{"title":"Personalized Models of Psychopathology.","authors":"Aidan G C Wright, William C Woods","doi":"10.1146/annurev-clinpsy-102419-125032","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-102419-125032","url":null,"abstract":"<p><p>The personalized approach to psychopathology conceptualizes mental disorder as a complex system of contextualized dynamic processes that is nontrivially specific to each individual, and it seeks to develop formal idiographic statistical models to represent these individual processes. Although the personalized approach draws on long-standing influences in clinical psychology, there has been an explosion of research in recent years following the development of intensive longitudinal data capture and statistical techniques that facilitate modeling of the dynamic processes of each individual's pathology. Advances are also making idiographic analyses scalable and generalizable. We review emerging research using the personalized approach in descriptive psychopathology, precision assessment, and treatment selection and tailoring, and we identify future challenges and areas in need of additional research. The personalized approach to psychopathology holds promise to resolve thorny diagnostic issues, generate novel insights, and improve the timing and efficacy of interventions.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"49-74"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-102419-125032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37654048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities.","authors":"Justin D Smith, Emily Fu, Marissa A Kobayashi","doi":"10.1146/annurev-clinpsy-100219-060201","DOIUrl":"10.1146/annurev-clinpsy-100219-060201","url":null,"abstract":"<p><p>Childhood obesity has become a global pandemic in developed countries, leading to a host of medical conditions that contribute to increased morbidity and premature death. The causes of obesity in childhood and adolescence are complex and multifaceted, presenting researchers and clinicians with myriad challenges in preventing and managing the problem. This article reviews the state of the science for understanding the etiology of childhood obesity, the preventive interventions and treatment options for overweight and obesity, and the medical complications and co-occurring psychological conditions that result from excess adiposity, such as hypertension, nonalcoholic fatty liver disease, and depression. Interventions across the developmental span, varying risk levels, and service contexts (e.g.,community, school, home, health care systems) are reviewed. Future directions for research are offered with an emphasis on translational issues for taking evidence-based interventions to scale in a manner that will reduce the public health burden of the childhood obesity pandemic.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"351-378"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259820/pdf/nihms-1591082.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37675707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intergenerational Transmission of Depression.","authors":"Sherryl H Goodman","doi":"10.1146/annurev-clinpsy-071519-113915","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-071519-113915","url":null,"abstract":"<p><p>The study of depression in mothers in relation to transmission of risk for the development of psychopathology in their children relies on solid foundations in the understanding of psychopathology, of development, and of developmental psychopathology per se. This article begins with a description of the scope of the problem, including a summary of knowledge of how mothers' depression is associated with outcomes in children and of moderators of those associations. The sense of scope then informs a theoretical and empirical perspective on knowledge of mechanisms in those associations, with a focus on what has been learned in the past 20 years. Throughout the article, and in conclusions at the end, are suggestions for next steps in research and practice.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"213-238"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-071519-113915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37562230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Behavioral Conceptualization and Treatment of Chronic Pain.","authors":"Johan W S Vlaeyen, Geert Crombez","doi":"10.1146/annurev-clinpsy-050718-095744","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-050718-095744","url":null,"abstract":"<p><p>Pain is considered a hardwired signal of bodily disturbance belonging to a basic motivational system that urges the individual to act and to restore the body's integrity, rather than just a sensory and emotional experience. Given its eminent survival value, pain is a strong motivator for learning. Response to repeated pain increases when harm risks are high (sensitization) and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is adaptive in the short term but paradoxically may have detrimental long-term effects. Pain and pain-related responses compete with other demands in the environment. Exposure-based treatments share the aim of facilitating or restoring the pursuit of individual valued life goals in the face of persistent pain, and further improvements in pain treatment may require a paradigm shift toward more personalized approaches.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"187-212"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-050718-095744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37443388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick Luyten, Chloe Campbell, Elizabeth Allison, Peter Fonagy
{"title":"The Mentalizing Approach to Psychopathology: State of the Art and Future Directions.","authors":"Patrick Luyten, Chloe Campbell, Elizabeth Allison, Peter Fonagy","doi":"10.1146/annurev-clinpsy-071919-015355","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-071919-015355","url":null,"abstract":"<p><p>Mentalizing is the capacity to understand others and oneself in terms of internal mental states. It is assumed to be underpinned by four dimensions: automatic-controlled, internally-externally focused, self-other, and cognitive-affective. Research suggests that mental disorders are associated with different imbalances in these dimensions. Addressing the quality of mentalizing as part of psychosocial treatments may benefit individuals with various mental disorders. We suggest that mentalizing is a helpful transtheoretical and transdiagnostic concept to explain vulnerability to psychopathology and its treatment. This review summarizes the mentalizing approach to psychopathology from a developmental socioecological evolutionary perspective. We then focus on the application of the mentalizing approach to personality disorders, and we review studies that have extended this approach to other types of psychopathology, including depression, anxiety, and eating disorders. We summarize core principles of mentalization-based treatments and preventive interventions and the evidence for their effectiveness. We conclude with recommendations for future research.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"297-325"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-071919-015355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37612375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bottom-Up and Top-Down Paradigms for Psychopathology: A Half-Century Odyssey.","authors":"Thomas M Achenbach","doi":"10.1146/annurev-clinpsy-071119-115831","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-071119-115831","url":null,"abstract":"<p><p>Bottom-up paradigms prioritize empirical data from which to derive conceptualizations of psychopathology. These paradigms use multivariate statistics to identify syndromes of problems that tend to co-occur plus higher-order groupings such as those designated as internalizing and externalizing. Bottom-up assessment instruments obtain self-ratings and collateral ratings of behavioral, emotional, social, and thought problems and strengths for ages 1½-90+. Ratings of population samples provide norms for syndrome and higher-order scales for each gender, at different ages, rated by different informants, in relation to multicultural norms. The normed assessment instruments operationalize the empirically derived syndromes and higher-order groupings for applications to clinical services, research, and training. Because cross-informant agreement is modest and no single informant provides comprehensive assessment data, software compares ratings by different informants. Top-down paradigms prioritize conceptual representations of the nature and structure of psychopathology, as exemplified by psychodynamic, DSM/ICD, and HiTOP paradigms. Although these paradigms originated with observations, they tend to prioritize conceptual representations over empirical data.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"1-24"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-071119-115831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37913879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaylen E Fronk, Sarah J Sant'Ana, Jesse T Kaye, John J Curtin
{"title":"Stress Allostasis in Substance Use Disorders: Promise, Progress, and Emerging Priorities in Clinical Research.","authors":"Gaylen E Fronk, Sarah J Sant'Ana, Jesse T Kaye, John J Curtin","doi":"10.1146/annurev-clinpsy-102419-125016","DOIUrl":"10.1146/annurev-clinpsy-102419-125016","url":null,"abstract":"<p><p>Clinicians and researchers alike have long believed that stressors play a pivotal etiologic role in risk, maintenance, and/or relapse of alcohol and other substance use disorders (SUDs). Numerous seminal and contemporary theories on SUD etiology posit that stressors may motivate drug use and that individuals who use drugs chronically may display altered responses to stressors. We use foundational basic stress biology research as a lens through which to evaluate critically the available evidence to support these key stress-SUD theses in humans. Additionally, we examine the field's success to date in targeting stressors and stress allostasis in treatments for SUDs. We conclude with our recommendations for how best to advance our understanding of the relationship between stressors and drug use, and we discuss clinical implications for treatment development.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"401-430"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259491/pdf/nihms-1573181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37628815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Research on Improving Outcomes and Reducing Costs of Psychological Interventions: Toward Delivering the Best to the Most for the Least.","authors":"Brian T Yates","doi":"10.1146/annurev-clinpsy-071519-110415","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-071519-110415","url":null,"abstract":"<p><p>Treatment and prevention efforts guided by psychological theory, research, and practice can have outcomes of greater value than the resources consumed by those efforts-and outcomes superior to those attainable by other means, often at lower costs. How can we make this hope true more often, for more of the clients who need our services, despite severe resource constraints? Routinely reporting the costs, effectiveness, and benefits of psychological interventions from client, practitioner, and societal perspectives is only a beginning. We also need to use descriptive and inferential statistics to measure, report, and analyze the cost-effectiveness and cost-benefit of our interventions to discover the strongest determinants of intervention costs and outcomes. The emerging literature on cost-inclusive research in psychology suggests that delivery systems are one primary determinant of costs and outcomes of most interventions, as are the psychological techniques applied.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"125-150"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-071519-110415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37628814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gregory T Smith, Emily A Atkinson, Heather A Davis, Elizabeth N Riley, Joshua R Oltmanns
{"title":"The General Factor of Psychopathology.","authors":"Gregory T Smith, Emily A Atkinson, Heather A Davis, Elizabeth N Riley, Joshua R Oltmanns","doi":"10.1146/annurev-clinpsy-071119-115848","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-071119-115848","url":null,"abstract":"<p><p>An important advance in understanding and defining mental disorders has been the development of empirical approaches to mapping dimensions of dysfunction and their interrelatedness. Such empirical approaches have consistently observed intercorrelations among the many forms of psychopathology, leading to the identification of a general factor of psychopathology (the p factor). In this article, we review empirical support for p, including evidence for the stability and criterion validity of p. Further, we discuss the strong relationship between p and both the general factor of personality and the general factor of personality disorder, substantive interpretations of p, and the potential clinical utility of p. We posit that proposed substantive interpretations of p do not explain the full range of symptomatology typically included in p. The most plausible explanation is that p represents an index of impairment that has the potential to inform the duration and intensity of a client's mental health treatment.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"75-98"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-071119-115848","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37629216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Executive Function and Psychopathology: A Neurodevelopmental Perspective.","authors":"Philip David Zelazo","doi":"10.1146/annurev-clinpsy-072319-024242","DOIUrl":"https://doi.org/10.1146/annurev-clinpsy-072319-024242","url":null,"abstract":"<p><p>Executive function (EF) skills are neurocognitive skills that support the reflective, top-down coordination and control of other brain functions, and there is neural and behavioral evidence for a continuum from more \"cool\" EF skills activated in emotionally neutral contexts to more \"hot\" EF skills needed for the reversal of motivationally significant tendencies. Difficulties in EF are transdiagnostic indicators of atypical development. A neurodevelopmental model traces the pathway from adverse childhood experiences and stress to disruption of the development of neural systems supporting reflection and EF skills to an increased risk for general features of psychopathology. Research indicates that EF skills can be cultivated through scaffolded training and are a promising target for therapeutic and preventive intervention. Intervention efficacy can be enhanced by mitigating disruptive bottom-up influences such as stress, training both hot and cool EF skills, and adding a reflective, metacognitive component to promote far transfer of trained skills.</p>","PeriodicalId":50755,"journal":{"name":"Annual Review of Clinical Psychology","volume":"16 ","pages":"431-454"},"PeriodicalIF":18.4,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1146/annurev-clinpsy-072319-024242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37659047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}