Michael W. Otto’s research while affiliated with Boston University and other places

Although negative autobiographical memories play a defined etiological role in trauma-related disorders, it is less clear what role they play in other anxiety-related disorders. Understanding the prevalence of negative autobiographical memories that are conceptually related to a patient’s symptoms (i.e., symptom-relevant negative autobiographical memories [SNAMs]) in anxiety-related disorders may help inform the development of novel memory-based interventions. The current scoping review examined the prevalence of SNAMs in anxiety disorders and obsessive-compulsive disorder, including SNAMs that were reported to have occurred around symptom onset (i.e., symptom onset SNAMs) and SNAMs that were reported to have occurred at any time (i.e., Lifetime SNAMs). Lifetime SNAMs also included a subcategory of SNAMs associated with intrusive imagery. The relationship of the presence of SNAMs to symptom onset, disorder status, and symptom severity was also examined. A systematic search identified 39 relevant articles. The prevalence of symptom onset SNAMs assessed by the Phobic Origins Questionnaire, interviews, and the Origins Questionnaire ranged from 30% to 89% (interquartile range [IQR] = 50%–68.5%, samples = 23), 23%–61% (IQR = 30%–49%, samples = 11), and 17%–37% (samples = 6), respectively. The prevalence of lifetime SNAMs ranged from 89% to 100% (samples = 6) and intrusive imagery-related lifetime SNAMs ranged from 38% to 100% (IQR = 60.5%–79%, samples = 12). Five of 14 studies observed a significantly higher rate of SNAMs in patients relative to control samples. Findings are discussed with regard to limitations of the current evidence and future research that can inform the value of targeting SNAMs in treatment.

This article describes the work of a task force, commissioned by the American Psychological Association’s Society of Clinical Psychology (SCP), to define “psychological treatment.” We discuss SCP’s rationale for needing such a definition, including the potential for nonpsychological interventions to be considered under the current model of empirically supported treatments. The task force, in collaboration with the membership of SCP, proposes the following definition: Psychological treatment is an intervention consisting of specific actions between a person or persons and a mental health professional or designee, with the intent of engaging cognitive, emotional, behavioral, or interpersonal processes, in the service of modifying health or functional outcomes, and whose core assumptions about its procedures and mechanisms of change are founded in psychological science and consistent with scientific understanding. We outline our thinking around this definition and discuss alternatives that were rejected. The definition proposed here is largely consistent with the clinical practice guidelines of the American Psychological Association, though we note that at least one of those guidelines goes well beyond interventions that could reasonably be called psychological treatments. Potential uses and misuses of this definition are outlined, and we suggest additional areas for exploration and clarification.

This study examines the cost-effectiveness and cost-benefit of a fully automated smartphone-delivered digital cognitive behavioral therapy (CBT) intervention for Generalized Anxiety Disorder (GAD). In a simulated Markov model, 100,000 individuals with GAD were studied under one of five (n = 20,000 per arm) treatments (digital CBT [Daylight], individual CBT, group CBT, pharmacotherapy, or no GAD treatment). Model inputs were determined from the literature and included direct treatment costs and disease costs. Net monetary benefit (NMB) determined whether digital CBT is cost-beneficial from both a private payer and societal perspective in the United States in 2020. Digital CBT was found to generate the lowest 12-month total cost ($167.02m) and the second highest number of total quality-adjusted life years (14,711.86). Digital CBT showed a positive NMB relative to each alternative treatment and to no treatment for GAD in both a payer and societal perspective. Relative to no treatment, the average NMB of digital CBT was$1,836.83 from the payer perspective and $4,126.88 from the societal perspective. Digital CBT generates the most value in both a payer and societal perspective, and results were robust to sensitivity analysis with respect to effectiveness, pricing, and attrition parameters.

This chapter presents an overview of the status of cognitive-behavioral therapy (CBT) for benzodiazepine discontinuation. A conceptual model for treatment and elemental interventions are discussed and exemplified. Although benzodiazepine medications are efficacious for treating anxiety disorders, short-term treatment is generally recommended given the potential for concerning side effects, dependence, and misuse. Nonetheless, many patients undergo long-term treatment with benzodiazepines and face challenges discontinuing this medication due to withdrawal symptoms, rebound anxiety, and relapse, which can make abstinence difficult to achieve even with gradual dose reduction. The empirical literature suggests that exposure-based CBT paired with gradual tapering has engendered greater success with benzodiazepine discontinuation compared to either a slow taper alone or a slow taper combined with relaxation training. CBT treatment involves a systematic program of interoceptive exposure to prepare patients for the withdrawal symptoms they may experience, as to teach non-anxiogenic responses to these sensations and emotional distress more generally. These skills are then applied to management of the underlying anxiety disorders once the benzodiazepine medications are successfully tapered. New applications of these strategies to patients taking the combination of opioid and benzodiazepine medications are also discussed.

Background Lower socio-economic status (SES) is associated with experiencing a greater number of life stressors and increased risk for depression. This study investigated two factors for adaptive coping—working memory capacity (WMC) and distress intolerance (DI)—as moderators of the association between frequency of stressful life events and depressed mood, controlling for age and gender. We hypothesized that lower WMC and greater DI, alone and in interaction with each other, would moderate the association between the frequency of stressful life events and depression. Methods Our sample included 82 adolescents (M = 14 years) recruited from youth mentorship programs, charter schools, and youth community centers. A majority being female (54.9%) and reported their race and/or ethnicity as Other race/Hispanic (43.9%), and Black/non-Hispanic (30.5%). Participants completed self-report measures of stressful life events, depression, DI, and a behavioral measure of WMC. Results Results showed a statistically significant main effect of self-reported DI predicting depression (p < .001), such that higher DI scores were associated with higher levels of depression. Conclusions Our findings join broader literature indicating that DI is an important regulatory process that may be a useful mechanistic target to enhance emotional functioning, especially among racially/ethnically diverse adolescents from low SES neighborhoods, a relatively understudied population.

Enhancing Treatment Benefits with Exercise: Therapist Guide is an indispensable resource, expanding the therapeutic range to include exercise-based interventions. The guide, which serves as a complement to the accompanying client workbook, argues that exercise has powerful effects on mental health. The introductory chapters provide general guidance on strategies for initiating and maintaining exercise programs. Other chapters cover the role of exercise in improving mood and anxiety disorders, enhancing cognition, and promoting general resilience. The therapist guide also covers the relapse-prevention phase of treatment and provides motivational strategies to help clients start, continue, and succeed with exercise programs. It also discusses the benefits of exercise for specific conditions.

Enhancing Treatment Benefits with Exercise: Workbook provides an overview of motivational strategies for exercise that aim to improve an individual’s lifestyle and mental health. The strategies offer a fresh way to approach exercise as well. Ample evidence proves that exercise can be used to treat depression, anxiety, and panic while also improving cognition and reducing stress. Moreover, exercise-based treatment can also improve mood and smoking cessation and achieve a general sense of psychological resilience. The workbook can be used as a stand-alone treatment as an addition to another ongoing treatment or as a strategy to extend gains or prevent relapse from a previous treatment.

Enhancing Treatment Benefits with Exercise: Workbook provides an overview of motivational strategies for exercise that aim to improve an individual’s lifestyle and mental health. The strategies offer a fresh way to approach exercise as well. Ample evidence proves that exercise can be used to treat depression, anxiety, and panic while also improving cognition and reducing stress. Moreover, exercise-based treatment can also improve mood and smoking cessation and achieve a general sense of psychological resilience. The workbook can be used as a stand-alone treatment as an addition to another ongoing treatment or as a strategy to extend gains or prevent relapse from a previous treatment.

Enhancing Treatment Benefits with Exercise: Therapist Guide is an indispensable resource, expanding the therapeutic range to include exercise-based interventions. The guide, which serves as a complement to the accompanying client workbook, argues that exercise has powerful effects on mental health. The introductory chapters provide general guidance on strategies for initiating and maintaining exercise programs. Other chapters cover the role of exercise in improving mood and anxiety disorders, enhancing cognition, and promoting general resilience. The therapist guide also covers the relapse-prevention phase of treatment and provides motivational strategies to help clients start, continue, and succeed with exercise programs. It also discusses the benefits of exercise for specific conditions.

Enhancing Treatment Benefits with Exercise: Workbook provides an overview of motivational strategies for exercise that aim to improve an individual’s lifestyle and mental health. The strategies offer a fresh way to approach exercise as well. Ample evidence proves that exercise can be used to treat depression, anxiety, and panic while also improving cognition and reducing stress. Moreover, exercise-based treatment can also improve mood and smoking cessation and achieve a general sense of psychological resilience. The workbook can be used as a stand-alone treatment as an addition to another ongoing treatment or as a strategy to extend gains or prevent relapse from a previous treatment.