Mixed methods research has gained visibility within the last few years, although limitations persist regarding the scientific caliber of certain mixed methods research designs and methods. The need exists for rigorous mixed methods designs that integrate various data analytic procedures for a seamless transfer of evidence across qualitative and quantitative modalities. Such designs can offer the strength of confirmatory results drawn from quantitative multivariate analyses, along with “deep structure” explanatory descriptions as drawn from qualitative analyses. This article presents evidence generated from over a decade of pilot research in developing an integrative mixed methods methodology. It presents a conceptual framework and methodological and data analytic procedures for conducting mixed methods research studies, and it also presents illustrative examples from the authors' ongoing integrative mixed methods research studies.
The present review examines the relations between sleep disturbance and anxiety in children and adolescents. The review begins with a detailed discussion of normative developmental trends in sleep, and the relation between sleep quality and emotion dysregulation in children. The extant literature on sleep disturbance in clinically anxious children with a focus on subjective versus objective measures of sleep is then summarized in detail. Finally, a review of the reciprocal relationship between sleep and emotion regulation is provided. The available research suggests that sleep disturbance is quite prevalent in children with anxiety disorders, although the directionality of the association between sleep disturbance and anxiety in children remains unclear. Despite this limitation, a reciprocal relationship between sleep quality and anxiety appears to be well established. Research using objective measures of sleep quality (e.g. polysomnography, sleep actigraphy, sleep bruxism) is warranted to better understand this relation. Further, complicating factors such as the environment in which sleep quality is measured, the developmental stage of participants, varying severity of anxiety and the timeframe during which assessment takes place should all be considered when examining sleep disturbance in this population.
Differential sensitivity to alcohol effects (e.g., increased stimulation and decreased sedation) is associated with heavier use and problems. Although genetic factors contribute to alcohol response (AR), environmental factors may also play a role. This study examined effects of physical context on AR using a between subjects placebo-controlled design. There were 157 (57% male) participants (ages 21-30) who were randomized to 1 of 4 conditions based on beverage (placebo or alcohol [target BrAC = .08 g%]) and physical context (simulated bar or traditional lab). AR was assessed using the Subjective Effects of Alcohol Scale and the Biphasic Alcohol Effects Scale, as well as behavioral tasks including the Balloon Analogue Risk Task (BART) and its negative reinforcement counterpart (MRBURNS). A beverage condition by context interaction emerged for low arousal positive subjective response (SR), and among women, for performance on the BART task. In the lab context only, alcohol (relative to placebo) was associated with stronger low arousal positive SR and, for women, with impaired performance on the BART task. This suggests that a less stimulating lab context may be better suited to differentiating positive alcohol effects from expectancies, whereas a bar context may be better suited to detecting expectancy effects. The findings also suggest that the ability to better appreciate positive alcohol effects (relative to expectations) in less stimulating contexts may lead to a strengthening of these effects among individuals who drink in these environments.
Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.
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