Gregory L. Stuart’s research while affiliated with University of Tennessee at Knoxville and other places

Social anxiety disorder (SAD) is common and can significantly undermine an individual’s ability to participate effectively in social, occupational, and professional activities. Several cognitive behavioral therapy (CBT) strategies are implemented to treat SAD, including exposure therapy, social skills training, cognitive restructuring, and relaxation training. However, many people with SAD engage in substantial avoidance, which may be associated with difficulties in distress tolerance. This case study examined the utility of implementing distress tolerance skills into a manualized 13-session exposure-based CBT protocol for SAD with a female young adult. Distress tolerance skills were used to specifically target avoidance associated with strong physiological symptoms. Data suggested a significant reduction in SAD symptoms over the course of treatment, and these reductions persisted even amid other life stress that occurred toward the end of treatment. Additionally, follow-up data indicated that the client’s low level of avoidance was sustained after treatment, which might underscore the potential utility of improving distress tolerance in SAD treatment to reduce avoidance and maintain treatment gains. This case study provides evidence for incorporating distress tolerance skill training into manualized, exposure-based CBT for SAD.

Objective: Hookup behaviors (HUBs; i.e., sexual activity outside an exclusive relationship with no mutual expectation of romantic commitment) are prevalent on college campuses and are linked with alcohol use and sexual assault. There is limited understanding of risk factors for consensual and coercive HUBs. We examined the proximal associations between alcohol use and consensual and coercive HUBs and the moderating influence of positive urgency and alcohol-related sexual affect and drive expectancies among college men. Method: Ninety-nine college men completed a baseline assessment and 60 consecutive daily surveys assessing their alcohol use and HUBs. Results: An alcohol use day increased the odds of a consensual and coercive HUB, compared to no HUB. An alcohol use day decreased the odds of a consensual HUB, versus a coercive HUB, in the models that included alcohol-related sexual affect and drive expectancies. Only alcohol-related sexual affect expectancies was a significant moderator. An alcohol use day significantly associated with a consensual HUB, compared to no HUB, among college men at low, B = .93, p = .009, OR = 2.53 (95% CI: 1.27, 5.06), and high, B = 1.93, p < .001, OR = 6.87 (95% CI: 4.32, 10.92), levels of alcohol-related sexual affect expectancies. Conclusions: Results suggest that greater alcohol-related sexual affect expectancies may increase the odds of an alcohol-facilitated consensual HUB among college men. An alcohol use day increases the odds of engaging in a HUB and increases the odds of a coercive HUB, compared to a consensual HUB. Additional research is needed to identify risk factors for coercive HUBs.

Objective: Intimate partner violence (IPV) is a public health problem among college students. However, few studies have used ecological momentary assessment (EMA) to examine IPV and instead have relied on methods that may introduce recall bias (e.g., cross-sectional methods, daily diary). Thus, this study examined the feasibility of EMA to assess IPV among college students aged 18–25. Method: A sample of 164 college students (18–25 years old, 62.8% women) in a dating relationship with a recent history of IPV perpetration completed one morning and four randomly prompted surveys daily for 28 days. Results: Findings demonstrated high compliance (89.57% for morning and 73.49% for random surveys) with EMA surveys. The prevalence of psychological, physical, and sexual IPV reported on randomly prompted surveys was higher relative to morning surveys. The number of reported IPV instances was higher during the first half of sampling (i.e., first 14 days) compared to the last half of sampling (i.e., Days 15–28). Finally, participants reported an overall neutral reaction to EMA methods despite some technological challenges. Conclusions: EMA is a feasible method for assessing events of IPV in college students. The reduction of recall bias afforded with EMA methods could bring more accurate examination of prevalence and proximal risk factors for IPV. Intervention approaches could benefit from harnessing EMA methods to bring interventions to the moment they are needed among those who experience IPV.

This study examines the moderating role of relationship length on the association between coercive sexting and intimate partner violence (IPV) perpetration. Research has supported a positive association between coercive sexting and IPV perpetration (Drouin et al., 2015), though no prior research has examined how relationship length moderates this association. To test this relationship, we administered a multipart questionnaire online to 798 undergraduate participants (79% White, 77% female, M Age = 19.1 years) currently in a relationship. We assessed physical, psychological, and sexual IPV perpetration. Relationship length moderated the link between coercive sexting and sexual IPV perpetration. More specifically, the association was stronger in longer-term compared to shorter-term relationships. These results carry implications for future research and IPV education and intervention programs, suggesting that they should incorporate coercive sexting into their curriculums and target newer couples.

Background and Aims Numerous studies have demonstrated that alcohol preceded and increased the odds of intimate partner violence (IPV). These prior studies were restricted to one dyad member despite theory suggesting that acute alcohol use by both partners should increase the risk for IPV to a greater degree than when only one partner drinks. We hypothesized that alcohol use by both dyad members, relative to one or no dyad members, would proximally precede and increase the odds of IPV perpetration and victimization. Design A 60‐day daily diary design was used, where both dyad members of dating couples completed independent reports on IPV perpetration/victimization and alcohol use via a secure survey website. Setting and Participants Alcohol using college‐student couples, aged 18–25 ( n = 181 couples), from a Midwestern university in the United States participated. A convenience sample strategy was used. Measurements Daily surveys asked about alcohol use and IPV perpetration and victimization the prior day, including whether alcohol use preceded or followed IPV. The primary outcome was psychological IPV; secondary outcomes were physical and sexual IPV. Findings Longitudinal random effects models suggested statistically significant associations between drinking behavior and IPV outcomes. The odds of psychological IPV perpetration were higher when both partners were drinking relative to one partner drinking [adjusted odds ratio (aOR) = 1.13, 95% confidence interval (CI) = 1.06–1.99]. Exploratory analyses showed some indication that the odds of physical IPV victimization were higher when both partners were drinking relative to one partner drinking (aOR = 2.09, 95% CI = 1.71–4.21). Conclusions The risk for intimate partner violence appears to be greater when both partners drink, relative to one partner or neither partner.