Lorenzo Lorenzo-Luaces

Lorenzo Lorenzo-Luaces
Indiana University Bloomington | IUB · Department of Psychological and Brain Sciences

Doctor of Philosophy

About

86
Publications
82,854
Reads
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1,248
Citations
Introduction
Currently an Assistant Professor at the Department of Psychological and Brain Sciences, Indiana University Bloomington. I am broadly interested in the classification and treatment of depressive disorders.
Additional affiliations
September 2011 - present
University of Pennsylvania
Position
  • PhD Student
August 2009 - May 2011
University of Puerto Rico at Rio Piedras
Position
  • Research Assistant
Education
August 2011 - May 2012
University of Pennsylvania
Field of study
  • Psychology
August 2007 - May 2011

Publications

Publications (86)
Article
Full-text available
Two different and seemingly competing views on the diagnosis of major depressive disorder (MDD) exist. The first is that the diagnosis conflates adaptive sadness reactions with pathological states of depressed mood and that MDD is overdiagnosed and overtreated. The second is that MDD is an underdiagnosed and undertreated disorder, and one that is b...
Article
Full-text available
Since the introduction of Beck’s cognitive theory of emotional disorders, and their treatment with psychotherapy, cognitive-behavioral approaches have become the most extensively researched psychological treatment for a wide variety of disorders. Despite this, the relative contribution of cognitive to behavioral approaches to treatment are poorly u...
Article
Full-text available
Background: Self-guided internet-based cognitive behavioral therapies (iCBTs) for depressive symptoms may substantially increase accessibility to mental health treatment. Despite this, questions remain as to the generalizability of the research on self-guided iCBT. Objective: We sought to describe the clinical entry criteria used in studies of self...
Article
Full-text available
Cognitive-behavioral therapies (CBTs) are the most widely studied form of psychotherapy for disorders like depression and anxiety. Nonetheless, there is heterogeneity in response to CBTs vs. other treatments. Researchers have become increasingly interested in using pre-treatment individual differences (i.e., moderators) to match patients to the mos...
Preprint
Studies suggest that depression severity and duration interact to predict outcomes in depression treatment. To our knowledge, no study has explored this question in a sample with a placebo control, two therapies, and their combination nor with adolescents. We used data from the Treatment of Adolescent Depression Study (N = 439), in which adolescent...
Article
Full-text available
Background Cognitive therapy and behavioural activation are both widely applied and effective psychotherapies for depression, but it is unclear which works best for whom. Individual participant data (IPD) meta-analysis allows for examining moderators at the participant level and can provide more precise effect estimates than conventional meta-analy...
Preprint
Background: Although effective treatments for common mental health problems are available, individual responses to these treatments are heterogeneous and difficult to predict. Treatment efficacy can be optimized by targeting interventions using individual predictions of differential treatment outcomes. The aim of this study was to develop and test...
Preprint
Background: Internalizing, externalizing, and somatoform disorders are the most common and disabling forms of psychopathology. Our understanding of these clinical problems is limited by a reliance on self-report along with research using small samples. Social media has emerged as an exciting venue in which to collect large sample of longitudinal da...
Preprint
Full-text available
There is a growing interest in developing scalable interventions, including internet-based cognitive-behavioral therapy (iCBT), to meet the increasing demand for mental health services. Given the growth in diversity worldwide, it is essential that the clinical trials of iCBT for depression include diverse samples or, at the very least report inform...
Preprint
Full-text available
Objective: There is an ongoing debate about whether digital mental health interventions (DMHIs) can reduce racial and socioeconomic inequities in access to mental health care. One key factor in this debate involves the extent to which racial minority and socioeconomically disadvantaged individuals are willing to use, and pay for, DMHIs. We examined...
Preprint
BACKGROUND Common mental disorders (CMDs), including depression and anxiety, are leading causes of disability worldwide. Digital mental health interventions (DMHIs), like online self-help, and other low-intensity treatments (LITs) that are not digital, such as bibliotherapy, have potential to reach many individuals by circumventing common barriers...
Article
Background Common mental disorders, including depression and anxiety, are leading causes of disability worldwide. Digital mental health interventions, such as web-based self-help and other low-intensity treatments (LITs) that are not digital (eg, bibliotherapy), have the potential to reach many individuals by circumventing common barriers present i...
Preprint
Purpose: Quality of life (QOL) refers broadly to the assessment of well-being, life satisfaction, and psychosocial functioning. Depression, a leading cause of disability worldwide, is associated with lower QOL. However, QOL literature presents varying definitions of the concept with no consensus on the best definition or conceptual model. As measur...
Preprint
BACKGROUND Self-help interventions have the potential to increase access to evidence-based mental health care. Self-help can be delivered via different formats, including print media or digital mental health interventions (DMHIs). However, we do not know which delivery format is more likely to result in higher engagement. OBJECTIVE The aims of thi...
Article
Full-text available
Background: Self-help interventions have the potential to increase access to evidence-based mental health care. Self-help can be delivered via different formats, including print media or digital mental health interventions (DMHIs). However, we do not know which delivery format is more likely to result in higher engagement. Objective: The aims of...
Preprint
Common mental disorders (CMDs), including depression and anxiety, are leading causes of disability worldwide. Low-intensity treatments (LITs), such as bibliotherapy and online self-help, have potential to reach many individuals by circumventing common barriers present in traditional mental health care but it is unclear how often they are used in cl...
Preprint
Full-text available
BACKGROUND In recent years, social media has become a rich source of mental health data. However, there is a lack of research on the accuracy and validity of self-reported diagnostic information online. OBJECTIVE An analysis of the degree of correspondence between self-reported diagnoses and clinical indicators will afford researchers and clinicia...
Preprint
Full-text available
Identifying active ingredients of psychological interventions is a major goal of psychotherapy researchers that is often justified by the promise that it will lead to improved patient outcomes. Here, I challenge the idea that researching active ingredients will improve outcomes. Additionally, I argue that given how common and disabling mental healt...
Article
Full-text available
Increased quality of life (QoL) is rated by patients as a primary factor in determining recovery from psychopathology. Cognitive behavioral therapies (CBTs) are the most well-researched psychotherapies for internalizing disorders and appear effective at reducing symptoms even when delivered by trainees. Existing research suggests that the effects o...
Preprint
Depression and other internalizing disorder symptoms are leading causes of disability in theUnited States. Although there are effective interventions, the burden of disability attributableto internalizing disorder symptoms is not decreasing. I review clinical and epidemiological datato identify solutions to the public health burden of internalizing...
Preprint
Doing What Matters in Times of Stress (DWM) is a transdiagnostic five-module guided self-help (GSH) intervention developed by the World Health Organization. %The original DWM included group guidance in-person. %It appeared efficacious in pilot trials and a cluster randomized-controlled trial. In a sample of individuals recruited from across the Uni...
Article
Full-text available
Objective: Cognitive therapy (CT) skills are an index of treatment progress. They predict changes in patients' acute depressive symptoms and symptom relapses. However, the psychometric properties of the various measures of CT skills are poorly understood. This study aimed to investigate the factor structure of the Competencies of Cognitive Therapy...
Article
Smartphone apps for mental health (MH apps) and wellness reach millions of people and have the potential to reduce the public health burden of common mental health problems. Thousands of MH apps are currently available, but real-world consumers generally gravitate toward a very small number of them. Given their widespread use and the lack of empiri...
Article
Full-text available
Objectives The melancholic and atypical specifiers for a major depressive episode (MDE) are supposed to reduce heterogeneity in symptom presentation by requiring additional, specific features. Fried et al. (2020) recently showed that the melancholic specifier may increase the potential heterogeneity in presenting symptoms. In a large sample of outp...
Article
Full-text available
Cognitive behavior therapy (CBT) is an umbrella term that refers to psychological therapies founded on the premise that (a) cognitive and behavioral processes are implicated in the development and maintenance of psychopathology, and (b) those processes are likely to be present during the session and require the therapist to tailor the intervention...
Article
Full-text available
Significance Can entire societies become more or less depressed over time? Here, we look for the historical traces of cognitive distortions, thinking patterns that are strongly associated with internalizing disorders such as depression and anxiety, in millions of books published over the course of the last two centuries in English, Spanish, and Ger...
Article
Mental health treatment noncompliance (preintake attrition, premature termination) has serious consequences both for mental health providers, as well as for individuals suffering from mental illness. However, prior work has examined preintake attrition and premature treatment termination separately, which limits our ability to determine when attrit...
Preprint
BACKGROUND Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. OBJECTIVE To understand the attitudes of Indian college students towa...
Article
Full-text available
Depression is a leading cause of disability worldwide, but is often underdiagnosed and undertreated. Cognitive behavioural therapy holds that individuals with depression exhibit distorted modes of thinking, that is, cognitive distortions, that can negatively affect their emotions and motivation. Here, we show that the language of individuals with a...
Preprint
Smartphone apps for mental health and wellness (MH apps) reach millions of people and have the potential to reduce the public health burden of common mental health problems. Thousands of MH apps are currently available, but real-world consumers generally gravitate toward a very small number of them. Given their widespread use, and the lack of empir...
Article
Full-text available
Emotion regulation is a central task of daily life. Difficulty regulating emotions is a core feature of borderline personality disorder (BPD), one of the most common and impairing personality disorder diagnoses. While anger and symptoms of depression are instantiated in the criteria for BPD, anxiety is not, despite being among the most common psych...
Article
Full-text available
In this conceptual paper, we outline the many challenges on the road to personalized psychotherapy, using the example of cognitive behavior therapy (CBT) for depression. To optimize psychotherapy for the individual patient, we need to find out how therapy works (identification of mechanisms of change) and for whom it works (identification of modera...
Preprint
BACKGROUND An overwhelming majority of American adolescents have access to smartphones, and recent estimates suggest that they spend considerable time on social media in comparison to other physical and leisure activities. A large body of literature has established that social media use is related to poor mental health, but the complicated relation...
Article
Background: Most American adolescents have access to smartphones, and recent estimates suggest that they spend considerable time on social media compared with other physical and leisure activities. A large body of literature has established that social media use is related to poor mental health, but the complicated relationship between social medi...
Article
Full-text available
Abstract Human sleep/wake cycles follow a stable circadian rhythm associated with hormonal, emotional, and cognitive changes. Changes of this cycle are implicated in many mental health concerns. In fact, the bidirectional relation between major depressive disorder and sleep has been well-documented. Despite a clear link between sleep disturbances a...
Preprint
Objectives: Sudden gains were first identified in cognitive therapy (CT) for depression to characterize large and stable improvements. They have subsequently been studied in at least 50 studies across a range of disorders and treatments. There is evidence that sudden gains are reliably associated with positive treatment outcomes. Nonetheless, simul...
Article
Full-text available
Objective: Optimizing treatment selection may improve treatment outcomes in depression. A promising approach is the Personalized Advantage Index (PAI), which predicts the optimal treatment for a given individual. To determine the generalizability of the PAI, models needs to be externally validated, which has rarely been done. Method: PAI models wer...
Preprint
Full-text available
Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. In this study, Indian college students were asked to rate a variety of treatment...
Preprint
Full-text available
Objectives: Specifiers for the diagnosis of a major depressive disorder (MDD), like melancholic and atypical features, are supposed to reduce heterogeneity in symptom presentation. However, Fried et al. (2020) recently quantified how, at least the melancholic specifier, could increase heterogeneity in presenting symptoms. Methods: We analyzed basel...
Preprint
Full-text available
Parker and colleagues developed the Sydney Melancholia Prototype Index (SMPI), a 24-item measure to assess a potential subtype of depression: melancholia. While research supports the validity of the measure, no study has assessed its psychometric properties. We recruited 1633 participants online, of whom 487 reported a lifetime period of depressed...
Preprint
Emotion regulation is a central task of daily life. Difficulty regulating emotions is a core feature of borderline personality disorder (BPD), one of the most common and impairing personality disorder diagnoses. While anger and symptoms of depression are instantiated in the criteria for BPD, anxiety is not, despite being among the mostcommon psychi...
Article
Parker and colleagues developed the Sydney Melancholia Prototype Index (SMPI), a 24-item measure to assess a potential subtype of depression: melancholia. While research supports the validity of the measure, no study has assessed its psychometric properties. We recruited 1633 participants online, of whom 487 reported a lifetime period of depressed...
Preprint
Full-text available
Cognitive-behavioral therapies (CBTs) are the most widely studied form psychotherapy for disorders like depression and anxiety. Nonetheless, there is heterogeneity in response to CBTs vs. other treatments. Researchers have become increasingly interested in using pre-treatment individual differences (i.e., moderators) to match patients to the most e...
Article
Full-text available
Studies suggest that depression severity and duration interact to predict outcomes in depression treatment. To our knowledge, no study has explored this question in a sample with a placebo control, two therapies, and their combination nor with adolescents. We used data from the Treatment of Adolescent Depression Study (N = 439), in which adolescent...
Article
Full-text available
Introduction: Researchers have proposed that predicting who is a likely placebo responder may help guide treatment allocations to treatment regimens that differ in intensity. Methods: We used data from the Treatment of Adolescent Depression Study (TADS) in which adolescents (n = 439) were randomized 1:1:1:1 to placebo, cognitive-behavioral therapy...
Preprint
Full-text available
Internet-based cognitive-behavioral therapies (iCBTs) for depression appear efficacious, however, it is unknown to what extent these treatments are available to the public. We examined the availability and components of iCBTs for depression that have been tested in randomized-controlled trials (RCTs). Our search yielded 59 studies from which we rev...
Preprint
Full-text available
Depression is a leading cause of disability worldwide, but is often under-diagnosed and under-treated. One of the tenets of cognitive-behavioral therapy (CBT) is that individuals who are depressed exhibit distorted modes of thinking, so-called cognitive distortions, which can negatively affect their emotions and motivation. Here, we show that indiv...
Article
Full-text available
Identifying differences in the clinical response to specific interventions is an important challenge in the field of Clinical Psychology. This is especially true in the treatment of depression where many treatments appear to have comparable outcomes. In a controlled trial, we compared a positive psychology group intervention, the Integrative Positi...
Article
Full-text available
A landmark study (Jacobson et al., JCCP, 64:295–304, 1996) suggested that behavioral activation (BA) is as effective as cognitive therapy (CT) in the treatment of major depression. A conceptual replication supported the efficacy of BA and suggested BA is more effective than CT for severe depression (Dimidjian et al., JCCP, 74:658–670, 2006), though...
Article
Objectives: This study examined the presence of increased pharmacodynamic tolerance with reduced effectiveness following repeated antidepressant trials over the course of the affective illness in subjects with treatment-responsive bipolar II depression. Methods: Data were derived from the open-label phase of a prospective, randomized, placebo-co...
Article
Full-text available
One of the main debates in the study of psychotherapy is whether specific techniques are best indicated for different problems or whether “common factors” better account for the efficacy of psychotherapy. Evidence for the superiority of specific techniques is mixed and limited to a handful of diagnoses. By contrast, evidence for the importance of c...
Preprint
Full-text available
Eligibility in psychotherapy vs. antidepressant studies 1 Running header: Generalizability of unguided-CBT studies The generalizability of randomized controlled trials (RCTs) of self-guided internet-based cognitive-behavioral therapy (iCBT): Effects on study outcomes and a comparison with RCTs of antidepressants and face-to-face therapy Abstract Ba...
Article
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To the Editor Drs Leichsenring and Steinert argued that cognitive behavioral therapies (CBTs) should not be the gold standard treatment for mental disorders.¹ They acknowledged that CBTs have been more widely studied than other forms of therapy but suggested that other treatments should be considered equivalent to CBTs unless evidence emerges to su...
Article
Background: The generalizability of findings from studies exploring the efficacy of psychotherapy and antidepressants has been called into question in part because studies exclude many patients. Despite this, the frequency with which psychotherapy and antidepressant studies use specific inclusion and exclusion criteria has never been compared. We...
Article
Bipolar disorder is associated with decreased quality of life, especially during depressive episodes. There are few studies that have examined whether quality of life improves following pharmacological treatments of bipolar depression. In this exploratory study, we examined the effects of antidepressant versus mood stabilizer monotherapy on quality...
Article
Background: Anxiety symptoms are common in bipolar disorder. We explored the effect of anxiety on the outcome of acute and continuation pharmacotherapy of bipolar II depression. Methods: Data were derived from a randomized double-blind 12-week acute (N = 129) and 6-month continuation (N = 55) comparison of venlafaxine versus lithium monotherapy...
Chapter
In this chapter, we review the results of a research program aimed at testing a controversial hypothesis that was generated by an evolutionary approach to psychopathology. The evolutionary approach is in conflict with the standard symptom-based approach to diagnosis utilized by the American Psychiatric Association’s official Diagnostic and Statisti...
Article
Objectives: We examined differences in treatment outcome between Diagnostic and Statistical Manual Fourth Edition (DSM-IV)-defined rapid cycling and average lifetime-defined rapid cycling in subjects with bipolar II disorder. We hypothesized that, compared with the DSM-IV definition, the average lifetime definition of rapid cycling may better iden...
Article
Full-text available
Some have proposed that all psychotherapies for depression, as well as for other common mental disorders, are equally efficacious and that they all work through common processes, especially a relationship with a therapist. One reason it may be difficult to discern differential efficacy among treatments, as well as how they exert their effects, is t...
Article
Full-text available
Objective: This study examined the relationship between the number of prior antidepressant treatment trials and step-wise increase in pharmacodynamic tolerance (or progressive loss of effectiveness) in subjects with bipolar II depression. Methods: Subjects ≥18 years old with bipolar II depression (n=129) were randomized to double-blind venlafaxi...
Article
Full-text available
Prior studies have suggested that the association between the alliance and depression improvement varies as a function of prior history of depression. We sought to replicate these findings and extend them to short-term psychodynamic supportive psychotherapy (SPSP) in a sample of patients who were randomized to one of these treatments and were admin...
Chapter
Full-text available
• This chapter provides contemporary descriptions of the mood disorders and of the means of diagnosing and assessing the presence, type, and severity of mood disturbances. It also surveys what is known about the prevalence of these disorders and factors that increase the likelihood that a given individual will experience a mood disorder. It reviews...
Chapter
Full-text available
About half of all individuals meet the criteria for DSM-defined major depressive disorder (MDD) by the age of 30. These and other considerations suggest that MDD criteria are too inclusive and apply to individuals who are not ill but are experiencing normal sadness. This chapter reviews a research program that attempts to address this issue by exam...
Chapter
Full-text available
The symptoms that define depressive conditions have been recognized for millennia of medical history. The earliest Hippocratic writings not only define depression in similar ways as current works but also use context to differentiate ordinary sadness from depressive disorder. Sadness was understood as a natural reaction to loss; symptoms indicated...
Article
Full-text available
Background Controversy exists over antidepressant use in bipolar II depression.AimsTo compare the safety and effectiveness of antidepressant v. mood stabiliser monotherapy for bipolar type II major depressive episodes.Method Randomised, double-blind, parallel-group, 12-week comparison of venlafaxine (n = 65) v. lithium (n = 64) monotherapy in adult...