Lorenzo Lorenzo-Luaces’s research while affiliated with Indiana University Bloomington and other places

Background: Social media has been identified as a possible risk factor for depression in young adults, though it is unclear if it is associated with other dimensions of psychopathology. Moreover, it is unclear what aspects of social media use beyond frequency are associated to symptoms. Methods: A large sample of young adults (N= 7453) participated in a screening of transdiagnostic symptoms of psychopathology (i.e., depression, panic, generalized anxiety, social anxiety, alcohol use, drug use, insomnia, and pain). We correlated depression scores to time spent on social media and problematic social media use. We used a principal components analysis to identify shared dimensions of psychopathology and explored the correlations between symptom dimensions and social media use. Results: Participants who reported higher social media usage exhibited significantly higher self-reported depression. Our PCA suggested two dimensions of psychopathology consistent with the HiTOP model which we dubbed “emotional” and “externalizing” symptoms. Time spent on social media was correlated with emotional symptoms and with externalizing symptoms, albeit to a lesser extent. However, these associations were not significant after controlling for problematic social media use, which had differential relations to dimensions of psychopathology. e-value analysis suggested that unmeasured confounds could potentially explain these associations. Discussion: The association between time spent on social media and psychopathology could be accounted for by the way in which social media is used. However, unmeasured confounding remains a threat to these inferences.

Quality of life (QOL) broadly encompasses constructs including health, well-being, life satisfaction, and psychosocial functioning. Depression, a major cause of global disability, is linked to lower QOL. Despite the rise of measurement-based care and patient-reported outcomes, there is no consensus on QOL definitions or models, resulting in varied assessments. This study aims to describe the item content overlap among commonly used QOL measures in depression research. We analyzed 10 QOL measures from a meta-analysis, calculating Jaccard indices to quantify overlap, and used two coding approaches: one for similarly worded items and another for exact word matches. We also categorized items into broader themes. At the most, average Jaccard similarity was M = 0.14 (SD = 0.12), indicating significant heterogeneity among QOL measures in depression. This suggests that QOL outcomes may not be reproducible across different scales. Future research should examine the relationships between the content assessed by various QOL measures.

Depression is one of the leading causes of disability worldwide. Individuals with depression often experience unrealistic and overly negative thoughts, i.e. cognitive distortions, that cause maladaptive behaviors and feelings. Now that a majority of the US population uses social media platforms, concerns have been raised that they may serve as a vector for the spread of distorted ideas and thinking amid a global mental health epidemic. Here, we study how individuals (N=838) interact with distorted content on social media platforms using a simulated environment similar to Twitter (now X). We find that individuals with higher depression symptoms tend to prefer distorted content more than those with fewer symptoms. However, a simple one-shot intervention can teach individuals to recognize and drastically reduce interactions with distorted content across the entire depression scale. This suggests that distorted thinking on social media may disproportionally affect individuals with depression, but simple awareness training can mitigate this effect. Our findings have important implications for understanding the role of social media in propagating distorted thinking and potential paths to reduce the societal cost of mental health disorders.

Background Depression and anxiety are associated with patterns of negative thinking that can be targeted through cognitive restructuring as a part of cognitive therapy (CT) or cognitive behavioral therapy (CBT). Our team has created a set of cognitive distortion schemata (CDS) n-grams based on theories underlying CT to measure the linguistic markers that indicate cognitive vulnerability to depression. These CDS were specifically designed to examine online language. Our prior work supports a relationship between CDS and a diagnosis of depression, but less is known about the relationship between online language, CDS, and anxiety. The current study measures if CDS can be detected in people who report anxiety symptoms, and whether CDS increase with symptom severity. Methods 1,377 participants were recruited from a study assessing social media use and mental health symptoms, the Studies of Online Cohorts of Internalizing Symptoms and Language (SOCIAL). From this, 804 timelines were harvested, and after removing missing data and bots, our final sample was 537 respondents who posted 999,859 tweets. This is a longitudinal, multi-method design, using surveys and text-based analysis of social media timelines. We used bootstrap resampling to compare differences in CDS prevalence in anxious and depressed participants. Results CDS can be observed in anxiety disorders, significantly increase as a function of anxiety symptom severity, and are related to depression and anxiety comorbidity. Conclusions Using behavioral, affective, and cognitive indicators of distorted thinking from social media may yield new insight into the trajectories of depression and anxiety. This work has implications for the future of CT/CBT and other online interventions that target distorted thinking styles.

Background This study explores changes in treatment adherence and alliance during a novel parent- and child-psychotherapy for pediatric irritability. Associations between in-session therapeutic processes and symptom change were examined. Methods Forty participants (Mean age = 11.23, SD = 1.85; 37.5% female, 77.5% white) with severe irritability, and their parents, received 12 sessions of exposure-based cognitive behavioral therapy (CBT) with parent management training (PMT). Measures included clinician-rated adherence to the manual, alliance scales (Alliance Scale for Children-revised; TASC-r, and Working Alliance Inventory; WAI, respectively), and clinician-, parent- and child-reported irritability scales (Affective Reactivity Index; ARI). Linear mixed models examined session-by-session changes and associations between adherence/alliance and subsequent irritability, and vice versa. Results First, adherence to standard treatment elements decreased over time (Bs ≥ − 0.03, ps ≤ 0.010), while the focus on specific treatment components increased (i.e., exposure: B = 0.15, p = 0.001; PMT: B = 0.07, p = 0.002). Second, adherence to standard treatment elements were associated with decreased clinician-reported irritability (Bs ≥ − 2.23, p ≤ 0.042). For the alliance measures, parent-reported alliance increased over time (Bs ≥ 0.10, p ≤ 0.01); child-reported alliance did not change. Bidirectional associations were found between alliance and symptoms; specifically, child-reported alliance predicted clinician-rated irritability at next session (Bs ≥ − 0.66, p ≤ 0.053), and decreases in clinician- (Bs ≥ − 0.02, ps ≤ 0.043) and parent- (B = − 0.15, p = 0.024) reported irritability predicted increased alliance at next session. Conclusions Findings underscore the predictive role of treatment adherence and therapeutic alliance on outcomes, in exposure-based CBT for pediatric irritability. Trial registration ClinicalTrials.gov identifier: NCT02531893; date of registration: 25/08/2015.

Mental health care in the United States is prohibitively difficult to access. Barriers of entry include a shortage of providers, high cost of services, insufficient insurance coverage, and layers of bureaucracy. This problem of low supply and high demand created a unique environment for capitalist problem solvers to enter the therapeutic market, via "therapy-matching platforms." Several ethically related Federal Trade Commission (FTC) complaints and independent investigations into these platforms highlight that the forward progress is not without growing pains. This commentary focuses on ensuring proper informed consent when providing services on therapy-matching platforms (e.g., BetterHelp, TalkSpace). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract Objective There is a pervasive underrepresentation of researchers and clinicians from diverse backgrounds in psychology. This is the first study to focus on diversity gaps in Psychotherapy Research. We examine a gap in the representation of research from low-income countries and summarize barriers and solutions to increase diversity in the field. Method We examined trends in submission, acceptance, and rejection rates of all submissions (n = 7183) from 75 countries, representing eight geographical regions to Psychotherapy Research, between 28 April 2005 and 22 June 2023. Results Most submissions were from Europe and North America, with the fewest from Africa and Asia/Northeast Asia. High-income countries had significantly more submissions than low-income countries, with gaps increasing over time. North America and Europe had the highest acceptance rates and Africa and Asia/Southeast Asia had the lowest rates. Conclusion Psychotherapy Research is one of the most internationally representative journals in the field. Yet, we found underrepresentation of non-western countries. There is a need to increase the representation of research participants and researchers from non-western countries through direct initiatives and investments in research and researchers from underrepresented backgrounds.

Background: Young adults in the United States are heavy users of social media which has been identified as a possible risk factor for depression. However, it is unclear whether social media use is associated with internalizing disorder symptom vulnerability beyond depression or whether it is related to other relevant symptom dimensions like externalizing symptoms (e.g., substance use). Moreover, it is unclear what aspects of social media use beyond frequency are associated to symptoms. Methods: A large cohort of undergraduate students from a Midwest university (N= 7123) participated in a screening of transdiagnostic symptoms of psychopathology. Data collected included: time spent on social media, social media platforms used, and aspects of problematic social media use (i.e., use for emotion regulation, compulsive use, or social-media-related impairment). We also collected sociodemographics and self-reported symptoms: depression, panic, generalized anxiety, social anxiety, alcohol use, drug use, insomnia, and pain. We correlated depression scores to time spent on social media to confirm prior findings of an association between social media use and depression. We then used a principal components analysis to identify shared dimensions of psychopathology across these symptoms and explored the correlations between symptom dimensions and elements of social media use. Results: Participants who reported higher social media usage exhibited significantly higher self-reported depression. Our PCA suggested two dimensions of psychopathology consistent with the HiTOP model which we dubbed “emotional” and “externalizing” symptoms. Time spent on social media was correlated with emotional symptoms and with externalizing symptoms, albeit to a lesser extent. However, these associations were not significant after controlling for problematic social media use. Moreover, problematic social media use had differential relations to dimensions of psychopathology. For example, using social media for emotion regulation was associated with more severe internalizing symptoms but less severe externalizing symptoms. E-value analysis suggested that unmeasured confounds could potentially explain these associations. Discussion: Our results suggest that the association between time spent on social media and psychopathology could be accounted for by the way in which social media is used, which in turn is differentially associated to emotional and externalizing symptoms. However, unmeasured confounding remains a threat to these inferences.

Sexual and gender minority (SGM) individuals show disproportionately high rates of mental distress relative to their cisgender, heterosexual peers resulting from minority stress, or unique identity-related stressors. The majority of research on minority stress and mental health in SGM individuals has focused on adults, a notable gap given that SGM youth face unique developmental factors that intersect with identity development and availability of support resources. SGM youth therefore represent a critical population for the mental health workforce to serve competently. Mental health providers risk significant harm to their SGM youth clients if they do not understand the mechanisms underlying mental health disparities in this population. This article will review treatment practices that carry the potential for harm with SGM youth, including harms that are more overt and attempt to change SGM identities (i.e., so-called “conversion therapies”), and others that are more covert, such as neglecting to consider SGM identity in conceptualization and treatment (e.g., eating disorders), pathologizing SGM identity and behaviors (e.g., personality disorders, social anxiety), and reinforcing stigma related to SGM identities (e.g., obsessive-compulsive disorder). Accordingly, this article reviews each of these potential harms in detail and provides alternative recommendations for affirming and justice-based treatment for SGM youth.