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Boston University · Psychology
Active 1966–2025
Michael W. Otto, Ph.D., is a Professor in the Psychological and Brain Sciences department at Boston University and serves as the Director of the Translational Research Program. His career has focused on developing and validating new psychosocial treatments for mood, anxiety, and substance use disorders. His work includes a translational research agenda investigating brain-behavior relationships in therapeutic learning. Dr. Otto's research also emphasizes health-behavior promotion, including investigations of addictive behaviors, medication adherence, sleep, and exercise. With over 25 years of continuous funding from NIH, he has published more than 500 articles, chapters, and books related to his research interests. Recognized as a top producer in clinical empirical literature and an ISI Highly Cited Researcher, he has received numerous awards including the Distinguished Scientific Contributions to Clinical Psychology from the American Psychological Association, the 2024 Outstanding Researcher award from the Association for Behavioral and Cognitive Therapies, and the Elizabeth Hurlock Beckman Award for excellence in mentoring. Dr. Otto has served as past President of the Association for Behavioral and Cognitive Therapies and the American Psychological Association Division 12, and his service has been recognized with awards such as the Outstanding Service Award from ABCT. He is a regular provider of continuing education workshops across the United States, has been a frequent industry consultant, and has received media coverage in outlets like the New York Times, Wall Street Journal, and Scientific American-Mind. He is also the founder of the Mechanistic Behavior Research Consortium and a member of the Exposure Therapy Consortium.
Physiology & Behavior · 2025-05-09 · 1 citations
Rescuing Cognitive and Emotional Regulatory Processes to Aid Smoking Prevention
NIH · $459k · 2016–2019
Improving Therapeutic Learning in Depression: Proof of Concept
NIH · $452k · 2014–2017
NIH · $158k · 2013
Enhancing Panic and Smoking Reduction Treatment with D-Cycloserine
NIH · $622k · 2013–2018
NIH · $2.3M · 2011
Mark H. Pollack
Jasper A. J. Smits
The University of Texas at Austin
Andrew A. Nierenberg
Steven A. Safren
University of Miami
Naomi M. Simon
Thilo Deckersbach
Diploma Hochschule
Ph.D.
University of New Mexico
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Addictive Behaviors · 2025-05-17
Journal of Substance Use and Addiction Treatment · 2025-02-16 · 1 citations
BACKGROUND: Compulsivity characterizes an important subtype of substance use disorders (SUDs), but there has been variability in how compulsive substance use is defined and measured. The current study was designed to (1) develop a new measure of substance use compulsivity, (2) validate this scale in a community sample of adults who drink alcohol, and (3) evaluate the association between this new measure of compulsivity and substance use severity. We hypothesize that compulsivity will be characterized by automaticity, craving and insensitivity to negative consequences, and greater substance use severity will be associated with higher levels of substance use compulsivity. METHODS: A preliminary set of items were generated for the novel Compulsive Substance Use Questionnaire (CSUQ) to reflect three conceptual aspects of substance use compulsivity: automaticity, craving, and disregarding negative consequences. The study recruited a total of 253 adults who drink alcohol, with a range of severity. Participants answered online surveys on compulsivity, frequency of alcohol use, craving, and negative consequences of alcohol use. RESULTS: We obtained a single-factor solution with 22 items that included 3 automaticity items, 10 craving items, and 9 disregarding negative consequences items. The resulting measure had excellent internal consistency (α = 0.96). The CSUQ was associated with substance use severity; specifically, greater compulsivity was associated with heavy alcohol use and higher frequency of negative consequences associated with alcohol use. CONCLUSIONS: The current study supports the validity of a new measure of substance use compulsivity, composed of items that closely hew to the concept of substance use compulsivity. Future work investigating compulsivity in other substance use populations with varying levels of severity will further our understanding of compulsive substance use and SUD subtypes.
SSRN Electronic Journal · 2025-01-01
Correlates of Functioning in Bipolar Disorder
Psychopharmacology Bulletin · 2025-08-12 · 15 citations
Objectives: Our primary aim was to describe unique correlates of functioning in bipolar disorder (BD). Experimental Design: The study included the first 500 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Patients were 41.9 ± 12.7 years old, and diagnosed with bipolar I, II, or NOS, verified by structured interview. Overall functionality was determined by the Range of Impaired Function Tool (LIFE-RIFT). Stepwise multiple regression analysis tested the non-redundant independent association of 28 variables on functioning. Principal Observations: Severity of depression symptoms was significantly and uniquely correlated with impaired functioning in the context of a wide variety of demographic and clinical variables, contributing 60.9% to the total variance in overall functioning (β = 0.254, p < 0.0001). Substantial variance in function remains unexplained. Conclusions: Intensity of depressive symptoms is the major determinant of impaired functioning in bipolar disorder, but longitudinal analyses may further explain the substantial variance in function not explained by this large and comprehensive model. Treatments and outcome assessment for patients with bipolar disorders should consider both functional and symptomatic change.
Exposure Therapy Consortium: Outcomes of the Proof-of-Principle Study
SSRN Electronic Journal · 2025-01-01
JMIR Research Protocols · 2025-10-30
Abstract Background The identification of moderators of exposure-based cognitive behavioral therapy (EXCBT) outcomes has the potential to (1) guide the judicious application of the limited resource that is EXCBT and (2) identify additional treatment targets for ameliorating the deleterious effects of an identified moderator, thereby enhancing clinical response. Experimental and clinical studies have yielded intriguing findings for the moderating influence of positive affect on EXCBT outcomes. Mixed findings for state positive affect (at the time of extinction or exposure trials) as a predictor of EXCBT outcomes stand in contrast to evidence that baseline levels of trait positive affect may be a more effective predictor. As such, questions remain about the best way to assess positive affect as a potential treatment moderator. Objective This study was designed to investigate (1) the relative value of state and trait positive affect for predicting the outcome of a single-session virtual reality exposure intervention for public speaking anxiety in adults attending college and (2) the role of 3 related constructs—optimism, hopefulness, and mental health self-efficacy—that may explain the predictive significance of trait positive affect. Methods State affect will be manipulated at an experimental level using affect induction procedures; trait positive affect will be measured at baseline. Three dependent measures—a primary outcome of public speaking anxiety and secondary outcomes of social phobia and self-reported valence—will be examined. This study relies on a team science approach and is being conducted across 12 collaborating sites through the Exposure Therapy Consortium, allowing for replication of all findings across diverse study sites worldwide. Results Data collection for this study began in October 2024 and ended in August 2025. We expect to complete data analysis and submit results for publication in approximately November 2025. Conclusions This study will help clarify the relationship among positive affect (state and trait), exposure learning, and 3 related constructs (optimism, hopefulness, and mental health self-efficacy). These findings will illuminate strategies for future treatment improvement and enhanced efficacy.
Cognitive-Behavioral Treatment for Breathlessness in Lung Cancer: A Randomized Controlled Trial
Annals of the American Thoracic Society · 2025-08-07 · 2 citations
Abstract Rationale Dyspnea (breathlessness) commonly impacts patients with lung cancer, worsening depression, anxiety, quality of life, and functioning. Current treatments are limited. Objectives To test the acceptability, feasibility, and preliminary efficacy of “Take a Breath” (TAB), a novel cognitive-behavioral treatment for dyspnea. Methods A randomized controlled trial compared TAB with standard of care (SOC) in patients with lung cancer reporting at least moderate dyspnea (N = 45). TAB consisted of five 1-hour weekly individual sessions employing exposure-based interventions paired with pulse oximetry biofeedback, psychoeducation, and behavioral skills (e.g., pursed lip breathing). The Client Satisfaction Questionnaire-8 measured acceptability. Accrual, treatment retention, and homework completion measured feasibility. Primary outcomes were the American Thoracic Society Dyspnea Scale (dyspnea-related functioning) and Cancer Dyspnea Scale (dyspnea-related effort, discomfort, and anxiety). Secondary outcomes included depression (Patient Health Questionnaire-9), health-related quality of life (12-item Short Form Health Survey), physical activity (International Physical Activity Questionnaire Short Form), and functional status (Karnofsky performance status). Measurements occurred at baseline, midtreatment (3 wk), post-treatment (6 wk), and 1-month follow-up. Robust mixed-effects modeling tested group × time interactions. Results TAB was at least “mostly satisfactory” for 75% of participants. The accrual was 25.6%, with 60% completing all sessions and an 88.7% homework completion rate. Intention-to-treat analysis revealed greater improvements in TAB than SOC for dyspnea-related functioning (Cohen’s d = 0.82; P = 0.03) and anxiety (Cohen’s d = 0.87; P < 0.01) at post-treatment and follow-up. TAB outperformed SOC in improving depressive symptoms, health-related quality of life, sedentary time, and performance status over time (all P < 0.05). Conclusions TAB yielded symptom, psychological, and functional improvements, establishing its readiness for further testing as the first comprehensive cognitive-behavioral treatment for dyspnea and related sequelae. Clinical trial registered with www.clinicaltrials.gov (NCT 05304793).
Drug and Alcohol Dependence Reports · 2025-09-05
Introduction: Evidence based treatments for smoking cessation have high recurrence rates. Targeting cue-induced craving, a strong predictor of smoking recurrence, may be critical to promoting sustained abstinence. We previously found that isradipine, an FDA-approved antihypertensive, enhanced the effect of virtual reality cue exposure therapy (VR-CET) on cue-induced craving. In this secondary analysis we tested whether this augmentation strategy was more beneficial for participants with high (relative to low) baseline cue-induced craving. Methods: After a 24-h abstinence challenge, participants (N = 78) completed a single session of VR-CET with isradipine or placebo, and returned for a 24-h follow-up to repeat the procedure in a medication-free state. We conducted a moderator analysis to test the hypothesis that the effect of isradipine on cue-induced craving at follow-up would be larger among participants with higher (relative to lower) baseline cue-reactivity. Results: = 0.11). Conclusions: Results suggest isradipine enhances VR-CET, particularly for individuals with higher baseline levels of cue-induced craving. Future studies testing prevention strategies that target higher cue-induced craving with isradipine to reduce rates of smoking recurrence are warranted.
Cognitive Behaviour Therapy · 2025-09-23
Chronic musculoskeletal pain (MSKP) is a common and challenging condition often occurring with generalized anxiety disorder (GAD). Cognitive behavior therapy (CBT) is a first-line treatment for GAD, but limitations on the potential availability or engagement in CBT have encouraged consideration of remote and autonomous treatment options. Yet, little is known about preferences for different modalities of CBT. This study evaluated relative preferences for in-person, telehealth, or digital CBT among individuals with comorbid MSKP and anxiety. Using local and national online advertising, we recruited a sample of 85 individuals with MSKP and self-reported clinical levels of anxiety (mean age: 40.3, 74.4% female, 67.1% White). Results indicated a significant preference for in-person therapy over digital treatment. Nonetheless, multiple indices of higher pain-related fear and distress were linked to a greater relative preference for digital therapy. Dissemination of scalable digital treatment for anxiety for adults with MSKP may find the best reception among individuals with these characteristics.
David J. Miklowitz
Stefan G. Hofmann
Philipps University of Marburg