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Schwartzman JM, Antezana L, Conner CM. The relationship between distress tolerance and behavioral activation on anxiety and depression symptomatology in autistic youth: Leveraging self and caregiver perspectives. Autism Res 2024. [PMID: 39105310 DOI: 10.1002/aur.3208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
Anxiety and depression are prevalent among autistic adolescents and may be difficult to accurately diagnose and treat given various factors (e.g., diagnostic overshadowing, heterogeneity). Therefore, efforts to examine transdiagnostic factors (i.e., distress tolerance, behavioral activation) may afford more parsimonious means for assessment and treatment. To our knowledge, there has been little research on distress tolerance, behavioral activation, and depressive and anxiety symptoms in autistic adolescents to guide diagnostic practices and treatment planning. In the current study, we examined the interrelationships between these transdiagnostic factors and depressive and anxiety symptoms using ratings from 100 verbally fluent autistic adolescents without intellectual disability (Mage = 13.70, SDage = 2.23, Range: 11:00-17:11 years) and 100 of their caregivers. Many adolescents reported male sex assigned at birth (61%), cisgender (87%), not Hispanic/Latinx (90%), and White (80%) identities. A series of correlational analyses were employed to examine associations between these constructs from youth and caregiver perspectives, and multiple linear regression analyses were conducted to explore the mediating roles of distress tolerance and behavioral activation. Preliminary results show that low distress tolerance and behavioral activation were associated with more severe internalizing symptoms per self- and caregiver-report. Some differences by rater emerged, which highlight the importance of multi-informant ratings in autism. Results from mediation analyses may show that behavioral activation may be more salient to assessments and treatment planning for depression than distress tolerance, while distress tolerance may be important for both anxiety and depression; however, findings are preliminary given the cross-sectional nature of the data. Findings suggest that these transdiagnostic concepts may be important to individualizing treatment approaches, including the timing of certain approaches, for anxiety and/or depression in autistic adolescents.
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Affiliation(s)
- Jessica M Schwartzman
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Ligia Antezana
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Caitlin M Conner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Erol Y, Inozu M. An Investigation of the Mediating Roles of Emotion Regulation Difficulties, Distress Tolerance, Self-Compassion, and Self-Disgust in the Association Between Childhood Trauma and Nonsuicidal Self-Injury. Arch Suicide Res 2024; 28:815-829. [PMID: 37470456 DOI: 10.1080/13811118.2023.2237083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Childhood maltreatment has been associated as a risk factor with the development of nonsuicidal self-injury (NSSI), with difficulty in emotion regulation explaining the association. However, little is known about the potential factors that make some individuals with maltreatment history more vulnerable to difficulties in emotion regulation and, in turn, engage in NSSI. The current study aimed to examine the roles of distress tolerance, self-compassion, and self-disgust in the association between childhood maltreatment types and emotion regulation difficulty, which was expected to predict NSSI. METHOD The sample included 397 university students between the ages of 18 and 30. Participants completed self-report scales assessing childhood maltreatment, emotion regulation difficulty, distress tolerance, self-compassion, self-disgust, and NSSI using the paper-pencil and online methods. The mediation model suggested for the association between childhood maltreatment types and NSSI was tested using path analysis. RESULTS Low distress tolerance, low self-compassion, high self-disgust, and resulting high emotion regulation difficulty mediated the indirect effect of emotional neglect on NSSI. CONCLUSION The current study sheds light on various factors in the development and maintenance of NSSI and reveals three developmental pathways from emotional neglect in childhood to engaging in NSSI.HIGHLIGHTSEmotional neglect may be a distal risk factor for nonsuicidal self-injury (NSSI).Low distress tolerance and self-compassion and high self-disgust may increase the risk of NSSI.Emotion regulation difficulty may make people engage in NSSI to regulate emotions.
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Wang Y, Tian J, Yang Q. Experiential Avoidance Process Model: A Review of the Mechanism for the Generation and Maintenance of Avoidance Behavior. PSYCHIAT CLIN PSYCH 2024; 34:179-190. [PMID: 39165887 PMCID: PMC11332439 DOI: 10.5152/pcp.2024.23777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/09/2023] [Indexed: 08/22/2024] Open
Abstract
Experiential avoidance refers to a phenomenon in which individuals exhibit an unwillingness to engage with certain personal experiences, including physical sensations, emotions, thoughts, memories, and behavioral tendencies. They employ cognition and emotions to avoid these experiences. Extensive research has linked experiential avoidance to various mental diseases, conduct disorder, and posttraumatic stress disorder. While the existing literature highlights the significance of understanding experiential avoidance as a central mechanism underlying psychological symptomatology development and maintenance, further investigation is required to comprehend its dimensions and mechanisms fully. Therefore, this article aims to provide a comprehensive review of the current theories and empirical evidence on experiential avoidance while elucidating its association with psychopathology. We propose a model of experiential avoidance processes based on an extensive review and critical analysis of the previous emotion regulation model that integrates expressive suppression and cognitive reappraisal during emotion regulation through experiential avoidance. This proposed model seeks to explain both the formation and maintenance aspects of experiential avoidance by offering valuable insights for future research. We also examined the association between experiential avoidance and various psychiatric disorders, including anxiety, depression, obsessive-compulsive disorder, and posttraumatic stress disorder. Elaborating on these mechanisms provides a roadmap for future research endeavors and clinical interventions.
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Affiliation(s)
- Yi Wang
- Weinan Normal University, School of Physical Education, Weinan, China
| | - Jing Tian
- Weinan Normal University, School of Foreign Languages, Weinan, China
| | - Qingxuan Yang
- Department of Physical Education, Chang’an University, Xi’an, China
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Zemestani M, Abdolmaleki S, McGrew SJ, Vujanovic A. Associations between Sleep Disturbance and Suicidal Ideation Severity in Iranian University Students: Evaluating Emotion Regulation Difficulties and Distress Tolerance. Arch Suicide Res 2024; 28:454-470. [PMID: 36927369 DOI: 10.1080/13811118.2023.2190366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
AIM Although sleep disturbance is associated with suicide ideation, underlying cognitive-affective mechanisms that may explain this association are not well understood. The aim of the present study was to concurrently evaluate whether emotion regulation difficulties and distress tolerance explain this association among Iranian university students. METHOD A total of 679 Iranian university students (66.42% females; Mage = 24.34 years, SD = 4.86) completed a battery of online self-report questionnaire. Structural equation modeling was used to empirically explore the relations among variables. RESULTS Sleep disturbance was positively associated with suicide ideation. Higher sleep disturbance symptoms were associated with higher levels of suicide ideation. Sleep disturbance was indirectly related to suicide ideation through both emotion regulation difficulties and distress tolerance. CONCLUSION Findings expand knowledge of cognitive-emotional processes that may explain the sleep disturbance-suicide ideation association among Iranian university students. Iranian students experiencing sleep disturbance may benefit from intervention strategies targeting emotion regulation skills and distress tolerance to reduce suicide ideation.
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Chen F, Ou M, Xia W, Xu X. Psychological adjustment to death anxiety: a qualitative study of Chinese patients with advanced cancer. BMJ Open 2024; 14:e080220. [PMID: 38458799 DOI: 10.1136/bmjopen-2023-080220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES Death anxiety (DA) refers to the negative emotions experienced when a person reflects on the inevitability of their own death, which is common among patients with cancer. It is crucial to understand the causes, coping styles and adjustment processes related to DA. The purpose of this qualitative study is to explore the adaptation process and outcome of patients with advanced cancer with DA and to provide evidence-based support for the development of targeted intervention measures to improve the mental health of such patients. DESIGN This cross-sectional qualitative study sampled patients with advanced cancer (n=20). Grounded theory procedures were used to analyse transcripts and a theoretical model generated. SETTING All interviewees in this study were from a tertiary oncology hospital in Hunan Province, China. The data analysis followed the constructive grounded theory method, involving constant comparison and memo writing. PARTICIPANTS A purposive and theoretical sampling approach was used to recruit 20 patients with advanced cancer with diverse characteristics. RESULTS A total of 20 participants were included in the study. Four stages of DA in patients with advanced cancer were extracted from the interview data: (1) death reminder and prominence; (2) perception and association; (3) defence and control; (4) transformation and Acceptance. CONCLUSIONS This study highlights the psychological status and coping strategies of dynamic nature of patients with advanced cancer when confronted with negative emotions associated with death. It emphasises the importance of timely identification of DA in psychological nursing for patients with advanced cancer and the need for targeted psychological interventions based on their specific psychological processes. IMPLICATIONS Knowing interventions that aim to promote the integration of internal and external resources, enhance self-esteem and facilitate a calm and accepting attitude towards death could ultimately reduce the overall DA of patients with advanced cancer.
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Affiliation(s)
- Furong Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
- University of South China School of Nursing, Hengyang, China
| | - Meijun Ou
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Wanting Xia
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
- Central South University Xiangya School of Nursing, Changsha, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
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Jacques DT, Sturge-Apple ML, Davies PT, Cicchetti D. Maternal alcohol dependence symptoms, maternal insensitivity to children's distress, and young children's blunted emotional reactivity. Dev Psychopathol 2024:1-23. [PMID: 38426705 PMCID: PMC11366043 DOI: 10.1017/s0954579424000324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.
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Affiliation(s)
| | - Melissa L Sturge-Apple
- Department of Psychology and Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Patrick T Davies
- Department of Psychology and Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Caiado B, Santos D, Pereira B, Góis AC, Canavarro MC, Moreira H. The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders. CHILDREN (BASEL, SWITZERLAND) 2024; 11:115. [PMID: 38255428 PMCID: PMC10814728 DOI: 10.3390/children11010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND The Distress Tolerance Scale (DTS) was adapted for American and Chinese youth, but never for European youth. Moreover, the factor structures found in these previous studies were not consistent. METHODS The DTS was adapted for Portuguese children and then validated among 153 children aged 6-13 years with emotional disorders. A confirmatory factor analysis (CFA) was conducted; the DTS reliability and validity were analyzed, and sex and age differences were explored. A sub-sample of children who received a transdiagnostic CBT (Unified Protocol for Children) was used to analyze the DTS's sensitivity to therapeutic change. RESULTS The five tested models (based on previous studies) exhibited adequate fit in the CFA. However, the model previously reported for use in American children with emotional disorders was selected as the most appropriate. The DTS demonstrated adequate psychometric properties, and its validity was established through significant negative associations with measures of anxiety, depression and negative affect, as well as positive associations with positive affect. Age and sex differences were discussed. The DTS scores significantly increased from pre- to post-treatment, demonstrating sensitivity to therapeutic change. CONCLUSIONS The DTS is a suitable and useful measure for assessing children's distress tolerance and to assess the efficacy of CBT.
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Affiliation(s)
| | | | | | | | | | - Helena Moreira
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, 3000-548 Coimbra, Portugal; (B.C.); (D.S.); (B.P.); (A.C.G.); (M.C.C.)
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Baker SN, Burr EK, De Leon AN, Leary AV, Rozek DC, Dvorak RD. The Mediating Roles of Affect Lability and Experiential Avoidance Between Distress Tolerance and Suicidal Ideation Among College Students. Psychol Rep 2023:332941231216671. [PMID: 37967570 DOI: 10.1177/00332941231216671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Objective: Suicidal ideation (SI) is highly prevalent among college students. Research has shown that college students are also more likely to experience low distress tolerance, affect lability, and experiential avoidance, which have been linked to SI. There is a critical need to examine the mechanisms that increase the risk of SI among college students. It is hypothesized that distress tolerance will be a strong predictor of SI, and affect lability as well as experiential avoidance will mediate this relationship. Participants and Methods: Participants (n = 820) from a Southeastern University completed an online survey, inquiring about demographic information, affect lability, SI, experiential avoidance, and distress tolerance. Data were analyzed utilizing structural equation modeling. Results: Distress tolerance was not directly related to SI. However, affect lability and experiential avoidance were found to mediate this relationship. Conclusions: Affect lability and experiential avoidance may be important predictors of SI among college students.
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Affiliation(s)
| | - Emily K Burr
- The University of Central Florida, Orlando, FL, USA
| | | | | | - David C Rozek
- The University of Central Florida, Orlando, FL, USA
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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Russo JE, Dhruve DM, Oliveros AD. Childhood Trauma and PTSD Symptoms: Disentangling the Roles of Emotion Regulation and Distress Tolerance. Res Child Adolesc Psychopathol 2023; 51:1273-1287. [PMID: 37039922 DOI: 10.1007/s10802-023-01048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/12/2023]
Abstract
Research documents that a history of childhood trauma increases risk for post-traumatic stress disorder (PTSD), greater emotion regulation difficulties (ERD), and reduced distress tolerance (DT). Independent lines of research implicate ERD and DT as transdiagnostic risk factors and link them to PTSD. To elucidate how such mechanisms may influence the etiology, maintenance, and treatment of PTSD, the current study investigates the distinct mediating roles of emotion regulation and DT, exploring which explains a larger indirect effect from childhood trauma to PTSD symptom severity. Participants (N = 385, aged 18-48) who endorsed a history of childhood trauma provided retrospective report of cumulative childhood trauma exposure, and of current ERD, DT, and PTSD symptom severity. Single and dual mediation analyses were used to assess indirect effects through ERD and DT in the relation between cumulative childhood trauma exposure and current PTSD symptom severity. ERD and DT were significantly and inversely related. Higher current self-ratings of PTSD symptom severity were explained by cumulative childhood trauma through ERD (B = 0.93, p < 0.001) and DT (B = 0.50, p < 0.05). The full model explained 36% of the variance in PTSD symptom severity. Current findings provide preliminary evidence of DT and emotion regulation (with specific facets identified) as distinct mechanisms in the development of PTSD. Of clinical relevance, current findings support post-trauma processing theories that contend individuals' recovery requires accepting and learning to modulate trauma-related emotional states. Implications for methods of treatment and prevention are discussed.
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Affiliation(s)
- Jenna E Russo
- Department of Psychology, Mississippi State University, 110 Magruder Hall, P.O. Box 6161, Mississippi State, MS, 39762, USA.
| | - Deepali M Dhruve
- Department of Psychology, Mississippi State University, 110 Magruder Hall, P.O. Box 6161, Mississippi State, MS, 39762, USA
| | - Arazais D Oliveros
- Department of Psychology, Mississippi State University, 110 Magruder Hall, P.O. Box 6161, Mississippi State, MS, 39762, USA
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Sargu L, Andrioni F, Popp L, Netedu A, Bularca MC, Otovescu A, Motoi G, Negrilă I, Goian C, Coman C, Chirugu G. The Role of Mass Media in Influencing the Lifestyle of the Elderly during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:1816. [PMID: 37444648 DOI: 10.3390/healthcare11131816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
The elderly represent one of the categories that was most affected by the pandemic period. The purpose of this research was to analyze the ways in which mass media and very often contradictory information flows influenced the lives and personal communications of the Romanian elderly population during the COVID-19 pandemic. In order to conduct the research, we used a mixed-methods approach. For the quantitative research, we gave a questionnaire to the elderly population of Romania, and for the qualitative research, we conducted interviews. Our quantitative sample included 881 retired persons with an age between 55 and 94 years old; the mean age was 71.48 years old with 6.6 years standard deviation. The elderly described the pandemic period using negative words: fear, loneliness, anxiety, disaster; the channel they mostly watched and trusted was the TV; they were aware of the measures they had to take to protect themselves; they missed most of the meetings with the family and the main problems they had were represented by loneliness, the inability to be with their families or the lack of access to medical services. The elderly's mass media consumption during the pandemic was mostly represented by TV consumption; the information spread by mass media was sometimes contradictory; it influenced their behavior and may have generated feelings of anxiety among them.
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Affiliation(s)
- Lilia Sargu
- Department of Economy and Tourism, Faculty of Economic Sciences, University of European Studies of Moldova, 2069 Chisinau, Moldova
| | - Felicia Andrioni
- Department of Socio-Humanities Sciences, Faculty of Sciences, University of Petrosani, 332006 Petrosani, Romania
| | - Lavinia Popp
- Department of Social Work, Faculty of Sociology and Social Work, University "Babeş-Bolyai"-Reşiţa University Center, 400347 Resita, Romania
| | - Adrian Netedu
- Department of Sociology and Social Work, Faculty of Philosophy and Socio-Political Sciences, Alexandru Ioan Cuza University of Iasi, 700506 Iasi, Romania
| | - Maria Cristina Bularca
- Department of Social Sciences and Communication, Faculty of Sociology and Communication, Transilvania University of Brasov, 500036 Brasov, Romania
| | - Adrian Otovescu
- Department of Communication, Journalism and Education Sciences, Faculty of Letters, University of Craiova, 200585 Craiova, Romania
| | - Gabriela Motoi
- Department of Sociology, Philosophy, and Social Work, Faculty of Social Sciences, University of Craiova, 200585 Craiova, Romania
| | - Ion Negrilă
- Doctoral School of Social and Humanities Sciences, University of Craiova, 200585 Craiova, Romania
| | - Cosmin Goian
- Department of Social Work, Faculty of Sociology and Psychology, West University of Timisoara, 300223 Timisoara, Romania
| | - Claudiu Coman
- Department of Social Sciences and Communication, Faculty of Sociology and Communication, Transilvania University of Brasov, 500036 Brasov, Romania
| | - Gianina Chirugu
- Faculty of Theology, Ovidius University of Constanta, 900527 Constanta, Romania
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Son M, Jeong GC. Influence of Sensation Seeking and Life Satisfaction Expectancy on Stock Addiction Tendency: Moderating Effect of Distress Tolerance. Behav Sci (Basel) 2023; 13:bs13050378. [PMID: 37232615 DOI: 10.3390/bs13050378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023] Open
Abstract
Due to the COVID-19 pandemic, a very low interest rate policy was economically applied in Korea, and various investment activities through loans were activated. Real estate and stock prices rose rapidly, and many people became involved in stock investments because of economic instability. However, hastily started investment behavior resulted in economic loss and addictive behavior in stocks. The phenomenon of using stock investment to satisfy individual sensation seeking or addictive dependence on stocks due to lowered life satisfaction expectancy can become a serious social problem. However, the improvement of distress tolerance and the ability to endure pain despite frequent stock price fluctuations or lowered life satisfaction expectancy would be good alternatives to prevent stock addiction tendency. Therefore, the purpose of this study is to test the moderating effect of distress tolerance on the effect of adults' sensation seeking and life satisfaction expectancy in stock addiction tendencies. The participants were 272 adults with stock investment experience. As a result, distress tolerance significantly moderated the positive effect of sensation seeking on stock addiction tendency. In addition, life satisfaction expectancy did not significantly increase in the group with high distress tolerance even if life satisfaction expectancy was lowered. These results suggest that stock addiction can be prevented by enhancing distress tolerance.
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Affiliation(s)
- Myounghwan Son
- Department of Counseling Psychology, Graduate School, Sahmyook University, Seoul 01795, Republic of Korea
| | - Goo-Churl Jeong
- Department of Counseling Psychology, College of Health and Welfare, Sahmyook University, Seoul 01795, Republic of Korea
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12
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Koire A, Feldman N, Erdei C, Mittal L, Liu CH. Postpartum experiences among individuals with suspected and confirmed prenatal generalized anxiety disorder during the COVID-19 pandemic: Implications for help-seeking. Psychiatry Res 2023; 323:115169. [PMID: 36989907 PMCID: PMC10010836 DOI: 10.1016/j.psychres.2023.115169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023]
Abstract
Prenatal generalized anxiety disorder (GAD) is a common and underdiagnosed condition with negative health consequences to both the pregnant individual and child. Here we studied the relationship between diagnosis and treatment status of GAD during pregnancy (no GAD diagnosis, suspected but not diagnosed, diagnosed but not treated, diagnosed and treated) during the COVID-19 pandemic and postpartum mental health outcomes, while considering the potential influence of individual psychological factors such as distress tolerance and resilience and the role of COVID-19-related health worries. In this sample of predominantly highly educated and white birthing individuals, one in five respondents experienced GAD during pregnancy and another one in six suspected GAD but was not diagnosed. Amongst those with a GAD diagnosis, 30% did not receive treatment. We found that those with a GAD diagnosis during pregnancy who did not receive treatment showed the highest levels of postpartum anxiety and depressive symptoms in the postpartum, even after controlling for covariates, and experienced the most COVID-19-related health worries. In comparison, individuals with a GAD diagnosis during pregnancy who received treatment experienced significantly lower anxiety symptom burden and depressive symptom burden, with a symptom burden similar to those without a confirmed or suspected diagnosis after controlling for individual psychological factors. We conclude that clinicians should strongly consider screening for and treating prenatal anxiety to prevent suboptimal postpartum mental health outcomes.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Natalie Feldman
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Carmina Erdei
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115,Corresponding Author: Cindy H. Liu, Tel: 617-525-4131, 221 Longwood Ave., BLI 341, Boston, MA 02115
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13
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Smits JAJ, Monfils MH, Otto MW, Telch MJ, Shumake J, Feinstein JS, Khalsa SS, Cobb AR, Parsons EM, Long LJ, McSpadden B, Johnson D, Greenberg A. CO 2 reactivity as a biomarker of exposure-based therapy non-response: study protocol. BMC Psychiatry 2022; 22:831. [PMID: 36575425 PMCID: PMC9793569 DOI: 10.1186/s12888-022-04478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Exposure-based therapy is an effective first-line treatment for anxiety-, obsessive-compulsive, and trauma- and stressor-related disorders; however, many patients do not improve, resulting in prolonged suffering and poorly used resources. Basic research on fear extinction may inform the development of a biomarker for the selection of exposure-based therapy. Growing evidence links orexin system activity to deficits in fear extinction and we have demonstrated that reactivity to an inhaled carbon dioxide (CO2) challenge-a safe, affordable, and easy-to-implement procedure-can serve as a proxy for orexin system activity and predicts fear extinction deficits in rodents. Building upon this basic research, the goal for the proposed study is to validate CO2 reactivity as a biomarker of exposure-based therapy non-response. METHODS We will assess CO2 reactivity in 600 adults meeting criteria for one or more fear- or anxiety-related disorders prior to providing open exposure-based therapy. By incorporating CO2 reactivity into a multivariate model predicting treatment non-response that also includes reactivity to hyperventilation as well as a number of related predictor variables, we will establish the mechanistic specificity and the additive predictive utility of the potential CO2 reactivity biomarker. By developing models independently within two study sites (University of Texas at Austin and Boston University) and predicting the other site's data, we will validate that the results are likely to generalize to future clinical samples. DISCUSSION Representing a necessary stage in translating basic research, this investigation addresses an important public health issue by testing an accessible clinical assessment strategy that may lead to a more effective treatment selection (personalized medicine) for patients with anxiety- and fear-related disorders, and enhanced understanding of the mechanisms governing exposure-based therapy. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05467683 (20/07/2022).
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Affiliation(s)
- Jasper A. J. Smits
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA
| | - Marie-H. Monfils
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA
| | - Michael W. Otto
- grid.189504.10000 0004 1936 7558Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215 USA
| | - Michael J. Telch
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA
| | - Jason Shumake
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA
| | - Justin S. Feinstein
- grid.417423.70000 0004 0512 88633The Laureate Institute for Brain Research, 6655 South Yale Ave., Tulsa, Oklahoma 74136 USA
| | - Sahib S. Khalsa
- grid.417423.70000 0004 0512 88633The Laureate Institute for Brain Research, 6655 South Yale Ave., Tulsa, Oklahoma 74136 USA
| | - Adam R. Cobb
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA ,grid.259828.c0000 0001 2189 3475Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina and Ralph H. Johnson VAHCS, 67 President Street MSC 862, Charleston, SC 29425 USA
| | - E. Marie Parsons
- grid.189504.10000 0004 1936 7558Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215 USA
| | - Laura J. Long
- grid.189504.10000 0004 1936 7558Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215 USA
| | - Bryan McSpadden
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA
| | - David Johnson
- grid.89336.370000 0004 1936 9924Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, 1 University Station, Austin, TX 78712 USA
| | - Alma Greenberg
- grid.189504.10000 0004 1936 7558Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215 USA
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14
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Fight or Flight? Curvilinear Relations between Previous Cyberbullying Victimization Experiences and Continuous Use of Social Media: Social Media Rumination and Distress as Chain Mediators. Behav Sci (Basel) 2022; 12:bs12110421. [DOI: 10.3390/bs12110421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
Recently, the number of active users of social media platforms is declining, posing a challenge to the sustainability of interest in social media and related industries. Therefore, it is of great significance to examine the environmental and psychological factors that influence the continuous use of social media. Until recently, little research has examined this topic from the perspective of the relationship between previous cyberbullying victimization experiences (PCVE) and the continuous use of social media (CUOSM), not to mention the psychological mechanisms that lead to this relationship. In addition, there are paradoxes in existing studies: one side believes that PCVE causes users to become addicted to using social media, while the other side argues that PCVE drives users to escape from using social media. In order to respond to this controversy and clarify the relationship between PCVE and CUOSM, this study introduces two psychological variables, namely “social media rumination (SMR)” and “distress”, in order to construct a chain mediation model. Researchers surveyed 692 people who had experienced social media cyberbullying, and analyzed the data through SPSS and Mplus. The findings were as follows: 1. There is an inverted U-shaped curve relationship between PCVE and CUOSM. Specifically, the relationship initially exhibits a positive correlation (the period named fight), which then becomes negative (the period named flight). 2. When PCVE and CUOSM are positively correlated, SMR is the main factor that contributes to an increase in CUOSM. 3. When PCVE and CUOSM are negatively correlated, distress is the major factor that causes a decline in CUOSM. This study provides an explanation for the controversy in previous research, expands the scope of social media research, and provides a practical reference for social media platforms to enhance their existing users’ continuous use.
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15
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Lim CYS, Laidsaar-Powell RC, Young JM, Solomon M, Steffens D, Blinman P, O'Loughlin S, Zhang Y, Butow P. Fear of Cancer Progression and Death Anxiety in Survivors of Advanced Colorectal Cancer: A Qualitative Study Exploring Coping Strategies and Quality of Life. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221121493. [PMID: 36127158 DOI: 10.1177/00302228221121493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to examine coping strategies used by advanced colorectal cancer (CRC-A) survivors to manage death anxiety and fear of cancer progression, and links between these strategies and quality of life (QoL), distress, and death acceptance. Qualitative semi-structured interviews of 38 CRC-A survivors (22 female) were analysed via framework analysis. QoL and distress were assessed through the FACT-C and Distress Thermometer. Eleven themes were identified and mapped to active avoidance (keeping busy and distracted), passive avoidance (hoping for a cure), active confrontation (managing negative emotions; reaching out to others; focusing on the present; staying resilient), meaning-making (redefining one's identity; contributing to society; gaining perspective; remaining spiritual), and acceptance (accepting one's situation). Active confrontation (specifically utilising informal support networks) and meaning-making appeared beneficial coping strategies; more research is needed to develop and evaluate interventions which increase CRC-A survivors' use of these strategies to manage and cope with their death anxiety.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah C Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW
| | - Michael Solomon
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Prunella Blinman
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Scott O'Loughlin
- Ramsay Mental Health, Macarthur Hospital, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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16
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Development and preliminary validation of a scale to assess physicians’ emotional distress intolerance in end-of-life care communication. Palliat Support Care 2022; 21:399-410. [PMID: 35369897 DOI: 10.1017/s1478951522000219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Context
End-of-life care (EOLC) communication is beneficial but underutilized, particularly in conditions with a variable course such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). Physicians’ emotional distress intolerance has been identified as a barrier to EOLC communication. However, studies of emotional distress intolerance in EOLC have largely relied on anecdotal reports, qualitative data, or observational studies of physician–patient communication. A free-standing measure of multiple dimensions of distress tolerance is warranted to enable the identification of individuals experiencing distress intolerance and to facilitate the effective targeting of interventions to improve distress tolerance.
Objectives
This study provides preliminary data on the reliability and validity of the Physician Distress Intolerance (PDI) scale. We examine potential subdimensions of emotional distress intolerance.
Method
Family medicine and internal medicine physicians completed the PDI, read vignettes describing patients with COPD or CHF, and indicated whether they initiated or delayed EOLC communication with their patients with similar conditions.
Results
Exploratory and confirmatory factor analyses were performed on separate samples. Confirmatory factor analysis confirmed that a three-factor solution was superior to a two- or one-factor solution. Three subscales were created: Anticipating Negative Emotions, Intolerance of Uncertainty, and Iatrogenic Harm. The full scale and subscales had adequate internal consistency and demonstrated evidence of validity. Higher scores on the PDI, indicating greater distress intolerance, were negatively associated with initiation and positively associated with delay of EOLC communication. Subscales provided unique information.
Significance of results
The PDI can contribute to research investigating and addressing emotional barriers to EOLC communication.
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17
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When is your distress harder to tolerate? A qualitative analysis of situations in which distress tolerance is impaired and strengthened. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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18
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Weiss NH, Kiefer R, Goncharenko S, Raudales AM, Forkus SR, Schick MR, Contractor AA. Emotion regulation and substance use: A meta-analysis. Drug Alcohol Depend 2022; 230:109131. [PMID: 34864568 PMCID: PMC8714680 DOI: 10.1016/j.drugalcdep.2021.109131] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/26/2021] [Accepted: 09/30/2021] [Indexed: 01/03/2023]
Abstract
There has been exponential growth in research on emotion regulation and substance use in the past decade. The current meta-analysis evaluated variability in the magnitude of the relation between aspects of emotion regulation and substance use. A search of PsycINFO, Embase, PubMed, CINAHL Plus, and PILOTS in December 2020 resulted in 6642 initial studies, of which 95 met inclusion criteria (association between emotion regulation and substance use was reported, participants were > 18 years old, article was in English). A total of 445 effects were obtained (N = 156,025 participants; weighted Mage = 29.31; 59.5% female; 66.1% White; 76.6% non-clinical). Emotion regulation and substance use were significantly related (r = 0.19; p < 0.001; 95%CI [0.17, 0.20]). Emotion regulation abilities were generally more strongly related to substance use than emotion regulation strategies; this pattern was stronger for behavioral vs. cognitive abilities and extended to both negative and positive emotions. Relations were stronger for older and clinical samples; mixed effects were found for sex and no conclusive effects were found for race. Despite limitations of the existing literature (e.g., cross-sectional, self-reports), results indicated that the magnitude of the relation between emotion regulation and substance use varied considerably as a function of emotion regulation and substance use constructs and sample characteristics.
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19
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Unsupportive romantic partner behaviors increase neural reactivity to mistakes. Int J Psychophysiol 2021; 170:12-19. [PMID: 34592343 DOI: 10.1016/j.ijpsycho.2021.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022]
Abstract
Romantic relationships involve a range of positive and negative experiences, from supportive and security-enhancing behaviors to unsupportive interactions involving criticism and dismissiveness. The present study aimed to examine the functional impact of these experiences on reactivity to mistakes, as error salience has key implications for adaptive functioning in areas such as goal-striving and appropriate risk-taking. To this end, a study was conducted in which participants completed the Eriksen Flanker Task (EFT) alone and under romantic partner observation while electrophysiological brain activity related to error salience (the error-related negativity (ERN)) was recorded. Findings indicated that unsupportive, but not supportive, partner behaviors were associated with changes in error salience, furthering the notion that negative relationship experiences have a stronger effect on functioning than do positive ones and highlighting the impact of relationship context on reactivity to mistakes.
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20
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Heleniak C, Bolden CR, McCabe CJ, Lambert HK, Rosen ML, King KM, Monahan KC, McLaughlin KA. Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence. Res Child Adolesc Psychopathol 2021; 49:1211-1225. [PMID: 33786696 PMCID: PMC8324573 DOI: 10.1007/s10802-021-00805-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance-the ability to persist in the face of distress-and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16-17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial Addition Task. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling for socio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.
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Affiliation(s)
- Charlotte Heleniak
- Department of Psychology, Columbia University, 1190 Amsterdam Ave, New York, NY, 10027, USA.
| | - China R Bolden
- School of Psychology, Family, and Community, Seattle Pacific University, Seattle, Washington, USA
| | - Connor J McCabe
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Hilary K Lambert
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Maya L Rosen
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Kevin M King
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Kathryn C Monahan
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA
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21
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Pacella-LaBarbara ML, Maltese C, McConaghy M, Porter J, Young ML, Suffoletto B. Distress Tolerance Among Emergency Department Patients in Acute Pain: Associations with Substance Use Treatment. Stress Health 2021; 37:588-595. [PMID: 33369098 PMCID: PMC8713510 DOI: 10.1002/smi.3020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 11/08/2022]
Abstract
Managing acute pain in individuals with a history of substance use disorders (SUD) is complex. Distress tolerance (DT) (e.g., the ability to handle uncomfortable sensations) may serve as an ideal non-pharmacological intervention target in this population. Among 293 emergency department (ED) patients seeking treatment for pain (Mage = 41; 42% Female; 43% Black), we examined rates of SUD treatment and DT, whether an objective DT task is feasible to conduct in the ED, and relationships between DT and SUD. Patients completed a self-report DT survey, an objective DT task, and brief surveys of pain, drug use, current or past SUD treatment, and depression/anxiety. Average DT was 18.50 (SD = 9.4) out of 50; patients with past or current SUD treatment (n = 43; 14.7%) reported lower DT than patients with no SUD treatment history (n = 250; 85.3%). Controlling for demographics, depression/anxiety, and pain severity, lower subjective DT (adjusted odds ratio [aOR] = 1.05) and objective DT (aOR = 1.02) was associated a current or past history or SUD treatment. Assessing subjective and objective DT in ED patients with acute pain is feasible; interventions aimed at boosting DT may improve outcomes among patients with acute pain and SUD.
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Affiliation(s)
| | - Caroline Maltese
- University of Pittsburgh School of Medicine, Department of Emergency Medicine
| | - Madelyn McConaghy
- University of Pittsburgh School of Medicine, Department of Emergency Medicine
| | - James Porter
- University of Pittsburgh School of Medicine, Department of Emergency Medicine
| | - Michael L. Young
- University of Pittsburgh School of Medicine, Department of Emergency Medicine
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22
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Martins A, Canavarro MC, Pereira M. Multidimensional factors associated with perceived risk of HIV among sexually experienced individuals in Portugal. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1933146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alexandra Martins
- Faculty of Psychology and Educational Sciences, University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Maria Cristina Canavarro
- Faculty of Psychology and Educational Sciences, University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Marco Pereira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal
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23
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Patel ZS, Casline E, Jensen-Doss A, Timpano KR. Parent Distress Intolerance, Repetitive Negative Thinking, and Mental Health Service Use. Child Psychiatry Hum Dev 2021; 52:365-375. [PMID: 32632828 DOI: 10.1007/s10578-020-01017-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While extensive evidence links service use for mental health problems to demographic variables and positive attitudes, studies have not explored the role of transdiagnostic risk factors, like distress intolerance (DI) and repetitive negative thinking (RNT). This study examined the relationship between parental DI and RNT on mental health treatment seeking for parents themselves and their children. Results suggest higher DI and RNT predict service use among parents (p < 0.05) but were not significantly associated with help seeking for their children, indicating that factors more proximal to the child may have greater influence when parents make treatment decisions for their children. Results also indicte that DI moderates the relationship between parent psychopathology and parent service use, such that parent psychopathology is significantly associated with service use for those with lower DI, but not at moderate or high levels of DI. Implications for marketing mental health information to parents and engaging them in treatment are discussed.
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Affiliation(s)
- Zabin S Patel
- Department of Psychology, University of Miami, Coral Gables, FL, 33124, USA.
| | - Elizabeth Casline
- Department of Psychology, University of Miami, Coral Gables, FL, 33124, USA
| | - Amanda Jensen-Doss
- Department of Psychology, University of Miami, Coral Gables, FL, 33124, USA
| | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, FL, 33124, USA
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24
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Kremyar AJ, Lee TTC. MMPI-3 Predictors of Anxiety Sensitivity and Distress Intolerance. Assessment 2021; 29:1103-1116. [PMID: 33759600 DOI: 10.1177/10731911211001948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Documenting empirical correlates of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scale scores is important for expanding the clinical utility of the instrument. To this end, the goals of the current study were to examine associations between scores on MMPI-3 scales and measures of anxiety sensitivity and distress intolerance, two constructs reflecting intolerance of negative emotional states that are implicated in many psychological conditions, and to identify the scales that most strongly predict each construct. Using a sample of 287 undergraduate students (71% women; Mage = 18.90, SD = 1.12; 85% White), zero-order correlational, regression, and dominance analyses were performed to address these goals. Results indicate that when MMPI-3 scale scores are considered conjointly by scale family, they predict meaningful variance in anxiety sensitivity and distress intolerance measure scores, with conceptually implicated scales offering the strongest prediction across scale families. Implications for both research and practice, limitations, and future research directions are discussed.
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25
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Klein KP, Bartholomay EM, Stevens KT, Harris EK, Björgvinsson T, Kertz SJ. Re-examination of the Latent Structure of the Distress Intolerance Index. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00103-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Javed S, Parveen H. Adaptive coping strategies used by people during coronavirus. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:122. [PMID: 34084869 PMCID: PMC8150078 DOI: 10.4103/jehp.jehp_522_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/14/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Coronavirus (COVID-19) a worldwide pandemic has significantly affected life of people around the globe. It has also caused various psychological issues among public such as uncertainty, fear, anxiety, and of course stress. Globalization has facilitated it and has added greater complexity to the containment of infection leading to urgent call for public health challenge. Consequently, a multilevel stress coping adjustment process is going on. Hence, it is imperative to explore how people are affected psychologically and how they are coping with it. People are adopting different strategies for coping up from this challenging situation. In this sense, the present study intended to: explore which coping strategies were of relevance for people for adjusting in COVID-19 crises and were sociodemographic factors influencing the coping strategies. MATERIALS AND METHODS The research is descriptive study. For the present study, a sample of 475 participants was asked for coping strategies used by them using valid and reliable scales. RESULTS Results revealed that positive attitude and trust in God were the most used adaptive coping strategies and sociodemographic variables were playing a significant role in adaptive coping strategies. CONCLUSION Hence, understanding and identification of coping strategies and their relationship with demographic variables can help health professionals to direct interventions to control stressors related to the pandemics.
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Affiliation(s)
- Sarah Javed
- Department of Psychology, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Heena Parveen
- Department of Psychology, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
- Address for correspondence: Dr. Heena Parveen, Department of Psychology, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. E-mail:
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27
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Veilleux JC, Skinner KD. Differences in Distress Intolerance Among Daily and Intermittent Smokers. Nicotine Tob Res 2020; 22:1867-1874. [PMID: 31867636 DOI: 10.1093/ntr/ntz237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/17/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Distress intolerance is an important risk factor for smokers. Smokers have greater problems tolerating distress than nonsmokers, and distress intolerance is theoretically an important predictor of early lapse. However, much of the distress intolerance research has been conducted on daily smokers. Understanding distress intolerance in nondaily or intermittent smokers may help elucidate whether distress intolerance is a function of current smoking habits. AIMS AND METHODS Daily (n = 36) and intermittent (n = 28) smokers completed behavioral distress intolerance tasks (breath holding, mirror tracing persistence, and image persistence) along with self-report measures of both general and smoking-specific distress intolerance. They also completed 1 week of ecological momentary assessment where positive and negative affect were assessed along with momentary distress intolerance, at both random times (7×/day) and immediately prior to smoking a cigarette. RESULTS Results found no differences between intermittent and daily smokers on behavioral distress intolerance tasks or general self-reported distress intolerance. Daily smokers reported greater self-reported smoking-specific distress intolerance compared to intermittent smokers. In addition, across both smoker groups, momentary distress intolerance was higher at smoking compared to random sessions, and low positive affect predicted greater momentary distress intolerance specifically for intermittent smokers prior to smoking. CONCLUSIONS The lack of differences between daily and intermittent smokers on general distress intolerance measures suggests that distress intolerance abilities and self-perceptions are not a function of higher levels of current smoking. However, the contextual variation in momentary distress intolerance is worth further exploration in both daily and intermittent smokers. IMPLICATIONS The overall lack of differences between intermittent and daily smokers on distress intolerance tasks and self-report measures suggests that daily smoking is not associated with lower abilities to manage or tolerate distress at the individual difference level. However, understanding fluctuations in distress intolerance across time and context is crucial, as smokers' perceptions of their abilities to manage distress shift based on affect and smoking contexts. Stabilizing or increasing self-efficacy in tolerating distress during daily life is likely an important avenue for future research.
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Affiliation(s)
- Jennifer C Veilleux
- Department of Psychological Science, University of Arkansas, Fayetteville, AR
| | - Kayla D Skinner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR.,EVMS Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA
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28
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Jacques DT, Sturge-Apple ML, Davies PT, Cicchetti D. Maternal alcohol dependence and harsh caregiving across parenting contexts: The moderating role of child negative emotionality. Dev Psychopathol 2020; 32:1509-1523. [PMID: 31735197 PMCID: PMC7231671 DOI: 10.1017/s0954579419001445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Parental alcohol dependence is a significant risk factor for harsh caregiving behaviors; however, it is unknown whether and how harsh caregiving changes over time and across parenting contexts for alcohol-dependent mothers. Furthermore, to our knowledge, no studies have examined whether and how distinct dimensions of child characteristics, such as negative emotionality modulate harsh caregiving among alcohol-dependent mothers. Guided by parenting process models, the present study examined how two distinct domains of children's negative emotionality-fear and frustration-moderate the association between maternal alcohol dependence and maternal harshness across discipline and free-play contexts. A high-risk sample of 201 mothers and their two-year-old children were studied over a one-year period. Results from latent difference score analyses indicated that harsh parenting among alcohol-dependent mothers increased over time in the more stressful discipline context, but not in the parent-child play context. This effect was maintained even after controlling for other parenting risk factors, including other forms of maternal psychopathology. Furthermore, this increase in harsh parenting was specific to alcohol-dependent mothers whose children were displaying high levels of anger and frustration. Findings provide support for specificity in conceptualizations of child negative emotionality and parenting contexts as potential determinants of maladaptive caregiving among alcohol-dependent mothers.
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Affiliation(s)
| | | | - Patrick T Davies
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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29
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Doorley JD, Goodman FR, Kelso KC, Kashdan TB. Psychological flexibility: What we know, what we do not know, and what we think we know. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2020. [DOI: 10.1111/spc3.12566] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- James D. Doorley
- Department of Psychology George Mason University Fairfax Virginia USA
| | - Fallon R. Goodman
- Department of Psychology University of South Florida Tampa Florida USA
| | - Kerry C. Kelso
- Department of Psychology George Mason University Fairfax Virginia USA
| | - Todd B. Kashdan
- Department of Psychology George Mason University Fairfax Virginia USA
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30
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Validation and Clinical Correlates of the Behavioral Indicator of Resiliency to Distress Task (BIRD) in a University- and Community-Based Sample of Youth with Emotional Disorders. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09830-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tonarely NA, Ehrenreich-May J. Confirming the Factor Structure and Validity of the Distress Tolerance Scale (DTS) in Youth. Child Psychiatry Hum Dev 2020; 51:514-526. [PMID: 31637572 DOI: 10.1007/s10578-019-00935-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Distress tolerance (DT) is an individual's ability to handle uncomfortable emotion states or sensations (Simons and Gaher in Motiv Emot 29(2): 83-102, 2005). DT is associated with heightened risk for psychopathology, including internalizing symptoms. However, little research has examined the feasibility of assessing DT via youth self-report. The purpose of this investigation was to assess the psychometric properties of the Distress Tolerance Scale (DTS) (Simons and Gaher in Motiv Emot 29(2): 83-102, 2005) in community (n = 117; ages 10-19; 56.4% female) and clinical samples (n = 165; ages 10-18, 52.7% female) of youth. Predictors of DT and its association with internalizing symptoms were investigated. The majority of fit indices confirmed a four-factor hierarchical structure for the clinical sample data. Females reported lower DT than males and DT was associated with internalizing symptoms. Validation of the factor structure of the DTS allows for investigation of child and adolescent-reported perceptions of DT as a risk factor for psychopathology in youth.
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Affiliation(s)
- Niza A Tonarely
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building, Room 345, Coral Gables, FL, 33146, USA. .,University of Miami, Coral Gables, FL, USA.
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Lass ANS, Winer ES, Collins AC, Rokke PD. The Associations among Distress Tolerance, Unhelpful Coping Behaviors, and Symptoms of Depression: A Network Analysis. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10131-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Correa-Fernández V, McNeel MM, Sandoval JR, Tavakoli N, Kahambwe JK, Kim H. Acceptance and Action Questionnaire II: Measurement invariance and associations with distress tolerance among an ethnically diverse university sample. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Faghani N, Akbari M, Hasani J, Marino C. An emotional and cognitive model of problematic Internet use among college students: The full mediating role of cognitive factors. Addict Behav 2020; 105:106252. [PMID: 32062334 DOI: 10.1016/j.addbeh.2019.106252] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
Abstract
Numerous researches have shown that the problematic Internet use (PIU) is significantly associated with a variety of psychological problems among young people. However, limited research has focused on the psychological mechanism underlying PIU. The purpose of this study was to investigate the relationship between several emotional and cognitive factors in predicting PIU in a sole model. In this model, difficulties in emotion regulation was the independent variable, three cognitive variables (i.e. experiential avoidance, desire thinking, and intolerance of uncertainty) were the mediators, and PIU was the dependent variable. Participants were 300 college students from four universities in Tehran (60% females; Mean age = 20.27). Results of the Structural Equation Modeling analysis revealed a full mediation role of experiential avoidance and desire thinking in the relationship between difficulties in emotion regulation and PIU (R2 = 57%). Based on these findings a special attention to cognitive factors is suggested in the treatment of PIU.
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Can clinical psychology students benefit from brief and intensive mindfulness training? COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Raudales AM, Preston TJ, Albanese BJ, Schmidt NB. Emotion dysregulation as a maintenance factor for posttraumatic stress symptoms: The role of anxiety sensitivity. J Clin Psychol 2020; 76:2183-2197. [DOI: 10.1002/jclp.22966] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Alexa M. Raudales
- Department of Psychology University of Rhode Island Kingston Rhode Island
| | - Thomas J. Preston
- Department of Psychology Florida State University Tallahassee Florida
| | | | - Norman B. Schmidt
- Department of Psychology Florida State University Tallahassee Florida
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The Construct Validity of Distress Intolerance: Is it Distinct from Demoralization and Negative Emotionality? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09764-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Direct and indirect associations between perception of childhood trauma and suicidal ideation through emotion dysregulation in males who use heroin. Addict Behav 2019; 98:106011. [PMID: 31233952 DOI: 10.1016/j.addbeh.2019.05.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 12/17/2022]
Abstract
Emotion dysregulation is considered as one of the factors related to suicide in individuals with childhood trauma (CT). However, no research has been performed on the role of emotion dysregulation in the relationship between perception of CT and suicidal ideation in individuals who use heroin. This study aimed to evaluate direct and indirect relationships between perception of CT and suicidal ideation through emotion regulation difficulties (ERD) and cognitive emotion regulation strategies (CERSs) in males with a DSM diagnosis of heroin dependence. In a cross-sectional design, 310 males with a DSM diagnosis of heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS). The results revealed that perception of CT had no direct relation to suicidal ideation. Perception of CT was indirectly associated with suicidal ideation through some ERD dimensions [e.g., non-acceptance of emotional responses (Non-acceptance), limited access to emotion regulation strategies (Strategies), lack of emotional awareness (Awareness)] and the CERS of positive reappraisal. The findings suggest that high suicidal ideation may stem from a perception of CT and subsequently emotion dysregulation in individuals who use heroin. Also, the findings of this research may have implications for the prevention and treatment of suicidal ideation in individuals using heroin with a perception of CT. The results of the present study require further examination through longitudinal studies.
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Visted E, Sørensen L, Vøllestad J, Osnes B, Svendsen JL, Jentschke S, Binder PE, Schanche E. The Association Between Juvenile Onset of Depression and Emotion Regulation Difficulties. Front Psychol 2019; 10:2262. [PMID: 31695636 PMCID: PMC6816416 DOI: 10.3389/fpsyg.2019.02262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/23/2019] [Indexed: 01/04/2023] Open
Abstract
Juvenile onset of Major Depressive Disorder (MDD) is associated with increased likelihood of recurrent episodes of depression and more detrimental clinical trajectories. The aim of the current study was to investigate the effect of juvenile onset of MDD on emotion regulation as measured by self-report and Heart Rate Variability (HRV). Furthermore, we wanted to assess whether juvenile onset impacted the association between rumination and depressive symptoms. Sixty-four individuals with at least three prior episodes of MDD were recruited and filled out self-report questionnaires measuring rumination and emotion regulation abilities. In addition, electrocardiographic assessments were used to calculate HRV. Based on self-reported age of MDD onset, individuals were divided in two groups: Juvenile onset of MDD (first MDD episode before the age of 18, n = 30) and adult onset of MDD (first MDD episode after the age of 18, n = 34). Results showed that individuals whose first depressive episode occurred in childhood and adolescence reported more rumination and less emotional clarity compared to individuals who had their first episode of MDD in adulthood. Moreover, the tendency to ruminate was strongly associated with depressive symptoms in the juvenile onset of MDD group, whereas no such association was found in the adult onset group. There was no significant group difference for HRV. The findings are discussed in light of existing literature, in addition to suggesting how our findings may inform clinical practice and future research. We conclude that juvenile onset of MDD may lead to difficulties in emotion regulation and that these difficulties may increase depressive symptoms and vulnerability for relapse in this particular subgroup.
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Affiliation(s)
- Endre Visted
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Lin Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jon Vøllestad
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
- Solli District Psychiatric Center (DPS), Nesttun, Norway
| | - Berge Osnes
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Bjørgvin District Psychiatric Centre, Haukeland University Hospital, Bergen, Norway
| | - Julie Lillebostad Svendsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | | | - Per-Einar Binder
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
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Keller AE, Langer DA, Pincus DB, Elkins RM, Kerns CE, Comer JS. A Psychometric Evaluation of the Distress Intolerance Index for Youth. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019; 41:447-455. [PMID: 31452578 PMCID: PMC6709990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Distress Intolerance (DI), defined as the perceived inability to tolerate negative mood states and experiential discomfort, has been posited as a vulnerability factor for several anxiety and emotional disorders. There is a relative paucity of research on DI in youth samples, in large part due to the absence of a psychometrically sound measure of DI in youth. The current study evaluated the psychometric properties of the Distress Intolerance Index for Youth (DII-Y) and the Distress Intolerance Index for Youth-Parent Report (DII-Y-P), which are downward extension adaptations of the adult-oriented Distress Intolerance Index (McHugh & Otto, 2012). Participants were 176 youth (ages 9-17) and their parents who were seeking treatment for child anxiety problems. The DII-Y and DII-Y-P demonstrated good-to-excellent internal consistency. Convergent validity of the DII-Y and the DII-Y-P was supported by large, significant associations with measures of intolerance of uncertainty, as well as with anxiety sensitivity in the case of the DII-Y. Discriminant validity of the DII-Y and the DII-Y-P was supported by the absence of significant direct relationships with a measure of defiant behavior. Results support the use of DII-Y and DII-Y-P as reliable and valid instruments for the assessment of youth DI, providing a practical and efficient tool to study DI as a potential factor in the etiology and maintenance of youth anxiety and emotional disorders.
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Affiliation(s)
- Alex E. Keller
- Department of Psychological and Brain Sciences, Boston University
| | - David A. Langer
- Department of Psychological and Brain Sciences, Boston University
| | - Donna B. Pincus
- Department of Psychological and Brain Sciences, Boston University
| | - R. Meredith Elkins
- Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School
| | | | - Jonathan S. Comer
- Mental Health Interventions and Technology (MINT) Program, Florida International University
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Khosravani V, Messman-Moore TL, Mohammadzadeh A, Ghorbani F, Amirinezhad A. Effects of childhood emotional maltreatment on depressive symptoms through emotion dysregulation in treatment-seeking patients with heroin-dependence. J Affect Disord 2019; 256:448-457. [PMID: 31252238 DOI: 10.1016/j.jad.2019.06.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/05/2019] [Accepted: 06/21/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although individuals who experience childhood emotional maltreatment (CEM) are more likely to use maladaptive emotion regulation strategies, resulting in vulnerability to depression, no research has examined whether emotion dysregulation may explain the association between CEM and current depressive symptoms in a clinical sample of heroin-dependent individuals. OBJECTIVES The current study aimed to assess the direct effect of CEM on current depressive symptoms and its indirect effect via emotion dysregulation in a treatment-seeking sample of males with heroin dependence. In a cross-sectional design, participants (N = 350) completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Obsessive-Compulsive Drug Use Scale (OCDUS), and the Beck Depression Inventory-II (BDI-II). RESULTS Emotional abuse and neglect severity had significant direct effects on current depressive symptoms and significant indirect effects through emotion dysregulation after controlling for clinical factors related to heroin use. LIMITATIONS Study limitations include the cross-sectional design and use of self-report scales. CONCLUSIONS Findings suggest emotion dysregulation may increase depressive symptoms in heroin users who experienced CEM. Training in emotion regulation strategies may decrease depressive symptoms in heroin-dependent individuals with CEM. Additional research with a longitudinal design to confirm these results is warranted.
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Affiliation(s)
- Vahid Khosravani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
| | | | | | - Fatemeh Ghorbani
- Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Amirinezhad
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
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42
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The role of emotion dysregulation in the relation of childhood trauma to heroin craving in individuals with heroin dependence. Drug Alcohol Depend 2019; 195:132-139. [PMID: 30634108 DOI: 10.1016/j.drugalcdep.2018.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Difficulties in emotion regulation (DER) may be important in heroin craving in individuals with heroin dependence who have experienced childhood trauma (CT). However, no research has been performed on DER in the context of heroin dependence. The aim of this study was to evaluate direct and indirect relations of CT to the subscales of heroin craving (i.e., heroin thoughts and interference, intention to use heroin and control of its consumption, and resistance to thoughts and decisions to use heroin) via DER dimensions in individuals with a DSM diagnosis of heroin dependence. METHODS In a cross-sectional design, 330 males with heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS). RESULTS The results revealed that CT had no direct relations to the subscales of heroin craving, but it indirectly was related to all three subscales of heroin craving via one of the DER dimensions named limited access to emotion regulation strategies (Strategies) after adjusting for demographic and clinical factors. CONCLUSIONS The findings suggest that Strategies may be related to heroin craving in individuals with heroin dependence who have CT. This proposes that treatment and prevention attempts focused on training the use of effective emotion regulation strategies may be useful to reduce heroin craving in individuals with heroin dependence who have experienced a history of CT.
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Keller AE, Langer DA, Pincus DB, Meredith Elkins R, Kerns CE, Comer JS. A Psychometric Evaluation of the Distress Intolerance Index for Youth. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9711-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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44
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Preece DA, Becerra R, Robinson K, Dandy J, Allan A. Measuring emotion regulation ability across negative and positive emotions: The Perth Emotion Regulation Competency Inventory (PERCI). PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.07.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McDermott KA, Smith HL, Cougle JR. An Examination of Perseverative Thinking and Perception of Threat from Emotion as Mechanisms Underlying the Relationship Between Distress Intolerance and Internalizing Symptoms. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9960-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Feinberg L, Kerns C, Pincus DB, Comer JS. A Preliminary Examination of the Link Between Maternal Experiential Avoidance and Parental Accommodation in Anxious and Non-anxious Children. Child Psychiatry Hum Dev 2018; 49:652-658. [PMID: 29352362 PMCID: PMC6029431 DOI: 10.1007/s10578-018-0781-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Studies point to parental experiential avoidance (EA) as a potential correlate of maladaptive parenting behaviors associated with child anxiety. However, research has not examined the relationship between EA and parental accommodation of child anxiety, nor the extent to which parental negative beliefs about child anxiety help explain such a relationship. In a sample of mothers (N = 45) of anxious and non-anxious children, the present study investigated the potential link between maternal EA and accommodation of child anxiety and whether this link may be indirectly accounted for via maternal negative beliefs about child anxiety. EA was significantly and positively associated with accommodation of child anxiety, but when negative beliefs about child anxiety were incorporated into the model this direct effect was no longer significant. Findings highlight the contribution of parental emotions and cognitions to behaviors that may exacerbate child anxiety, and may inform treatment and prevention efforts with families of anxious youth.
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Affiliation(s)
- Leah Feinberg
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Caroline Kerns
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Donna B Pincus
- Department of Psychology, Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA.
- Mental Health Interventions and Technology (MINT) Program, Department of Psychology, Center for Children and Families, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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47
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Anderson NL, Smith KE, Mason TB, Crowther JH. Testing an Integrative Model of Affect Regulation and Avoidance in Non-Suicidal Self-Injury and Disordered Eating. Arch Suicide Res 2018; 22:295-310. [PMID: 28644927 PMCID: PMC5917567 DOI: 10.1080/13811118.2017.1340854] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This research tested a model that integrates risk factors among non-suicidal self-injury (NSSI) and eating disorder (ED) behaviors with the aim of elucidating possible shared and unique mechanisms underlying both behaviors. Emotional distress, limited access to emotion regulation (ER) strategies, experiential avoidance, and NSSI/ED frequency were examined in a sample of 230 female undergraduates. Structural equation modeling indicated that limited access to ER strategies and avoidance mediated relationship between emotional distress and avoidance, which in turn was associated with NSSI and ED behaviors. Results suggest NSSI and ED behaviors may serve similar emotion regulation functions, and specifically highlight the role of experiential avoidance in these behaviors.
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Katz D, Rector NA, Laposa JM. The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder. Cogn Behav Ther 2017. [DOI: 10.1080/16506073.2017.1334087] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Danielle Katz
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Neil A. Rector
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Judith M. Laposa
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Macatee RJ, Albanese BJ, Schmidt NB, Cougle JR. The moderating influence of heart rate variability on stressor-elicited change in pupillary and attentional indices of emotional processing: An eye-Tracking study. Biol Psychol 2017; 123:83-93. [PMID: 27916689 PMCID: PMC5347391 DOI: 10.1016/j.biopsycho.2016.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/20/2016] [Accepted: 11/26/2016] [Indexed: 01/20/2023]
Abstract
Low resting heart rate variability (HRV) is associated with a broad array of negative psychosocial outcomes. Recent theoretical explications of HRV suggest it is an autonomic marker of emotion regulation capacity, but limited research has examined its relationship with emotional information processing indices. The present study utilized eye-tracking methodology to test HRV's theorized role as a marker of emotion regulation capacity in a non-clinical sample. Attentional biases towards threatening, dysphoric, and positive emotional information as well as affective modulation of pupil size were assessed before and after a stress induction. Low resting HRV marginally predicted larger increases in attentional bias towards positive emotional stimuli from pre to post-stress induction and significantly predicted decreased pupil dilation to positive stimuli after the stress induction only; exploratory analyses suggested that this pattern might reflect an unsuccessful attempt at anxious mood repair. HRV was unrelated to negative emotional information processing. Findings are consistent with existing theories of HRV's psychological significance and suggest a specific association with altered positive emotional processing under acute stress.
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Affiliation(s)
- Richard J Macatee
- Department of Psychology, Florida State University, P.O. Box 3064301, Tallahassee, FL 32306, USA
| | - Brian J Albanese
- Department of Psychology, Florida State University, P.O. Box 3064301, Tallahassee, FL 32306, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, P.O. Box 3064301, Tallahassee, FL 32306, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, P.O. Box 3064301, Tallahassee, FL 32306, USA.
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Moshier SJ, Landau AJ, Hearon BA, Stein AT, Greathouse L, Smits JAJ, Otto MW. The Development of a Novel Measure to Assess Motives for Compensatory Eating in Response to Exercise: The CEMQ. Behav Med 2016; 42:93-104. [PMID: 25148129 DOI: 10.1080/08964289.2014.955077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Compensatory eating in response to exercise may be an obstacle to achieving weight-loss and fitness goals. In this study we develop and conduct a preliminary examination of the psychometric properties of the Compensatory Eating Motives Questionnaire (CEMQ), a self-report questionnaire of motives for compensatory eating. Development and testing of the CEMQ was conducted in two student samples. Of respondents, 75% reported engaging in compensatory eating. Factor analysis yielded factors representing three domains of motives for compensatory eating: Eating for Reward, Eating for Recovery, and Eating for Relief. Internal consistency of the factors was adequate, and the factor structure was replicated. Correlations between the CEMQ subscales and trait questionnaires supported hypotheses for convergent and divergent validity. These results encourage further investigation of compensatory eating as a potential obstacle to weight loss, and support the continued assessment of the CEMQ as a tool to measure three conceptually distinct motives for compensatory eating.
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