Implicit associations tied to psychopathology
Implicit associations reflect relatively uncontrollable automatic
associations between concepts in memory. Our lab has demonstrated that
anxiety and many other forms of psychopathology are characterized by
biases in these associations. For instance, we have shown that phobic
individuals are more likely than non-phobic individuals to associate
their feared object with danger. Moreover, persons with panic disorder
associate themselves with panic (vs. calm) relatively more than do
non-anxious individuals, and importantly, these associations change
following successful treatment and even predict the extent someone will
experience a reduction in symptoms. To allow the public to learn about
implicit mental health associations, we direct a public web site called
Project Implicit Mental Health (www.implicitmentalhealth.com) that
allows visitors to try an Implicit Association Test and receive
feedback on their score. More than 500,000 tests have been completed!
Sample publications:
• Glenn, J. J., Werntz, A. J., Slama, S. J. K.,
Steinman, S. A., Teachman, B. A., & Nock, M. K. (in press). Suicide
and self-injury-related implicit cognition: A large-scale examination
and replication. Journal of Abnormal Psychology.
• Werntz, A. J., Steinman, S. A., Glenn, J., Nock,
M., & Teachman, B. A. (2016). Characterizing implicit mental health
evaluations across clinical domains. Journal of Behavior Therapy and Experimental Psychiatry, 52, 17-28.
• Teachman, B. A., Joormann, J., Steinman, S. A.,
& Gotlib, I. H. (2012). Automaticity in anxiety disorders and major
depressive disorder. Clinical Psychology Review, 32, 575-603.
Cognitive bias modification
A primary focus of our recent work has been to examine the causal link
between change in cognitive biases and symptom (e.g., anxiety)
reduction using cognitive bias modification paradigms. These
computer-based training programs are designed to directly alter biased
ways of thinking, such as the tendency to make threat interpretations.
For instance, we have trained interpretations to be more benign to
decrease anxious responding among obsessional, contamination fearful,
socially anxious, trait anxious, spider fearful, and anxiety sensitive
samples, and even found that symptom changes following interpretation
training for acrophobia (height fear) were as large as those achieved
by a group receiving the gold-standard exposure therapy. These
demonstrations are significant because they permit evaluation of the
causal, rather than simply correlational, claims that underlie
cognitive models, and because they offer promise for new interventions
that are easy to disseminate given they are computer-based and do not
require a therapist. We recently launched MindTrails
(https://mindtrails.virginia.edu/), a public web site for people to try
different online interpretation training programs.
Sample publications:
• Beadel, J. R., Mathews, A., & Teachman, B. A.
(2016). Cognitive Bias Modification to Enhance Resilience to a Panic
Challenge. Cognitive Therapy and Research, 40(6), 799-812.
• Steinman, S. A., & Teachman, B.A. (2014).
Reaching new heights: Comparing interpretation bias modification to
exposure therapy for extreme height fear. Journal of Consulting and Clinical Psychology, 82, 404-417.
• Clerkin, E. M., & Teachman, B. A. (2011).
Training interpretation biases among individuals with symptoms of
obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 337-343.
Dynamic monitoring of thoughts, feelings, and behaviors
Rather than rely on a static snapshot of biased processing, we seek new
ways to more dynamically track anxious and other disorder-related
thoughts, feelings, and behaviors. For instance, in collaboration with
colleagues in engineering we use active (e.g., ecological momentary
assessment) and passive (e.g., GPS, accelerometer, psychophysiology)
mobile sensing via smartphones to learn how social anxiety and
depressive symptoms tie to communication patterns and emotion
regulation efforts in natural environments. In addition, we are
developing new paradigms that enable more fine-grained, continuous
assessment of biased processing of emotional information (e.g.,
tracking moment-to-moment changes in responding as positive and
negative information is encountered; tracking computer mouse movements
in response to feared stimuli to capture avoidance motivation; tracking
sensitivity to reward and punishment cues as they shift over time).
Sample publications:
• Chow, P. I., Fua, K., Huang, Y., Bonelli, W.,
Xiong, H., Barnes, L. E., & Teachman, B. A. (in press). Using
mobile sensing to test clinical models of depression, social anxiety,
state affect, and social isolation among college students. Journal of Medical Internet Research.
• Fua, K., & Teachman, B. A. (in press).
Dynamically tracking anxious individuals' affective response to
valenced information. Emotion.
• Chow, P. I., Fua., K., Xiong., H., Bonelli, W.,
Teachman, B. A., & Barnes, L. E. (2016). SAD: Social anxiety
and depression dynamic monitoring system. In: Computing and Mental
Health Workshop, CHI: ACM Conference on Human Factors in Computing
Systems. pp. 1-4.
Change in cognitive processing over treatment and across time
To evaluate whether change in cognitive biases predicts later symptom
change, we have used repeated measures designs and dynamic modeling
approaches. For instance, we have shown that change in the tendency to
negatively (mis)interpret ambiguous stimuli tied to panic-related
bodily cues predicts later reductions in maladaptive avoidance
behaviors, and a myriad of other panic responses. Additionally, given
that most cognitive bias measures are not process pure, we have started
to look more in depth at just what is changing during treatment (e.g.,
to what extent changes reflect relatively more automatic vs. strategic
components). We also collaborate with Dr. Kristen Lindgren to
investigate change in alcohol associations across time.
Sample publications:
• Lindgren, K. P., Neighbors, C., Teachman, B. A.,
Baldwin, S. A., Norris, J., Kaysen, D., ... & Wiers, R. W. (2016).
Implicit alcohol associations, especially drinking identity, predict
drinking over time. Health Psychology, 35(8), 908.
• Clerkin, E. M., Fisher, C. R., Sherman, J. W.,
& Teachman, B. A. (2014). Applying the Quadruple Process Model to
evaluate change in implicit attitudinal responses during therapy for
panic disorder. Behaviour Research and Therapy, 52, 17-25.
• Teachman, B. A., Marker, C. D., & Clerkin, E.
M. (2010). Catastrophic misinterpretations as a predictor of symptom
change during treatment for panic disorder. Journal of Consulting and Clinical Psychology, 78, 964-973.
Intrusive, unwanted thought
Intrusive unwanted thinking is tied to numerous forms of
psychopathology. We have been investigating individual differences in
the nature of intrusive thoughts and methods to control unwanted
thinking, such as thought suppression. For example, we have conducted a
series of studies to better understand how age-related changes in
cognitive processing and emotion regulation alter the ability to
suppress the recurrence of intrusive unwanted thoughts, and mitigate
the thoughts’ potentially negative affective consequences. Relatedly,
we completed a meta-analysis of thought suppression outcomes tied to
psychopathology, finding that, while psychopathology is associated with
greater rates of intrusive thinking, contrary to many theoretical
predictions, there were no overall differences in the recurrence of
thoughts following thought suppression between groups with and without
psychopathology.
Sample publications:
• Lambert A. E., Hu, Y., Magee, J. C., Beadel, J. R.,
& Teachman B. A. (2014). Thought suppression across time: Change in
frequency and duration of thought recurrence. Journal of Obsessive-Compulsive and Related Disorders, 3, 21-28.
• Magee, J. C., Smyth, F. L., & Teachman, B. A.
(2014). A web-based examination of responses to intrusive thoughts
across the adult lifespan. Aging and Mental Health, 18, 326-339.
• Magee, J. C., Harden, K. P., & Teachman, B. A.
(2012). Psychopathology and thought suppression: A quantitative review.
Clinical Psychology Review, 32, 189-201.
Attitudes about mental illness and its treatment
Building from the social cognition literature and our understanding of
how to modify negative beliefs and attitudes about stigmatized groups,
we are examining how automatic biases affect clinical populations. We
seek to better understand stigma toward persons with mental illness and
treatment seeking, as well as what factors motivate people to seek care
(e.g., beliefs about the value of science in determining a treatment
plan; role of biases at the State level).
Sample publications:
• Kulesza, M., Matsuda, M., Ramirez, J. J., Werntz,
A. J., Teachman, B. A., & Lindgren, K. P. (2016). Towards greater
understanding of addiction stigma: Intersectionality with
race/ethnicity and gender. Drug and Alcohol Dependence, 169, 85-91.
• Saporito, J., Ryan, C., & Teachman, B. A.
(2011). Reducing stigma toward seeking mental health treatment among
adolescents. Stigma Research and Action, 1, 9-21.
• Peris, T. S., Teachman, B. A., & Nosek, B. A.
(2008). Implicit and explicit stigma of mental illness: Links to
clinical care. Journal of Nervous and Mental Disease, 196, 752-760.
updated February 2017
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