Timothy J Strauman

Duke University | DU · Department of Psychology and Neuroscience

Background: Despite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression, there is a limited understanding of the mechanisms of action and how potential treatment-related brain changes help to characterize treatment response. To address this gap in understanding we investigated the effects of an appr...

Background For patients and their intimate partners, advanced cancer poses significant challenges that can negatively impact both individuals and their relationship. Prior studies have found evidence that couple-based communication skills interventions can to be beneficial for patients and partners. However, these studies have been limited by relia...

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples’ ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models...

PurposeSelf-discrepancy (i.e., perceived differences between one’s actual self and personal standards) has been associated with binge eating disorder (BED) symptoms. However, little is known about how weight discrepancy (i.e., the difference between one’s actual and ideal weights) interacts with or is distinguished from nonappearance self-discrepan...

Major depression is an episodic disorder which, for many individuals, has its onset in a distinct change of emotional state which then persists over time. The present article explores the utility of combining a dynamical systems approach to depression, focusing specifically on the change of state associated with episode onset, with a self-regulatio...

A general psychopathology (‘p’) factor captures transdiagnostic features of mental illness; however, the meaning of the p factor remains unclear. Regulatory focus theory postulates that individuals regulate goal pursuit either by maximizing gains (promotion) or minimizing losses (prevention). As maladaptive goal pursuit has been associated with mul...

Turner et al. (2021) subtly relapse in conceptualizing the Examination for Professional Practice in Psychology (Part 2-Skills) exam as a competency evaluation despite Association of State and Provincial Psychology Boards' (ASPPB) prior concession that Part 2 measures only the knowledge of skills (not skill competency). They do not address the purpo...

Objective Recent studies on atypical interoceptive capabilities have focused on clinical populations, including anorexia nervosa[1,2]. The present exploratory study aims to characterize the influence of disordered eating symptomology on interoceptive capabilities in college students, a population for which dangerous dieting behaviors may emerge. M...

Background Substance use is a major risk factor for negative health and functioning outcomes among middle schoolers. The purpose of this study was to assess whether individual differences in the adolescents’ goal orientation are associated with elevated or attenuated risk for substance use. Regulatory focus theory stipulates that individuals vary i...

Objective: Inadequate nutrition adversely impacts brain development and cognitive functioning (Pollitt et al., 1983). Studies examining the acute impact of eating regular meals on cognition have reported inconsistent findings, necessitating the exploration of individual differences in samples contributing to equivocal results. The present study ex...

Objective Innovative treatments and outcome measures are needed for binge‐eating disorder (BED). This randomized controlled trial compared Integrative Cognitive‐Affective Therapy (ICAT‐BED), an individual psychotherapy targeting momentary behavioral and emotional precipitants of binge eating, with an established cognitive‐behavioral guided self‐hel...

Regulatory focus theory (RFT) postulates two cognitive-motivational systems for personal goal pursuit: the promotion system, which is associated with ideal goals (an individual’s hopes, dreams, and aspirations), and the prevention system, which is associated with ought goals (an individual’s duties, responsibilities, and obligations). The two syste...

The national licensing exam for psychologists acts as a gatekeeping evaluation intended to protect public welfare. To date, the suitability and value added of the EPPP Part 2 is unclear, and ASPPB has described only limited plans to conduct validation of the EPPP Part 2. Validation of the planned revision to the exam is of crucial significance to t...

Introduction Burnout is considered to be at the opposite end of the continuum from engagement. People who experience burnout first go through various intermediate patterns that lead to burnout, which in medical students is associated with reduced empathy, intention to leave school, and suicidal ideation. Thus, understanding how to mitigate burnout...

Auto-biological beliefs—beliefs about one’s own biology—are an understudied component of personal identity. Research participants who are led to believe they are biologically vulnerable to affective disorders report more symptoms and less ability to control their mood; however, little is known about the impact of self-originating beliefs about risk...

Self-discrepancy theory (SDT) is a model of the relations between the self and affect which has been applied to the study of different types of psychopathology including depression, anxiety, and eating disorders. Although the theory itself is compatible with a transdiagnostic perspective on psychopathology, to date no systematic review of the liter...

Cancer treatment poses significant challenges not just for those diagnosed with the disease but also for their intimate partners. Evidence suggests that couples' communication plays a major role in the adjustment of both individuals and in the quality of their relationship. Most descriptive studies linking communication to adjustment have relied on...

Objectives: Despite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for unipolar depression, its typical effect sizes have been modest, and methodological and conceptual challenges remain regarding how to optimize its efficacy. Linking rTMS to a model of the neurocircuitry underlying depression and applying su...

To benefit from cognitive behavioral therapy (CBT), individuals must not only learn new skills but also strategically implement them outside of session. Here, we tested a novel technique for personalizing CBT skills and facilitating their generalization to daily life. We hypothesized that showing participants the impact of specific CBT strategies o...

OBJECTIVES/SPECIFIC AIMS: The purpose of this study was to provide individuals who have experience with cognitive behavioral therapy (CBT) with a demonstration of how using their therapeutic strategies affects their brain activity. Two challenges that face CBT and other cognitive therapies are (1) sustaining the gradual, incremental behavioral chan...

Clarifying individual differences that predict resilience or vulnerability to emotional distress is crucial for identifying etiological factors contributing to affective disturbances, and to promoting emotional well-being. Despite recent progress identifying specific brain regions and personality traits, it remains unclear whether there are common...

To benefit from cognitive behavioral therapy (CBT), individuals must not only learn new skills but also strategically implement them outside the session. Here, we tested a novel technique for personalizing CBT skills and facilitating their generalization to daily life. We hypothesized that showing participants the impact of specific CBT strategies...

Chapter 6 addresses goal 2 of the exploration phase of self-system therapy, which focuses on how clients pursue their goals. Clients assess their self-regulatory style by exploring their self-guides (clients’ own standards and expectations that other people have of them), promotion and prevention goals, and self-beliefs. With a better understanding...

Chapter 5 provides a session-by-session guide to the orientation phase of self-system therapy (SST). The main goals of orientation are to familiarize the client with the structure and focus of SST and to establish a strong, collaborative working alliance that supports the client’s efforts in identifying and addressing underlying sources of problems...

Chapter 8, which addresses module the 2 goal of the adaptation phase of self-system therapy, takes a step-by-step approach to evaluating the extent to which certain personal goals are realistic and to identifying obstacles to progress in goal pursuit. The importance of balancing promotion- and prevention-type goals is emphasized. Two strategies can...

Chapter 7 provides a session-by-session guide to the adaptation phase of self-system therapy, which focuses on reducing chronic, distressing self-discrepancies and modifying unsuccessful patterns of self-regulation. The approaches and tactics used by therapists can be broadly categorized as altering one or more of the maladaptive aspects of self-re...

Chapter 4 introduces the core strategies in self-system therapy (SST) and discusses how SST is similar to and different from other short-term, structured therapies, such as cognitive-behavioral therapy, interpersonal psychotherapy, behavioral activation therapy, and acceptance and commitment therapy. SST focuses on self-regulation as a motivational...

In addressing the first goal of the exploration phase of self-system therapy (SST), Chapter 5 focuses on helping clients identify self-beliefs and self-guides. Self-beliefs are characteristics that describe people as they actually are. Ideal self-guides are characteristics that clients would like to have, and ought self-guides are characteristics c...

People with depression often focus too little on promotion goals (i.e., making good things happen). Pursuing promotion goals is important because they provide opportunities for experiencing positive emotions. The third goal in the orientation phase of self-system therapy is to encourage clients to focus on promotion goals. The therapist completes a...

Chapter 9, which addresses the module 3 goal of the adaptation phase of self-system therapy, focuses on managing perfectionism. Many people with depression have standards that are unrealistically high, and they become very self-critical and fear rejection when extreme standards cannot be met. Perfectionists often are willing to cut others some slac...

Chapter 3 explains how relationships with other people can affect the ways in which people think about goals. The second goal of the orientation phase of self-system therapy is to determine the source of the client’s particular style of self-regulation. Style in this context refers to the client’s tendency to focus on promotion goals (i.e., trying...

Self-system therapy (SST) for depression is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. The treatment is grounded in an extensive research literature on self-regulation, and it translates that empirical work into therapeutic strategies aimed at enhancing effective goal pursuit in cli...

Self-system therapy (SST) is an appropriate treatment for clients with a primary diagnosis of major depressive disorder (MDD) or persistent depressive disorder, with symptom severity ranging from mild to severe using standardized measures. SST was developed for individuals with depression characterized by problematic self-regulation, but it can als...

During the orientation phase of self-system therapy (SST), the therapist familiarizes the client with the structure and focus of SST and establishes a strong, collaborative working alliance that supports the client’s efforts to identify and address underlying sources of problems in self-regulation. The first goal after beginning the program is to l...

Chapter 8 addresses common issues associated with treatment termination and recommends strategies and tactics for addressing end-of-treatment issues, including relapse prevention and maintenance of longer-term change processes that were started during therapy. Short-term, structured therapies such as self-system therapy (SST) help clients develop t...

Chapter 10 focuses on end-of-treatment issues, such as maintaining gains, continuing to monitor depressive symptoms, addressing fears about relapse, and identifying long-term goals for continued growth and self-improvement. As clients approach the end of the self-system therapy program, it is important to recognize the progress they have made and t...

Chapter 2 introduces the theory underlying self-system therapy (SST). The terminology and concepts of SST are clarified for therapists and their clients. Self-regulation is a motivational process involving ongoing comparisons between the actual self (i.e., the person I am) and the ideal self (i.e., the person I want to be) or ought self (i.e., the...

Chapter 7 addresses the module 1 goal of the adaptation phase of self-system therapy. It describes strategies aimed at reducing self-discrepancies, including modifying standards and enhancing the importance of positive qualities or characteristics. Depression typically involves self-discrepancies, and most people with depression can benefit from re...

Depression is one of the most common forms of mental illness, and mental health professionals in a variety of practice settings have witnessed its debilitating effects. Many pathways can lead to depression, and no single approach to treatment is successful for all clients. Chapter 1 provides an overview of self-system therapy (SST), a treatment app...

Chapter 6 provides a session-by-session guide to the exploration phase of self-system therapy (SST). This phase involves assessing important aspects of the client’s self-regulation, including self-knowledge and regulatory style. The therapist applies two tactics specific to SST. Self-belief analysis is used to examine the content, function, origins...

Chapter 1 provides clients with an overview of self-system therapy (SST), which is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. Depression robs people of the ability to enjoy the pleasures of life. Because there can be a fine line between a normal sad mood and a diagnosis such as majo...

This article presents a general framework in which different manifestations of psychopathology can be conceptualized as dysfunctions in one or more mechanisms of self-regulation, defined as the ongoing process of managing personal goal pursuit in the face of internal, interpersonal, and environmental forces that would derail it. The framework is ba...

The standard clinical technique for using repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) is associated with limited efficacy to date. Such limited efficacy may be due to reliance on scalp-based targeting rather than state-of-the-science methods which incorporate fMRI-guided neuronavigation based on a specifi...

This article presents a general framework in which different manifestations of psychopathology can be conceptualized as dysfunctions in one or more mechanisms of self-regulation, defined as the ongoing process of managing personal goal pursuit in the face of internal, interpersonal, and environmental forces that would derail it. The framework is ba...

As knowledge of the neurobiological basis of psychopathology has advanced, public perceptions have shifted toward conceptualizing mental disorders as disorders of biology. However, little is known about how patients respond to biological information about their own disorders. We refer to such information as auto-biological—describing our own biolog...

Self-regulation models of psychopathology provide a theory-based, empirically supported framework for developing psychotherapeutic interventions that complement and extend current cognitive-behavioral models. However, many clinicians are only minimally familiar with the psychology of self-regulation. The aim of the present manuscript is twofold. Fi...

The standard clinical technique for using repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) is associated with limited efficacy to date. Such limited efficacy may be due to reliance on scalp-based targeting rather than state-of-the-science methods which incorporate fMRI-guided neuronavigation based on a specifi...

This study examined self-discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi-structured interviews assessing specific types of self-discrepancies...

Despite a growing interest in understanding the cognitive deficits associated with major depressive disorder (MDD), it is largely unknown whether such deficits exist before disorder onset or how they might influence the severity of subsequent illness. The purpose of the present study was to conduct a systematic review and meta-analysis of longitudi...

Purpose of review Increased understanding of “how” and “for whom” treatment works at the level of the brain has potential to transform addiction treatment through the development of innovative neuroscience-informed interventions. The 2015 Science of Change meeting bridged the fields of neuroscience and psychotherapy research to identify brain mecha...

Although goal pursuit is related to both functioning of the brain’s reward circuits and psychological factors, the literatures surrounding these concepts have often been separate. Here we use the psychological construct of regulatory focus to investigate individual differences in neural response to reward. Regulatory focus theory proposes two motiv...

Individuals orient themselves in relationships using different goals and preoccupations, often conceptualized as four distinct attachment styles (Bartholomew & Horowitz, 1991). Individuals also orient themselves in the social world more broadly using different motivational preferences and styles. Self-discrepancy theory (Higgins, 1987) and regulato...

Persistent low back pain (PLBP) is associated with vulnerability to depression. PLBP frequently requires major changes in occupation and lifestyle, which can lead to a sense of failing to attain one's personal goals (self-discrepancy). We conducted a clinical trial to examine the efficacy of self-system therapy (SST), a brief structured therapy for...

The purpose of this manuscript is to describe the PhenX RISING network and the site experiences in the implementation of PhenX measures into ongoing population-based genomic studies. Eighty PhenX measures were implemented across the seven PhenX RISING groups, thirty-three of which were used at more than two sites, allowing for cross-site collaborat...

Objective: This article reviews neuroimaging studies that inform psychotherapy research. An introduction to neuroimaging methods is provided as background for the increasingly sophisticated breadth of methods and findings appearing in psychotherapy research. Method: We compiled and assessed a comprehensive list of neuroimaging studies of psychot...

As changes in health-care delivery impel us to refine clinical science training, the opportunity arises to reconceptualize internship training to align more closely with clinical science values and outcomes. We present observations on the evolution of internship training with a focus on the following issues. First, we highlight the significance of...

Objective: Psychotherapy for depression emphasizes techniques that can help individuals regulate their moods. The present study investigated the affective impact and electrocortical correlates of cognitive restructuring, delivered as a 90-minute psychotherapeutic microintervention in a dysphoric sample. Method: Participants (N = 92) who reported...

Objective: Past research has associated childhood characteristics and experiences with alcohol use at single time points in adolescence. Other work has focused on drinking trajectories across adolescence but with risk factors typically no earlier than middle or high school. Similarly, although the connection between underage drinking and affiliati...

Failure to make progress toward personal goals can lead to negative affective states, such as depression and anxiety. Past research suggests that rumination in response to goal failure may prolong and intensify those acute emotional responses, but that process remains unclear. We examined ruminative thought processes following experimentally manipu...

Background Recent studies implicate individual differences in regulatory focus as contributing to self-regulatory dysfunction, particularly not responding to positive outcomes. How such individual differences emerge, however, is unclear. We conducted a proof-of-concept study to examine the moderating effects of genetically driven variation in dopam...

Regression results: Regulatory focus variables, COMT rs4680 genotype, and interactions predicting total response bias.

COMT rs4680 Val/Val verses Met-carrier response bias scores by promotion success groups. The * indicates that mean response bias values were significantly different, p<.05.

Subthreshold posttraumatic stress disorder (PTSD) is associated with increased risk for suicidality, depression, and functional impairment. We thus conducted a small (N=12) pilot randomized controlled trial (RCT) with paroxetine for subthreshold PTSD in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) era veterans. Hospital Anxiety and...

How is the brain engaged when people are thinking about their hopes, dreams, and obligations? Regulatory focus theory postulates two classes of personal goals and motivational systems for pursuing them. Ideal goals, such as hopes and aspirations, are pursued via the promotion system through "making good things happen." Ought goals, such as obligati...

The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of co...

The focus of this article is the increasingly narrow range of therapeutic orientations represented in clinical psychology graduate training programs, particularly within the most research‐oriented programs. Data on the self‐reported therapeutic orientations of faculty at “clinical science” Ph.D. programs, Ph.D. programs at comprehensive universitie...

Psychotherapy is a complex, multi-layered process with the potential to bring about changes at multiple levels of functioning, from the neurobiology of the brain to the individual's role in the social world. Although studies of the mechanisms by which psychotherapy leads to change continue to appear, there remains much to be learned about how psych...

What is the relationship between cognitive vulnerability to depression and immunity? Beginning to fill this knowledge gap, Strauman et al. (2004) demonstrated that idiographic feedback about motivationally significant goals affected natural killer cell numbers and activity differently for individuals based on their self-evaluation. This connection...