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Estimates of the causal effects of hormonal contraceptives on psychological outcomes are likely distorted by contraceptive discontinuation (including starting or stopping a method and switching between methods) because of side effects. Few studies examine contraceptive discontinuation and most are based on correlational cross-sectional data. The literature suggests method- and sexuality-related variables as predictors of contraceptive discontinuation. The current study therefore analyzed type of contraceptive method, contraceptive satisfaction and usage duration, as well as sexual frequency and sexual satisfaction as predictors of contraceptive switches, which is one form of contraceptive discontinuation. In addition, we examined the sensitivity of the reported effects to unobserved selection effects. Analyses were based on longitudinal data from the Continuity and Change in Contraceptive Use Study with a sample of up to 1,993 women. We found substantial and robust effects of contraceptive method and contraceptive satisfaction on contraceptive switches, but no clear evidence on interaction effects between contraceptive method and contraceptive satisfaction. Furthermore, we found no effects of sexual satisfaction or frequency across all analyses.

Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners.