Seeing the silver lining: cognitive reappraisal ability moderates the relationship between stress and depressive symptoms

Does getting stigma under the skin make it thinner? Emotion regulation as a stress-contingent mediator of stigma and mental health

Emotion regulation deficits may link stigma to poor mental health, yet existing studies rely on self-reported stigma and do not consider contextual factors. In the present research, we examined associations among cultural stigma (i.e., objective devaluation of others' status), emotion regulation deficits, and poor mental health. In Study 1, we created an index of cultural stigma by asking members of the general public and stigma experts to indicate desired social distance towards 93 stigmatized attributes. In Study 2, emotion regulation deficits mediated the association between cultural stigma and adverse mental health outcomes, including depressive symptoms and alcohol use problems, among individuals endorsing diverse stigmatized identities. The indirect effect of cultural stigma, via emotion regulation, on these outcomes was stronger among those reporting more life stress. These findings highlight the adverse impact of cultural stigma on mental health and its role in potentiating stigmatized individuals' susceptibility to general life stress.

Emotion regulation in autism: Reappraisal and suppression interactions

Emotion regulation has been proposed to be a transdiagnostic factor in the development and maintenance of psychopathology in the general population, yet the nature of the relationships between emotion regulation strategy use and psychological well-being has not been comprehensively explored in individuals with autism spectrum disorder (ASD). The aim of this study was to assess how the individual differences in self-reported emotion regulation strategy use relate to levels of both positive and negative psychological well-being. In total, 56 individuals with ASD aged 14-24 years (M_age = 18.15; SD_age = 2.30) completed Emotion Regulation Questionnaire, Diagnostic and Statistical Manual of Mental Disorders-5 Generalized Anxiety Disorder Dimensional Scale, Patient Health Questionnaire-9, Warwick-Edinburgh Mental Well-being Scale and Autism-Spectrum Quotient - Short. Individuals were grouped into four clusters based on their Emotion Regulation Questionnaire subscale scores. Individuals in the high suppression and low reappraisal group expressed higher depressive symptoms and lower positive well-being when compared with the low suppression and high reappraisal group. Interestingly, individuals who self-reported using both high suppression and reappraisal expressed relatively high positive well-being and low depression symptoms. We suggest that the maladaptive effect of habitual suppression usage may be buffered by the habitual use of reappraisal, and this interaction between adaptive and maladaptive emotion regulation strategy use has clinical implications.

Cognitive reappraisal attenuates the association between depressive symptoms and emotional response to stress during adolescence

Depression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship between depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents (M-age = 15.28; 49% female, 47% Caucasian), at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recovery from the stressor. Findings suggested that cognitive reappraisal was associated with an attenuated impact of depressive symptoms on trait and state emotional recovery. These results provide evidence that cognitive reappraisal may be an effective strategy for improving some aspects of emotional responding in relation to depressive symptoms among adolescents.

Work Stress and Depressive Symptoms in Fishermen With a Smoking Habit: A Mediator Role of Nicotine Dependence and Possible Moderator Role of Expressive Suppression and Cognitive Reappraisal

This study examined pathways of influence between work stress, depressive symptoms, nicotine dependence, expressive suppression, and cognitive reappraisal in fishermen with smoking habits in Qionghai, Hainan province, China (N = 1068). These fishermen responded to multiple assessments a week before leaving on a deep-sea fishing trip, including a Mental Stressor Investigation Questionnaire (MSIQ), the Center for Epidemiological Studies Depression Scale (CES-D), the Russell Reason for Smoking Questionnaire (RRSQ), and an Emotion Regulation Questionnaire (ERQ). Structural equation modeling (SEM) analyses of the collected data in Mplus 7 showed that work stress and nicotine dependence were independent predictors of depressive symptoms. The relationship between work stress and depressive symptoms was found to be partially mediated by nicotine dependence and be moderated by cognitive reappraisal. The evidence suggests it advantageous to examine the need of work stress, nicotine dependence, and cognitive reappraisal when attempting to understand depressive symptoms in fishermen with a smoking habit. These findings suggest that improving nicotine dependence through work stress management and training in cognitive reappraisal could be utilized as effective modalities for improving depressive symptoms.

Individual differences in emotion regulation moderate the associations between empathy and affective distress

Individual differences in empathy can have positive and negative psychological outcomes. Yet, individual differences in the processing and regulation of empathy-induced emotion have not been fully explored within this dynamic. This study was designed to explore whether individual differences in emotion regulation strategies moderated the effects of empathy on common forms of affective distress. Eight hundred and forty four participants completed survey measures of trait empathy, emotion regulation strategies, and symptoms of depression, anxiety, and stress. Affective empathy typically predicted greater affective distress, but the effects on depression and anxiety were offset when people were effective at reappraising their emotions. Cognitive empathy predicted lower distress on average, but this beneficial effect on anxiety and stress was absent in those who typically suppressed their emotions. Finally, suppression unexpectedly reduced the depression and stress reported for people high in affective empathy. Individual differences in emotion regulation are an important moderator between empathy and psychological health, and thus a useful target for intervention.

Reappraisal inventiveness: impact of appropriate brain activation during efforts to generate alternative appraisals on the perception of chronic stress in women

BACKGROUND AND OBJECTIVES

Previous research indicated that more left-lateralized prefrontal activation during cognitive reappraisal efforts was linked to a greater capacity for generating reappraisals, which is a prerequisite for the effective implementation of cognitive reappraisal in everyday life. The present study examined whether the supposedly appropriate brain activation is relevant in terms of more distal outcomes, i.e., chronic stress perception.

DESIGN AND METHODS

Prefrontal EEG alpha asymmetry was recorded while female participants were generating reappraisals for stressful events and was correlated with their self-reported chronic stress levels in everyday life (n = 80).

RESULTS

Women showing less left-lateralized brain activity in the ventrolateral prefrontal cortex during cognitive reappraisal efforts reported experiencing more stress in their daily lives. This effect was independent of self-efficacy beliefs in managing negative emotions.

CONCLUSION

These findings underline the practical relevance of individual differences in appropriate brain activation during emotion regulation efforts and the assumedly related basic capacity for the generation of cognitive reappraisals to the feeling of being stressed. Implications include the selection of interventions for the improvement of coping with stress in women in whom the capability for appropriate brain activation during reappraisal efforts may be impaired, e.g., due to depression or old age.

Stressful life events, relationship stressors, and cortisol reactivity: The moderating role of suppression

Stressful life events (SLEs) are exceedingly common and have been associated with a range of psychological disorders, perhaps through dysregulation in the hypothalamic-pituitary-adrenal (HPA) axis. The use of certain emotion regulation strategies in response to stress, such as expressive suppression and cognitive reappraisal, has additionally been linked to heightened HPA axis reactivity to acute stress. However, it is unclear how emotion regulation may interact with SLEs to affect HPA axis reactivity, particularly concerning relationship stressors (RSs). Using cross-sectional data from 117 men and 85 women aged 18-55 years old (M = 39.9 ± 10.7), we investigated whether trait use of suppression or reappraisal interacted with recent negatively perceived SLEs and relationship stressors to impact HPA axis response to an acute stressor. Separate area under the curve and linear mixed models revealed that trait suppression interacted with SLEs and RSs to predict cortisol response to stress, while reappraisal did not. Findings indicate higher trait expressive suppression may influence the cortisol response to acute stress after exposure to more recent stressful events, particularly when those stressful events include relationship stress.

The capacity for generating cognitive reappraisals is reflected in asymmetric activation of frontal brain regions

Encouraging patients to use cognitive reappraisal constitutes the core of modern psychotherapeutic approaches. However, evidence for specific neural correlates of the capacity for cognitive reappraisal, which is a necessary prerequisite for the effective implementation of cognitive reappraisal in everyday life, has been sparse to date. In the present study, the capacity for cognitive reappraisal was studied in terms of the participants’ inventiveness in generating alternative appraisals of anger-evoking events, and was correlated with frontal EEG alpha asymmetry recorded while the participants were generating reappraisals as well as during a common creative idea generation task. During cognitive reappraisal efforts, individuals higher on the capacity for generating cognitive reappraisals showed more left-lateralized activity in lateral prefrontal cortex, specifically in ventrolateral prefrontal cortex extending toward the frontal pole. This effect was observed independently from the activation during novel idea generation without emotional component, indicating that specific demands are implicated in the generation of reappraisals of emotional events. Taken together, the results indicate that individuals higher on the capacity for cognitive reappraisal are more capable or more prone to recruit appropriate brain regions when the situation demands coming up with alternative appraisals of stressful events. The findings may stimulate the development of more individually targeted interventions.

Are parents identifying positive aspects to parenting their child with an intellectual disability or are they just coping? A qualitative exploration

Although acknowledging the stress of raising their child with intellectual disabilities, parents also report that their child has brought about many positive changes in themselves and family. This study reports what parents perceive to be a positive aspect of parenting their child, as currently what constitutes a 'positive' is unclear. Seven key themes were identified; an increased sense of personal strength and confidence, changed priorities, greater appreciation of life, pleasure in the child's accomplishments, increased faith/spirituality, more meaningful relationships and the positive effect that the child has on the wider community. Interpretive examination of the themes reveals that the positive aspects identified consist mostly of meaning-focused coping strategies. These enable parents to adapt successfully to the stressful experiences of raising their child and therefore could be amenable to meaning-focused therapeutic interventions for parents with newly diagnosed children or for those unable to identify any positive aspects of parenting their child.

Cognitive reappraisal and acceptance: Effects on emotion, physiology, and perceived cognitive costs

Two emotion regulation strategies-cognitive reappraisal and acceptance-are both associated with beneficial psychological health outcomes over time. However, it remains unclear whether these 2 strategies are associated with differential consequences for emotion, physiology, or perceived cognitive costs in the short-term. The present study used a within-subjects design to examine the effects of reappraisal (reframing one's thoughts) and acceptance (accepting feelings without trying to control or judge them) on the subjective experience of negative emotions, positive emotions, and physiological responses during and following recovery from sad film clips shown in the laboratory. Participants also reported on perceived regulatory effort, difficulty, and success after deploying each emotion regulation strategy. In 2 samples of participants (N = 142), reappraisal (vs. acceptance) was associated with larger decreases in negative and larger increases in positive emotions, both during the film clips and recovery period. However, acceptance was perceived as less difficult to deploy than reappraisal, and was associated with a smaller dampening of skin conductance level (indicating more successful regulation) during the film clips in 1 sample. These results suggest that reappraisal and acceptance may exert differential short-term effects: Whereas reappraisal is more effective for changing subjective experiences in the short term, acceptance may be less difficult to deploy and be more effective at changing one's physiological response. Thus, these 2 strategies may both be considered "effective" for different reasons. (PsycINFO Database Record

Investigating the association between emotion regulation and distress in adults with psychotic-like experiences

Many individuals in the general population experience psychotic-like experiences in the absence of a psychotic disorder. The degree of psychological distress associated with these experiences is a key predictor of clinical outcomes. One factor that may influence the degree of distress from psychotic-like experiences is emotion regulation. Although it has been demonstrated that emotion regulation deficits are present in psychotic disorders, the association between emotion regulation and subclinical psychotic-like experiences is not well understood. Here, we examined the associations between frequency of and distress from psychotic-like experiences and several key components of emotion regulation: difficulties with emotion regulation; emotion regulation self-efficacy; and emotion regulation strategy use. Difficulties with emotion regulation and maladaptive patterns of emotion regulation strategy use were associated with the frequency of both positive and negative psychotic-like experiences. In addition, results suggest that habitual acceptance use and reappraisal self-efficacy may serve as protective factors against the distress associated with psychotic-like experiences.

Negative Academic Emotion and Psychological Well-being in Chinese Rural-to-Urban Migrant Adolescents: Examining the Moderating Role of Cognitive Reappraisal

The study aimed to explore the relationship among negative academic emotions (e.g., anxiety, shame, anger, boredom, hopelessness, disappointment, and hatred), psychological well-being (including life vitality, health concern, altruism commitment, self-value, friendly relationship, and personal development), and cognitive reappraisal in rural-to-urban migrant adolescents in China. Specifically, it was hypothesized that the relationship between psychological well-being and negative academic emotions is moderated by cognitive reappraisal. A total of 311 migrant adolescents aged 14-20 years were selected, including 132 boys and 179 girls. Results of a regression analysis showed that cognitive reappraisal (positive) and negative academic emotions were significant predictors of psychological well-being. The interaction effect between cognitive reappraisal and negative academic emotion was also a significant predictor of psychological well-being. In the simple slope analysis the group with a below average cognitive reappraisal score the negative academic emotions were associated with lower psychological well-being, whereas in the group with above average cognitive reappraisal the effect of negative academic emotions on psychological well-being was not significant. However, for those with a cognitive reappraisal score of 1 standard deviation above the average, the effect of negative academic emotions on psychological well-being was not significant. These results suggest that cognitive reappraisal was a significant moderator in the relationship between negative academic emotion and psychological well-being.

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors

BACKGROUND AND OBJECTIVES

Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type.

METHODS

A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N = 62; HSA) and low (N = 52; LSA) on social anxiety.

RESULTS

Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity.

CONCLUSIONS

Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.

Pupillary response to emotional stimuli as a risk factor for depressive symptoms following a natural disaster: The 2011 Binghamton flood

Understanding pathways of risk following a natural disaster may help create next-generation targeted interventions. The current study examined if a biomarker of cognitive-affective response (pupil dilation) could identify which individuals are at greatest risk for depression following disaster-related stress. Fifty-one women completed a computer-based task assessing pupillary response to facial expressions of emotion and reported their depressive symptoms before the 2011 Binghamton flood. Following the flood, women were assessed for objective levels of flood-related stress and again reported their depressive symptoms. Supporting the proposed diathesis-stress model, decreased pupil dilation to emotional expressions predicted a significant increase in post-flood depressive symptoms, but only among women who experienced higher levels of flood-related stress. Findings suggest that reduced cognitive-affective response to emotional stimuli (measured via pupillary response) can increase risk for depression in the context of high levels of objective life stress.

Reminiscing about positive memories buffers acute stress responses

Recalling happy memories elicits positive feelings and enhances one's wellbeing, suggesting a potential adaptive function in using this strategy for coping with stress. In two studies, we explored whether recalling autobiographical memories that have a positive content - i.e., remembering the good times - can dampen the hypothalamic-pituitary-adrenal (HPA) axis stress response. Participants underwent an acute stressor or control task followed by autobiographical memory recollection (of only positive or neutral valence). Across both studies, recalling positive, but not neutral, memories resulted in a dampened cortisol rise and reduced negative affect. Further, individuals with greater self-reported resiliency showed enhanced mood, despite stress exposure. During positive reminiscence, we observed engagement of corticostriatal circuits previously implicated in reward-processing and emotion regulation, and stronger connectivity between ventrolateral and dorsolateral prefrontal cortex as a function of positivity. These findings highlight the restorative and protective function of self-generated positive emotions via memory recall in the face of stress.

Understanding reappraisal as a multicomponent process: The psychological health benefits of attempting to use reappraisal depend on reappraisal success

When is reappraisal-reframing a situation's meaning to alter its emotional impact-associated with psychological health? To answer this question, we should consider that reappraisal is a multicomponent process that includes, first, deciding to attempt to use reappraisal and, second, implementing reappraisal with varying degrees of success. Although theories of emotion regulation suggest that both attempting reappraisal more frequently and implementing reappraisal more successfully are necessary to achieve greater psychological health, no research has directly tested this assumption. We propose that daily diaries are particularly well suited to assess these 2 components because diaries can capture repeated attempts and success in daily life and with relative precision. In a sample of community adults (N = 219), we found that among participants experiencing elevated life stress (but not among those experiencing lower life stress), attempting reappraisal more frequently was associated with fewer depressive symptoms for those who used reappraisal more successfully, but was associated with somewhat more depressive symptoms for those who used reappraisal less successfully. These findings suggest that attempting reappraisal is associated with benefits only when individuals can implement it successfully. Thus, to fully understand the health implications of emotion regulation, we must consider it as a multicomponent process. (PsycINFO Database Record

Individual differences in positive and negative emotion regulation: Which strategies explain variability in loneliness?

Loneliness is the distressing feeling accompanying the perception that one's social needs are not being met by one's social relationships. Conceptual models point to a role for cognitive factors in this experience. Because research on determinants of loneliness is sparse, this study investigates associations between individual differences in emotion regulation (ER) and loneliness. Participants (N = 116) completed measures of loneliness, and a vignette-based measure of adaptive and maladaptive ER in response to positive and negative scenarios. Regression analyses indicated that the regulation of positive and negative emotions explained comparable variance in loneliness, and associations were only partially reduced by the inclusion of social support. The specific strategies positive reappraisal, being present and negative mental time travel explained the most variance in loneliness. The findings are consistent with both the cognitive and the social needs models of loneliness and suggest that variability in ER strategies should be considered relevant to loneliness. Copyright © 2016 John Wiley & Sons, Ltd.

Cognitive Costs of Reappraisal Depend on Both Emotional Stimulus Intensity and Individual Differences in Habitual Reappraisal

Recent models of emotion regulation suggest that the cognitive costs of reappraisal depend on stimulus intensity and habitual reappraisal. In the current experiment, we tested these hypotheses by manipulating the intensity of unpleasant and pleasant images, which participants reappraised, viewed, or suppressed their emotions to. To assess cognitive costs, we measured participants’ performance on a concurrent simple reaction time task. Participants also reported on their everyday use of reappraisal and suppression. Higher intensity stimuli were associated with greater cognitive costs of reappraisal, for unpleasant, but not pleasant pictures. Also, greater habitual reappraisal predicted lower cognitive costs of reappraisal and greater reductions in subjective feelings. Results support the role of stimulus intensity and habitual use of reappraisal in predicting the cognitive costs of reappraisal.

Emotion Dysregulation of Women with Premenstrual Syndrome

The aim of the current study was to test whether women with premenstrual syndrome (PMS) had difficulties in emotion regulation. In Study 1, we investigated the relationship between the habitual use of emotion-regulation strategies and the severity of PMS (n = 230). The results showed that the severity of PMS was negatively associated with the habitual use of reappraisal, but positively associated with the habitual use of suppression. In Study 2, we first investigated the difference in the spontaneous use of suppression versus reappraisal between women with (n = 42) and without PMS (n = 42) when watching sad film clips. Then we instructed some participants (PMS group = 20, healthy group = 21) to use reappraisal to regulate their emotions induced by a second sad film clip, and the other participants were asked to watch the second film clip freely (PMS group = 22, healthy group = 21). The results showed that there was no significant difference between participants with and without PMS in the self-reported spontaneous use of emotion-regulation strategies. For participants with PMS, increases in spontaneous suppression use were associated with increases in skin conductance level (SCL), while this association was not found among participants without PMS.

Reappraisal Buffers the Association between Stress and Negative Mood Measured over 14 Days: Implications for Understanding Psychological Resilience

Reappraisal is thought to be an adaptive emotion regulation strategy, and research suggests that individuals who habitually reappraise report more positive patterns of affect overall. However, some experimental studies indicate that a greater tendency to reappraise can exacerbate stress response, and it is unclear whether reappraisal confers resilience or exacerbates response to naturally occurring stressors. In order to address this, the present study investigated whether reappraisal prospectively moderated the association between daily stressors and daily negative mood measured over 14 days. Participants (n = 236) completed a measure of reappraisal at baseline, before completing daily online entries of stress and positive and negative mood. Data were analysed using multilevel modelling. Results suggested that reappraisal moderated the association between stress and negative mood, such that higher levels of reappraisal were associated with lower levels of negative mood in response to stress. Moreover, higher reappraisal was also independently associated with lower levels of daily negative mood and higher levels of positive mood. These results suggest that higher reappraisal may confer resilience to stress. Copyright © 2016 European Association of Personality Psychology

Emotion regulation and emotional distress: The mediating role of hope on reappraisal and anxiety/depression in newly diagnosed cancer patients

PURPOSE

A proportion of newly diagnosed cancer patients may experience anxiety and depression. Emotion suppression has been associated with poorer psychoemotional outcomes, whereas reappraisal may be an adaptive emotion regulation strategy. Few studies have examined potential mechanisms linking reappraisal to psychoemotional outcomes in cancer patients. This study aims to replicate findings on reappraisal and suppression and further examines if hope mediates the association between reappraisal and anxiety/depression in patients newly diagnosed with cancer.

METHODS

Participants were 144 adult cancer patients (65.3% female, mean age = 48.96 years, SD = 9.23). Patients completed a set of study questionnaires, including the Emotion Regulation Questionnaire, Adult Hope Scale, and the Hospital Anxiety and Depression Scale. Path analysis was used to examine if hope mediated the association between reappraisal and anxiety/depression.

RESULTS

Prevalence of anxiety was 39.6% and depression was 25.0%. Reappraisal and hope were correlated with lower anxiety and depression, whereas suppression was correlated with higher anxiety and depression. The hypothesized mediation model provided fit to the data, comparative fit index = 0.95, Tucker-Lewis index = 0.94, root-mean-square-error of approximation = 0.05. There was a significant indirect effect of reappraisal on anxiety and depression via hope, b = -0.95, SE = 0.42, 95% confidence interval = -1.77 to -0.12, whereas the direct effect of reappraisal was nonsignificant.

CONCLUSION

The study findings suggest that hope mediated the association between reappraisal and anxiety/depression outcomes. Moreover, the high prevalence of anxiety and depression implies a need for healthcare providers to attend to the psychoemotional needs of newly diagnosed cancer patients.

Using cognitive behaviour therapy to explore resilience in the life-stories of 16 UK centenarians

Aim

In 2010, we interviewed 16 UK centenarians about their lives and later published a paper on the socio‐emotional aspects of positive ageing. We were struck by their ability to ‘move on’ from difficult situations which we recognized conceptually as ‘resilience’. In the effort to understand aspects of resilience as portrayed in their stories, we re‐examined their data.

Methodology

In the original study, we used participatory action research (PAR) for its storytelling and group process components. Here, we re‐examine data from the centenarians’ life stories using a cognitive behavioural therapy (CBT) lens.

Design

We focused on the notion of resilience in the centenarians’ stories guided by CBT insights to analyse and develop psychosocial interpretations.

Results

Resilience comprised the ability to frame difficult life events in positive terms, accept what cannot be changed, manage worry and anxiety effectively, develop psychological flexibility in the face of change and continually seek opportunities for growth and development. We suggest that these resilient behaviours may have contributed to positive ageing.

Finding Positive Meaning in Negative Experiences Engages Ventral Striatal and Ventromedial Prefrontal Regions Associated with Reward Valuation

Neuroimaging research has identified systems that facilitate minimizing negative emotion, but how the brain is able to transform the valence of an emotional response from negative to positive is unclear. Behavioral and psychophysiological studies suggest a distinction between minimizing reappraisal, which entails diminishing the arousal elicited by negative stimuli, and positive reappraisal, which instead changes the emotional valence of arousal from negative to positive. Here we show that successful minimizing reappraisal tracked with decreased activity in the amygdala, but successful positive reappraisal tracked with increased activity in regions involved in computing reward value, including the ventral striatum and ventromedial pFC (vmPFC). Moreover, positive reappraisal enhanced positive connectivity between vmPFC and amygdala, and individual differences in positive connectivity between vmPFC and amygdala, ventral striatum, dorsomedial pFC, and dorsolateral pFC predicted greater positive reappraisal success. These data broaden models of emotion regulation as quantitative dampening of negative emotion and identify activity in a network of brain valuation, arousal, and control regions as a neural basis for the ability to create positive meaning from negative experiences.

Change the things you can: Emotion regulation is more beneficial for people from lower than from higher socioeconomic status

Emotion regulation is central to psychological health, and several emotion-regulation strategies have been identified as beneficial. However, new theorizing suggests the benefits of emotion regulation should depend on its context. One important contextual moderator might be socioeconomic status (SES), because SES powerfully shapes people's ecology: lower SES affords less control over one's environment and thus, the ability to self-regulate should be particularly important. Accordingly, effectively regulating one's emotions (e.g., using cognitive reappraisal) could be more beneficial in lower (vs. higher) SES contexts. Three studies (N = 429) tested whether SES moderates the link between cognitive reappraisal ability (CRA; measured with surveys and in the laboratory) and depression. Each study and a meta-analysis of the 3 studies revealed that CRA was associated with less depression for lower SES but not higher SES individuals. Thus, CRA may be uniquely beneficial in lower SES contexts. More broadly, the effects of emotion regulation depend upon the ecology within which it is used. (PsycINFO Database Record

Appraisal and coping as mediators of the effects of cumulative risk on preadolescent adjustment

This study examined the concurrent and longitudinal relations among cumulative risk, appraisal, coping, and adjustment. Longitudinal path models were tested in a community sample of 316 children in preadolescence to examine hypotheses that threat appraisal and avoidant coping mediate the effects of cumulative risk on child adjustment, whereas positive appraisal and active coping were hypothesized to predict better adjustment independently. Children and their mothers were assessed during in-home interviews at three time points at one-year intervals. Children reported on appraisal and coping strategies. Mothers and children reported on child adjustment problems and positive adjustment. Rank-order changes in appraisal and coping predicted rank-order changes in adjustment. Cumulative risk was concurrently related to higher threat appraisal and avoidant coping at each time point. Threat appraisal and avoidant coping mediated the relations of cumulative risk to rank-order changes in adjustment. There is specificity in the relations of cumulative risk to threat appraisal and avoidant coping, whereas positive appraisal and active coping are independent of risk and operate as individual resource factors.

The psychosocial experiences of older palliative patients while participating in a Living with Hope Program

Objective:

Several studies have reported the effectiveness of a variety of psychosocial interventions in increasing levels of hope in palliative care patients. The experience of palliative patients while participating in these interventions is unknown. Understanding these experiences would provide a rich understanding of how the interventions work to foster hope. The purpose of the present study was to describe the psychosocial processes that participants with advanced cancer receiving palliative care experienced when taking part in a Living with Hope Program (LWHP).

Method:

In the context of a study evaluating the LWHP, data were collected from 13 dyads (persons with advanced cancer and their caregivers) at two timepoints (one week apart). A thematic qualitative analysis of 52 open-ended audiotaped interviews was conducted that focused on the psychosocial processes that occurred during the LWHP.

Results:

The average age of palliative participants was 67 (SD = 6.6) and of their family caregivers 61 years of age (SD = 13.9). A thematic analysis suggested that the participants experienced the following psychosocial processes while participating in the LWHP: (1) reminiscing, (2) leaving a legacy, (3) positive reappraisal, and (4) motivational processes. These processes are the mechanisms by which the LWHP fosters the positive outcomes of increasing hope and improving quality of life. As well, the finding of motivational processes suggested that the LWHP may also increase life satisfaction, which is an outcome of motivational processes.

Significance of the results:

The findings from our study underscore the importance of uncovering the psychosocial processes through which the LWHP works to foster hope. They will assist in making revisions to the intervention that will increase its effectiveness, as well as providing a better understanding of hope in persons with advanced cancer.

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

OBJECTIVES

To provide guidance for the management of mood disorders, based on scientific evidence supplemented by expert clinical consensus and formulate recommendations to maximise clinical salience and utility.

METHODS

Articles and information sourced from search engines including PubMed and EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (MDC) (e.g., books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Information was reviewed and discussed by members of the MDC and findings were then formulated into consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous successive consultation and external review involving: expert and clinical advisors, the public, key stakeholders, professional bodies and specialist groups with interest in mood disorders.

RESULTS

The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (Mood Disorders CPG) provide up-to-date guidance and advice regarding the management of mood disorders that is informed by evidence and clinical experience. The Mood Disorders CPG is intended for clinical use by psychiatrists, psychologists, physicians and others with an interest in mental health care.

CONCLUSIONS

The Mood Disorder CPG is the first Clinical Practice Guideline to address both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus.

MOOD DISORDERS COMMITTEE

Professor Gin Malhi (Chair), Professor Darryl Bassett, Professor Philip Boyce, Professor Richard Bryant, Professor Paul Fitzgerald, Dr Kristina Fritz, Professor Malcolm Hopwood, Dr Bill Lyndon, Professor Roger Mulder, Professor Greg Murray, Professor Richard Porter and Associate Professor Ajeet Singh.

INTERNATIONAL EXPERT ADVISORS

Professor Carlo Altamura, Dr Francesco Colom, Professor Mark George, Professor Guy Goodwin, Professor Roger McIntyre, Dr Roger Ng, Professor John O'Brien, Professor Harold Sackeim, Professor Jan Scott, Dr Nobuhiro Sugiyama, Professor Eduard Vieta, Professor Lakshmi Yatham.

AUSTRALIAN AND NEW ZEALAND EXPERT ADVISORS

Professor Marie-Paule Austin, Professor Michael Berk, Dr Yulisha Byrow, Professor Helen Christensen, Dr Nick De Felice, A/Professor Seetal Dodd, A/Professor Megan Galbally, Dr Josh Geffen, Professor Philip Hazell, A/Professor David Horgan, A/Professor Felice Jacka, Professor Gordon Johnson, Professor Anthony Jorm, Dr Jon-Paul Khoo, Professor Jayashri Kulkarni, Dr Cameron Lacey, Dr Noeline Latt, Professor Florence Levy, A/Professor Andrew Lewis, Professor Colleen Loo, Dr Thomas Mayze, Dr Linton Meagher, Professor Philip Mitchell, Professor Daniel O'Connor, Dr Nick O'Connor, Dr Tim Outhred, Dr Mark Rowe, Dr Narelle Shadbolt, Dr Martien Snellen, Professor John Tiller, Dr Bill Watkins, Dr Raymond Wu.

Emotional Reactivity and Internalizing Symptoms: Moderating Role of Emotion Regulation

Emotion dysregulation has been associated with increases in many forms of psychopathology in adolescents and adults. The development of effective emotion regulation skills is important during adolescence, especially as stressful life events increase during this time. The current study examined two emotion regulation strategies, cognitive reappraisal and affective suppression, in interaction with self-report and biological measures of emotional reactivity as predictors of internalizing symptoms. A community sample of adolescents (n = 127), at an age of risk for depression and anxiety, completed self-report measures of emotional reactivity and internalizing symptoms. In addition, they completed a modified social stress task and were assessed on biological measures of reactivity and regulation. Findings suggested that the trait tendency to reappraise was associated with a reduced impact of emotional reactivity on depressive, but not anxiety symptoms. Implications for shared and specific aspects of emotional reactivity and regulation are discussed.

Reappraisal and resilience to stress: Context must be considered

Kalisch et al. propose that positive reappraisal constitutes a resilience mechanism for highly stressed individuals. Both empirical and theoretical accounts suggest that this claim is too simplistic – the relationship between reappraisal and resilience depends on context. Indeed, there may be contexts in which reappraisal leads to harm, not resilience. Future research should examine multiple regulatory processes as well as context.

Evidence of Contrasting Patterns for Suppression and Reappraisal Emotion Regulation Strategies in Alexithymia

Alexithymia generally refers to difficulties in identifying and describing emotions. In this paper, two studies explored whether the emotion deficits observed in alexithymia may be related to the use of emotion regulation strategies. Relations with various sociodemographic variables were also explored. In the first study, 255 students completed the Emotion Regulation Questionnaire (ERQ) and the Toronto Alexithymia Scale-20. For the second study, 1107 participants from the general population completed the ERQ and the Bermond-Vorst Alexithymia Questionnaire. Results demonstrated that alexithymia was related to the use of a suppression strategy and in particular to difficulties verbalizing emotions, suggesting that the capacity to communicate and name one's emotion is a central aspect in alexithymia. Concerning sociodemographic variables, alexithymia and the use of a suppression strategy were found to be related to age and to be higher in males. The results of these studies and their clinical implications for treatment are discussed.

That's not funny! - But it should be: effects of humorous emotion regulation on emotional experience and memory

Previous research has shown that humorous reappraisal can reduce elicited negative emotions, suggesting that humor may be a functional strategy to cope with emotionally negative situations. However, the effect of humorous reappraisal on later memory about the emotion-eliciting situation is currently unknown, although this is crucial for more adaptive responding in future situations. To address this issue, we examined the effects of humorous reappraisal on both emotional experience and memory, compared to non-humorous rational reappraisal and a non-reappraisal control condition. Replicating previous findings, humorous reappraisal reduced evoked negative valence and arousal levels very effectively, and the down-regulation of experienced negative emotions was even more pronounced after humorous compared to rational reappraisal. Regarding later memory for emotion-eliciting stimuli, both humorous and rational reappraisal reduced free recall, but recognition memory was unaffected, with memory strength being stronger after humorous than after rational reappraisal. These results indicate that humor seems to be indeed an optimal strategy to cope with negative situations because humor can help us to feel better when confronted with negative stimuli, but still allows us to retrieve stimulus information later when afforded to do so by the presence of appropriate contextual features.

Maladaptive and adaptive emotion regulation through music: a behavioral and neuroimaging study of males and females

Music therapists use guided affect regulation in the treatment of mood disorders. However, self-directed uses of music in affect regulation are not fully understood. Some uses of music may have negative effects on mental health, as can non-music regulation strategies, such as rumination. Psychological testing and functional magnetic resonance imaging (fMRI) were used explore music listening strategies in relation to mental health. Participants (n = 123) were assessed for depression, anxiety and Neuroticism, and uses of Music in Mood Regulation (MMR). Neural responses to music were measured in the medial prefrontal cortex (mPFC) in a subset of participants (n = 56). Discharge, using music to express negative emotions, related to increased anxiety and Neuroticism in all participants and particularly in males. Males high in Discharge showed decreased activity of mPFC during music listening compared with those using less Discharge. Females high in Diversion, using music to distract from negative emotions, showed more mPFC activity than females using less Diversion. These results suggest that the use of Discharge strategy can be associated with maladaptive patterns of emotional regulation, and may even have long-term negative effects on mental health. This finding has real-world applications in psychotherapy and particularly in clinical music therapy.

Regulatory Flexibility: An Individual Differences Perspective on Coping and Emotion Regulation

People respond to stressful events in different ways, depending on the event and on the regulatory strategies they choose. Coping and emotion regulation theorists have proposed dynamic models in which these two factors, the person and the situation, interact over time to inform adaptation. In practice, however, researchers have tended to assume that particular regulatory strategies are consistently beneficial or maladaptive. We label this assumption the fallacy of uniform efficacy and contrast it with findings from a number of related literatures that have suggested the emergence of a broader but as yet poorly defined construct that we refer to as regulatory flexibility. In this review, we articulate this broader construct and define both its features and limitations. Specifically, we propose a heuristic individual differences framework and review research on three sequential components of flexibility for which propensities and abilities vary: sensitivity to context, availability of a diverse repertoire of regulatory strategies, and responsiveness to feedback. We consider the methodological limitations of research on each component, review questions that future research on flexibility might address, and consider how the components might relate to each other and to broader conceptualizations about stability and change across persons and situations.

Differences in emotion modulation using cognitive reappraisal in individuals with and without suicidal ideation: An ERP study

Difficulties in emotion regulation have been associated with increased suicidal thoughts and behaviours. The majority of studies have examined self-reported use of emotion regulation strategies. In contrast, the current study focused on a direct measure of individuals' ability to use a specific emotion regulation strategy, cognitive reappraisal, using the late positive potential (LPP), an event-related potential component that reflects attention to emotional stimuli. Specifically, the cognitive reappraisal ability of 33 undergraduate students was assessed via an image-viewing task during which the participants had to passively view, increase or reduce their emotions in response to looking at neutral, positive or dysphoric images. We found that participants with a history of suicidal ideation (SI) had significantly higher LPP when asked to reduce negative emotion in response to dysphoric images, compared to individuals with no history of SI. These findings suggest that difficulties with using cognitive reappraisal, specifically to decrease negative affect, might be linked to suicide risk.

Rumination in major depressive disorder is associated with impaired neural activation during conflict monitoring

Individuals with major depressive disorder (MDD) often ruminate about past experiences, especially those with negative content. These repetitive thoughts may interfere with cognitive processes related to attention and conflict monitoring. However, the temporal nature of these processes as reflected in event-related potentials (ERPs) has not been well-described. We examined behavioral and ERP indices of conflict monitoring during a modified flanker task and the allocation of attention during an attentional blink (AB) task in 33 individuals with MDD and 36 healthy controls, and whether their behavioral performance and ERPs varied with level of rumination. N2 amplitude elicited by the flanker task was significantly reduced in participants with MDD compared to healthy controls. Level of self-reported rumination was also correlated with N2 amplitude. In contrast, P3 amplitude during the AB task was not significantly different between groups, nor was it correlated with rumination. No significant differences were found in behavioral task performance measures between groups or by rumination levels. These findings suggest that rumination in MDD is associated with select deficits in cognitive control, particularly related to conflict monitoring.

Multifaceted emotion regulation, stress and affect in mothers of young children

We tested a novel multi-component emotion self-regulation construct that captured physiological (vagal tone), cognitive (reappraisal) and temperament (effortful control) aspects of emotion regulation (ER) as a moderator of the link between more stressors and greater negative/less positive affectivity (NA and PA). A socio-economically diverse sample of 151 women with young children completed questionnaires and a laboratory visit (including cognitive and parent-child interaction tasks and vagal tone measurement). Women with more stressors had more NA and less PA. Furthermore, for NA only, having more stressors was substantially associated with NA but only among women with the lowest ER. This pattern was evident for the composite as well as individual indicators of ER. Results were not attributable to individual differences in executive function. Findings are discussed in light of the diathesis-stress model of stress and coping.

A thematic analysis of how prisoners overcome suicidality

Purpose

– The purpose of this paper is to explore the perceptions, beliefs and abilities that support adult male prisoners in overcoming suicidality.

Design/methodology/approach

– Semi-structured interviews were conducted with eight male life sentenced prisoners in a Category B prison. Thematic analysis was used to analyse the data and interpret how prisoners have overcome suicidality.

Findings

– Five overarching themes were identified; sense of self, presence of meaning, connectedness, shift of perspective and re-establishing control. The themes were closely interconnected and revealed novel insights into the variables that supported prisoners to overcome suicidality.

Research limitations/implications

– The themes were drawn from a specific prisoner population, which may not be representative of the wider prison population. Additionally, the sole focus on suicidality may be an oversimplification of self-destructive behaviours and could have affected the factors identified.

Practical implications

– The results highlight the need to refine suicide prevention strategies in prisons; in the assessment of suicide risk, the improvement of supportive regimes and the development of psychological interventions.

Originality/value

– This research is the first to qualitatively examine the factors involved in overcoming suicide in adult male prisoners. The research is of value to researchers and practitioners alike, as it extends previous research in prison populations and suggests avenues for the development of suicide prevention strategies.

Repertoires of emotion regulation: A person-centered approach to assessing emotion regulation strategies and links to psychopathology

Despite growing research on emotion regulation (ER) strategies and psychopathology, research has primarily focused on identifying one-to-one associations between ER strategies and symptoms. Thus, little is known about how patterns in the repertoires of ER strategies are associated with different mental disorders. We utilised latent class analysis to identify distinct repertoires of ER strategies, and their links with various psychopathology domains (i.e., anxiety, depression, disordered eating, borderline personality). Participants (N = 531) reported on their use of seven ER strategies in six recalled stressful contexts, as well as on their symptoms of psychopathology. We identified five classes of ER strategies: Low Regulators (n = 168), High Regulators (n = 140), Adaptive Regulators (n = 99), Worriers/Ruminators (n = 96) and Avoiders (n = 28). Generally, High Regulators and Worriers/Ruminators endorsed greater levels of psychopathology, relative to Low and Adaptive Regulators. Our findings underscore the importance of characterising the dynamics of ER repertoires when seeking to understand links between ER strategies and psychopathology.