Matthew T Tull

• PhD
• Professor at University of Toledo

Despite the Heterosexist Harassment, Rejection, and Discrimination Scale (HHRDS) being a routinely used measure of discrimination , there is no current consensus regarding its fundamental psychometric properties. This study sought to: (a) test the dimensionality of the scale using a classical test theory approach, and (b), if lacking a clear multid...

The Perceived Invalidation of Emotions Scale (PIES), developed to measure emotional invalidation, could aid research efforts on various internalizing disorders and minority mental health. A prerequisite for its use includes its psychometric evaluation in diverse samples; thus, the current study aimed to evaluate the psychometric properties of the P...

Background: Although health anxiety is broadly related to the overutilization of healthcare, limited research has examined this relation among individuals with substance use disorders (SUDs), or the extent to which racial/ethnic differences influence this relationship. Objectives: The purpose of the current study is to examine the moderating role o...

Background Despite the wide‐ranging negative consequences of nonsuicidal self‐injury (NSSI), there are few evidence‐based treatments for NSSI among adolescents and little is known about what treatments that work best for whom. The objective of this study was to investigate moderators (i.e., for whom a specific treatment works) and predictors (i.e.,...

Objectives Anxiety is a global problem that is readily treatable with psychosocial interventions, though many individuals do not benefit following participation in extant treatment protocols. Accordingly, clarification of process‐related variables that may be leveraged to enhance outcomes appears warranted. Emotion regulation (ER) is a robust corre...

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provid...

Purpose/Objective: People with disabilities (PWD) generally exhibit an increased risk of suicidal ideation (SI) and behaviors. Underlying cognitive states, namely perceived burdensomeness, have been identified as a contributor to the increased risk of suicidal thoughts and behaviors in PWD. However, the role of body esteem in the development of SI...

This study examined the prospective relations of baseline borderline personality disorder (BPD) symptoms to later coping- and health-related outcomes during the early stages of the COVID-19 pandemic, as well as the moderating role of social media addiction in these relations. A U.S. nationwide community sample of 377 adults completed a prospective...

Importance: Nonsuicidal self-injury is prevalent in adolescence and associated with adverse clinical outcomes. Effective interventions that are brief, transportable, and scalable are lacking. Objective: To test the hypotheses that an internet-delivered emotion regulation individual therapy for adolescents delivered adjunctive to treatment as usu...

Despite evidence for the intergenerational transmission of borderline personality disorder (BPD) pathology from mothers to offspring, the factors underlying the relation between mother and child BPD symptoms remain unclear and little is known about the pathways through which maternal BPD symptoms may relate to BPD symptoms in their offspring. One s...

Introduction Distress during pregnancy and postpartum is common and contributes to poor infant and maternal outcomes, such as developmental delays and mental health disorders, respectively. Anxiety sensitivity, or fear of the symptoms of anxiety (eg, palpitations, confusion), is a risk factor known to increase distress across psychological and heal...

Background Borderline personality disorder (BPD) pathology is common among patients with substance use disorders (SUDs) and associated with a variety of negative outcomes, including worse SUD outcomes. One particularly relevant outcome with links to substance use problems that is likely to be elevated among SUD patients with BPD symptoms is ineffec...

Background Affective associations have been shown to predict physical activity, but interventions designed to manipulate affective associations are limited. Purpose To increase physical activity through manipulation of affective associations toward physical activity using the values component from Acceptance and Commitment Therapy (ACT) in cardiac...

To identify factors that increase risk for nonadherence to recommended health protective behaviors during pandemics, this study examined the prospective relations of substance use frequency to both adherence to social distancing recommendations and social distancing intentions during the COVID-19 pandemic, as well as the role of social distancing s...

Direct and indirect body-focused self-damaging behaviors are highly prevalent and associated with negative outcomes. Despite progress in understanding the expected consequences (i.e., expectancies) that motivate individuals to engage in these behaviors, less is known about the co-occurrence of, and specific expectancies for, body-focused self-damag...

Obesity is a major public health concern, and sugar consumption is a key risk factor for obesity. Thus, there is a need to identify factors that may increase motivation to consume sugar. One such factor may be negative affect, as research has shown that negative affect increases motivation for and engagement in appetitive behaviors, including sugar...

Background: Disability status is associated with correlates of suicide risk (perceived burdensomeness, thwarted belongingness, negative future disposition, felt stigma, suicidal ideation, and suicide attempts). Aims: This study aimed to examine whether suicide-related correlates differ significantly as a function of disability type. Methods: I...

Nonsuicidal self‐injury (NSSI) is defined as the deliberate destruction of one's own body tissue without suicidal intent and for purposes not socially sanctioned. However, this definition limits the understanding and assessment of NSSI by excluding a clinically relevant form of NSSI that is both self‐driven and associated with self‐injurious intent...

Introduction: Suicide models propose that the capability for suicide, such as fearlessness about death (FAD), is necessary for the transition from suicidal desire to a suicide attempt. Most studies have relied on self-report methods to assess FAD. However, this research has produced equivocal results. As individuals may have limited awareness of l...

Background Despite the strong link between borderline personality disorder (BPD) symptoms and suicide risk, little is known about the mechanisms underlying this association. Theory-driven research clarifying the pathways through which BPD symptoms increase suicide risk over time is needed and may highlight relevant treatment targets for decreasing...

Despite often being mandated to substance use treatment after release, many people on probation do not complete treatment. Several historical factors have been identified as relevant to substance use treatment in this population (i.e., past substance use, treatment history, and criminal history); however, less is known about the psychological chara...

Objective: This study examined the associations of the experience and tolerance of shame-related emotions to suicide risk, as well as the moderating role of sexual minority status. Methods: Community adults (N = 360) were recruited via MTurk and completed self-report questionnaires. Hierarchical regression analyses examined the main and interact...

Objectives: Emotional and interpersonal dysfunction appears central to nonsuicidal self-injury (NSSI), yet research examining the interplay of these factors among individuals with NSSI is limited. This study aimed to specify such associations before and after daily stressful events among individuals with (vs. without) NSSI. Methods: Young adult...

Maternal borderline personality disorder (BPD) symptoms have been found to relate to parenting difficulties that subsequently predict children's maladjustment. One specific area of difficulty for mothers with BPD symptoms surrounds responses to infant distress. Based in mentalization theories of BPD, the current study tested the relation between BP...

Introduction: People report multiple motives for nonsuicidal self-injury (NSSI), but few studies have examined how these motives relate to one another. This study identified person-centered classes of NSSI motives, their NSSI and psychopathological correlates, and their utility in predicting future NSSI across two samples. Methods: Participants...

Background Despite research and theory linking emotion regulation (ER) difficulties to suicidal thoughts and behaviors, limited research has examined the relations of specific ER strategies to suicide risk outcomes, and almost no research has examined interpersonal ER strategies in particular. Thus, this study sought to examine associations of spec...

Despite the clearly established link between posttraumatic stress disorder (PTSD) and emotion dysregulation, little is known about how individual symptoms of PTSD and aspects of emotion dysregulation interrelate. The network approach to mental health disorders provides a novel framework for conceptualizing the association between PTSD and emotion d...

In 2020, a novel emerging infectious disease—COVID-19—became a global pandemic and prompted unprecedented social distancing measures. We examined the associations of voluntary stay-at-home (SAH) orders during the COVID-19 pandemic with vulnerability assessments and precautionary intentions (e.g., social distancing, hand washing). A quasi-experiment...

Introduction The ongoing coronavirus disease 2019 (COVID-19) pandemic is a globally significant crisis with a rapid spread worldwide, high rates of illness and mortality, a high degree of uncertainty, and a disruption of daily life across the sociodemographic spectrum. The clinically relevant psychological consequences of this catastrophe will be l...

Background: Although substance use has been linked to both suicidal ideation and suicide attempts, the factors underlying these relations remain unclear. The Interpersonal-Psychological Theory of Suicide (ITS) provides a framework for understanding how substance use may increase suicide risk. The purpose of the current study was to examine if frequ...

Objectives Extant research indicates a robust association between anxiety and nonsuicidal self-injury (NSSI). However, research identifying factors that may account for this relation is lacking. Mindfulness is one candidate construct that may account for the relation of anxiety to NSSI. The objective of the present study was to examine the indirect...

Background Pain anxiety has been associated with more severe posttraumatic stress disorder (PTSD) symptoms. However, the unique role of individual domains of pain anxiety has yet to be explored in the prediction of PTSD severity. This study examined whether specific pain anxiety domains (i.e., cognitive anxiety, escape/avoidance, fear of pain, and...

This study sought to examine the explanatory role of sleep disturbance in the associations of borderline personality disorder (BPD) symptom severity to nonsuicidal self‐injury (NSSI) and suicide risk within an at‐risk sample of patients with substance use disorders (SUDs), as well as whether emotion regulation (ER) difficulties account for signific...

There is a need to identify the subset of individuals with borderline personality disorder (BPD) symptoms at greatest risk for transitioning from suicidal ideation to a suicide attempt. Contemporary models of suicide risk propose that the capability for suicide is necessary for moving from suicidal ideation to a suicide attempt. Few studies have ex...

Given concerns of increased suicide risk among university students during the COVID-19 pandemic, this study examined rates of lifetime and past-year suicidal ideation (SI) among university students in Fall 2020 (vs. two earlier semesters), overall and across gender, racial/ethnic background, and sexual identity. Participants included 1700 universit...

Background Adherence to COVID-19 social distancing guidelines varies across individuals. Purpose This study examined the relations of pseudoscientific and just world beliefs, generalized and institutional trust, and political party affiliation to adherence to COVID-19 social distancing guidelines over three months, as well as the explanatory role...

Background: Researchers have highlighted the risk for alcohol use problems in the context of COVID-19, although the factors associated with this risk remain unclear. Objectives: This study examined the prospective relation of baseline financial strain (reported at the beginning of the pandemic) to problematic alcohol use one month later, as well as...

Despite evidence for the association between emotion regulation difficulties and posttraumatic stress disorder (PTSD), less is known about the specific emotion regulation abilities that are most relevant to PTSD severity. This study examined both item-level and subscale-level models of difficulties in emotion regulation in relation to PTSD severity...

Purpose of review Posttraumatic stress disorder (PTSD) commonly co-occurs with substance use disorder (SUD) and is challenging to treat. We review all behavioral therapy models with at least one randomized controlled trial in a current PTSD/SUD population. We identify factors in selecting a model for clinical use, emphasizing a public health framew...

Introduction: Theory and research suggest the need to expand research on emotion regulation (ER) within borderline personality disorder (BPD). This research examined the relations of BPD symptoms to interpersonal (venting, reassurance-seeking) and socially-oriented (social comparison) ER strategies (in addition to acceptance and avoidance), and exp...

Emotion dysregulation has been shown to be of importance in the onset and maintenance of psychiatric disorders, including substance use disorders. How difficulties in emotion regulation differ across levels of substance use, and whether these relations are influenced by co-occurring psychiatric disorders, is less clear. This study aimed to identify...

Despite the established relations between borderline personality disorder (BPD) and substance use problems in general, there is a dearth of research on the relation between BPD pathology and opioid use problems, as well as factors that may explain this relation. Therefore, this study examined the indirect relations of BPD pathology to opioid use pr...

Research has largely not identified processes contributing to the relationship between physical disability and suicide risk. This cross-sectional research is aimed at examining the associations among felt stigma, perceived burdensomeness, disability severity, and perceptions about future suicidal ideation and attempts. Adults (N = 127) with physica...

Little research has examined the role of emotion regulation self-efficacy (ERSE; i.e., beliefs in one's own ability to regulate emotions) in self-injurious thoughts and behaviors (SITBs) or the factors that may underlie this relation. This study investigated whether low ERSE relates to SITBs both directly and indirectly through avoidance of negativ...

Objective Although once considered a defining feature of borderline personality disorder, research has found high rates of NSSI among individuals with other psychiatric disorders, particularly posttraumatic stress disorder (PTSD) and depressive disorders. A recent study from our research team found that lifetime PTSD and depressive disorders were a...

Cancer survivors are more at risk for physical and psychological health problems than the general population. Regular aerobic physical activity can mitigate these risks, but survivors frequently fail to engage in recommended levels of physical activity. In the present study, we propose and test a moderated-mediation model of physical activity of ca...

The COVID-19 pandemic is likely to increase risk for the development of health anxiety. Given that elevated health anxiety can contribute to maladaptive health behaviors, there is a need to identify individual difference factors that may increase health anxiety risk. This study examined the unique and interactive relations of COVID-19 affective ris...

Background : Despite theories that negative reinforcement in the form of relief from negative emotions maintains nonsuicidal self-injury (NSSI), no studies have examined the extent to which specific emotional consequences of NSSI predict the maintenance of NSSI over time or explain the greater risk for NSSI found among individuals with borderline p...

Objective The social and economic consequences of COVID‐19 and related public health interventions aimed at slowing the spread of the virus have been proposed to increase suicide risk. However, no research has examined these relations. This study examined the relations of two COVID‐19 consequences (i.e., stay‐at‐home orders and job loss) to suicide...

Despite growing evidence in support of emotion dysregulation as a risk factor for the development of posttraumatic stress disorder (PTSD) following trauma exposure, few studies have examined temporal relations between emotion dysregulation and the onset and/or worsening of PTSD symptoms over time. The aim of the present study was to extend research...

The COVID-19 pandemic has resulted in the widespread implementation of extraordinary physical distancing interventions (e.g., stay-at-home orders) to slow the spread of the virus. Although vital, these interventions may be socially and economically disruptive, contributing to adverse psychological outcomes. This study examined relations of both sta...

Despite growing evidence in support of emotion dysregulation as a risk factor for the development of posttraumatic stress disorder (PTSD) following traumatic exposure, few studies have examined temporal relations between emotion dysregulation and the onset and/or worsening of PTSD symptoms over time. The aim of this study was to extend research on...

Despite the robust relation between nonsuicidal self-injury (NSSI) and suicidal behaviors, there is considerable heterogeneity in NSSI characteristics that may have implications for the strength of the NSSI-suicide attempt relation. In particular, NSSI methods that are more severe/painful (e.g., cutting) may be more likely to increase an individual...

There is extensive variability in cocaine-related attentional bias (AB) following trauma script exposure among cocaine-dependent (CD) patients with posttraumatic stress disorder (PTSD). Therefore, research is needed to identify the specific PTSD-CD patients most likely to exhibit an AB to cocaine cues. A common polymorphism in brain-derived neurotr...

Background: Opioid abuse/dependence is associated with multiple negative outcomes relative to other forms of substance abuse/dependence, including relapse. Research identifying modifiable characteristics associated with opioid dependence and associated negative outcomes may inform the development of targeted interventions for this high-risk populat...

Despite evidence of a strong relationship between BPD and substance use problems in general, little research has examined the associations of BPD symptoms with the misuse of sedatives or opioids, and no studies have explored possible factors that may underlie these associations. Thus, this study examined the relationships of BPD symptoms (i.e., the...

Generalized anxiety disorder (GAD), a chronic disorder characterized by excessive and difficult-to-control worry, has been shown associated with heightened risk for depression. However, despite the high rate of co-occurrence between GAD and depression, few studies have examined factors that might account for this comorbidity. Contemporary models of...

Objective Although past literature has emphasized the role of acquired capability in the relationship between nonsuicidal self‐injury (NSSI) and suicide attempts, support for the indirect relationship of NSSI to suicide attempts through acquired capability is limited. Thus, research examining other factors that may underlie this relationship is nee...

To facilitate self-evaluations and guide behavior, students often compare domain-specific academic achievements (e.g., math scores) to peers (social comparison), past achievements (temporal comparison), and other domains (e.g., verbal scores; dimensional comparison). However, no studies have examined the impact of all three comparison types (and th...

Individuals exposed to a traumatic event commonly develop symptoms of depression, a psychiatric disorder associated with a number of negative clinical and public health consequences. Both intrapersonal and interpersonal risk factors have been associated with heightened risk for depression following traumatic event exposure; however, less is known a...

Despite advancements in the treatment and prevention of HIV/AIDS, adherence to antiretroviral therapy (ART) remains suboptimal. Research indicates that health care provider (HCP) engagement is related to adherence, yet little is known about the specific pathways that underlie this relation. This cross-sectional study examined the relation between p...

Although researchers have identified a number of factors that may motivate individuals to engage in nonsuicidal self-injury (NSSI), few studies have examined whether motives for NSSI differ as a function of psychiatric diagnosis. Therefore, the goal of the present study was to examine motives for lifetime NSSI among individuals with a history of ps...

Attenuated reward responsiveness (RR) reflects alterations in responding to ordinarily rewarding experiences (Der-Avakian & Markou, 2012), and is associated with negative outcomes, such as increases in depression symptoms over time (Morgan et al., 2013), poor response to antidepressant treatment (McMakin et al., 2012), and suicidal ideation (Winer...

Non-suicidal self-injury (NSSI) has primarily been studied in the context of borderline personality disorder, with research demonstrating that NSSI is often used to obtain emotional relief. However, few studies have examined whether motivations for NSSI are comparable in other disorders associated with heightened rates of NSSI, including depressive...

Sleep disturbances are common within days after experiencing a traumatic event, and may exacerbate the development of posttraumatic stress disorder (PTSD) symptoms. However, the mechanisms between acute sleep disturbances and PTSD symptom development remain unclear. Sleep disturbances have been associated with emotion dysregulation, and emotion dys...

Although evidence suggests that risk-taking among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) may be precipitated by trauma-related emotional distress, studies have yet to examine moderators of this effect. One moderator worth investigating is recurrent major depressive disorder (MDD), given i...

Background Currently, little is known about the implicit evaluations that cancer survivors have for health behaviors, such as eating fruits and vegetables. Understanding both the implicit and explicit evaluations of fruit and vegetable consumption among cancer survivors may aid future interventions for changing motivations and intentions in this hi...

Objective Opioid use disorders are associated with heightened suicidal ideation, suicide attempts, and suicide death. This study aimed to examine the extent to which opioid differentiates between those with suicide attempts from those with lifetime suicidal ideation but no history of attempt. Methods Participants were drawn from the US National Gu...

Nonsuicidal Self-Injury moves beyond the basics to tackle the clinical and conceptual complexity of NSSI, with an emphasis on recent advances in both science and practice. Directed towards clinicians, researchers, and others wishing to advance their understanding of NSSI, this volume reviews and synthesizes recent empirical findings that clarify NS...

Objective Despite the theoretical and empirical relevance of anxiety sensitivity (AS) to nonsuicidal self‐injury (NSSI), few studies have investigated this association. This study examined the incremental validity of AS dimensions in NSSI frequency and versatility, above and beyond emotion dysregulation and relevant covariates (racial/ethnic backgr...

Studies show that patients with substance use disorders (SUD) and posttraumatic stress disorder (PTSD) are at high risk for engaging in risky behaviors. However, these studies do not speak to the context in which these behaviors are more likely to occur. This study examined whether SUD patients with current PTSD, compared to those without a history...

Theories of borderline personality disorder (BPD) highlight the central role of emotional dysfunction in this disorder, with a particular emphasis on emotional reactivity and emotion regulation (ER) difficulties. However, research on emotion-related difficulties in BPD has produced mixed results, often related to the particular indices of emotional...

Chronic spontaneous urticaria (CSU) has been associated with depression and can have an impact on quality of life. Therefore, researchers have suggested the potential utility of psychological interventions for targeting depression among CSU patients. Psychological interventions that may hold the most promise are those that are brief and easily tran...

Limited research has examined associations between physiological reactivity and nonsuicidal self-injury (NSSI), despite evidence that NSSI is often motivated by a desire to regulate internal states (Hamza et al. , 2013). Preliminary research examining physiological reactivity among self-injuring individuals has produced mixed results, with some stu...

Introduction: The global incidence and prevalence of allergic diseases are increasing as is the intensity and duration of excessive psychological stress due to multiple factors associated with living in today’s world such as personal, social and political unrest, increased fear and anxiety and/or depression often leading to hopelessness. Both aller...

Background Nonsuicidal self-injury (NSSI) is common among adolescents and associated with negative outcomes. However, treatments developed specifically for NSSI and the proposed NSSI disorder (NSSID) are scarce, and access to empirically supported treatments for NSSI in many areas is limited. Online treatments carry the potential to increase the av...

Despite the effectiveness of mindfulness-based interventions (MBIs) for psychological disorders, the underlying psychological and neurobiological mechanisms are unclear (Guendelman et al., 2017). Although research has found a negative relationship between mindfulness training and heart rate variability (HRV; Krygier et al., 2013) - a central modula...

Adherence to antiretroviral therapy (ART) is associated with positive health outcomes among HIV+ patients. However, non-adherence remains high. Though factors that account for non-adherence remain unclear, social support has been consistently associated with ART adherence. As such, identifying malleable factors that hinder patients’ ability to form...

Research has consistently shown that regular physical activity may protect against the development and maintenance of depression and anxiety, whereas sedentary behavior may exacerbate depression and anxiety. However, much of the past research in this area has focused on non-clinical populations. Therefore, the goal of this study was to examine the...

Background and objectives Despite strong support for the role of emotional relief in deliberate self-harm (DSH), no research has examined the impact of emotional distress on the strength of the DSH-relief association. Thus, it remains unclear whether the association of DSH with emotional relief is stable across emotional contexts or context-depende...

Background Nonsuicidal self-injury (NSSI) is a serious health risk behavior that forms the basis of a tentative diagnosis in DSM-5, NSSI Disorder (NSSID). To date, established treatments specific to NSSI or NSSID are scarce. As a first step in evaluating the feasibility, acceptability, and utility of a novel treatment for adolescents with NSSID, we...

Sleep disturbance is a common problem among individuals with anxiety and substance use disorders (SUD). Anxiety sensitivity (AS) is elevated in patients with anxiety disorders and SUD and has been linked to sleep-related problems, including insomnia and somnolence (i.e., daytime sleepiness). We examined the unique roles of AS cognitive, physical, a...

This study examined the relations of PTSD pathology to both the lability of three specific emotions (anxiety, anger, self-conscious emotions [SCE]) and the extent to which changes in one emotional state co-occur with changes in another emotional state (i.e. affective synchrony). Moreover, given evidence that emotional responding in PTSD may be heig...

Objective Emotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of empirically supported treatments for individuals with borderline personality disorder and deliberate self-harm, an evaluation of ERGT in rou...