Moria J. Smoski’s research while affiliated with Duke University and other places

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Publications (106)


Individualized functional brain mapping machine learning prediction of symptom-change resulting from selective kappa-opioid antagonism in an anhedonic sample from a FAST-FAIL trial
  • Article

May 2025

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18 Reads

Journal of Mood and Anxiety Disorders

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Joseph L. Valenti

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Poorvi Keshava

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[...]

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Task paradigm. Participants were sequentially presented with 48 trials. Each trial consisted of a relax period (4.5 seconds), a fixation period that lasted until the eye tracker successfully captured both eyes looking at the fixation cross, and a pair of images (10 seconds) taken from a 96-item subset of the IAPS repository. Participants could freely gaze between the two images. The 48 pairs consisted of 16 positive-neutral, 16 neutral-neutral, and 16 negative-neutral pairings, presented in random sequence. On each trial, the location of the images on the screen (left or right) was randomly assigned.
Dwell times on images as a function of emotion. (A) Overall, participants (n = 72) spent more time looking at the emotional than the neutral images in each pair, irrespective of spatial location (left or right). We also observed a significant interaction of image emotion and pair condition due to a stronger differential attentional bias toward positive images in the positive–neutral pairs relative to the attentional bias toward negative images in the negative–neutral pairs (middle and right panels). No difference in dwell time was observed as a function of spatial location for neutral-neutral image pairs (left panel). (B) Regression with Beck Depression Inventory (BDI) sum scores revealed that only participants with lower depressive symptoms exhibited a stronger attentional bias for positive–neutral pairs than negative–neutral pairs. On the x-axis, the range of BDI scores for individuals diagnosed with Major Depressive Disorder (MDD) are indicated in purple while those for healthy controls are indicated in orange. All plots depict estimated marginal means from the linear mixed effects model and 95% confidence intervals/bands. *p < 0.05, **p < 0.01, ***p < 0.001.
Emotion regulation strategy preferences in healthy and depressed individuals. (A) Reappraisal use is negatively associated with suppression use in healthy controls, but not MDD participants. (B) Healthy controls exhibit a general preference for reappraisal use, while MDD participants exhibit no preference for either strategy (ERQ preference score = reappraisal average – suppression average). (C) For both groups, age was not significantly associated with an ERQ preference for reappraisal or suppression. Plots depict averages for each participant and 95% confidence intervals/bands. **p < 0.01.
Emotion regulation style moderates age-related positivity biases in non-depressed individuals. (A) The relationship between age and dwell times (y-axis) shifts based on ERQ preference scores (x-axis). Regions where the regression line and confidence band do not cross zero indicate a significant (p < 0.05) slope of age. As ERQ preference score increases (more preference for using reappraisal than suppression), the relationship between age and dwell times becomes more positive for positive images, and more negative for negative images, but only in healthy controls. (B) The relationship between age and dwell times at specific levels of ERQ preference, only for healthy controls. Values in parentheses indicate the raw ERQ preference score at each level from −1.5 to +1.5 SD (standardized within controls). Both plots depict estimated marginal trends computed from the higher-level linear mixed effects model and 95% confidence intervals/bands. *p < 0.05, **p < 0.01.
Depression and emotion regulation strategy use moderate age-related attentional positivity bias
  • Article
  • Full-text available

December 2024

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26 Reads

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2 Citations

Effective emotion regulation is critical for maintaining emotional health in the face of adverse events that accumulate over the lifespan. These abilities are thought to be generally maintained in older adults, accompanied by the emergence of attentional biases to positive information. Such age-related positivity biases, however, are not always reported and may be moderated by individual differences in affective vulnerabilities and competencies, such as those related to dispositional negative affect and emotion regulation styles. To examine these relationships, we analyzed eye-tracking data from 72 participants (35–74 years; 50 female), 44 without and 28 with a diagnosis of Major Depressive Disorder during a free-viewing task comprising neutral-neutral, negative-neutral, and positive-neutral image pairs. Emotional bias scores were calculated based on the ratio of time spent dwelling on the emotional image vs. the neutral image in each emotional-neutral pair. Results indicate that healthy participants exhibited a stronger positivity bias than a negativity bias, whereas individuals with higher depressive symptom scores showed no difference. Next, we examined how age and emotion regulation strategy use (reappraisal vs. suppression, measured with the Emotion Regulation Questionnaire) impacted these effects. Individuals with Major Depressive Disorder did not exhibit a significant relationship between age and positivity bias. However, for healthy participants who self-reported a preference for using reappraisal in daily life, increased age was associated with an increased positivity bias. These findings indicate that the emergence of the positivity effect in older adults is related to reappraisal regulatory preferences in the absence of depressive symptoms.

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Conceptual model of EFA of mind-wandering
Structural model of associations between mind-wandering facets and neuroticism
Demographics
Standardized factor loadings for final three-factor EFA
Exploring the optimal factor structure of mind-wandering: Associations with neuroticism

December 2024

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38 Reads

Mind-wandering is an essential cognitive process in which people engage for 30–50% of their waking day and is highly associated with neuroticism. The current study identified the factor structure of retrospective self-report items related to mind-wandering and perseverative cognition content and explored these associations with neuroticism. In an adult community sample (N = 309), items from the NYC Cognition Questionnaire, the Penn State Worry Questionnaire Short Form, and the Rumination Responses Brooding Subscale were entered into factor analyses to test the optimal factor structure of these items. We employed a structural model to investigate associations of mind-wandering facets with neuroticism. A correlated three factor solution best fit the data (CFI = .94, TLI = .93, SRMR = .07, RMSEA = .07). Bifactor models failed to provide evidence for a general mind-wandering construct above and beyond variance explained by mind-wandering and perseverative cognition facets. The structural model revealed differential associations of each facet with neuroticism. A wandering mind is not always an unhappy mind. Whereas worry and rumination are associated with higher levels of neuroticism, mind-wandering has other components that relate to positively valenced cognition and lower neuroticism. Adaptive and maladaptive mind-wandering should be tested together in future studies of personality and psychopathology.







Identifying modifiable factors associated with psychological health in women experiencing infertility

July 2023

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30 Reads

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2 Citations

This study assessed the relationship between modifiable psychological variables and depression, anxiety, and posttraumatic growth in women experiencing infertility. U.S. women (N = 457) who identified as experiencing infertility completed standardized self-report measures of mindfulness, self-compassion, positive affect, intolerance of uncertainty, relationship satisfaction, experiential avoidance, depression, anxiety, and posttraumatic growth. Clinical and demographic characteristics (age, duration trying to conceive, miscarriage, and childlessness) did not predict depression or anxiety. Lower positive affect and higher experiential avoidance were associated with depression and anxiety. Lower self-compassion was associated with depression; higher intolerance of uncertainty was associated with anxiety. There were indirect effects of mindfulness on anxiety and depression via these variables. Future research should explore whether intervening on these factors reduces depressive and anxiety symptoms. Promoting mindfulness may have beneficial effects on symptoms via its downstream effects on multiple coping variables. Counterintuitively, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance.


Using latent profile analyses to classify subjects with anhedonia based on reward-related measures obtained in the FAST-MAS study

July 2023

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44 Reads

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4 Citations

Journal of Affective Disorders

Background: Growing evidence indicates that anhedonia is a multifaceted construct. This study examined the possibility of identifying subgroups of people with anhedonia using multiple reward-related measures to provide greater understanding the Research Domain Criteria's Positive Valence Systems Domain and pathways for developing treatments. Methods: Latent profile analysis of baseline data from a study that examined the effects of a novel kappa opioid receptor (KOR) antagonist drug on measures and biomarkers associated with anhedonia was used to identify subgroups. Measures included ventral striatal activation during the Monetary Incentive Delay task, response bias in the Probabilistic Reward Task, reward valuation scores from the Effort-Expenditure for Rewards Task, and scores from reward-related self-report measures. Results: Two subgroups were identified, which differed on self-report measures of reward. Participants in the subgroup reporting more anhedonia also reported more depression and had greater illness severity and functional impairments. Graphs of change with treatment showed a trend for the less severe subgroup to demonstrate higher response to KOR antagonist treatment on the neuroimaging measure, probabilistic reward task, and ratings of functioning; the subgroup with greater severity showed a trend for higher treatment response on reward-related self-report measures. Limitations: The main limitations include the small sample size and exploratory nature of analyses. Conclusions: Evidence of possible dissociation between self-reported measures of anhedonia and other measures with respect to treatment response emerged. These results highlight the importance for future research to consider severity of self-reported reward-related deficits and how the relationship across measurement methods may vary with severity.


Citations (68)


... In a follow-up study, a larger parallel-arm randomized control trial (RCT) compared BATA and MBCT for clinically significant anhedonia in a transdiagnostic cohort of adults with clinically significant anhedonia (SHAPS ≥ 20). 70 Both treatments yielded substantial SHAPS reductions of~7 points without significant differences between them. Similarly, internalizing symptoms decreased in both conditions. ...

Reference:

Anhedonia: Current and future treatments
A Parallel-Arm, Randomized Trial of Behavioral Activation Therapy for Anhedonia versus Mindfulness-Based Cognitive Therapy for Adults with Anhedonia
  • Citing Article
  • August 2024

Behaviour Research and Therapy

... The main definition of anhedonia is pleasure loss or decreased reactivity to pleasurable stimulus in any form. This symptom is implicated in diagnosing several psychological disorders, such as schizophrenia, post-traumatic stress disorder, and major depressive disorder [31]. Nevertheless, it is among the main symptoms during the onset of sickness behavior, contributing to the depressive state. ...

Using latent profile analyses to classify subjects with anhedonia based on reward-related measures obtained in the FAST-MAS study
  • Citing Article
  • July 2023

Journal of Affective Disorders

... The age of infertile patients has also been studied, with diverse results. Some research indicates that age, specifically being over 30, is a predictive factor for anxiety in infertile couples (Drosdzol & Skrzypulec, 2009), while other studies do not find this relationship (Schuette et al., 2023;Wang et al., 2023) or only observe it in men (Kumar et al., 2023). ...

Identifying modifiable factors associated with psychological health in women experiencing infertility
  • Citing Article
  • July 2023

... -By stimulating the DLPFC with rTMS, we aim to enhance its feedback control over subcortical structures. -By using odorants with positive hedonic value known to recruit/activate the reward circuit, we aim to enhance DA release and thereby increase ventral striatal activity which is reduced in anhedonia, Based on evidence linking anhedonia to reduced DA transmission and blunted mesocorticolimbic network functional connectivity (Phillips et al., 2023), we hypothesize that rTMS would alleviate depressive symptoms through changes in functional and effective connectivity within DA-related brain regions. ...

Striatal Dopamine in Anhedonia: A Simultaneous [11C]Raclopride Positron Emission Tomography and Functional Magnetic Resonance Imaging Investigation
  • Citing Article
  • June 2023

Psychiatry Research Neuroimaging

... A randomized trial compared behavioral activation treatment for anhedonia (BATA) and mindfulness-based cognitive therapy (MBCT) in 73 transdiagnostic subjects. 69 While both treatments reduced SHAPS scores over time, no between-condition differences emerged. Critically, within-person homework completion predicted greater sessionto-session improvements in anhedonia, particularly in BATA when clinician-reported homework was considered. ...

Parsing within & between-person dynamics of therapy homework completion and clinical symptoms in two cognitive behavioral treatments for adults with anhedonia
  • Citing Article
  • April 2023

Behaviour Research and Therapy

... More precisely, reducing the level of perceived stress by early treatment was able to make changes in hedonic functioning during mid-late treatment. Therefore, what is especially vital for us is to evaluate new interventions for anhedonia to measure stress levels repeatedly [21]. Stress also is a well-validated predictor for the occurrence and relapse of depression [22,23], and depression has been confirmed by numerous experiments that reward-related function always changes [24]. ...

Longitudinal associations between perceived stress and anhedonia during psychotherapy
  • Citing Article
  • March 2023

Journal of Affective Disorders

... Conversely, di culties in emotional regulation can lead to various troubles for individuals and diminish their psychological motivation and mental health status [2]. Studies have found that emotional regulation di culties are closely related to mood and anxiety disorders, eating disorders, attention-de cit/hyperactivity disorder, conduct problems, self-harming behaviors, substance abuse, borderline personality disorder, and other psychological and behavioral problems [3,4,5,6,7]. ...

Emotion regulation difficulties link trait resilience and symptoms of depression and anxiety in psychiatric outpatients
  • Citing Article
  • November 2022

Annals of Clinical Psychiatry

... To elicit a reward response, participants will complete a monetary incentive delay (MID) task during imaging. This task has previously shown sensitivity to altered reward-related dopamine release in a transdiagnostic anhedonia sample [35]. The first study objective aims to characterize the relationship between striatal reward responses and perimenopausal-onset anhedonia and psychosis symptoms at baseline. ...

Striatal Dopamine Binding in Anhedonia: A Simultaneous [11C]Raclopride Positron Emission Tomography and Functional Magnetic Resonance Imaging Investigation
  • Citing Preprint
  • July 2022

... 25 Women with infertilitypreferred behavioral interventions and were willing to practice coping skills and mindfulness to help manage the uncertainty and stress of infertility. 26 Mindfulness meditation improves emotional well-being and outcomes in infertility. 27 Group psychological interventions, (based on CBT and mindfulness) improved the mental health, fertility stress and pregnancy rates of women undergoing fertility treatment. ...

Preferences Toward Psychological Interventions Among Women Experiencing Infertility
  • Citing Article
  • March 2022

Integrative Medicine Reports

... The capacity to experience likely also varies from person to person (cites in §2.1) and is likely amenable to alteration and training, as suggested by the effect of pain relief to dull emotional and even empathetic responses (Durso et al., 2015;Mischkowski et al., 2019), emotional blunting in SSRI treatments for depression (e.g., Goodwin et al., 2017), and therapeutic services both to reduce and increase the intensity of emotional experience (e.g., Engelhard et al., 2011; clinical trials on anhedonia, Phillips et al., 2022). Such context-dependency does not refute HTV. ...

Longitudinal associations between perceived stress and anhedonia during psychotherapy