Randi E McCabe

• Ph.D.
• Professor (Full) at McMaster University

Generalized anxiety disorder (GAD) is common during the perinatal period. Since its inception, substantial efforts have been put forth to improve the specificity and interrater reliability of GAD. More recently, increased attention has been given to the behavioral features of GAD, with evidence to suggest that hypervigilance, checking, and avoidanc...

Nurses are at risk of adverse mental health symptoms due to frequent exposure to workplace stressors, but less is known about nurses' experiences with interprofessional stressors. This study was designed to understand nurses' perspectives on interprofessional stressors in the workplace. Nurses rated exposures to stressful events through an online s...

Objectives Mindfulness-based interventions (MBIs) have received great attention in both healthy and clinical populations, with recent studies supplementing self-report and behavioural outcomes with neurobiological evidence. This paper reviewed the impact of MBIs on the neuroplasticity of healthy populations, and those with depression, bipolar disor...

Group cognitive-behavioral therapy (CBT) has facilitated increased accessibility to treatment for anxiety disorders, and previous research shows that group cohesion is an important predictor of group-CBT for social anxiety disorder (SAD). Less is known about the differential effects of group cohesion across treatment for anxiety disorders. We exami...

Introduction Healthcare workers (HCWs) have reported COVID-19 pandemic-related adverse mental health impacts. We examined the demographic profile of HCWs who self-referred for mental health treatment, how referrals changed over time in relation to waves of COVID-19, what the main problem was for which HCWs sought treatment, and how this changed dur...

Introduction Les travailleurs de la santé ont fait état d’effets néfastes sur leur santé mentale dus à la pandémie de COVID-19. Nous avons exploré le profil sociodémographique des travailleurs de la santé ayant demandé par eux-mêmes à recevoir des soins de santé mentale, l’évolution des demandes de traitement au fil des vagues de COVID- 19, la natu...

Public safety personnel (PSP), such as police officers, firefighters, correctional workers, and paramedics, routinely face work stressors that increase their risk of developing posttraumatic stress disorder (PTSD). PSP may additionally face moral transgressions in the workplace (e.g., witnessing human suffering, working within broken systems), heig...

Aims Structured clinical interviewing is considered the gold standard in psychiatric diagnosis. The Diagnostic Assessment Research Tool (DART) is a novel modularized, non-copywritten, semi-structured interview; however, no studies have examined the psychometric properties of its alcohol use disorder (AUD) module. The primary aims of this study were...

Adults with clinical anxiety have significant symptom overlap and above average rates of attention-deficit/hyperactivity disorder (ADHD). Despite this, ADHD remains a vastly under-detected disorder among this population, indicating the need for a screener with well-understood symptom dimensions and good discriminant validity. The current study comp...

Aims: Structured clinical interviewing is considered the gold standard in psychiatric diagnosis. The Diagnostic Assessment and Research Tool (DART) is a novel modularized semi-structured interview; however, no studies have examined the psychometric properties of its alcohol use disorder (AUD) module. The primary aims of this study were: (1) to vali...

Background Obsessive-compulsive disorder (OCD) symptoms are hypothesized to be driven by two core motivations: harm avoidance and incompleteness. While cognitive-behavioural therapy (CBT) is an effective treatment for OCD, many posit that OCD presentations characterized by high incompleteness may be harder to treat. The relationship between the cor...

Background: Staffing shortages across the healthcare sector pose a threat to the continuity of the Canadian healthcare system in the post-COVID-19 pandemic era. We sought to understand factors associated with turnover intention as well as Canadian healthcare providers' (HCPs) perspectives and experiences with turnover intention as related to both...

Introduction: Individuals with insomnia disorder often exhibit differences between reported experiences of sleep and objectively measured sleep parameters; however, the implications of this subjective-objective sleep discrepancy during treatment remains unclear. Objective: The aim of this study was to investigate the impact of cognitive behaviou...

Transcranial direct current stimulation (tDCS) has been used with increasing frequency as a therapeutic tool to alleviate clinical symptoms of obsessive compulsive-disorder (OCD). However, little is known about the effects of tDCS on neurocognitive functioning among OCD patients. The aim of this review was to provide a comprehensive overview of the...

Background Symptom accommodation is suggested to maintain anxiety pathology and interfere with treatment effectiveness for anxiety and related disorders. However, little is known about symptom accommodation in generalized anxiety disorder (GAD). Aim This study investigated the associations between romantic partner symptom accommodation, GAD sympto...

En tant que lauréate du Prix de la Société canadienne de psychologie pour contributions remarquables à la psychologie en tant que profession, j’ai le plaisir de partager le fruit de mes travaux dans cet article. À travers le regard unificateur d’une psychologue travaillant dans un centre universitaire de sciences de la santé, je présente mon travai...

Background Cognitive behavioural therapy (CBT) has been shown to be effective for several psychiatric and somatic conditions; however, most randomized controlled trials (RCTs) have administered treatment in person and whether remote delivery is similarly effective remains uncertain. We sought to compare the effectiveness of therapist-guided remote...

La dévalorisation des gains futurs (Delay discounting, ou DD), un indice comportemental économique estimant les préférences d’une personne pour la satisfaction (ou gratification) immédiate par rapport à la satisfaction différée, apparaît aujourd’hui comme un processus transdiagnostique potentiel. On constate également une dévalorisation des gains f...

Generalized anxiety disorder (GAD) is a leading mental health concern during pregnancy and the postpartum (perinatal) period. People with GAD engage in problematic behaviors to manage their distress. However, the extent of GAD behaviors during the perinatal period may not be adequately captured by the Worry Behaviors Inventory (WBI), the most compr...

Background: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its...

Background:Cognitive behavioural therapy (CBT) is an empirically supported treatment for generalized anxiety disorder (GAD). Little is known about the effectiveness of CBT for GAD in real-world treatment settings. Aim:This study investigated the effectiveness of group CBT and predictors of treatment response in an out-patient hospital clinic. Metho...

Introduction Les thérapeutes respiratoires ont été confrontés à des situations moralement difficiles tout au long de la pandémie de COVID-19, en particulier le fait d’avoir peu de ressources pour effectuer leur travail ou encore la participation à des appels vidéo avec les familles de patients mourants. La détresse morale est associée à une foule d...

Introduction Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttr...

Objective: This review aimed to identify if heterogeneity exists across outcomes measured and reported in treatment studies targeting perinatal individuals with Generalized Anxiety Disorder (GAD). Design: Scoping review. Setting: Existing literature that evaluates the effectiveness of interventions for GAD during the perinatal period (i.e., pregnan...

Healthcare providers (HCPs) have described the onset of shame- and trust-violation-related moral injuries (MI) throughout the COVID-19 pandemic. Previous research suggests that HCPs may turn to various coping methods and supports, such as spirituality/religiosity, substance use, friends/family or organizational support, to manage workplace stress....

Cognitive behavioural therapy (CBT) including exposure and response prevention is the first‐line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in‐person delivery, few studies have asses...

Although much is known about how intrusive thoughts become obsessions, the factors that determine which particular thoughts do so is not. The degree to which intrusions are personally significant may be such a determinant. Obsessive-compulsive disorder (OCD) is heterogeneous; thus, it is possible that contradictions of personal values may play a va...

Objective: Although the coronavirus disease 2019 (COVID-19) pandemic has had widespread negative impacts on the mental health of healthcare workers (HCWs), there has been little research on psychological interventions during the pandemic for this population. The current study examines whether a brief coping-focused treatment intervention delivered...

Post-Event Processing (PEP) is prevalent and problematic in Social Anxiety Disorder (SAD) but is typically not a direct target in evidence-based treatments such as cognitive behavioural therapy (CBT) for SAD. The primary aim of the current study was to examine the impact of several theoretically and empirically derived interventions for PEP in SAD,...

Purpose: Cognitive behavioural therapy (CBT) has been found to be an effective treatment for OCD, but there remains a significant proportion of individuals who fail to show a treatment response. Aerobic exercise has previously been associated with decreases in anxiety and depression, as well as improvements in OCD symptoms in small-scale studies....

Background: Generalized anxiety disorder (GAD)-characterised by excessive and uncontrollable worry-is the most frequently diagnosed anxiety disorder during pregnancy and the postpartum period. Identification of GAD often relies on assessment of its cardinal feature, pathological worry. The Penn State Worry Questionnaire (PSWQ) is the most robust m...

Background: Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between P...

Background: Healthcare providers (HCPs) may be at elevated risk for moral injury due to increased exposure to potentially morally injurious events (PMIEs) throughout the COVID-19 pandemic. Identifying PMIEs experienced during the COVID-19 pandemic is a critical first step for understanding moral injury in HCPs. Accordingly, the purpose of the pres...

Worry is a transdiagnostic characteristic across many mental health disorders and given the increased interest and recognized importance of measurement-based care and progress monitoring for mental health treatment, there is a need for psychometrically sound questionnaires that can track weekly progress. The Penn State Worry Questionnaire-Past Week...

Introduction: Healthcare professionals (HCPs) appear to be at increased risk for negative psychological outcomes [e.g. depression, anxiety, post-traumatic stress disorder (PTSD), moral distress] and associated impacts on functioning throughout the COVID-19 pandemic. HCPs working on designated COVID-19 units may be further impacted than their collea...

This article describes an innovative, trauma-focused cognitive behavioral protocol, Transcending, to address the effects of minority stress on mental health among transgender and gender diverse individuals. The protocol merges minority stress and cognitive behavioral therapy models to provide a framework for (a) understanding the impact of minority...

Throughout the COVID-19 pandemic, healthcare workers (HCWs) have been exposed to highly stressful situations, including increased workloads and exposure to mortality, thus posing a risk for adverse psychological outcomes, including acute stress, moral injury, and depression or anxiety symptoms. Although several reports have sought to identify the t...

Background Safety behaviours are hypothesized to play a vital role in maintaining social anxiety disorder (SAD), in part by orienting socially anxious individuals to adopt an avoidance-based mindset focused on self-protection and self-concealment. Evidence suggests an association between safety behaviour use and negative social outcomes for individ...

This study examined cannabis use motives in individuals with anxiety disorders and compared motives between infrequent and frequent cannabis users. It was hypothesised that coping motives would be endorsed at a significantly higher rate than other motives, and that frequent cannabis users would endorse coping motives significantly more than infrequ...

Obsessive-compulsive disorder (OCD) can involve repugnant obsessions with aggressive, sexual, and/or religious themes. Although exposure and response prevention (ERP) is an effective treatment for OCD, negative beliefs about exposure are common and may cause clinicians to be hesitant to encourage exposures, especially for repugnant obsessions. This...

Importance Chronic, non-cancer pain affects approximately 20–30% of the population in North America, Europe, and Australia, with surgery and trauma frequently cited as inciting events. Prospective studies of fracture patients have demonstrated an association between somatic pre-occupation, poor coping, and low recovery expectations following surger...

Objectives The current study examined whether cannabis use frequency and cannabis-related problem severity (as per the Cannabis Use Disorder Identification Test-Revised) predicted outcomes of cognitive behavioural therapy (CBT) for anxiety and related disorders. It was predicted that greater frequency of cannabis use and greater cannabis-related pr...

With the publication of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the American Psychiatric Association published several disorder-specific severity measures to support a dimensional approach to disorder classification. The Severity Measure for Specific Phobia – Adult (SMSP; Craske et al., 2013) was designed to provid...

Objective: A recent clinical trial demonstrated that a group cognitive-behavioral therapy protocol for menopause (CBT-Meno; Green et al. Menopause 2019;26(9):972-980) was effective in reducing menopausal symptoms, including vasomotor and depressive symptoms. The current analyses evaluated the effectiveness of CBT-Meno in improving menopause-specif...

Recent meta-analyses highlight alterations in cognitive functioning among individuals with major depressive disorder (MDD), with performance deficits observed across multiple cognitive domains including executive functioning, memory, and attention. Moreover, impaired concentration is a formal diagnostic criterion for a major depressive episode. Not...

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders in pregnancy and the postpartum (perinatal) period. Perinatal women with GAD engage in problematic behaviours, yet the focus and function of these behaviours remain unknown. Objective: Given that worry during the perinatal period is largely maternally focused, the obje...

Healthcare workers (HCWs) and public safety personnel (PSP) across the globe have continued to face ethically and morally challenging situations during the COVID-19 pandemic that increase their risk for the development of moral distress (MD) and moral injury (MI). To date, however, the global circumstances that confer risk for MD and MI in these co...

The perinatal period (pregnancy and the first-year postpartum) is a time of increased vulnerability to mental health difficulties including emotion dysregulation. Research conducted on treatments targeting emotion dysregulation during this time is limited. Dialectical behavioral therapy (DBT) skills groups are considered the gold standard for targe...

Objective A recent randomized controlled trial of group cognitive behavior therapy (CBGT) for perinatal anxiety showed that CBGT is effective in reducing anxiety and depression in pregnant and postpartum women. In secondary analyses, the role of potential mechanisms of symptom change was examined, including intolerance of uncertainty (IU), self-ori...

The COVID-19 pandemic has resulted in a still-unfolding series of novel, potentially traumatic moral and ethical challenges that place many healthcare workers at risk of developing moral injury. Moral injury is a type of psychological response that may arise when one transgresses or witnesses another transgress deeply held moral values, or when one...

The perinatal period is considered a window of vulnerability given the increased risk of psychiatric difficulties during this time, such as mood and anxiety disorders (ADs). Pre-pandemic rates of ADs in perinatal women were one in five but have since increased with the onset of the COVID-19 pandemic (COVID). In addition, recent research suggests th...

Emotion dysregulation is conceptualized to be at the core of multiple psychopathological conditions and has gained a lot of attention as a construct in both research and clinical settings. Measuring emotion dysregulation proves to be difficult due to inconsistencies in the literature about the definition of emotion and emotion dysregulation. Likewi...

The novel COVID pandemic has had a substantial impact on global mental health, including those populations that are inherently vulnerable such as pregnant and postpartum (perinatal) women. Anxiety disorders (ADs) are the most common mental health disorders during the perinatal period, affecting up to 1 in 5 women. However, since the onset of the pa...

Background : Post-event processing (PEP) is an important maintenance factor of social anxiety disorder (SAD). This study examined psychometric properties of the Positive Beliefs about Post-Event Processing Questionnaire (PB-PEPQ; Fisak & Hammond, 2013), which measures metacognitive beliefs about PEP. Method : Participants receiving treatment for SA...

Executive functions (EF) deficits are hypothesized to be a core contributor to hoarding symptoms. EF have been studied in adult hoarding populations, but studies in youth are lacking. The current study compared multiple EF subdomains between youth with obsessive-compulsive disorder (OCD) and youth with OCD and hoarding symptoms. Forty youth (8–18 y...

The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is a widely used, self-report measure that is employed to assess PTSD symptom severity and determine the presence of probable PTSD in various trauma-exposed populations. The PCL-5 is often administered in clinical settings as a screening tool for PTSD, with a suggested cutoff scor...

Emotion regulation difficulties (difficulty regulating the experience, occurrence, and expression of emotions) are associated with the severity of posttraumatic stress disorder (PTSD) symptoms across trauma types (e.g., childhood abuse, sexual assault, combat trauma). Despite emerging research suggesting that evidence-based treatments for PTSD, inc...

Study objectives: Sleep is one of the most common factors related to health, yet a standard definition of sleep quality has not been identified. Polysomnography (PSG) provides important information about objective sleep variables. However, the relationship between objective sleep variables and perception of sleep quality remains unclear. The purpo...

This article describes the initial validation of the Diagnostic Assessment Research Tool (DART), a modular semistructured interview to facilitate diagnosis of various disorders among adults corresponding with the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). In this study, the construct, convergent, and discriminant va...

Objective Communication is a core competency for all physicians in training. In Canada, the importance of communication during residency is recognized through the CanMEDS framework. Although literature exists around teaching communication skills to residents, research in psychiatry residents is lacking. The purpose of this study was to explore how...

Repugnant obsessions are a common theme of intrusions in obsessive-compulsive disorder and are typically ego-dystonic. Exposure and response prevention (ERP) is the first-line intervention and involves in vivo and/or imaginal exposures. Many therapists are however reluctant to conduct ERP and the reasons remain unclear. Similarly, little is known a...

Obesity has been variously linked to differences in brain functional connectivity in regions associated with reward, emotional regulation and cognition, potentially revealing neural mechanisms contributing to its development and maintenance. This systematic review summarizes and critically appraises the existing literature on differences in resting...

The primary objective of the study was to determine the sensitivity, specificity and accuracy, as well as positive predictive validity and negative predictive validity of the Diagnostic Assessment Research Tool (DART) Screener, a self-report screening questionnaire for identifying possible DSM-5 disorders. The design of the screening tool allows it...

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar o...

Background : Emotion dysregulation (ED) has been implicated in anxiety disorders and may play an important role in perinatal anxiety Cognitive Behavioural Therapy (CBT) treatment outcomes although there is a dearth of research in this area. The current study investigated the role of ED in perinatal anxiety treatment outcome to determine whether it...

Background Individuals with hoarding report stressful and traumatic life events at an elevated rate compared with those with obsessive‐compulsive disorder and healthy controls, but have not been compared with other clinical groups. This study compared rates of traumatic life events between those with clinically significant hoarding, anxiety disorde...

Although cognitive behavioral therapy (CBT) is a highly effective treatment for individuals with obsessive-compulsive disorder (OCD), a portion people with OCD do not benefit fully from CBT due to ambivalence about participating in treatment, nonadherence to exposure exercises, and dropout. This paper reviews the promising evidence for motivational...

Background Although numerous self-report measures of social anxiety exist, most instruments assess symptom severity by examining the range of social situations that provoke anxiety, rather than the distress and impairment associated with social anxiety. The Ryerson Social Anxiety Scales (RSAS; Lenton-Brym, A. P., Rogojanski, J., Hood, H. K., Vorste...

This article reviews three approaches to assessment of psychological difficulties in adults. First, we review case formulation, which includes developing a comprehensive understanding of a client's presenting problems, precipitating factors, mechanisms, and the origins of the problem. Second, we review behavior analysis and assessment, used to gath...

Generalized Anxiety Disorder (GAD) is the most frequently diagnosed anxiety disorder among women in the perinatal period (pregnancy to one year postpartum). Recent studies have examined the relationship between problematic behaviors and GAD symptoms. Studies in non-perinatal samples indicate that adults with GAD engage in avoidance and safety behav...

Despite speculation that highly religious individuals may be predisposed toward developing obsessive–compulsive disorder (OCD), results regarding the relationship between religiosity and spirituality and OCD symptoms are mixed. Limitations of the literature include the use of measures with unknown psychometric properties that do not differentiate b...

Background Recent meta-analyses point towards cognitive impairments in obsessive-compulsive disorder (OCD), particularly in such executive function subdomains as planning and organization. Scant attention has focused on cognitive remediation strategies that may reduce cognitive dysfunction, with a possible corresponding decrease in symptoms of OCD....

Objective: Substance use disorders (SUD) are frequently comorbid with other psychiatric conditions, but a comprehensive diagnostic assessment is often not feasible clinically. Efficient psychometrically-validated screening tools exist for commonly comorbid conditions, but cutoff accuracies have typically not been evaluated in addiction treatment s...

Objective: The literature on transdiagnostic psychotherapy among youths is limited. Group transdiagnostic behavior therapy (TBT) has been shown to be effective for adults with affective disorders and may contain beneficial features for youths (e.g., behavioral focus, group format, ease of dissemination, and diversity of targeted diagnoses). This s...

Cognitive behavioural therapy (CBT) for Social Anxiety Disorder (SAD) is an effective intervention for SAD, however, many individuals with SAD remain symptomatic at the end of CBT. Therefore, it is important to understand variables that influence patients’ responses to treatment. The present study investigated temporal changes in SAD symptoms as re...

Background: Extant self-report measures of social anxiety primarily assess the breadth of social situations in which respondents feel anxious, rather than assessing severity in terms of the distress and impairment that individuals experience due to their social anxiety symptoms. This paper describes the development and validation of the Ryerson Soc...

Objective: Vasomotor symptoms (hot flashes, night sweats) are common during the menopausal transition. Pharmacotherapy is effective but is associated with health risks for some women. There is an increasing demand for non-pharmacological interventions. The CBT-Meno protocol is a psychological intervention targeting a range of common menopausal symp...

Introduction: Obsessive-compulsive disorder (OCD) is a heterogeneous disorder, with multiple symptom presentations. Delineating the neuropsychological characteristics associated with previously identified symptom clusters may therefore be useful in assisting to better define symptom subtypes of OCD. Areas Covered: This review summarizes the existin...

Intolerance of uncertainty (IU) is a dispositional characteristic wherein individuals interpret uncertainty in a negative fashion. No research has investigated the relationship between the IU subfactors, inhibitory (IU-I) and prospective (IU-P) IU, and symptoms of social anxiety disorder while utilizing a hybrid approach of symptom assessment. The...

Major depressive disorder (MDD) is associated with information processing deficits across several cognitive domains. Two examples include biased reactivity (e.g., emotional arousal/reaction) to, and explicit (episodic) memory for, emotional information. Recent research suggests that, compared to healthy controls (HCs), acute depressive states may b...

Background Up to one in five women meet diagnostic criteria for an anxiety disorder during the perinatal period (i.e. pregnancy and up to 1 year postpartum). While psychotropic medications are effective, they are associated with risks for mothers and babies. There is a growing demand for evidence-based non-pharmacological treatments for perinatal a...

In Reply We thank King and Ehrlich for their thoughtful Letter critiquing our meta-analysis¹ that examined delay discounting as a transdiagnostic process in psychiatric disorders. In our article, we proposed that delay discounting, an index of impulsive decision-making, falls on a continuum. At the aggregate level, most disorders examined (eg, majo...

Prevalence of perinatal anxiety disorders continues to grow, with estimates greater than those of postpartum depression. Generalized anxiety disorder (GAD) is the most commonly reported perinatal anxiety disorder, yet very little is known about the worry content experienced during the perinatal period in those with GAD. This study investigated worr...

Cognitive behavioural therapy (CBT) for problematic hoarding is an effective treatment, but further research in diverse, naturalistic settings is needed to see whether this treatment is effective across settings and in smaller doses. The current study investigated the outcome of a 12-session group CBT for hoarding offered in an outpatient hospital...

We investigated the association between cognitive control and individual differences in cortisol response to stress in participants with generalised anxiety disorder (GAD) and in never-disordered controls (CTL). To assess cognitive control, participants completed an affective version of the reading span task, which measures working memory capacity...

Objectives The present study describes patterns of cannabis use, motives for use, and the relationship between cannabis use and problematic alcohol use in a large sample of individuals seeking treatment for anxiety and related disorders at a specialized outpatient clinic in a Canadian hospital. Methods Seven hundred ninety-six participants (n = 30...

Generalized anxiety disorder (GAD) is a prevalent and chronic mental disorder that elicits widespread functional impairment. Given the high degree of non-response/partial response among patients with GAD to available pharmacological treatments, there is a strong need for novel approaches that can optimize outcomes, and lead to medications that are...