Heidi J. Ojalehto’s research while affiliated with University of North Carolina at Chapel Hill and other places

Childhood maltreatment (CM) is associated with elevated depression and anxiety in young adulthood; however, there is a dearth of research identifying the intermediary pathways that link CM to these phenomena. The present study investigated two psychological factors— contrast avoidance , sensitivity to and avoidance of sudden negative emotional shifts, and anxiety sensitivity , the fear of arousal-related body sensations—as potential mediators of the relationship between CM and psychological distress in young adulthood. Our sample consisted of 280 undergraduate students who completed self-report measures of childhood maltreatment, anxiety sensitivity, contrast avoidance (i.e., the Contrast Avoidance Questionnaire), and psychological distress. We constructed a series of parallel mediation models to test whether contrast avoidance and anxiety sensitivity mediate the relationships between child maltreatment and psychological distress. CM was related to anxiety and stress indirectly through both contrast avoidance and anxiety sensitivity but was related to depression only through contrast avoidance. There were no significant differences in the magnitude of the indirect effects between contrast avoidance and anxiety sensitivity for the models predicting anxiety and stress. Contrast avoidance and anxiety sensitivity both appear to play important roles in understanding how early experiences of CM relate to psychological distress in young adulthood. Theoretical and clinical implications are discussed.

Mental contamination (MC), an internal feeling of dirtiness that is typically experienced in the absence of contact with a physical contaminant, is increasingly recognized as a sequela of trauma. This scoping review identified 19 studies on MC among trauma survivors and aimed to (a) summarize qualitative research on the phenomenology of MC among trauma survivors, (b) examine how MC is operationalized and measured in studies of trauma survivors, (c) identify the nature and extent of research linking trauma exposure to MC, and (d) identify the nature and extent of research linking MC to other psychopathology among trauma survivors. Qualitative studies indicated relative coherence in the phenomenology of MC across trauma survivors. Quantitative studies showed strong evidence for a link between sexual assault and MC. There was also strong support for a relationship between MC and posttraumatic stress symptoms. Insufficient evidence exists for relationships between MC and obsessive-compulsive symptoms, depression, and suicidal thoughts and behaviors among trauma survivors. The cross-sectional design of most studies limits conclusions about the directionality of relationships between trauma, MC, and other psychopathology, including whether MC represents a transdiagnostic risk factor for psychological distress among trauma survivors.

Background: Acceptance and commitment therapy (ACT) has been shown to promote willingness to experience intrusive thoughts among individuals with obsessive-compulsive disorder (OCD). Exposure with response prevention (ERP) delivered from an ACT framework (i.e., ACT+ERP) may facilitate changes in how patients relate to their unwanted internal experiences. Aims: Accordingly, the present study aimed to examine the effect of ACT+ERP on appraisals of intrusive thoughts, relative to standard ERP. Methods: Forty-eight adults who received 16 treatment sessions as part of a randomized controlled trial comparing standard ERP to ACT+ERP completed the Interpretation of Intrusions Inventory (III) at pre-treatment, post-treatment, and follow-up. Results: Results showed a significant main effect of time for all III subscales, suggesting that appraisals of intrusive thoughts shift over the course of treatment. The effect of the condition × time interaction, however, differed between the III subscales. Specifically, a significant interaction emerged for the control of thoughts subscale, such that individuals who received ACT+ERP experienced greater reductions in beliefs about the need to control thoughts. The interaction term was not significant for importance of thoughts or responsibility subscales. Conclusions: Findings suggest that augmenting ERP with ACT enhances change in beliefs about the need to control thoughts, but not in beliefs about responsibility and the importance of thoughts. Clinical implications and future research directions will be discussed.