The Importance of Being Flexible

The effect of cognitive reappraisal on physiological reactivity and emotional memory

We investigated the effect of cognitive reappraisal on emotional arousal, facial expressivity and subsequent memory. Men and women viewed emotionally negative pictures while they attempted to either increase or decrease negative emotions elicited by the pictures, or to simply view the pictures. Neutral pictures were also presented with instructions to simply view the pictures. Concurrent changes in emotional arousal and valence were assessed with skin conductance responses (SCRs) and facial corrugator electromyographic responses (EMG), respectively. Picture memory was assessed with an immediate recall test and a delayed recognition test. Relative to simply viewing pictures, voluntary reappraisal to increase negative emotion generated greater facial corrugator EMG and SCR responses, and reappraisal to decrease negative emotion generated decreased corrugator EMG responses. Men showed enhanced recognition for pictures presented during the increase and decrease conditions, whereas women showed comparable recognition performance across all regulation conditions. The modulation of subsequent recognition memory associated with decreasing emotion was inversely associated with changes in physiological responses. Our results suggest that sex is an important factor to consider in determining how reappraisal-induced physiological changes are associated with subsequent changes in memory. These findings contribute to our understanding of how reappraising emotion exerts both immediate and enduring influences on physiological responses and subsequent memory.

Emotion dysregulation and anxiety in late adulthood

Recent research has highlighted the important role of emotion dysregulation in the occurrence and maintenance of anxiety symptoms. The purpose of the present study was to investigate the relationship between anxiety symptoms and older adults' ability to regulate emotional experiences. A total of 167 community dwelling older adults completed self-report measures of affect and were asked to report how often they use specific emotion regulation strategies. Consistent with previous theories older adults experiencing increasing levels of anxiety reported greater difficulties in regulating emotional responses. Present results provide support for previous findings demonstrating that experiencing anxiety symptoms affects the ability to regulate emotional experiences. Current findings are likely to be informative in terms of understanding emotion dysregulation in older adults at risk of experiencing clinical symptoms of anxiety.

Cognitive consequences of expressive regulation in older adults

Previous research has suggested that older and young adults are equally able to regulate their outward expressions of emotion and that the regulation of emotional expression in younger adults results in decreased memory for the emotional stimulus. In the current study, we examined whether older adults show this same memory effect. Older and young adults viewed positive and negative emotional pictures under instructions to view the pictures naturally, enhance their facial expressions, or suppress their facial expressions. Older and young adults showed equivalent outward regulation of expression, but suppressing their emotional expressions led to reduced memory for emotional stimuli only in the young adults. The results suggest that older and young adults are achieving control of their expressions through different mechanisms or strategies.

Emotion regulation and psychopathology: the role of gender

This review addresses three questions regarding the relationships among gender, emotion regulation, and psychopathology: (a) are there gender differences in emotion regulation strategies, (b) are emotion regulation strategies similarly related to psychopathology in men and women, and (c) do gender differences in emotion regulation strategies account for gender differences in psychopathology? Women report using most emotion regulation strategies more than men do, and emotion regulation strategies are similarly related to psychopathology in women and men. More rumination in women compared to men partially accounts for greater depression and anxiety in women compared to men, while a greater tendency to use alcohol to cope partially accounts for more alcohol misuse in men compared to women. The literature on emotion regulation is likely missing vital information on how men regulate their emotions. I discuss lessons learned and questions raised about the relationships between gender differences in emotion regulation and gender differences in psychopathology.

Flexible emotional responsiveness in trait resilience

Field studies and laboratory experiments have documented that a key component of resilience is emotional flexibility--the ability to respond flexibly to changing emotional circumstances. In the present study we tested the hypotheses that resilient people exhibit emotional flexibility: (a) in response to frequently changing emotional stimuli and (b) across multiple modalities of emotional responding. As participants viewed a series of emotional pictures, we assessed their self-reported affect, facial muscle activity, and startle reflexes. Higher trait resilience predicted more divergent affective and facial responses (corrugator and zygomatic) to positive versus negative pictures. Thus, compared with their low-resilient counterparts, resilient people appear to be able to more flexibly match their emotional responses to the frequently changing emotional stimuli. Moreover, whereas high-trait-resilient participants exhibited divergent startle responses to positive versus negative pictures regardless of the valence of the preceding trial, low-trait-resilient participants did not exhibit divergent startle responses when the preceding picture was negative. High-trait-resilient individuals, therefore, appear to be better able than are their low-resilient counterparts to either switch or maintain their emotional responses depending on whether the emotional context changes. The present findings broaden our understanding of the mechanisms underlying resilience by demonstrating that resilient people are able to flexibly change their affective and physiological responses to match the demands of frequently changing environmental circumstances.

Emotion-Regulation Choice

Despite centuries of speculation about how to manage negative emotions, little is actually known about which emotion-regulation strategies people choose to use when confronted with negative situations of varying intensity. On the basis of a new process conception of emotion regulation, we hypothesized that in low-intensity negative situations, people would show a relative preference to choose to regulate emotions by engagement reappraisal, which allows emotional processing. However, we expected people in high-intensity negative situations to show a relative preference to choose to regulate emotions by disengagement distraction, which blocks emotional processing at an early stage before it gathers force. In three experiments, we created emotional contexts that varied in intensity, using either emotional pictures (Experiments 1 and 2) or unpredictable electric stimulation (Experiment 3). In response to these emotional contexts, participants chose between using either reappraisal or distraction as an emotion-regulation strategy. Results in all experiments supported our hypothesis. This pattern in the choice of emotion-regulation strategies has important implications for the understanding of healthy adaptation.

Interpersonal emotion regulation as a mechanism of social support in depression

Although social support is widely considered to be protective against depression, the mechanisms through which it acts on depressive psychopathology are not well known. This integrative review argues that emotion regulation serves as such a mechanism. First, the literature on the effects of social support on depression is reviewed, with an emphasis on open empirical questions regarding mechanisms linking support and depression. Then, the literature on emotion regulation is reviewed, highlighting its importance as a mechanism in the psychopathology of depression. Finally, potential interpersonal influences on depressive emotion regulation and dysregulation are suggested, drawing from theory and research on psychotherapy and on close relationships. The review suggests that emotion regulation is responsive to interpersonal influences, and that this responsiveness may account for the effects of social support on depression. Implications of an interpersonal perspective for basic and clinical research on depression, close relationships, and emotion regulation are discussed.

Regulation of affect in late adulthood: effects of mild depressive symptoms

BACKGROUND

Recent research has highlighted the important role of emotion dysregulation in the occurrence and maintenance of depressive symptomatology.

OBJECTIVES

The purpose of this study was to test the effects of mild depressive symptoms (MDS) on older adults' ability to regulate emotional experiences.

METHOD

A total of 70 community dwelling older adults completed self-report measures of affect and were asked to report how often they use specific emotion regulation strategies.

RESULTS

Consistent with previous theories older adults experiencing MDS reported greater difficulties in regulating affect compared to normal controls (NCs).

CONCLUSION

The present results provide support for previous findings demonstrating that experiencing depressive symptoms affects the ability to regulate emotional responses. Current findings are likely to be informative in terms of understanding emotion dysregulation in older adults at risk of experiencing clinical symptoms of depression.

Amygdalar function reflects common individual differences in emotion and pain regulation success

Although the co-occurrence of negative affect and pain is well recognized, the mechanism underlying their association is unclear. To examine whether a common self-regulatory ability impacts the experience of both emotion and pain, we integrated neuroimaging, behavioral, and physiological measures obtained from three assessments separated by substantial temporal intervals. Our results demonstrated that individual differences in emotion regulation ability, as indexed by an objective measure of emotional state, corrugator electromyography, predicted self-reported success while regulating pain. In both emotion and pain paradigms, the amygdala reflected regulatory success. Notably, we found that greater emotion regulation success was associated with greater change of amygdalar activity following pain regulation. Furthermore, individual differences in degree of amygdalar change following emotion regulation were a strong predictor of pain regulation success, as well as of the degree of amygdalar engagement following pain regulation. These findings suggest that common individual differences in emotion and pain regulatory success are reflected in a neural structure known to contribute to appraisal processes.

Protection against perceptions of powerlessness and helplessness during palliative care: The family members' perspective

Objective:

Resilience in relation to coping with stress, loss, and bereavement has recently received increased attention. The aim of the current study was to describe aspects that are experienced as a protection against powerlessness and/or helplessness during advanced palliative home care (APHC) or as a help when coping with such perceptions.

Method:

Both family members during ongoing APHC and family members 3–9 months after the patient's death responded (in total, N = 233; response rate 72%) to a postal questionnaire with mainly open-ended questions. The text responses were analyzed using Manifest Content Analysis.

Results:

Protection against powerlessness and helplessness had been facilitated by a stable patient condition, the patient coping well, a trusting relationship with the patient, practical and emotional support from family and friends, access to palliative expertise, and staff support that was both individually-focused and cooperative. Other aspects that had helped or protected family members against powerlessness and helplessness were a belief that they had their own reliable knowledge to manage the difficult situation, talking to someone, doing good for the patient, distracting activities, acceptance, meaning and hope, and an inner feeling of security.

Significance of results:

The findings are discussed in relation to existential psychology, the dual process model of coping with bereavement, and repressive coping. Clinical implications are suggested.

The unconscious pursuit of emotion regulation: implications for psychological health

Because of the central involvement of emotion regulation in psychological health and the role that implicit (largely unconscious) processes appear to play in emotion regulation, implicit emotion-regulatory processes should play a vital role in psychological health. We hypothesised that implicitly valuing emotion regulation translates into better psychological health in individuals who use adaptive emotion-regulation strategies. A community sample of 222 individuals (56% women) who had recently experienced a stressful life event completed an implicit measure of emotion regulation valuing (ER-IAT) and reported on their habitual use of an important adaptive emotion-regulation strategy: cognitive reappraisal. We measured three domains of psychological health: well-being, depressive symptoms, and social adjustment. As hypothesised, individuals who implicitly valued emotion regulation exhibited greater levels of psychological health, but only when they were high in cognitive reappraisal use. These findings suggest that salutary effects of unconscious emotion-regulation processes depend on its interplay with conscious emotion-regulation processes.

Temporal Interpersonal Emotion Systems

Emotion is often framed as an intrapersonal system comprised of subcomponents such as experience, behavior, and physiology that interact over time to give rise to emotional states. What is missing is that many emotions occur in the context of social interaction or ongoing relationships. When this happens, the result can be conceptualized as a temporal interpersonal emotion system (TIES) in which the subcomponents of emotion interact not only within the individual but across the partners as well. The present review (a) suggests that TIES can be understood in terms of the characteristics of dynamic systems, (b) reviews examples from diverse research that has investigated characteristics of TIES, (c) attempts to clarify the overlapping terms that have been used to refer to those characteristics by mapping them to the statistical, mathematical, and graphical models that have been used to represent TIES, and (d) offers pragmatic advice for analyzing TIES data.

The coping flexibility questionnaire: development and initial validation in patients with chronic rheumatic diseases

Coping flexibility may be beneficial for the adjustment in the context of a progressive and unpredictable course of chronic rheumatic diseases. The aim of this study was to develop and initially validate a self-report measure that assesses coping flexibility. Study participants were 147 outpatients with chronic rheumatic diseases (73% women, mean age 59 (range 20-79) years). Principal axis factoring analysis with oblique rotation was applied and internal consistency was determined. To investigate the initial validity of the coping flexibility questionnaire (COFLEX), hypothesised correlations with psychological and physical adjustment outcomes, pain, and coping strategies were examined. Factor analysis yielded a two-factor model of coping flexibility with acceptable internal consistency: versatility, the capability of switching between assimilative and accommodative coping strategies according to personal goals and situational demands (α = .88) and reflective coping, the capability of generating and considering coping options, and appraising the suitability of a coping strategy in a given situation (α = .70). Versatility was correlated with adaptive ways of coping and psychological adjustment, but not with physical adjustment and pain. Reflective coping was correlated with both adaptive and maladaptive ways of coping, but it was not correlated with adjustment outcomes. In conclusion, the current study suggests acceptable internal consistency of the COFLEX. Preliminary evidence of the validity of the versatility dimension is indicated, while the validity of reflective coping could not be firmly established. The associations of versatility with favourable adjustment to the disease warrant future confirmatory and validity research in larger samples of patients with chronic rheumatic diseases.

Coping and experiential avoidance: unique or overlapping constructs?

The present study examined associations between coping as measured by the Brief COPE and experiential avoidance as measured by the AAQ-II and the role of both constructs in predicting psychological distress and well-being. Specifically, associations between experiential avoidance and other types of coping were examined, and factor analysis addressed the question of whether experiential avoidance is part of coping or a related but independent construct. Results showed that experiential avoidance loads on the same factor as other emotion-focused and avoidant types of coping. The higher people are in experiential avoidance, the more they tend to utilize these types of coping strategies. Both experiential avoidance and coping predicted psychological distress and well-being, with most variance explained by coping but some additional variance explained by experiential avoidance. ANOVAS also showed gender differences in experiential avoidance and coping approaches. Results are discussed in light of previous relevant findings and future treatment relevant implications.

The ability to regulate emotion is associated with greater well-being, income, and socioeconomic status

Are people who are best able to implement strategies to regulate their emotional expressive behavior happier and more successful than their counterparts? Although past research has examined individual variation in knowledge of the most effective emotion regulation strategies, little is known about how individual differences in the ability to actually implement these strategies, as assessed objectively in the laboratory, are associated with external criteria. In two studies, we examined how individual variation in the ability to modify emotional expressive behavior in response to evocative stimuli is related to well-being and financial success. Study 1 showed that individuals who can best suppress their emotional reaction to an acoustic startle are happiest with their lives. Study 2 showed that individuals who can best amplify their emotional reaction to a disgust-eliciting movie are happiest with their lives and have the highest disposable income and socioeconomic status. Thus, being able to implement emotion regulation strategies in the laboratory is closely linked to well-being and financial success.

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

Individuals differ in their adjustment to stressful life events, with some exhibiting impaired functioning, including depression, while others exhibit impressive resilience. The present study examined the hypothesis that the ability to deploy a particularly adaptive type of emotion regulation-cognitive reappraisal-may be a protective factor. It expands upon existing research in three ways. First, participants' ability to use reappraisal (cognitive reappraisal ability: CRA) was measured by using a behavioral challenge that assessed changes in experiential and physiological domains, rather than questionnaires. Second, all participants had been exposed to one or more recent stressful life events, a context in which emotion regulation may be particularly important. Third, a community sample of 78 women aged 20 to 60 was recruited, as opposed to undergraduates. Results indicate that, at low levels of stress, participants' CRA was not associated with depressive symptoms. However, at high levels of stress, women with high CRA exhibited less depressive symptoms than those with low CRA, suggesting that CRA may be an important moderator of the link between stress and depressive symptoms.

Emotion blocks the path to learning under stereotype threat

Gender-based stereotypes undermine females' performance on challenging math tests, but how do they influence their ability to learn from the errors they make? Females under stereotype threat or non-threat were presented with accuracy feedback after each problem on a GRE-like math test, followed by an optional interactive tutorial that provided step-wise problem-solving instruction. Event-related potentials tracked the initial detection of the negative feedback following errors [feedback related negativity (FRN), P3a], as well as any subsequent sustained attention/arousal to that information [late positive potential (LPP)]. Learning was defined as success in applying tutorial information to correction of initial test errors on a surprise retest 24-h later. Under non-threat conditions, emotional responses to negative feedback did not curtail exploration of the tutor, and the amount of tutor exploration predicted learning success. In the stereotype threat condition, however, greater initial salience of the failure (FRN) predicted less exploration of the tutor, and sustained attention to the negative feedback (LPP) predicted poor learning from what was explored. Thus, under stereotype threat, emotional responses to negative feedback predicted both disengagement from learning and interference with learning attempts. We discuss the importance of emotion regulation in successful rebound from failure for stigmatized groups in stereotype-salient environments.

The normalisation of terror: the response of Israel's stock market to long periods of terrorism

Man-made disasters such as acts of terrorism may affect a society's resiliency and sensitivity to prolonged physical and psychological stress. The Israeli Tel Aviv stock market TA-100 Index was used as an indicator of reactivity to suicide terror bombings. After accounting for factors such as world market changes and attack severity and intensity, the analysis reveals that although Israel's financial base remained sensitive to each act of terror across the entire period of the Second Intifada (2000-06), sustained psychological resilience was indicated with no apparent overall market shift. In other words, we saw a 'normalisation of terror' following an extended period of continued suicide bombings. The results suggest that investors responded to less transitory global market forces, indicating sustained resilience and long-term market confidence. Future studies directly measuring investor expectations and reactions to man-made disasters, such as terrorism, are warranted.

Staying cool when things get hot: emotion regulation modulates neural mechanisms of memory encoding

During times of emotional stress, individuals often engage in emotion regulation to reduce the experiential and physiological impact of negative emotions. Interestingly, emotion regulation strategies also influence memory encoding of the event. Cognitive reappraisal is associated with enhanced memory while expressive suppression is associated with impaired explicit memory of the emotional event. However, the mechanism by which these emotion regulation strategies affect memory is unclear. We used event-related fMRI to investigate the neural mechanisms that give rise to memory formation during emotion regulation. Twenty-five participants viewed negative pictures while alternately engaging in cognitive reappraisal, expressive suppression, or passive viewing. As part of the subsequent memory design, participants returned to the laboratory two weeks later for a surprise memory test. Behavioral results showed a reduction in negative affect and a retention advantage for reappraised stimuli relative to the other conditions. Imaging results showed that successful encoding during reappraisal was uniquely associated with greater co-activation of the left inferior frontal gyrus, amygdala, and hippocampus, suggesting a possible role for elaborative encoding of negative memories. This study provides neurobehavioral evidence that engaging in cognitive reappraisal is advantageous to both affective and mnemonic processes.

Psychosocial factors in the development of heart disease in women: current research and future directions

OBJECTIVE

To review the recent (1995-2009) literature on psychosocial risk and protective factors for coronary heart disease (CHD) among women, including negative emotions, stress, social relationships, and positive psychological factors.

METHODS

Articles for the review were identified using PubMed and bibliographies of relevant articles. Eligible studies included at least 100 women and either focused on a) exclusively female participants or b) both men and women, conducting either gender-stratified analyses or examining interactions with gender. Sixty-seven published reports were identified that examined prospective associations with incident or recurrent CHD.

RESULTS

In general, evidence suggests that depression, anxiety disorders, anger suppression, and stress associated with relationships or family responsibilities are associated with elevated CHD risk among women, that supportive social relationships and positive psychological factors may be associated with reduced risk, and that general anxiety, hostility, and work-related stress are less consistently associated with CHD among women relative to men.

CONCLUSIONS

A growing literature supports the significance of psychosocial factors for the development of CHD among women. Consideration of both traditional psychosocial factors (e.g., depression) and factors that may be especially important for women (e.g., stress associated with responsibilities at home or multiple roles) may improve identification of women at elevated risk as well as the development of effective psychological interventions for women with or at risk for CHD.

Metacognition as a mediator of the effects of impairments in neurocognition on social function in schizophrenia spectrum disorders

OBJECTIVE

This study explored whether Mastery, a domain of metacognition that reflects the ability to use knowledge about mental states to respond to psychological challenges, mediated the effects of neurocognition on the frequency of social contact and persons' capacity for social relatedness.

METHOD

Participants were 102 adults with schizophrenia or schizoaffective disorder. Neurocognition was represented by a single factor score produced by a principal components analysis of a neurocognitive test battery. Mastery was assessed using the metacognitive assessment scale and social functioning by the quality of life scale.

RESULTS

Using structural equation modeling, specifically measured-variable path analysis, a mediational model consisting of neurocognitive capacity linked to mastery and capacity for social relationships and mastery linked with frequency of social contact and capacity for social relatedness showed acceptable fit to the observed data. This persisted after controlling for negative and cognitive symptoms.

CONCLUSION

Results suggest that certain forms of metacognition mediate the influence of neurocognition upon function in schizophrenia.

The impact of experienced emotion on evaluative judgments: the effects of age and emotion regulation style

Adults aged from 24 to 79 were exposed to four commercial advertisements within the context of television programs designed to induce either a positive or negative mood. Although age was associated with memory for the content of the commercials, it did not moderate the impact of mood on evaluations of the advertised products. Instead, participants who reported engaging in expressive suppression as a common emotion regulation strategy were more likely to make evaluations that were biased by moods than those individuals who reported low use of this strategy. The results suggest that the maintenance of emotion regulation ability in later adulthood may help people control certain affective influences on thought.

Acceptance: An Historical and Conceptual Review

Recognition of the value of acceptance of the self, others, and the flux of human experience, has philosophical and religious roots that date back thousands of years. The past two decades have witnessed a swell of interest in acceptance, as evidenced by an increase in acceptance-based therapeutic interventions, and a growing appreciation of the paradoxical nature of acceptance and personal change and the role of experiential avoidance in psychopathology. In this article we review historical and contemporary descriptions and definitions of acceptance, measures of acceptance, the relation between acceptance and change, and the role of acceptance in psychopathology and psychotherapy. Our central objective is to delineate a rich conceptual scheme that encompasses the diverse ways in which acceptance has been explicated in classical and contemporary writings, and to highlight the need for further validation of this useful and popular construct.

Autobiographical integration of trauma memories and repressive coping predict post-traumatic stress symptoms in undergraduate students

What differentiates those who are able to adapt well to adverse life events (i.e., persons who are resilient) from those who are not (e.g., persons who develop post-traumatic stress symptoms)? Previous work suggests that enhanced autobiographical integration of trauma memories is associated with more severe post-traumatic stress symptoms. Extending this line of work, the present study looked at whether the integration of trauma memories, repressive coping and cognitive reactivity are related to post-traumatic stress symptomatology following negative life events among otherwise healthy young adults (N = 213). Results show that while enhanced integration of trauma memories and high levels of dissociation are related to elevated levels of post-traumatic stress, people who generally engage in repressive coping report fewer post-traumatic stress symptoms.

Increasing negative emotions by reappraisal enhances subsequent cognitive control: a combined behavioral and electrophysiological study

To what degree do cognitively based strategies of emotion regulation impact subsequent cognitive control? Here, we investigated this question by interleaving a cognitive task with emotion regulation trials, where regulation occurred through cognitive reappraisal. In addition to obtaining self-reports of emotion regulation, we used the late positive potential (LPP) of the event-related brain potential as an objective index of emotion regulation. On each trial, participants maintained, decreased, or increased their emotional response to an unpleasant picture and then responded to a Stroop stimulus. Results revealed that (1) the magnitude of the LPP was decreased with reappraisal instructions to decrease negative emotion and were enhanced with reappraisal instructions to increase negative emotion; (2) after cognitive reappraisal was used to increase the intensity of negative emotion, RT interference in the subsequent Stroop trial was significantly reduced; and (3) increasing negative emotions by reappraisal also modulated the cognitive control-related sustained potential. These results suggest that increasing negative emotions by cognitive reappraisal heightens cognitive control, which may be sustained for a short time after the regulation event.

Cortisol awakening response (CAR)'s flexibility leads to larger and more consistent associations with psychological factors than CAR magnitude

The cortisol awakening response (CAR) is increasingly recognized as a potential biological marker of psychological and physical health status. Yet, the CAR literature is replete with contradictory results: both supposedly protective and vulnerability psychosocial factors have been associated with both increased and decreased CAR. In this study, we tested the hypothesis that the CAR flexibility would be a better indicator of psychological status than CAR magnitude. Forty-two men measures of happiness, perceived stress and neuroticism, and took saliva samples immediately on awakening, then at 15, 30, 45 and 60min post-awakening on three study days (i.e., Sunday, Monday and Tuesday). When considering the CAR magnitude, our effects perfectly reflect the inconsistencies previously observed in the literature (i.e., the main effects of the psychological predictors are not consistent with each other, and the effect of one predictor on a given day contradicts the effect of the same predictor on another day). However, considering the CAR flexibility leads to a fully consistent pattern: protective factors (i.e., high happiness, low stress, low neurotiscim) are associated with a flexible CAR (i.e., lower CAR during weekends compared to workdays) whereas vulnerability factors (i.e., low happiness, high stress, high neurotiscim) are associated with a stiff CAR (i.e., same magnitude during weekends and workdays). We conclude that considering the CAR flexibility (e.g., between weekends and workdays) rather than the traditional CAR magnitude might be a way to understand the apparent conflicts in the CAR literature.

Impact of resilience enhancing programs on youth surviving the Beslan school siege

The objective of this study was to evaluate a resilience-enhancing program for youth (mean age = 13.32 years) from Beslan, North Ossetia, in the Russian Federation. The program, offered in the summer of 2006, combined recreation, sport, and psychosocial rehabilitation activities for 94 participants, 46 of who were taken hostage in the 2004 school tragedy and experienced those events first hand. Self-reported resilience, as measured by the CD-RISC, was compared within subjects at the study baseline and at two follow-up assessments: immediately after the program and 6 months later. We also compared changes in resilience levels across groups that differed in their traumatic experiences. The results indicate a significant intra-participant mean increase in resilience at both follow-up assessments, and greater self-reported improvements in resilience processes for participants who experienced more trauma events.

Psychological flexibility as a fundamental aspect of health

Traditionally, positive emotions and thoughts, strengths, and the satisfaction of basic psychological needs for belonging, competence, and autonomy have been seen as the cornerstones of psychological health. Without disputing their importance, these foci fail to capture many of the fluctuating, conflicting forces that are readily apparent when people navigate the environment and social world. In this paper, we review literature to offer evidence for the prominence of psychological flexibility in understanding psychological health. Thus far, the importance of psychological flexibility has been obscured by the isolation and disconnection of research conducted on this topic. Psychological flexibility spans a wide range of human abilities to: recognize and adapt to various situational demands; shift mindsets or behavioral repertoires when these strategies compromise personal or social functioning; maintain balance among important life domains; and be aware, open, and committed to behaviors that are congruent with deeply held values. In many forms of psychopathology, these flexibility processes are absent. In hopes of creating a more coherent understanding, we synthesize work in emotion regulation, mindfulness and acceptance, social and personality psychology, and neuropsychology. Basic research findings provide insight into the nature, correlates, and consequences of psychological flexibility and applied research provides details on promising interventions. Throughout, we emphasize dynamic approaches that might capture this fluid construct in the real-world.

Emotion Regulation and the Anxiety Disorders: An Integrative Review

The construct of emotion regulation has been increasingly investigated in the last decade, and this work has important implications for advancing anxiety disorder theory. This paper reviews research demonstrating that: 1) emotion (i.e., fear and anxiety) and emotion regulation are distinct, non-redundant, constructs that can be differentiated at the conceptual, behavioral, and neural levels of analysis; 2) emotion regulation can augment or diminish fear, depending on the emotion regulation strategy employed; and 3) measures of emotion regulation explain incremental variance in anxiety disorder symptoms above and beyond the variance explained by measures of emotional reactivity. The authors propose a model by which emotion regulation may function in the etiology of anxiety disorders. The paper concludes with suggestions for future research.

Neurobiological constituents of active, passive, and variable coping strategies in rats: integration of regional brain neuropeptide Y levels and cardiovascular responses

Effective coping strategies build resilience against stress-induced pathology. In the current study, young male rats were categorized as active, passive, or variable copers by observing their responses to being gently restrained on their backs (i.e., the back-test). The rats were subsequently exposed to chronic unpredictable stress, which included several ethologically relevant stressors such as predator odors and calls, for approximately three weeks. During this time, the variable copers, defined as rats that demonstrated a variable as opposed to a rigid response to stress, exhibited more seemingly adaptive responsiveness in three successive forced swim tests than the more consistently responding passive and active copers. This behavioral flexibility was accompanied by increased neuropeptide Y-immunoreactivity in the bed nucleus of the stria terminalis (BNST) and the amygdala and increased fos-immunoreactivity in the BNST. Additionally, the alterations in fecal corticosteroid levels and cardiovascular measures (systolic blood pressure and tail blood volume) between baseline and stress conditions differed according to coping strategy. Factor analysis indicates that variable copers were characterized by a distinct cardiovascular and neural response to the stress exposure. These results suggest that this animal coping model may be useful in discerning the adaptive nature of particular response strategies in the face of environmental exigencies.

Patterns of emotion regulation and psychopathology

Emotion regulatory strategies such as higher expressive suppression and lower cognitive reappraisal may be associated with increased psychopathology (Gross & John, 2003). Yet, it is unclear whether these strategies represent distinct cognitive styles associated with psychopathology, such that there are individuals who are predominantly "suppressors" or "reappraisers." Using cluster analysis, we examined whether women with and without exposure to potentially traumatic events evidence distinct patterns of emotion regulation frequency, capacity, suppression, and cognitive reappraisal. Four patterns emerged: high regulators; high reappraisers/low suppressors; moderate reappraisers/low suppressors; and low regulators. Individuals who reported infrequently and ineffectively regulating their emotions (low regulators) also reported higher depression, anxiety, and posttraumatic stress disorder (PTSD). In contrast, individuals who reported frequently and effectively using reappraisal and low levels of suppression (high reappraisers/low suppressors) reported the lowest levels of these symptoms, suggesting that this specific combination of emotion regulation may be most adaptive. Our findings highlight that the capacity to regulate emotions and the ability to flexibly apply different strategies based on the context and timing may be associated with reduced psychopathology and more adaptive functioning.

Predictors and parameters of resilience to loss: toward an individual differences model

Although there is marked variation in how people cope with interpersonal loss, there is growing recognition that most people manage this extremely stressful experience with minimal to no impact on their daily functioning (G. A. Bonanno, 2004). What gives rise to this resilient capacity? In this paper, we provide an operational definition of resilience as a specific trajectory of psychological outcome and describe how the resilient trajectory differs from other trajectories of response to loss. We review recent data on individual differences in resilience to loss, including self-enhancing biases, repressive coping, a priori beliefs, identity continuity and complexity, dismissive attachment, positive emotions, and comfort from positive memories. We integrate these individual differences in a hypothesized model of resilience, focusing on their role in appraisal processes and the use of social resources. We conclude by considering potential cultural constraints on resilience and future research directions.

L’impact du suicide d’un patient chez des professionnels en santé mentale

Cet article rapporte les résultats d’une recherche réalisée auprès de 141 professionnels en santé mentale pratiquant au Québec et ayant vécu le suicide d’un patient. Les professionnels ont réagi à cet événement différemment en fonction de leur sexe. Les femmes y ont répondu par un niveau de stress élevé au cours du premier mois, alors que les hommes ont dévoilé un niveau de stress faible. Le niveau élevé de stress relevé chez les femmes était accompagné de répercussions initialement plus intenses sur leur pratique professionnelle : tendance accrue à hospitaliser des patients suicidaires ou précautions accrues dans leur traitement, évaluation d’un plus grand nombre de patients comme présentant un risque de suicide, sentiment accru d’impuissance lors de l’évaluation ou du traitement de patients suicidaires, consultation plus fréquente de collègues et de superviseurs, attention accrue aux aspects légaux dans la pratique. L’article tente de mieux comprendre les différences entre les réactions des professionnels observées selon leur sexe, à la lumière des théories de la socialisation et du développement professionnel.

Cardiovascular disease and psychiatric comorbidity: the potential role of perseverative cognition

The high comorbidity between psychiatric disorders and cardiovascular disease has received increasing attention, yet little is known about the processes linking the two. One plausible contributing mechanism is the tendency of those with psychiatric disorders to ruminate on stressful events. This phenomenon, sometimes called perseverative cognition, can extend the psychological and physiological effects of stress, which could contribute to cardiovascular disease etiology. In this paper, we discuss the potential role of perseverative cognition in mediating the relationship between psychiatric illness and cardiovascular disease. Rumination can delay physiological recovery from acute stress, which in turn has been found to predict future cardiovascular health. This delayed recovery could act as a mechanism in the longitudinal link between worry and cardiovascular health. The cognitive inflexibility that characterizes mood and anxiety disorders may then contribute to disease not by producing greater reactivity, but instead through extending activation, increasing the risks for cardiovascular damage.

The consequences of effortful emotion regulation when processing distressing material: a comparison of suppression and acceptance

The present study investigated the consequences of different forms of emotion regulation. Eighty nine healthy participants viewed a distressing video of the aftermath of road traffic accidents under either suppression (of both felt and expressed affect), acceptance, or no-regulation control instructions and the immediate and longer-term consequences on emotion, mood, and memory were examined. Suppression (relative to control) led to reduced subjective experience of fear when viewing the video, but did not alter electrodermal (EDA) or heart rate (HR) response. Subsequently, suppression led to a less marked subjective emotional reaction to positive but not negative emotional images, reduced free recall memory of the video, and a greater likelihood of experiencing zero intrusions of the video's content. Acceptance (relative to control) had no impact when viewing the video, was associated with a less marked increase in EDA activity in the 5 min period immediately after viewing the video, a more marked HR deceleration and EDA response to both positive and negative images, and elevated negative affect at one week follow-up. These findings suggest, contrary to the current clinical zeitgeist, that emotion suppression can successfully lead to an ongoing down-regulation of emotion and memory, whereas acceptance may elevate subsequent emotionality.