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    Brook Marcks

    Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of... more
    Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of peer education and whether it need be Tourette syndrome (TS) specific remains unclear. One hundred and seventy college students were randomly assigned to view either an educational video about TS, a video about depression, or no educational video, before providing attitudinal and behavioral data on social acceptance of either an actor or actress engaging in motor and vocal tics. Those viewing the TS-specific educational video held more positive attitudes toward persons with tics than those receiving the other two interventions; however, the effect on social behavior intentions and actual social behavior was unclear. Implications of these findings and directions for future research are discussed.
    Many individuals with trichotillomania (TTM) do not disclose their condition to others. Although disclosure may have beneficial effects, little is known about the consequences of it. The purpose of the current study was to examine the... more
    Many individuals with trichotillomania (TTM) do not disclose their condition to others. Although disclosure may have beneficial effects, little is known about the consequences of it. The purpose of the current study was to examine the effects of a brief, simplified preventative disclosure of TTM. Young adults (N=225) read one of four vignettes, which varied in a 2 (male versus female character)x2 (preventative disclosure of TTM versus nondisclosure) design, and answered several questions regarding the character in the vignette. Although some potential positive effects of disclosure were found (e.g., reduced likelihood of misattribution), some areas of concerns also surfaced. The findings suggest that a brief, simplified preventative disclosure of TTM led to an increase in negative social perceptions compared to non-disclosure. More specifically, those characters that disclosed TTM were evaluated more negatively and more socially rejected than those that did not disclose. However, the overall perceptions of persons with noticeable hair loss, regardless of disclosure status, were not necessarily negative. Implications of the findings, limitations to the study, and directions for future research are discussed.
    Body-focused repetitive behaviors (BFRBs) such as skin picking or scratching and nail biting can be physically and socially detrimental. Given the potential consequences associated with these behaviors, it is unfortunate this area has... more
    Body-focused repetitive behaviors (BFRBs) such as skin picking or scratching and nail biting can be physically and socially detrimental. Given the potential consequences associated with these behaviors, it is unfortunate this area has received relatively limited attention. The two purposes of the current study were (a) to determine the prevalence of BFRBs among typically developing persons and (b) to examine the contribution of reported somatic activity to the occurrence of BFRBs. Results indicated that 13.7% of the sample met criteria for at least one BFRB, of which the most common topography was nail biting. Persons with a BFRB reported significantly more somatic activity than persons without a BFRB. Further analyses revealed consistent findings across three separate topographies in which persons with a BFRB for nail biting, mouth chewing, and/or skin picking reported significantly more somatic activity than did persons without a BFRB. Clinical implications and diagnostic considerations are discussed.
    The purpose of this study was to compare the effectiveness of habit reversal with a placebo control as a treatment for chronic nail biting in adults. Thirty adults with a chronic nail-biting problem (occurring > or = 5 times/day nearly... more
    The purpose of this study was to compare the effectiveness of habit reversal with a placebo control as a treatment for chronic nail biting in adults. Thirty adults with a chronic nail-biting problem (occurring > or = 5 times/day nearly every day for > or = 4 weeks and causing physical damage or social impairment) were randomly assigned to a placebo control or habit reversal group. Five participants withdrew from the study prior to the completion of treatment. The remaining individuals in both groups received a total of 2 hours of treatment over 3 sessions. Individuals in the habit reversal group (N = 13) received the components of awareness training, competing response training, and social support. Individuals in the placebo control group (N = 12) simply discussed their nail biting. At pretreatment, posttreatment, and a 5-month follow-up, nail length was measured, photographs were taken of the damaged nails and later rated by independent observers, and data on participant depr...
    Individuals with Tourette Syndrome (TS) often experience social difficulties, which may be caused or compounded by others' negative perceptions of persons with the disorder. As a result, researchers and clinicians have called for the... more
    Individuals with Tourette Syndrome (TS) often experience social difficulties, which may be caused or compounded by others' negative perceptions of persons with the disorder. As a result, researchers and clinicians have called for the development of attitude change strategies. One such strategy is preventative disclosure, in which one informs others about his or her condition. To date, no known research exists exploring the effects of this type of disclosure with TS. In an attempt to examine the effects of TS disclosure, adults (N = 369) read vignettes that varied in a 2 (male vs. female character) x 2 (preventative disclosure of disorder vs. nondisclosure) design. Respondents answered several questions regarding the character presented in the vignette, which when factor-analyzed, resulted in four factors (social rejection, attributions of a drug/alcohol problem, perceptions of psychological/medical problems, and general concern). The results of this preliminary study are promisi...
    Many individuals with trichotillomania (TTM) do not disclose their condition to others. Although disclosure may have beneficial effects, little is known about the consequences of it. The purpose of the current study was to examine the... more
    Many individuals with trichotillomania (TTM) do not disclose their condition to others. Although disclosure may have beneficial effects, little is known about the consequences of it. The purpose of the current study was to examine the effects of a brief, simplified preventative disclosure of TTM. Young adults (N=225) read one of four vignettes, which varied in a 2 (male versus female character)x2 (preventative disclosure of TTM versus nondisclosure) design, and answered several questions regarding the character in the vignette. Although some potential positive effects of disclosure were found (e.g., reduced likelihood of misattribution), some areas of concerns also surfaced. The findings suggest that a brief, simplified preventative disclosure of TTM led to an increase in negative social perceptions compared to non-disclosure. More specifically, those characters that disclosed TTM were evaluated more negatively and more socially rejected than those that did not disclose. However, the overall perceptions of persons with noticeable hair loss, regardless of disclosure status, were not necessarily negative. Implications of the findings, limitations to the study, and directions for future research are discussed.
    Body-focused repetitive behaviors (BFRBs) such as skin picking or scratching and nail biting can be physically and socially detrimental. Given the potential consequences associated with these behaviors, it is unfortunate this area has... more
    Body-focused repetitive behaviors (BFRBs) such as skin picking or scratching and nail biting can be physically and socially detrimental. Given the potential consequences associated with these behaviors, it is unfortunate this area has received relatively limited attention. The two purposes of the current study were (a) to determine the prevalence of BFRBs among typically developing persons and (b) to examine the contribution of reported somatic activity to the occurrence of BFRBs. Results indicated that 13.7% of the sample met criteria for at least one BFRB, of which the most common topographywas nail biting. Persons with aBFRBreported significantly more somatic activity than persons without a BFRB. Further analyses revealed consistent findings across three separate topographies in which persons with a BFRB for nail biting, mouth chewing, and/or skin picking reported significantly more somatic activity than did persons without a BFRB. Clinical implications and diagnostic considerati...
    Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of... more
    Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of peer education and whether it need be Tourette syndrome (TS) specific remains unclear. One hundred and seventy college students were randomly assigned to view either an educational video about TS, a video about depression, or no educational video, before providing attitudinal and behavioral data on social acceptance of either an actor or actress engaging in motor and vocal tics. Those viewing the TS-specific educational video held more positive attitudes toward persons with tics than those receiving the other two interventions; however, the effect on social behavior intentions and actual social behavior was unclear. Implications of these findings and directions for future research are discussed.
    Insomnia and anxiety disorders are highly prevalent and are associated with significant impairment and disability. There is evidence that insomnia and anxiety disorders commonly co-occur, in addition to both being highly comorbid with... more
    Insomnia and anxiety disorders are highly prevalent and are associated with significant impairment and disability. There is evidence that insomnia and anxiety disorders commonly co-occur, in addition to both being highly comorbid with major depressive disorder. Thus, it is important for health care providers to be familiar with the literature in this area. Therefore, the purpose of this review was
    Although the majority of individuals with panic disorder first present to the primary care setting, little is known about the psychiatric treatment that primary care patients with the disorder typically receive. The purpose of this study... more
    Although the majority of individuals with panic disorder first present to the primary care setting, little is known about the psychiatric treatment that primary care patients with the disorder typically receive. The purpose of this study was to explore characteristics of treatment received by patients with panic disorder with agoraphobia and by those with panic disorder without agoraphobia, examine demographic and clinical predictors of receiving treatment, and explore treatment barriers. This study used data from the Primary Care Anxiety Project (PCAP), which is a naturalistic, longitudinal study of anxiety disorders among primary care patients. This study presents data for 235 PCAP participants diagnosed at the study intake assessment as having panic disorder with agoraphobia (N=150) or without agoraphobia (N=85). Many patients with panic disorder were not receiving psychiatric treatment at study intake (38%), with those without agoraphobia being less likely to receive treatment. ...
    Individuals with Tourette Syndrome (TS) often experience social difficulties, which may be caused or compounded by others' negative perceptions of persons with the disorder. As a result, researchers and clinicians have called for the... more
    Individuals with Tourette Syndrome (TS) often experience social difficulties, which may be caused or compounded by others' negative perceptions of persons with the disorder. As a result, researchers and clinicians have called for the development of attitude change strategies. One such strategy is preventative disclosure, in which one informs others about his or her condition. To date, no known research exists exploring the effects of this type of disclosure with TS. In an attempt to examine the effects of TS disclosure, adults (N = 369) read vignettes that varied in a 2 (male vs. female character) x 2 (preventative disclosure of disorder vs. nondisclosure) design. Respondents answered several questions regarding the character presented in the vignette, which when factor-analyzed, resulted in four factors (social rejection, attributions of a drug/alcohol problem, perceptions of psychological/medical problems, and general concern). The results of this preliminary study are promisi...
    Although obsessive-compulsive disorder (OCD) is typically described as a chronic condition, relatively little is known about the naturalistic, longitudinal course of the disorder. The purpose of the current study was to examine the... more
    Although obsessive-compulsive disorder (OCD) is typically described as a chronic condition, relatively little is known about the naturalistic, longitudinal course of the disorder. The purpose of the current study was to examine the probability of OCD remission and recurrence as well as to explore demographic and clinical predictors of remission. This study uses data from the Harvard/Brown Anxiety Disorders Research Program, which is a prospective, naturalistic, longitudinal study of anxiety disorders. Diagnoses were established by means of a clinical interview at study intake. One hundred thirteen Harvard/Brown Anxiety Disorders Research Program participants with OCD were included in the study; all had a history of at least 1 other anxiety disorder. Assessments were conducted at 6-month and/or annual intervals during 15 years of follow-up. Survival analyses showed that the probability of OCD remission was .16 at year 1, .25 at year 5, .31 at year 10, and .42 at year 15. For those who remitted from OCD, the probability of recurrence was .07 at year 1, .15 by year 3, and by year 5, it reached .25 and remained at .25 through year 15. In predictors of course, those who were married and those without comorbid major depressive disorder (MDD) were more likely to remit from OCD. By year 15, 51% of those without MDD remitted from OCD compared to only 20% of those with MDD. In the short term, OCD appears to have a chronic course with low rates of remission. However, in the long term, a fair number of people recover from the disorder, and, for those who experience remission from OCD, the probability of recurrence is fairly low.
    Given the low prevalence rate and rather secretive nature of trichotillomania, it is uncertain how much trichotillomania-related knowledge physicians and psychologists possess, what the perceived role of a psychologist is in the treatment... more
    Given the low prevalence rate and rather secretive nature of trichotillomania, it is uncertain how much trichotillomania-related knowledge physicians and psychologists possess, what the perceived role of a psychologist is in the treatment process, what level of familiarity practitioners have with effective treatments and whether providers have resource materials available for patients. In a postal survey of 501 psychologists and physicians in the USA, providers responded correctly to 61% of the general knowledge items about trichotillomania. Most providers believed that psychologists may play a variety of roles in the clinical management of the disorder. Although providers were fairly accurate about the effectiveness of certain treatments for trichotillomania (e.g. medication, habit-reversal), a number of non-empirically supported treatments were endorsed as being effective. Furthermore, an overwhelming majority of healthcare providers did not have resources or referral information available for patients with trichotillomania. Implications of the findings and limitations of the study are discussed.
    Many individuals with trichotillomania (TTM) do not disclose their condition to others. Although disclosure may have beneficial effects, little is known about the consequences of it. The purpose of the current study was to examine the... more
    Many individuals with trichotillomania (TTM) do not disclose their condition to others. Although disclosure may have beneficial effects, little is known about the consequences of it. The purpose of the current study was to examine the effects of a brief, simplified preventative disclosure of TTM. Young adults (N=225) read one of four vignettes, which varied in a 2 (male versus female character)x2 (preventative disclosure of TTM versus nondisclosure) design, and answered several questions regarding the character in the vignette. Although some potential positive effects of disclosure were found (e.g., reduced likelihood of misattribution), some areas of concerns also surfaced. The findings suggest that a brief, simplified preventative disclosure of TTM led to an increase in negative social perceptions compared to non-disclosure. More specifically, those characters that disclosed TTM were evaluated more negatively and more socially rejected than those that did not disclose. However, the overall perceptions of persons with noticeable hair loss, regardless of disclosure status, were not necessarily negative. Implications of the findings, limitations to the study, and directions for future research are discussed.
    Cognitive-behavioral models of obsessive-compulsive disorder (OCD) assume that obsessions have their origin in normal intrusive thoughts. These models propose that certain beliefs, such as thought-action fusion (TAF) beliefs, combined... more
    Cognitive-behavioral models of obsessive-compulsive disorder (OCD) assume that obsessions have their origin in normal intrusive thoughts. These models propose that certain beliefs, such as thought-action fusion (TAF) beliefs, combined with the use of ineffective coping strategies, such as thought suppression, lead to the development of OCD. The purpose of the current study was to examine the relationship between these variables in a non-clinical sample in addition to exploring the effects of an alternative, acceptance-based coping strategy. This study explored the relationship between TAF beliefs, thought suppression, and OC-consistent symptoms via mediational analyses. Results showed that thought suppression mediated the relationship between TAF beliefs and OC-consistent symptoms. This study also experimentally examined the effects of various coping strategies (suppression, acceptance, or monitor-only) on the frequency of a distressing intrusion and appraisal ratings (e.g., anxiety, guilt, responsibility) after a TAF induction. Spontaneous suppression in the monitor-only group made comparisons of the experimental data difficult. However, analyses provided preliminary evidence suggesting that thought suppression is related to more intrusions, higher levels of anxiety, and negative appraisals, whereas an acceptance-based approach may be a useful alternative. Additional findings, limitations of the current study, and directions for future research are discussed.
    Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of... more
    Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of peer education and whether it need be Tourette syndrome (TS) specific remains unclear. One hundred and seventy college students were randomly assigned to view either an educational video about TS, a video about depression, or no educational video, before providing attitudinal and behavioral data on social acceptance of either an actor or actress engaging in motor and vocal tics. Those viewing the TS-specific educational video held more positive attitudes toward persons with tics than those receiving the other two interventions; however, the effect on social behavior intentions and actual social behavior was unclear. Implications of these findings and directions for future research are discussed.
    Insomnia and anxiety disorders are highly prevalent and are associated with significant impairment and disability. There is evidence that insomnia and anxiety disorders commonly co-occur, in addition to both being highly comorbid with... more
    Insomnia and anxiety disorders are highly prevalent and are associated with significant impairment and disability. There is evidence that insomnia and anxiety disorders commonly co-occur, in addition to both being highly comorbid with major depressive disorder. Thus, it is important for health care providers to be familiar with the literature in this area. Therefore, the purpose of this review was