
Preprint
Distress is commonly characterized by prolonged internal suffering that can range from self-focused processing of negative emotions and stressors, to highly intensely aversive and prolonged emotional states thereby worsening or complicating emotional and physical conditions. Decentering represents a metacognitive capacity thought to reflect three i...
Preprint
Full-text available
We previously proposed that three metacognitive processes – meta-awareness, disidentification from internal experience, and reduced reactivity to thought content – together constitute decentering. We review emerging methods to study these metacognitive processes and the novel insights they provide regarding the nature and salutary function(s) of de...
Article
Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious t...
Article
Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious t...
Preprint
Cognitive behavior therapy (CBT) and mindfulness-based interventions (MBI) have made important contributions to resolving the global burden of mental illness. However, response rates are comparatively more modest for the distress disorders. Newer CBTs enriched with MBI components have emerged with promising findings for distress disorders but with...
Preprint
Full-text available
Analytical meditation and monastic debate are contemplative practices engaged in by Tibetan Buddhist monastics that have up to now been largely unexplored in Western contemplative science. The highly physical form of contemplative debating plays an important role in the monastic curriculum. Based on intensive discussions and recorded interviews wit...
Preprint
Full-text available
Monastic debate is an interactive and dyadic analytical meditation practice by which Tibetan monastics seek to jointly deepen their understanding of complicated philosophical issues. We examined the neural correlates of this analytical meditation practice by means of hyperscanning EEG. Consistent with the idea that analytical meditation helps to tr...
Article
Although women demonstrate higher levels of rumination than men, it is unknown whether instruments used to measure rumination have the same psychometric properties for women and men. To examine this question, we evaluated measurement invariance of the brooding and reflection subscales from the Ruminative Responses Scale (RRS) by gender, using data...
Article
Full-text available
Dysfunction in the ability to sustain, shift and broaden attention has been proposed as a mechanism of normative emotion regulation that is a common target of cognitive-behavioral therapies. Attention regulation deficits are central to generalized anxiety disorder (GAD) and may contribute to a generally rigid, avoidant, response style that produces...
Chapter
Full-text available
This chapter focuses on the assessment of depression in adults. It focuses on major depressive disorder (MDD) because the empirical support for the tools and theories and therapies described in this chapter focuses most frequently on MDD. Many other disorders, as well as phenomena that are not disorders (e.g., grief), share features with MDD, and m...
Article
Full-text available
Behavioral tasks offer an objective index of processes associated with psychopathology. The mirror tracing persistence task (MTPT) has been used as a measure of distress tolerance, or the ability to endure negative internal states. In generalized anxiety disorder (GAD), a poor ability to tolerate aversive internal states may relate to the inability...
Article
Objective: Generalized anxiety disorder (GAD) and major depression (MDD), especially when they co-occur, are associated with suboptimal treatment response. One common feature of these disorders is negative self-referential processing (NSRP; i.e., worry, rumination), which worsens treatment outcome. Emotion Regulation Therapy (ERT) integrates princ...
Article
Emotion Regulation Therapy (ERT) for generalized anxiety (GAD) and accompanying depression (MDD) is a theoretically-derived, evidence based, treatment that integrates principles from traditional and contemporary cognitive-behavioral and experiential approaches with basic and translational findings from affect science to offer a blueprint for improv...
Article
Full-text available
The current study represents a secondary analysis of the dismantling study of cognitive therapy of depression originally conducted by Jacobson et al. (J Consult Clin Psychol 64:295–304, 1996). New analyses examined the role of explanatory flexibility and explanatory style in the recovery from depression. Results indicated that BA treatment responde...
Article
Aims: African Americans with prehypertension have a 35% greater risk of progressing to hypertension as compared to Caucasian Americans. In this pilot study, we investigated how two neural networks associated with task-oriented and emotional/motivational cognition relate to self-management behaviors in prehypertensive African Americans. Methods. Com...
Article
The ability of the autonomic nervous system to flexibly adapt to environmental changes is thought to indicate efficient use of self-regulatory resources. Deficits in autonomic reactivity appear to characterize current depression; however, whether autonomic reactivity confers vulnerability to future depression when individuals encounter environmenta...
Article
Full-text available
The study of vulnerabilities to depression typically identifies factors that are thought to be universally maladaptive or adaptive. In contrast, researchers recently have theorized that the ability to flexibly engage in different thoughts and behaviors that fit situational demands may be most indicative of psychological health. We review empirical...
Poster
After Emotion Regulation Therapy, patients with generalized anxiety disorder (with and without co-occurring depression) evidenced strengthened dlPFC and vlPFC activation when instructed to down-regulate negative affect. Strenthened lateral PFC activation associated with improvements in attention regulation ability, and for dlPFC, improvements in cl...
Article
The ability of the parasympathetic nervous system to flexibly adapt to changes in environmental context is thought to serve as a physiological indicator of self-regulatory capacity, and deficits in parasympathetic flexibility appear to characterize affective disorders such as depression. However, whether parasympathetic flexibility (vagal withdrawa...
Article
Despite the success of available medical and psychosocial treatments, a sizable subgroup of individuals with commonly co-occurring disorders, generalized anxiety disorder (GAD) and major depressive disorder (MDD), fail to make sufficient treatment gains thereby prolonging their deficits in life functioning and satisfaction. Clinically, these patien...
Article
Full-text available
“Distress disorders,” which include generalized anxiety disorder and major depression are often highly comorbid with each other and appear to be characterized by common temperamental features that reflect heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss. Further, individuals with distress disorders...
Article
Awareness of the body (i.e., interoceptive awareness) and self-referential thought represent two distinct, yet habitually integrated aspects of self. A recent neuroanatomical and processing model for depression and anxiety incorporates the connections between increased but low fidelity afferent interoceptive input with self-referential and belief-b...
Article
Increasing evidence suggests that intolerance of uncertainty (IU) may be a transdiagnostic factor across the anxiety disorders, and to a lesser extent, unipolar depression. Whereas anxiety inherently involves uncertainty regarding threat, depression has traditionally been associated with certainty (e.g. the hopelessness theory of depression). Some...
Article
Full-text available
Generalized anxiety disorder (GAD) and unipolar depressive disorders (UDD) have been shown to differ from each other in dimensions of affective functioning despite their high rates of comorbidity. We showed emotional film clips to a community sample (n = 170) with GAD, GAD with secondary UDD, or no diagnosis. Groups had comparable subjective respon...
Article
Full-text available
Background and objectives: Describing emotional experiences using distinct terms, or affect differentiation, has been associated with emotion regulation and adaptive behavior under stress. There is little data, however, examining the association between differentiation and dispositional factors underlying psychopathology. The current study examine...
Article
Full-text available
The concept of cognitive bias is embedded in cognitive-behavioral theorizing, and treatment, of depression. Moore and Fresco (2007) were the first to examine this issue in the context of the etiology of depression by studying the accuracy of attributional style. One hundred and five predominantly Caucasian students from the Midwestern U.S. and 105...
Article
Full-text available
Mindfulness-based interventions are believed to counteract cognitive biases that exacerbate cognitive and physiological reactivity to emotional experiences and that contribute to the development and persistence of psychopathology. One process by which mindful practices may produce such salutary effects is by enhancing the capacity to "decenter"-or...
Article
Full-text available
The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible i...
Article
The capacity to shift experiential perspective—from within one’s subjective experience onto that experience—is fundamental to being human. Scholars have long theorized that this metacognitive capacity—which we refer to as decentering—may play an important role in mental health. To help illuminate this mental phenomenon and its links to mental healt...
Article
Cognitive diathesis stress models of depression emphasize individual styles of attributing causal explanations to negative and positive events in life. The Attributional Style Questionnaire (ASQ) has traditionally been used to measure explanatory style, defined as an individual’s habitual way of assigning causes to negative events. Explanatory flex...
Article
Although CBT is efficacious for a wide variety of psychiatric conditions, relatively fewer GAD patients achieve high endstate functioning as compared to patients receiving CBTs for other disorders. Moreover, GAD trials that utilized patient samples without prominent depression have tended to report that effect sizes for depressive outcomes were sma...
Article
Background: Although CBT is efficacious for a wide variety of psychiatric conditions, relatively fewer GAD patients achieve high endstate functioning as compared to patients receiving CBTs for other disorders. Moreover, GAD trials that utilized patient samples without prominent depression have tended to report that effect sizes for depressive outco...
Article
Objective: We sought to examine psychological mechanisms of treatment outcomes of a mindfulness meditation intervention for Generalized Anxiety Disorder (GAD). Methods: We examined mindfulness and decentering as two potential therapeutic mechanisms of action of generalized anxiety disorder (GAD) symptom reduction in patients randomized to receiv...
Article
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