Abstract: Pain and tobacco smoking are highly prevalent and comorbid conditions that impose considerable burdens on individuals and health care systems. A recently proposed reciprocal model suggests that these conditions interact in a bidirectional manner, resulting in greater pain and the maintenance of tobacco addiction. Anxiety and depression are common among smokers in pain and have been identified as central mechanisms of interest. There is emerging evidence that smokers with anxiety/depression may experience more severe pain and functional impairment, greater pain-induced motivation to smoke, and increased sensitivity to pain during periods of smoking abstinence. Based on empirical findings, we hypothesize that these experiences may engender expectations that abstaining from smoking will exacerbate both pain and negative affect, thus eroding self-efficacy for smoking cessation and increasing perceived barriers to quitting. The goal of this narrative review is to examine the role of anxiety/depression in complex pain-smoking relations so as to advance evolving theoretical perspectives and inform the development of tailored interventions.

Abstract: Researchers frequently rely on meta-analyses of prior research studies to efficiently evaluate a broad spectrum of results on a particular topic. In the realm of single-subject experimental designs (SSEDs), meta-analyses have a particular cachet: retaining the rigor of single-subject designs with the added robustness of replication to more fully determine the strength of a given approach or intervention. Until recently, researchers wishing to undertake meta-analytic research themselves have had limited options for synthesizing the intervention effects of a collection of studies. Researchers consistently use two software programs, DataThief III and GraphClick, to conduct meta-analytic work using SSEDs. The purpose of this study was to evaluate and compare the validity and reliability of the results yielded by each of these programs when evaluating the results of multiple research studies on the Good Behavior Game, a classroom-based intervention that has been in practice since 1969. Study findings suggest t...

Abstract: Anxiety sensitivity, particularly the physical concerns domain, is associated with more problematic asthma symptoms and greater functional limitations. It has been theorized that anxiety sensitivity fosters greater reactivity to asthma-related physical sensations; however, this theory has yet to be empirically tested. Thus, the present investigation sought to examine the role of anxiety sensitivity-physical concerns in terms of affective and physical reactivity to asthma-like symptoms. Participants were 101 undergraduates with asthma (76.2% female, Mage = 19.69 years, SD = 3.77 years, range = 18-49 years) who completed self-report measures and a straw-breathing task. Results indicated that after controlling for the effects of gender, asthma control (i.e., how well one's asthma symptoms are managed or controlled), and negative affectivity, greater levels of anxiety sensitivity-physical concerns significantly predicted greater anxiety (4.7% unique variance) and asthma symptoms (6.9% unique variance) and lower levels of lung function (4.4% unique variance) after the straw-breathing task. These findings suggest that individuals with asthma who are fearful of physiological arousal are a particularly "at-risk" population for poor asthma outcomes because of this greater reactivity and could benefit from interventions targeting anxiety sensitivity.

Abstract: Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive emotional or physical states, and therefore may have greater difficulty achieving healthy behavioral change. This may be particularly true for exercise, which produces many of the somatic sensations within the domain of AS concerns. Cross-sectional studies show a negative association between AS and exercise. However, little is known about how AS may prospectively affect attempts at behavior change in individuals who are motivated to increase their exercise. We recruited 145 young adults who self-identified as having a desire to increase their exercise behavior. Participants completed a web survey assessing AS and additional variables identified as important for behavior change-impulsivity, grit, perceived behavioral control, and action planning-and set a specific goal for exercising in the next week. One week later, a second survey assessed participants' success in meeting their exercise goals. We hypothesized that individuals with higher AS would choose lower exercise goals and would complete less exercise at the second survey. AS was not significantly associated with exercise goal level, but significantly and negatively predicted exercise at Time 2 and was the only variable to offer significant prediction beyond consideration of baseline exercise levels. These results underscore the importance of considering AS in relation to health behavior intentions. This is particularly apt given the absence of prediction offered by other traditional predictors of behavior change.

Abstract: Disruptions can prevent the classroom from being an effective learning environment. The Good Behavior Game (GBG) is a group contingency that has been proven to effectively prevent disruptions and increase engagement. However, the traditional methods of the GBG include teacher scanning for negative student behaviors, and may not align with Positive Behavioral Interventions and Supports (PBIS), which is becoming widely adopted in many schools. Extending the findings of Wright and McCurdy, the current study compared the effects of the GBG and a positive version of the GBG, called the Caught Being Good Game (CBGG), on student behavior, including engagement and off-task behaviors, as well as teachers' use of positive and negative statements. Results showed both the GBG and the CBGG improved student behavior, with data not clearly indicating one was superior. Neither intervention led to an increase in positive teacher statements. Implications for teachers and suggestions for further research are discussed.

Abstract: The present investigation examined associations between distress tolerance and posttraumatic stress disorder (PTSD) symptoms in a cocaine-dependent sample. Participants were comprised of 138 cocaine-dependent adults (Mage = 45.4, SD = 9.9; 81% male; 76.3% African American) who endorsed trauma exposure, defined according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) PTSD Criterion A. Participants were administered interview-based measures and completed a series of self-report questionnaires. Results indicated that distress tolerance was significantly, incrementally (negatively) associated with PTSD symptom severity, contributing 6.8% of unique variance to the model (p < .001); notably, the overall model explained 44.8% of variance in PTSD symptomatology. Distress tolerance also contributed between 2.7% and 6.8% of unique variance across each of the PTSD symptom clusters (ps < .05). Incremental effects were documented, after accounting for the variance explained by theoretically relevant covariates (i.e., gender, cocaine-use severity, depressive symptoms, trauma-exposure severity). Theoretical and clinical implications are discussed.

Abstract: Rates of both traumatic event exposure and posttraumatic stress disorder (PTSD; 22%-54%) are disproportionately elevated among people living with HIV/AIDS (PLHA). Trauma and related psychopathology significantly affect quality of life and disease management in this patient population. The current study examined associations between internalized HIV stigma, mindfulness skills, and the severity of PTSD symptoms in trauma-exposed PLHA. Participants included 137 PLHA (14.6% female; Mage = 48.94, SD = 8.89) who reported experiencing on average, five (SD = 2.67) traumatic events; 34% met diagnostic criteria for PTSD. Results indicate that after controlling for sex, age, education, and number of traumatic events, internalized HIV stigma was positively related to overall PTSD symptom severity (β = .16, p < .05) and severity of re-experiencing (β = .19, p < .05) and hyper-arousal (β = .16, p = .05), but not avoidance, PTSD symptom clusters. Among the mindfulness facets measured, acting with awareness was uniquely negatively related to the overall severity of PTSD symptoms (β = -.25, p < .01) and the severity of re-experiencing (β = -.25, p < .05), avoidance (β = -.25, p < .05), and hyper-arousal (β = -.29, p < .01) PTSD symptom clusters. These effects were observed after accounting for covariates and shared variance with other mindfulness facets. Theoretically, the present findings suggest that internalized HIV stigma may serve as a vulnerability factor for the severity of certain PTSD symptoms, whereas acting with awareness may function as a protective or resiliency factor for the severity of PTSD symptoms. Implications for the treatment of trauma-exposed PLHA are discussed.

Abstract: The current study used a novel real-time data capture strategy, ecological momentary assessment (EMA), to examine whether within-day variability in stress and context leads to exacerbations in asth...

Abstract: Individuals with intellectual disabilities (ID) often demonstrate impairments in social functioning, with deficits becoming more apparent during adolescence. This study evaluated the effects of the Superheroes Social Skills program, a program that combines behavioral skills training and video modeling to teach target social skills, on accurate demonstration of three target social skills in adolescents with ID. Skills taught in the present study include Expressing Wants and Needs, Conversation, and Turn Taking. Four adolescents with ID participated in a 3-week social skills intervention, with the intervention occurring twice per week. A multiple baseline across skills design was used to determine the effect of the intervention on social skill accuracy in both a training and generalization setting. All participants demonstrated substantial improvements in skill accuracy in both settings, with teacher ratings of social functioning further suggesting generalization of social skills to nontraining settings.

Abstract: Check-In/Check-Out (CICO) is a moderately effective Tier 2 intervention often used to address attention-maintained problem behaviors in schools. Recent studies on CICO have demonstrated the effectiveness of the intervention when combined with social skills training and when utilizing students' peers as interventionists. Using a concurrent multiple baseline across participants design, the present study evaluated the effectiveness of peer-mediated CICO to target social skills in elementary school students identified as socially neglected using a sociometric classification system. Results, implications for practice, limitations, and future directions are discussed.

Abstract: This study evaluated the effects of Group Triple P with Chinese parents on parenting and child outcomes as well as outcomes relating to child academic learning in Mainland China. Participants were 81 Chinese parents and their children in Shanghai, who were randomly allocated to an intervention group or wait-list control group. Parents in the intervention condition received Group Triple P training, and parents and children were assessed at three/two time points. Compared with the control group, parents in the intervention group reported significant improvements in child adjustment problems, parenting practices, parental adjustment, and parenting self-efficacy at post-assessment. Moreover, there was a significant increase in parents' satisfaction with children's academic achievement and a reduction in children's academic problem behaviors at post-intervention. All these effects were maintained at 6-month follow-up. There was also a significant increase in the child report of positive parenting at post-intervention.

Abstract: The current study examined cardiac denial and psychological predictors (i.e., depression, anxiety) of health outcomes including medical nonadherence and physical health in a sample of 80 adults with congenital heart disease (ACHD). Results indicated that denial of impact was elevated in this patient group compared with reference groups, and denial was negatively associated with depression and anxiety at ps < .01. Results indicated that depression, anxiety, and denial predicted unique variance in medical nonadherence, and gender moderated the relationships between these psychological factors and nonadherence. For depression, men and women showed similar relationships between depression and nonadherence at high levels of depression; however, at low levels of depression (i.e., a more normal mood state), men were less adherent compared with women. For anxiety, men and women did not differ in adherence at low levels of anxiety; however, men experiencing high anxiety were less adherent compared with women experiencing high anxiety. Implications of this study are discussed including the role of gender and denial and the impact of denial functioning to reduce negative affect. Depression was the only significant predictor of physical functioning. Results of this study suggest that psychological interventions aimed at depression and anxiety may function differently across gender to improve patient medical adherence and improve physical functioning in ACHD.

Abstract: Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.

Abstract: Girls often harm others' social standing by starting rumors about peers or by excluding others from peer group activities, which is called relational aggression. Although relational aggression is not a new phenomenon, there have been relatively few interventions designed to address this, especially for urban ethnic minority girls. The Friend to Friend (F2F) program, developed through an iterative participatory action research process, has proven to be effective in improving targeted relationally aggressive urban girls' social problem-solving knowledge and decreasing levels of relational aggression, with effects being maintained 1 year after treatment. In the current article, we examine the broader effects of the F2F program. Findings suggest that the indicated F2F program has broader effects such as increasing prosocial behaviors, decreasing relational and physical aggression, and improving teacher-student relationships among non-targeted boys. In addition, the program demonstrated some effects for non-targeted girls including an increase in prosocial behaviors and improved teacher-student relationships. Implications for examining the cost-effectiveness of indicated interventions such as F2F are discussed.

Abstract: Risky sexual behavior among adolescents is common and results in many negative consequences. The present study investigated longitudinal predictors of adolescents' likelihood of engaging in unprotected sexual intercourse. Parental knowledge, or the extent to which parents know about their children's activities, whereabouts, and friendships, is a robust predictor of youth risk behavior, including risky sexual behavior. However, parenting practices are typically less potent as predictors of subsequent behavior among youth with high levels of callous-unemotional (CU) traits. We conducted three logistic regression models, each of which examined parental knowledge in a different way (through child report, parent report, and a discrepancy score), allowing us to examine parental knowledge, CU traits, and their interaction as predictors of adolescents' subsequent engagement in sex without a condom. Results indicated that adolescents who perceived their parents to possess greater knowledge were less likely to engage in unprotected sex. Higher parent report of parental knowledge was also related to decreased likelihood of engaging in unprotected sex, but only for adolescents with high levels of CU traits. In addition, greater discrepancy between parent and adolescent reports of parental knowledge was related to increased likelihood of engaging in unprotected sex, but only for adolescents with low levels of CU traits. Results highlight the importance of considering both parent and adolescent perceptions of parental knowledge and have important implications for prevention and intervention efforts.

Abstract: Our primary purpose in this study was to examine the structure of a response class when new members are acquired through mand training. To do this, we replaced existing mands (e.g., reaching) in three children with autism with two new functionally equivalent mands. Next, we examined their responding under immediate- and delayed-reinforcement conditions. Then, we assessed generalization to novel social partners. We employed a reversal design to examine the effectiveness of mand training and to assess responding under both immediate- and delayed-reinforcement conditions. Our results suggest that all children acquired the new mands and that two of the children emitted these responses as replacements when the social partner did not provide access to the reinforcer contingent on the child's first mand. Generalization data indicate that all three children emitted the new mands and two of the children alternated between the new mands with novel social partners. We discuss the clinical implications and the conceptual significance of teaching multiple replacement mands to children with autism and severe language delays.

Abstract: Evidence suggests that installing a classroom management system known as the Color Wheel reduced inappropriate behaviors and increased on-task behavior in second- and fourth-grade classrooms; however, no systematic studies of the Color Wheel had been disseminated targeting pre-school or kindergarten participants. To enhance our understanding of the Color Wheel System (CWS) as a prevention system, a multiple-baseline design was used to evaluate the effects of the Color Wheel on inappropriate vocalizations (IVs) in three general education kindergarten classrooms. Partial-interval time-sampling was used to record classwide IVs, which were operationally defined as any comment or vocal noise that was not solicited by the teacher. Time series graphs and effect size calculations suggest that the CWS caused immediate, large, and sustained decreases in IVs across the three classrooms. Teacher acceptability and interview data also supported the CWS. Implications related to prevention are discussed and directions for future research are provided.

Abstract: Prior studies indicate extinguished fear often partially returns when participants are later tested outside the extinction context. Cues carried from the extinction context to the test context sometimes reduce return of fear, but it is unclear whether such extinction cues (ECs) reduce return of fear of public speaking. Here we assessed return of fear of public speaking, and whether either of two types of ECs can attenuate it. Participants gave speeches of increasing difficulty during an exposure practice session and were tested 2 days later in a different context. Testing occurred in the presence of physical ECs, after mentally rehearsing the exposure session, or without either reminder. Practice reduced fear of public speaking, but fear partially returned at test. Neither physical nor mental ECs reduced partial return of fear of public speaking. The return of extinguished fear of public speaking, although small, was reliable, but not appreciably sensitive to presence of ECs.

Abstract: This study tested whether distress tolerance, body image, and body mass index (BMI) predicted adherence to a yoga intervention. Participants were 27 women who participated in a yoga intervention as part of a randomized controlled trial. Attendance and distress tolerance were assessed weekly, and body image and BMI were measured at baseline. Multilevel modeling revealed a three-way interaction of distress tolerance, BMI, and body image (p < .001). For participants with few body image concerns, distress tolerance was positively associated with adherence regardless of BMI (p = .009). However, for those with poor body image, increases in distress tolerance were associated with increases in adherence among overweight participants (p < .001) but lower adherence among obese participants (p = .007). Distress tolerance may be implicated in adherence to a yoga intervention, although its effects may be dependent on body image concerns, BMI, and their interaction. Research and clinical implications are discussed.

Abstract: Engagement in valued activities is an important outcome, particularly in treatments that aim to enhance quality of life in those with chronic conditions. The present study describes the initial evaluation of the Values Tracker (VT), a two-item measure of values engagement, in 302 treatment-seeking adults with chronic pain. Hierarchical regression analyses were conducted to examine the utility of the VT in the statistical prediction of pain-related functioning, after controlling for demographic variables, pain intensity, and pain-related distress. Across analyses, pain intensity accounted for significant variance (range ΔR2 = .06-.09) with pain-related distress adding additional unique variance (range ΔR2 = .07-.19). The VT accounted for additional unique variance (range ΔR2 = .02-.17) for all variables with the exception of physical disability. These findings provide initial support for the utility of the VT in those with chronic pain. Given the VT’s brevity, it may be particularly useful for tracking cha...

Abstract: Recent syndemic models of sexual health disparities affecting racial/ethnic minorities have highlighted the role of discrimination. Yet no previous work has examined how acculturative stress (distress at the transition from one's original culture toward a new culture) associates with sexual HIV-risk behavior (SHRB). Work among other minority populations suggests sexual compulsivity (SC) may contribute to syndemic sexual health disparities as a means of coping with distress. With this in mind, the present study examined whether SC explained the relation between acculturative stress and SHRB. Separate analyses were conducted for males and females within a sample of 758 sexually initiated racial/ethnic minority college students. Among males and females, acculturative stress had an indirect effect on SHRB via SC. As the first study to examine SHRB in relation to acculturative stress, findings provide preliminary evidence that targeting SC among racial/ethnic minorities may help reduce sexual health disparities.

Abstract: In this study, we extended the literature on negatively-reinforced mands by teaching multiple novel, socially appropriate alternative mands to two young children with autism spectrum disorder (ASD). First, we replaced existing mands (e.g., pushing away) with two novel, socially appropriate, negatively-reinforced mands. Next, we examined responding under immediate- and delayed-reinforcement conditions to assess resurgence to existing mands and to determine whether the function of the communicative behavior influences the consistency with which different mands are emitted. Finally, we examined generalization to different social partners. Our data suggest that both children acquired the new mands and used them to avoid nonpreferred items. Resurgence to existing mands during delayed-reinforcement conditions was documented for one child, and the sequence in which mands were emitted within a response class was not influenced by the function of the communicative behavior. Generalization data indicate that both children emitted the new mands and one of the two children alternated between the two mands with a social partner who was not involved in the training. We discuss the importance of teaching multiple negatively-reinforced alternative mands to children with autism in applied settings.

Abstract: Few studies have sought to understand the concurrent relationship between cognitive and affective processes on alcohol use and negative alcohol-related consequences, despite both being identified as predictive risk factors in the college population. More research is needed to understand the relationships between identified factors of problem drinking among this at-risk population. The purpose of this study was to test if the relationship between psychological distress and problem drinking among university students (N = 284; M-age = 19.77) was mediated by negative affect regulation strategies and positive alcohol-related expectancies. Two latent mediation models of problem drinking were tested using structural equation modeling (SEM). The parsimonious three-path mediated latent model was supported by the data, as evidenced by several model fit indices. Furthermore, the alternate saturated model provided similar fit to the data, but contained several direct relationships that were not statistically significant. The relationship between psychological distress and problem drinking was mediated by an extended contributory chain, including negative affect regulation and positive alcohol-related expectancies. Implications for prevention and treatment, as well as future directions, are discussed.

Abstract: Anxiety sensitivity (AS), defined as the extent to which individuals believe that anxiety-related sensations have harmful consequences, is associated with smoking processes and poorer clinical outcomes among trauma-exposed smokers. Yet the specific mechanisms underlying this association are unclear. Smoking-specific avoidance and inflexibility is a construct implicated in multiple manifestations of mood regulation that may underlie smoking behavior. The current study examined the explanatory role of smoking-specific avoidance and inflexibility in terms of the relation between AS and indices of smoking behavior among trauma-exposed smokers. The sample consisted of 217 treatment-seeking adult smokers (44% female; M age = 37.8; SD = 13.2; age range: 18-65 years), who were exposed to at least one lifetime Criterion A trauma event (Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR] Criterion A for trauma exposure). Bootstrap analysis (5,000 re-samples) revealed that AS was indirectly related to the (a) number of cigarettes smoked per day, (b) number of years being a daily smoker, (c) number of failed quit attempts, and (d) heaviness of smoking index among trauma-exposed smokers through its relation with smoking-specific avoidance and inflexibility. These findings provide initial evidence suggesting that smoking-specific avoidance and inflexibility may be an important construct in better understanding AS-smoking relations among trauma-exposed smokers. Future work is needed to explore the extent to which smoking-specific avoidance and inflexibility account for relations between AS and other smoking processes (e.g., withdrawal, cessation outcome) in the context of trauma and smoking comorbidity.

Abstract: In terms of the transdiagnostic model of eating disorders, Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED) share the same distinctive psychopathology. However, empirical evidence showing similarities between these eating disorder diagnoses for core symptoms is scarce, and the role of weight status is unclear. Data from a total of 168 female participants were collected between April 2004 and April 2008, at an outpatient unit specialized in eating disorder treatment. Core symptoms of eating disorders were measured via self-report questionnaires. In particular, women with BED and BN showed similar patterns of core symptomatology compared with AN. However, when body mass index (BMI) was considered in the analyses, there were no differences between the three diagnostic groups in relation to body image. Differences in eating behavior are not solely triggered by weight differences, whereas body image disturbances are a transdiagnostic phenomenon among EDs and should also be considered in the treatment of BED.

Abstract: Different combinations of immediate and delayed consequences differentially affect choice. Basic research has found that nonhuman animals are more likely to choose an alternative that produces an immediate reinforcer that is followed by a delayed punisher as the delay to punishment increases. The purpose of the current effort was to examine the choices of three individuals with autism when they were given the choice between receiving a larger amount of preferred food followed by a mild, delayed verbal punisher and a smaller amount of the preferred food. A secondary purpose was to determine whether signal presence and duration would affect the efficacy of the punisher (i.e., whether children would be more likely to select the smaller reward that was not followed by a delayed punisher). Results were idiosyncratic across children and highlight the need to evaluate choice under multiple arrangements.

Abstract: Identification of evidence-based practices for promotion of social and emotional functioning of children at school is important for their academic and social development. This introduction reviews ...

Abstract: Students referred to treatment after violating campus drug policies represent a high-risk group. Identification of factors related to these students' cannabis use could inform prevention and treatment efforts. Distress tolerance (DT) is negatively related to substance-related behaviors and may be related to high-risk cannabis use vulnerability factors that can impact treatment outcome. Thus, the current study tested whether DT was related to cannabis use frequency, cannabis-related problems, and motivation to change cannabis use among 88 students referred for treatment after violating campus cannabis policies. DT was robustly, negatively related to cannabis use and related problems. DT was also significantly, negatively correlated with coping, conformity, and expansion motives. DT was directly and indirectly related to cannabis problems via coping (not conformity or expansion) motives. Motives did not mediate the relation of DT to cannabis use frequency. DT may be an important target in treatment with students who violate campus cannabis policies.

Abstract: Students with emotional and behavioral disorders and students considered at risk often have social deficits. Although social skills interventions are often provided to this student population, there are some concerns regarding how these interventions are conceived and provided. One possible way to improve the effectiveness of social skills interventions is to use functional behavior assessment data to tailor the interventions to a student's individual needs and the contexts in which social skills deficits and problem behaviors occur. This approach is commonly referred to as replacement behavior training. In this study, the literature on function-based replacement behavior interventions is systematically reviewed. In addition, studies are evaluated according to the What Works Clearinghouse design and evidence standards for single-case research. Although this research base does not meet the What Works Clearinghouse replication standards, function-based replacement behavior interventions appear to be a promising practice for addressing problem behaviors. Implications for practice, areas for future research, and study limitations are discussed.