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

Publications (601)

Article
Full-text available
Rationale The nature and predictors of insensitivity to aversive consequences of heroin + cocaine polysubstance use are not well characterized. Objectives Translational methods incorporating a tightly controlled animal model of drug self-administration and measures of inhibitory control and avoidance behavior might be helpful for clarifying this i...
Article
To provide a normative backdrop by which clinical-researchers and clinicians can consider the benefits of cognitive behavioral therapy (CBT) for major depressive disorder (MDD), we consider what is known and what can be extrapolated about the average patterns of remission and relapse for CBT-treated versus untreated individuals with MDD. To achieve...
Article
Study Objectives This study was designed to investigate the association between psychosocial factors and self-reported sleep duration and two indices of sleep quality in a racially and ethnically diverse sample of adults. We investigated the relations between both rumination and anxiety sensitivity with these self-reported sleep outcomes. We also e...
Article
Stage models encourage a longitudinal perspective on the care of those with major depression: supporting vigilance to the risk for stage progression and the selection of interventions to address that risk. A central goal for this article is to evaluate the role of cognitive-behavior therapy (CBT) in addressing stage progression in the treatment of...
Article
Comorbid substance use disorders are highly prevalent in bipolar disorder, and research suggests that individuals with the comorbid presentation typically have worse outcomes than individuals with bipolar disorder without this comorbidity. However, psychosocial treatments for the comorbid presentation have not demonstrated effectiveness for both mo...
Article
Given the varied emotional and behavioral responses to the COVID-19 pandemic across the United States, further attention to the personal and societal influences on such responses is necessary. We investigated the predictive influence of personal political affiliation and the congruity of personal and governor political affiliation on COVID-19 emoti...
Article
Fear conditioning paradigms are frequently used in the translational study of anxiety and fear-related disorders. Accordingly, it is important to understand whether the measurement of fear conditioning responses is systematically influenced by an individual's race. Studies have found increased pain sensitivity and smaller physiological startle resp...
Article
Full-text available
Background Young adults are overrepresented in terms of adverse mental health problems related to COVID-19. Emerging work has identified worry about the consequences and trajectory of COVID-19 and loneliness as important factors in mental health during the pandemic. However, the main and interactive effects of worry about COVID-19 and loneliness ha...
Article
The COVID-19 pandemic provided unique conditions for examining outpatient psychotherapy clinics’ rapid transition to telehealth. The current study utilized data from a large, specialty CBT clinic to investigate attendance and treatment engagement changes when services were provided via telehealth versus in-person. Results indicate that, following a...
Article
Full-text available
Introduction Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may negatively affect exposure therapy outcomes. Poor sleep may impair memory and learning, and thus compromise fear extinction learning thought to take place in exposure therapy. We examined poor sleep as a predictor of exposure therapy outcomes for SAD a...
Article
Full-text available
Personal space has been defined as “the area individuals maintain around themselves into which others cannot intrude without arousing discomfort”. However, the precise relationship between discomfort (or arousal) responses as a function of distance from an observer remains incompletely understood. Also the mechanisms involved in recognizing conspec...
Article
Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use...
Article
There has been a widespread increase in affective disorders after the emergence of the COVID-19 pandemic. In the current study, we investigated the effects of exposure to and perceived accuracy of news media and demographic characteristics on anxiety and depressive symptoms. We conducted an online survey of US adults (N = 480) using hierarchical li...
Article
Given recent declines in US vaccination rates and the emergence of COVID-19 vaccines, identifying sociodemographic influencers of vaccine willingness holds importance for developing effective public health campaigns aimed at enhancing nationwide COVID-19 vaccine acceptance. The present study utilized a hierarchical binary logistic regression model...
Article
Objectives: Non-pharmacologic pain management strategies are needed due to the growing opioid epidemic. While studies have examined the efficacy of virtual reality (VR) for pain reduction, there is little research in adult inpatient settings, and no studies comparing the relative efficacy of standard animated CGI VR (computer-generated imaging VR)...
Article
Background Preliminary evidence suggests that aerobic exercise may augment the effects of cognitive remediation on improving cognitive functioning in severe mental illness. It has also been hypothesized that increases in cognitive functioning associated with adding exercise are mediated by increases in brain derived neurotrophic factor (BDNF). Howe...
Article
Objective: Pain-related anxiety is a psychologically based construct that is associated with tobacco dependence and may have important relevance to e-cigarette use. Difficulties with emotion regulation, a relevant construct in motives for cigarette smoking, may interact with pain-related anxiety to yield worsened clinical outcomes among e-cigarett...
Article
Background and Aims People with anxiety disorders are more likely to smoke and less likely to succeed when they try to quit. Anxiety sensitivity may underlie both phenomena, such that people with high anxiety sensitivity react to interoceptive distress by avoidance. This study aimed to test the efficacy of an exercise program that induced interocep...
Article
Preliminary data suggest that cigarette smokers could have an increased mortality risk from the novel coronavirus (SARS-CoV-2), and that certain factors (e.g., increased age, medical comorbidities) can also increase risk of poor coronavirus disease (COVID-19) outcomes. Between April 30th, 2020 and May 28th, 2020, we evaluated self-reported changes...
Article
Full-text available
Background Cognitive behavioral therapy (CBT) is an efficacious intervention for generalized anxiety disorder (GAD). Digital CBT may provide a scalable means of delivering CBT at a population level. We investigated the efficacy of a novel digital CBT program in those with GAD for outcomes of anxiety, worry, depressive symptoms, sleep difficulty, we...
Article
High distress intolerance (DI: often assessed as anxiety sensitivity) and low working memory capacity (WMC) have each been identified as risk factors for negative health behaviors. To our knowledge, these risk factors have only been studied independently. The current study investigated both the independent and interactive effects of DI and WMC in p...
Article
Increased anxiety sensitivity (AS), or the fear of anxiety-related cognitive, social, and physical symptoms which are misinterpreted as having harmful implications, has shown a relationship with substance use disorders. People with substance use disorders also experience addiction-related problems across domains of life functioning. However, few st...
Article
Low income and low educational attainment are among the strongest predictors of both smoking prevalence and lapse (i.e., return) to smoking after cessation attempts. Treatment refinement is limited by inadequate knowledge of the specific lapse- or relapse-relevant vulnerabilities characteristic of populations that should be the target of treatment....
Article
In this study we provide information on e-cigarette use characteristics in relation to racial and ethnic characteristics in a sample of 535 adult e-cigarette users. We also evaluated how anxiety sensitivity (AS; fear of anxiety) interacted with race/ethnicity to predict vaping outcomes. We found an association between greater AS and higher e-cigare...
Article
Full-text available
Importance Findings suggest that the efficacy of D-cycloserine (DCS) for enhancing exposure therapy may be strongest when administered after sessions marked by low fear at the conclusion of exposure practice. These findings have prompted investigation of DCS dosing tailored to results of exposure sessions. Objective To compare tailored postsession...
Article
Full-text available
The present study aimed to replicate the finding that younger age predicts higher pre quit-day attrition. Our second aim was to explain this relation by examining empirically and theoretically informed age-related risk factors for low smoking cessation treatment engagement. 136 participants (Mage = 44.2 years, SD = 11.3 years; age = 22–64 years) we...
Article
Full-text available
Cigarette smoking remains a leading cause of preventable death in the United States, contributing to over 480,000 deaths each year. Although significant strides have been made in the development of effective smoking cessation treatments, most established interventions are associated with high relapse rates. One avenue for increasing the effectivene...
Article
Post and colleagues provide a call for consideration of a polypharmacy approach to later‐stage and treatment‐refractory bipolar patients, discussing potential future directions in the pharmacological management of bipolar disorder that can be delivered alongside a program involving psychosocial and lifestyle approaches. In this commentary, we provi...
Article
Brain-derived neurotrophic factor (BDNF) is associated with neuronal growth and reduced BDNF has been implicated in depression. A recent meta-analysis documented reliable effects of exercise on BDNF levels (Szuhany et al., 2015); although, few studies included participants with mental health conditions. In this study, we examine whether increased e...
Preprint
Full-text available
Cigarette smoking remains a leading cause of preventable death in the United States, contributing to over 480,000 deaths each year. Although significant strides have been made in the development of effective smoking cessation treatments, most established interventions are associated with high relapse rates. One avenue for increasing the effectivene...
Article
Full-text available
In this placebo-controlled randomized clinical trial, we examined the efficacy of 250 mg d-cycloserine (DCS) for enhancing the effects of cognitive behavior therapy targeting anxiety sensitivity reduction in the context of smoking cessation treatment among adults with a history of panic attacks. We hypothesized that DCS would enhance treatment of o...
Article
Evidence exists for a negative influence of exercise/weight-loss television on explicit attitudes towards exercise. However, it is unclear if this is specific to viewing intense exercise or the overweight/obese status of the viewed exercisers. Additionally, exposure to exercise cues can induce people to eat more, reflecting compensatory eating in r...
Article
Research to date provides striking evidence that youth from low socio-economic status (SES) households are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities have identified working memory and distress tolerance as potential cr...
Article
Full-text available
Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention of fear extinction in animals and the therapeutic learning from exposure therapy in humans. However, studies with non-clinical human samples in de novo fear conditioning paradigms have demonstrate...
Article
Objective: We examined the association between sleep quality and academic performance by attending to university students' self-defined goals to increase studying behaviors over a four-week period. Methods: We evaluated this association in 100 undergraduates, who self-elected to change their studying behaviors and were randomly assigned to one o...
Article
The apparent efficacy of d-cycloserine (DCS) for enhancing exposure treatment for anxiety disorders appears to have declined over the past 14 years. We examined whether variations in how DCS has been administered can account for this "declining effect". We also investigated the association between DCS administration characteristics and treatment ou...
Article
Background and objectives: Electronic cigarettes (e-cigarettes) are recognized as a prevalent form of substance use among adults in the United States. The rise in e-cigarette use has motivated research to identify subgroups of the population that may be particularly vulnerable to e-cigarette use and its associated harm. Individuals with elevated p...
Article
Background: Animal models and human studies have identified the potential of modafinil as a cognitive enhancing agent, independent of its effects on promoting wakefulness in sleep-deprived samples. Given that single-dose applications of other putative memory enhancers (eg, D-cycloserine, yohimbine, and methylene blue) have shown success in enhanci...
Article
Electronic cigarette (e-cigarette) use has risen exponentially since its initial introduction. The widespread and growing use of these novel products has prompted increased research to evaluate use from a nuanced perspective that considers patterns and antecedents of use. Specifically, research has identified sociodemographic characteristics relate...
Article
Exercise is an efficacious intervention for mental and physical health, but few studies have identified the additive benefits of exercise prescriptions for those undergoing empirically supported psychosocial treatment. Behavioral activation (BA) involves completing activities to improve mood, an ideal format for exercise augmentation. The purpose o...
Book
This book comprehensively covers empirically supported exposure methods (e.g., in vivo exposure, imaginal exposure, and interoceptive exposure) to a broad array of mental health symptoms. This transdiagnostic approach emphasizes the importance of a person-centered application, putting case formulation at the center of intervention planning and impl...
Chapter
Chapter 8 covers the impact of combined medication and exposure treatments. Any time two treatments coincide, there is a risk that patients may wonder what gains are associated with which treatment. Fortunately, the research supports that patients who are taking medications still benefit from exposure therapy. However, if medication is discontinued...
Chapter
Chapter 11 is a list of key references to research papers, chapters, and books that have informed the approach to exposure therapy that we described in the previous chapters. By listing these here, we (a) underscore that our approach is rooted in theory and guided by data from studies and clinical trials that have tested the principles, efficacy, a...
Chapter
Chapter 4 describes the core yardsticks of improvement. The chapter describes how success is defined from both patient and therapist perspectives and how this is modified from early to later sessions. Patients naturally want to have less anxiety. Therapists, however, know the only way to achieve this goal is to go through (rather than around) the d...
Chapter
Chapter 3 outlines the general approach to exposure therapy including three phases: planning for exposure therapy, delivering exposure therapy, and processing exposure therapy. The first phase includes specific steps to take in planning for exposure therapy including the initial phone contact, administering a questionnaire battery, conducting the i...
Chapter
Chapter 9 serves as a supplement to Chapter 4 and includes a list and brief description of available self-report measures that can help determine if the clinician and the patient are meeting the goals of exposure therapy. Consistent with the personalized approach to exposure therapy, the authors organize the list by feared cues, domains, and outcom...
Chapter
Chapter 10 is an accessible primer on the human alarm system and an introduction to exposure therapy. This general resource should be read by clinicians as an overall summary and may also be used as a patient handout as part of the psychoeducation phase of treatment. The handout discusses the alarm system as it related to worry, anxiety, and panic....
Chapter
Chapter 6 describes exposure therapy for the fear of people (fear of negative evaluation). Successful treatment shifts the perception of seeing other’s evaluations as harmful to viewing these evaluations as lacking true danger. The chapter includes the steps to plan, deliver, and process exposures to alleviate fears of people. Patients with these f...
Chapter
Chapter 5 provides an overview of fear of emotions and related physical sensations and introduces exposure methods to address the fear of what lies within. This chapter is particularly focused on planning, delivering, and processing in vivo exposures to fear of fear (interoceptive exposure). The chapter describes how to modify the exposures to fit...
Chapter
Chapter 2 introduces a model of fears in terms of a network of learned associations among interconnected nodes. When these memories are cued, they can elicit expectancies for potential threat outcomes. Exposure therapy is used to alter these danger expectancies through new learning through confronting feared cues. This is an active learning process...
Article
Edmondson et al. (2018) provided a compelling account of the causes and consequences of patients' perceptions of enduring somatic threat following a heart attack or related cardiac event. The purpose of the current article is to place some of these observations in the context of research on anxiety sensitivity and its role as a risk factor for card...
Chapter
Chapter 1 introduces exposure therapy as an empirically supported, simple, and flexible strategy to reduce a broad spectrum of worries, anxieties, and fears. It describes both what exposure therapy is and what it is not, including many common myths about exposure therapy. The authors describe the art of “playing” with fear as an overall approach. I...
Chapter
Like Chapter 5 (fear of emotions and bodily sensations), Chapter 7 discusses the treatment of internal threats including thoughts, images, and trauma memories. Imaginal exposure is particularly effective for the treatment of these fears. It has advantages over in vivo exposure because it can be used when in vivo exposure may not be appropriate or f...
Article
Refining the mechanisms behind illicit drug use is an important factor for improving the quality of clinical care. Research in alcohol, marijuana, and nicotine use disorders have linked coping motives (e.g. using substances to ameliorate negative emotional states) to problematic substance use. We evaluated the link between emotion regulation diffic...
Article
Objective: Electronic cigarettes (e-cigarettes) are a prevalent form of substance use among adults. Because of the novelty of e-cigarettes, users may not fully understand the consequences of long-term use and the potential difficulties involved with quitting e-cigarettes. Given the projected rise in the use of e-cigarettes, it is important to unde...
Article
Initial evidence suggests that experiential avoidance (EA) mediates the relation between anxiety sensitivity (AS) and depression. We examined the AS-EA-depression pathway, examining both concurrent, and prospective (cross-lag), mediation models. Utilizing data from a study that examined the effects of exercise on AS (N = 60), we modeled depressive...
Article
Full-text available
Prospective studies have shown during the years preceding and following menopause, also known as "menopause transition", that midlife women are at higher risk for developing first-onset major depressive disorder (MDD). The biological factors associated with risk and resilience in this population are, however, largely unknown. Considering the growin...
Article
Recent studies underscore the importance of studying d-cycloserine (DCS) augmentation under conditions of adequate cue exposure treatment (CET) and protection from reconditioning experiences. In this randomized trial, we evaluated the efficacy of DCS for augmenting CET for smoking cessation under these conditions. Sixty-two smokers attained at leas...
Article
Objective: Up to 60% of patients with bipolar disorder develop a substance use disorder during their lifetime. The purpose of this paper was to assess the impact of substance use disorders on depression recovery among bipolar patients randomly assigned to different psychotropic medications and psychosocial interventions. We hypothesized that patie...
Article
Over a dozen studies have examined the efficacy of post-retrieval extinction (PRE) in healthy adults in the fear conditioning laboratory, with a recent meta-analysis reporting an overall small-moderate effect on attenuating the return of fear compared to standard extinction. The current study was designed to extend PRE effects to a mixed sample of...
Article
A common challenge in fear conditioning studies is that a relatively large proportion of individuals fail to acquire a differential conditioned skin conductance response (SCR). Researchers have identified demographic factors associated with poorer fear learning and explored the use of different fear conditioning paradigms across various populations...
Article
Objective: Research shows that high anxiety sensitivity (AS) and dysphoria are related to poor smoking cessation outcomes. Engaging in exercise may contribute to improvement in smoking cessation outcomes through reductions in AS and dysphoria. In the current study, we examined whether exercise can aid smoking cessation through reductions in AS and...
Article
Background and objectives: Substance use disorders (SUDs) are present in up to 70% of patients with bipolar disorder (BD) and contribute to high rates of disability, morbidity, and treatment non-adherence. Despite this prevalence, few trials have investigated targeted psychosocial interventions for comorbid BD and SUDs. Methods: Using PubMed and...
Article
Adolescence is a vulnerable period for smoking initiation, with disadvantaged teens particularly at risk. In addition, emotional and cognitive dysregulation is associated with an increased risk of smoking and makes it particularly challenging to benefit from standard substance use prevention interventions. The goal of the current study is to invest...
Article
Modification of the ongoing influence of maladaptive cognitive, emotional, and behavioral patterns is a fundamental feature of many psychological treatments. Accordingly, a clear understanding of the nature of memory adaptation and accommodation to therapeutic learning becomes an important issue for (1) understanding the impact of clinical interven...
Article
Background and objectives: The impaired ability to delay rewards, delay discounting (DD), is associated with several problematic conditions in which impulsive decision-making derails long-term goals. Working memory (WM), the ability to actively store and manipulate information, is associated with DD. The purpose of this study was to examine the ef...
Chapter
A large body of research provides strong support for the use of cognitive-behavioral therapy or pharmacotherapy in treating psychiatric disorders. As such, researchers have investigated whether combining treatment modalities would lead to more robust interventions. Although the literature is mixed on the advantages of combined treatment, generally...
Article
Objective: This pilot randomized controlled trial compared Cognitive Behavior Therapy (CBT) and Supportive Psychotherapy (SP) for the treatment of depression in bipolar I disorder. We also examined whether exploratory verbal memory, executive functioning, and neural correlates of verbal memory during functional magnetic resonance imaging (fMRI) pr...