Parental Mentalizing During a Pandemic: Use of Mental-State Language on Parenting Social Media Before and During the COVID-19 Pandemic

The COVID-19 pandemic has been a demanding caregiving context for parents, particularly during lockdowns. In this study, we examined parental mentalization, parents’ proclivity to consider their own and their child’s mental states, during the pandemic, as manifested in mental-state language (MSL) on parenting social media. Parenting-related posts on Reddit from two time periods in the pandemic in 2020, March to April (lockdown) and July to August (postlockdown), were compared with time-matched control periods in 2019. MSL and self–other references were measured using text-analysis methods. Parental mentalization content decreased during the pandemic: Posts referred less to mental activities and to other people during the COVID-19 pandemic and showed decreased affective MSL, cognitive MSL, and self-references specifically during lockdown. Father-specific subreddits exhibited strongest declines in mentalization content, whereas mother-specific subreddits exhibited smaller changes. Implications on understanding associations between caregiving contexts and parental mentalization, gender differences, and the value of using social-media data to study parenting and mentalizing are discussed.

HiTOP Is Not an Improvement Over the DSM

In their response to our article (both in this issue), DeYoung and colleagues did not sufficiently address three fundamental flaws with the Hierarchical Taxonomy of Psychopathology (HiTOP). First, HiTOP was created using a simple-structure factor-analytic approach, which does not adequately represent the dimensional space of the symptoms of psychopathology. Consequently, HiTOP is not the empirical structure of psychopathology. Second, factor analysis and dimensional ratings do not fix the problems inherent to descriptive (folk) classification; self-reported symptoms are still the basis on which clinical judgments about people are made. Finally, HiTOP is not ready to use in real-world clinical settings. There is currently no empirical evidence demonstrating that clinicians who use HiTOP have better clinical outcomes than those who use the Diagnostic and Statistical Manual of Mental Disorders ( DSM). In sum, HiTOP is a factor-analytic variation of the DSM that does not get the field closer to a more valid and useful taxonomy.

Moral Injury, Traumatic Stress, and Threats to Core Human Needs in Health-Care Workers: The COVID-19 Pandemic as a Dehumanizing Experience

The pandemic has threatened core human needs. The pandemic provides a context to study psychological injury as it relates to unmet basic human needs and traumatic stressors, including moral incongruence. We surveyed 1,122 health-care workers from across the United States between May 2020 and August 2020. Using a mixed-methods design, we examined moral injury and unmet basic human needs in relation to traumatic stress and suicidality. Nearly one third of respondents reported elevated symptoms of psychological trauma, and the prevalence of suicidal ideation among health-care workers in our sample was roughly 3 times higher than in the general population. Moral injury and loneliness predict greater symptoms of traumatic stress and suicidality. We conclude that dehumanization is a driving force behind the psychological injury resulting from moral incongruence in the context of the pandemic. The pandemic most frequently threatened basic human motivations at the foundational level of safety and security relative to other higher order needs.

An Epidemiologic, Longitudinal, and Discordant-Twin Study of the Association Between Gambling Disorder and Suicidal Behaviors

Gambling disorder is associated with suicidal behaviors, but it is not clear whether the association is due to common etiologic factors or to gambling disorder being causally related to suicidality. This question was examined from the perspective of epidemiologic, longitudinal, and discordant-twin studies. The results suggested that the causes of the association with disordered gambling differed for suicidal ideation, plan, and attempt and differed for men and women. The association of suicidal thoughts with disordered gambling was noncausally explained by common genetic influences among women but not men. Conversely, there was evidence consistent with a potentially causal influence of disordered gambling on suicide attempt among men but not women, which might have been related to gambling-related financial problems. The use of monetary data to identify individuals experiencing financial harms associated with their gambling may represent a more practicable target for screening, intervention, and prevention and may reduce gambling-related financial crises, thereby warding off a potential gambling-related suicide attempt.

Negative Affectivity and Disinhibition as Moderators of an Interpersonal Pathway to Suicidal Behavior in Borderline Personality Disorder

In this longitudinal study, we examined whether personality traits moderate the link between interpersonal dysfunction and suicidal behavior in a high-risk sample of 458 individuals diagnosed with borderline personality disorder. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Using multilevel structural equation modeling, we examined (a) longitudinal, within-persons relationships among interpersonal dysfunction, suicidal ideation, and suicide attempts and (b) moderation of these relationships by negative affectivity and disinhibition. Negative affectivity predicted a stronger within-persons coupling between interpersonal dysfunction and suicidal ideation. Disinhibition predicted a stronger coupling between ideation and suicide attempts. Assessing negative affectivity and disinhibition in a treatment setting may guide clinician vigilance toward people at highest risk for interpersonally triggered suicidal behaviors.

The Interplay Between Reward-Relevant Life Events and Trait Reward Sensitivity in Neural Responses to Reward Cues

The reward-hypersensitivity model posits that trait reward hypersensitivity should elicit hyper/hypo-approach motivation following exposure to recent life events that activate (goal striving and goal attainment) or deactivate (goal failure) the reward system, respectively. To test these hypotheses, we had 87 young adults with high trait reward (HRew) sensitivity or moderate trait reward (MRew) sensitivity report frequency of life events via the Life Event Interview. Brain activation was assessed during the functional MRI monetary-incentive-delay task. Greater exposure to goal-striving events was associated with higher nucleus accumbens (NAc) reward anticipation among HRew participants and lower orbitofrontal cortex (OFC) reward anticipation among MRew participants. Greater exposure to goal-failure events was associated with higher NAc and OFC reward anticipation only among HRew participants. This study demonstrated different neural reward anticipation (but not outcome) following reward-relevant events for HRew individuals compared with MRew individuals. Trait reward sensitivity and reward-relevant life events may jointly modulate reward-related brain function, which has implications for understanding psychopathology.

Imagery Rescripting Versus Extinction: Distinct and Combined Effects on Expectancy and Revaluation Learning

Anxiety disorders are effectively treated with exposure therapy, but relapse remains high. Fear may reinstate after reoccurrence of the negative event because the expectancy of the aversive outcome (unconditioned stimulus [US]) is adjusted but not its evaluation. Imagery rescripting (ImRs) is an intervention that is proposed to work through revaluation of the US. The aim of our preregistered study was to test the effects of ImRs and extinction on US expectancy and US revaluation. Day 1 ( n = 106) consisted of acquisition with an aversive film clip as US. The manipulation (ImRs + extinction, extinction-only, or ImRs-only) took place on Day 2. Reinstatement of fear was tested on Day 3. Results showed expectancy learning in both extinction conditions but not in the ImRs-only condition and no enhanced revaluation learning in ImRs. The combination of ImRs and extinction slowed down extinction but did not protect against reinstatement, which pleads in favor of stand-alone interventions in clinical practice.

The Prognostic Utility of Personality Traits Versus Past Psychiatric Diagnoses: Predicting Future Mental Health and Functioning

Past psychiatric diagnoses are central to patient case formulation and prognosis. Recently, alternative classification models such as the Hierarchical Taxonomy of Psychopathology (HiTOP) proposed to assess traits to predict clinically relevant outcomes. In the current study, we directly compared personality traits and past diagnoses as predictors of future mental health and functioning in three independent, prospective samples. Regression analyses found that personality traits significantly predicted future first onsets of psychiatric disorders (change in [∆] R2 = .06–.15), symptom chronicity (∆ R2 = .03–.06), and functioning (∆ R2 = .02–.07), beyond past and current psychiatric diagnoses. Conversely, past psychiatric diagnoses did not provide an incremental prediction of outcomes when personality traits and other concurrent predictors were already included in the model. Overall, personality traits predicted a variety of outcomes in diverse settings beyond diagnoses. Past diagnoses were generally not informative about future outcomes when personality was considered. Together, these findings support the added value of personality traits assessment in case formulation, consistent with the HiTOP model.

How Robust Is the p Factor? Using Multitrait-Multimethod Modeling to Inform the Meaning of General Factors of Youth Psychopathology

We used multitrait-multimethod (MTMM) modeling to examine general factors of psychopathology in three samples of youths ( Ns = 2,119, 303, and 592) for whom three informants reported on the youth’s psychopathology (e.g., child, parent, teacher). Empirical support for the p-factor diminished in multi-informant models compared with mono-informant models: The correlation between externalizing and internalizing factors decreased, and the general factor in bifactor models essentially reflected externalizing. Widely used MTMM-informed approaches for modeling multi-informant data cannot distinguish between competing interpretations of the patterns of effects we observed, including that the p factor reflects, in part, evaluative consistency bias or that psychopathology manifests differently across contexts (e.g., home vs. school). Ultimately, support for the p factor may be stronger in mono-informant designs, although it does not entirely vanish in multi-informant models. Instead, the general factor of psychopathology in any given mono-informant model likely reflects a complex mix of variances, some substantive and some methodological.

The Benefits of Living With Close Others: A Longitudinal Examination of Mental Health Before and During a Global Stressor

For better or worse, the people one lives with may exert a powerful influence on one’s mental health, perhaps especially during times of stress. The COVID-19 pandemic—a large-scale stressor that prompted health recommendations to stay home to reduce disease spread—provided a unique context for examining how the people who share one’s home may shape one’s mental health. A seven-wave longitudinal study assessed mental health month to month before and during the pandemic (February through September 2020) in two diverse samples of U.S. adults ( N = 656; N = 544). Preregistered analyses demonstrated that people living with close others (children and/or romantic partners) experienced better well-being before and during the pandemic’s first 6 months. These groups also experienced unique increases in ill-being during the pandemic’s onset, but parents’ ill-being also recovered more quickly. These findings highlight the crucial protective function of close relationships for mental health both generally and amid a pandemic.