Research & PublicationsPonte Vedra Psychologists

"Healthy minds are not devoid of negativity—they are mostly positive, but balanced with enough negativity to alert us to danger and support our survival." —Gregory L. Garamoni, Ph.D.

Visual Key

• Author names are shown in bold at the beginning of each entry.
• Article or chapter titles are italicized in APA style.
• Journal or book titles are in bold italics.
• 🔹 Sections are grouped by topic and marked with emojis for easier scanning.

Quick Navigation

• 🧠 Cognitive Therapy & States of Mind
• 😴 Sleep & Affect Regulation
• 🧬 Sexual Functioning in Depression
• 🧪 Assessment Methods & Personality
• 🧍‍♂️ Gender Differences & Chronic Depression

🧠 Cognitive Therapy & States of Mind

These publications lay the theoretical foundation for the States of Mind Model and test its predictions in both clinical and nonclinical populations. The model proposes that healthy psychological functioning depends on a balanced ratio of positive to negative information.

Garamoni, G. L. A reformulation of the States of Mind model and a related study of euthymic, depressed, and hypomanic states in a nonclinical population. Doctoral dissertation, University of Pittsburgh.

Summary: Principles of information theory were used to model the relationship between psychopathology and the balance of positivity and negativity in information processing. This model is a reformulation of our earlier States of Mind model that relied heavily on the "golden section hypothesis." A compelling explanation is provided for the alternative "negative strikingness hypothesis," which suggests that there is an optimal theoretical balance between positivity (P) and negativity (N) in information processing, namely, one that maximizes the salience ("strikingness") of adverse events. This optimal balance is P/(P+N) = .632. It is presumed that the tendency to maintain this balance has evolved because noticing threatening events has survival value. The reformulated model retains the negative strikingness hypothesis but abandons the golden section hypothesis. As a result, the revised model is more parsimonious and internally consistent than the original. In a related study involving 372 undergraduates, euthymic individuals demonstrated an optimal affective balance, while depressed and hypomanic individuals deviated significantly, as predicted.

Note from Dr. Garamoni: “This study was completed years ago, but it contains theoretical foundations and empirical findings that remain relevant today. The Reformulated SOM Model advances several novel ideas that have yet to be fully explored. Hoping that others may build on these concepts in the years to come, I'm now making this previously hard-to-find and quite voluminous (442 pages) work available for download here.”

Download Full Dissertation (PDF, 442 pages)

Garamoni, G. L., Reynolds, C. F., Thase, M. E., Frank, E., & Berman, S. R. The balance between positive and negative affects during episodes of major depression: A further test of the States of Mind model. Psychiatry Research.

Summary: The SOM model was tested in 39 male outpatients with major depression and 43 healthy controls. Depressed patients showed a significantly lower balance score (P / [P + N] = .35) than the predicted optimal range. Results confirmed that affect balance is strongly related to symptom severity.

Garamoni, G. L., Thase, M. E., Reynolds, C. F., Frank, E., & Yeager, A. Shifts in affective balance during cognitive therapy of depression. Journal of Consulting and Clinical Psychology.

Summary: Thirty-two outpatients completed a 16–20 week CBT protocol. Those who responded to treatment shifted their emotional balance toward the optimal range, while nonresponders remained predominantly negative. Positive change was more critical to outcome than reducing negativity alone.

Schwartz, R. M., & Garamoni, G. L. Cognitive balance and psychopathology: Evaluation of an information-processing model of positive and negative states of mind. Clinical Psychology Review.

Summary: A meta-analysis of 27 studies confirmed that certain affective states align with predicted SOM ratios. States that deviate from the optimal ratio correlate with psychopathology.

Schwartz, R. M., & Garamoni, G. L. A structural model of positive and negative states of mind: Asymmetry in the internal dialogue. In P. C. Kendall (Ed.), Advances in Cognitive-Behavioral Research and Therapy. (Vol. 5). New York: Academic Press.

Summary: The theory underlying the States of Mind Model is presented. A meta-analysis of 27 studies provides empirical support for several hypotheses derived from the model. Suggestions for further research and clinical applications are discussed.

😴 Sleep & Affect Regulation

These publications explore how emotional states influence, and are influenced by, circadian rhythms and sleep patterns—especially in the context of clinical depression and treatment.

Nofzinger, E. A., Schwartz, R. M., Reynolds, C. F., Thase, M. E., Jennings, J. R., Frank, E., Fasiczka, A. L., Garamoni, G. L., & Kupfer, D. J. Affect intensity in phasic REM sleep in depressed men before and after treatment with cognitive behavioral therapy. Journal of Consulting and Clinical Psychology.

Summary: In depressed men, daytime affect intensity correlated positively with phasic REM activity. This relationship persisted post-treatment and was absent in healthy controls.

Thase, M. E., Reynolds, C. F., Frank, E., Jennings, J. R., Garamoni, G. L., Yeager, A., & Kupfer, D. J. Early return to REM sleep after nocturnal awakening in depression. Biological Psychiatry.

Summary: Depressed men returned to REM sleep significantly faster than controls. This rapid return was linked to depression severity rather than general sleep disruption.

Thase, M. E., Reynolds, C. F., Frank, E., Jennings, J. R., Nofzinger, E. A., Fasiczka, A. L., Garamoni, G. L., & Kupfer, D. J. Polysomnographic studies of unmedicated depressed men before and after cognitive behavior therapy. American Journal of Psychiatry.

Summary: REM sleep density decreased with treatment, suggesting a reversible aspect of depression. However, other sleep disturbances like reduced REM latency remained unchanged, indicating trait-like features.

🧬 Sexual Functioning in Depression

These articles examine the complex interplay between depression, affect intensity, and psychophysiological measures of sexual functioning in men.

Nofzinger, E. A., Fasiczka, A. L., Thase, M. E., Reynolds, C. F., Frank, E., Jennings, J. R., Garamoni, G. L., Mattzie, J. V., & Kupfer, D. J. Are buckling force measurements reliable in nocturnal penile tumescence studies? Sleep.

Summary: Though buckling force can be measured reliably, its stability over time is limited. This limits its utility as a proxy for waking erectile function.

Nofzinger, E. A., Schwartz, R. M., Reynolds, C. F., Thase, M. E., Jennings, J. R., Frank, E., Fasiczka, A. L., Garamoni, G. L., & Kupfer, D. J. Correlation of nocturnal penile tumescence and daytime affect intensity in depressed men. Psychiatry Research.

Summary: Affective intensity during the day predicted nighttime erectile function. After controlling for REM activity, these correlations persisted post-treatment.

Nofzinger, E. A., Thase, M. E., Reynolds, C. F., Frank, E., Jennings, J. R., Garamoni, G. L., Fasiczka, A. L., & Kupfer, D. J. Sexual functioning in depressed men: Assessment using self-report, behavioral, and nocturnal penile tumescence measures before and after treatment with cognitive behavioral therapy. Archives of General Psychiatry.

Summary: Sexual activity itself was not diminished in depression, but satisfaction and interest were. Some subgroups showed increased activity post-treatment, while NPT abnormalities remained, suggesting state-independent markers.

🧪 Assessment Methods & Personality

This cluster includes studies on psychological measurement, personality constructs, and the reliability of key diagnostic and assessment tools.

Garamoni, G. L., & Schwartz, R. M. Type A behavior pattern and compulsive personality: Toward a psychodynamic-behavioral integration. Clinical Psychology Review.

Summary: Findings support the idea that the Type A pattern may be a subtype of compulsive personality, rooted in a shared need for control and achievement.

Schwartz, R. M., & Garamoni, G. L. Cognitive assessment: A multibehavior-multimethod-multiperspective approach. Journal of Psychopathology and Behavioral Assessment.

Summary: The article critiques common cognitive assessment methods and proposes a more integrated model based on objective self-awareness theory.

McQuaid, J. R., Monroe, S. M., Roberts, J. R., Johnson, S. L., Garamoni, G. L., Kupfer, D. J., & Frank, E. Toward the standardization of life stress assessments: Definitional discrepancies and inconsistencies in methods. Stress Medicine.

Summary: This article highlights inconsistencies between self-report and interview-based assessments of life stress, emphasizing the need for standardized operational definitions and quantification strategies.

🧍‍♂️ Gender Differences & Chronic Depression

These studies evaluate gender-based differences in therapeutic outcomes and examine treatment response in chronic versus acute depressive disorders.

Thase, M. E., Reynolds, C. F., Frank, E., Simons, A. D., McGeary, J., Fasiczka, A. L., Garamoni, G. L., Jennings, J. R., & Kupfer, D. J. Do depressed men and women respond similarly to cognitive behavior therapy? American Journal of Psychiatry.

Summary: While CBT proved effective for both genders, women with more severe baseline symptoms had poorer outcomes. Men attended fewer sessions but responded comparably.

Thase, M. E., Reynolds, C. F., Frank, E., Simons, A. D., Garamoni, G. L., McGeary, J., Harden, T., Fasiczka, A. L., & Cahalane, J. F. Response to cognitive‑behavior therapy in chronic depression. The Journal of Psychotherapy Practice and Research.

Summary: Chronic depression showed slower and less complete responses to CBT than acute depression, suggesting that adapted therapeutic approaches may be needed.