Forecasting the Future, Remembering the Past: Misrepresentations of Daily Emotional Experience in Generalized Anxiety Disorder and Major Depressive Disorder

Less bang for my buck: Diminished anticipated enjoyment contributes to dysphoria-linked deficit in activity behavioural engagement choice

This study experimentally investigated the role of anticipated enjoyment and effort in mediating dysphoria-related deficit in activity engagement behavioural choice. Using a novel activity information processing task (about a fictional "new" Nintendo Wii sports game called "Tornado Ball"), N = 249 participants (n = 95 High Dysphoria; n = 154 Low Dysphoria) were presented information about the benefits (enjoyable features) and costs (mental and physical effort barriers) as product reviews from another player. The order of cost vs. benefit information was manipulated such that participants either heard cost information before benefit information, or vice versa. They then rated what their anticipated enjoyment and effort will be if they were to play Tornado Ball, before being given the opportunity to choose to try it themselves or not. The High Dysphoria group reported lower anticipated enjoyment (but not higher effort) relative to the Low Dysphoria group, but only when cost information was presented first. Importantly, a moderated mediation showed that the High Dysphoria group reported lower tendency to choose activity engagement (game play) as a function of having lower anticipated enjoyment, but only when cost information was presented first. The present finding indicate that reduced anticipated enjoyment may causally contribute to dysphoria-linked deficits in activity engagement behavioural choice.

Affective forecasting and psychopathology: A scoping review

Affective forecasting - estimations of future emotional reactions - is an important aspect of future thinking that informs judgement and decision making. Biases in affective forecasting have been noted generally and with people with emotional disturbances specifically. Still, the role of affective forecasting within models of psychopathology has received little attention. Given the state of the literature, a scoping review method was adopted to summarize and synthesize the methodological approaches used in measuring affective forecasting within the context of psychopathology and the scope of the evidence on this association. Three databases were searched for research published on or before November 13th, 2023. Original quantitative research that examined affective forecasting and its association with psychopathology was reviewed. Data were charted using a form designed for this study. Overall, the review highlights the heterogeneity in operationalization of affective forecasting. The majority of the evidence supports an association between severity of psychopathology and intensity of affective forecasts, with notable exceptions, which are discussed within the scope of methodology and operationalization of affective forecasting. This remains an important process to investigate in information processing models of psychopathology to elucidate its role in the development and maintenance of psychopathology and potential as a target for intervention.

Premorbid Psychological Factors Associated with Long-Term Postoperative Headache after Microsurgery in Vestibular Schwannoma-A Retrospective Pilot Study

Associations between premorbid psychological factors and postoperative headache (POH) after microsurgical treatment via the retrosigmoid approach for vestibular schwannoma (VS) were investigated in this retrospective single-center study. A total of 101 VS patients completed the Rostock headache questionnaire (RoKoKo), the hospital and anxiety scale (HADS-D), and the screening for somatoform disorders (SOMS-2), all of which were used as short self-assessed questionnaires. Fifty-four patients with POH were compared with 47 non-POH patients in terms of premorbid psychological factors, somatization tendencies, and psychological burden using the chi2-test and Mann-Whitney U-test. Regression analyses were conducted to assess the weighted contribution of psychological and procedural factors to POH. In individuals with POH, mental ailments, preexisting headaches, premorbid chronic pain syndromes, and higher somatization tendencies were found to be significantly more common. POH was predicted by the number of premorbid psychosomatic symptoms, preexisting mental ailments, and premorbid chronic pain syndromes. Depression and anxiety were predicted by low emotional stability. Additionally, the number of premorbid psychosomatic symptoms predicted depression, anxiety, and overall psychological burden. It was observed that the reported symptoms of headache might fit into the classification of chronic postsurgical pain (CPSP) rather than being classified as secondary headaches after craniotomy. Premorbid psychological factors were found to play an important role in the emergence of POH in VS, particularly after microsurgery via the retrosigmoid approach. Therefore, it is suggested that psychological screening be incorporated into the treatment process.

Investigating the role of action-contingent expectancy biases in dysphoria-linked activity engagement behavioural choice

Reduced tendency to engage in potentially rewarding activities is a hallmark of depression. The present study investigated the role of future expectancy biases in depression-linked behavioural choice, in participants varying in self-reported depression symptoms (dysphoria). A novel laboratory paradigm was developed to test the hypotheses that the degree to which higher dysphoria is associated with reduced tendency to engage in a potentially rewarding activity is dependent on the presence of negative biases in the expected outcomes of activity engagement. Specifically, two types of expectancy biases were distinguished: a) the expected likelihood of a negative rather than positive outcome, and b) the expected emotional impact of either outcome. N = 176 undergraduate students with varied levels of dysphoria were given the opportunity to choose to engage in a coin-tossing game that could result in a win or loss monetary outcome in terms of charity donations, and then rated both types of expectancies. Results indicated that higher dysphoria was associated with more negative expectations concerning the likelihood of objective outcomes and the emotional impact of such outcomes, and as hypothesised, such negative expectancy biases mediated indirect associations between dysphoria and behavioural choice.

Perseverative thinking is associated with features of spoken language

Perseverative thinking (PT), such as rumination or worry, is a transdiagnostic process implicated in the onset and maintenance of emotional disorders. Existing measures of PT are limited by demand and expectancy effects, cognitive biases, and reflexivity, leading to calls for unobtrusive, behavioral measures. In response, we developed a behavioral measure of PT based on language. A mixed sample of 188 participants with major depressive disorder, generalized anxiety disorder, or no psychopathology completed self-report PT measures. Participants were also interviewed, providing a natural language sample. We examined language features associated with PT, then built a language-based PT model and examined its predictive power. PT was associated with multiple language features, most notably I-usage (e.g., "I", "me"; β = 0.25) and negative emotion language (e.g., "anxiety", "difficult"; β = 0.19). In machine learning analyses, language features accounted for 14% of the variance in self-reported PT. Language-based PT predicted the presence and severity of depression and anxiety, psychiatric comorbidity, and treatment seeking, with effects in the r = 0.15-0.41 range. PT has face-valid linguistic correlates and our language-based measure holds promise for assessing PT unobtrusively. With further development, this measure could be used to passively detect PT for deployment of "just-in-time" interventions.

Situational uncertainty interacts with anxiety sensitivity and distress intolerance to predict anticipated worry and preparation for a hurricane

BACKGROUND

There is evidence for the impact of emotional intolerance on reactivity to stressors, but it is unknown whether the level of situational uncertainty may moderate this relationship. We examined whether situational uncertainty moderated the relationship between emotional intolerance and anticipated anxious responding to hurricane forecasts, considering three aspects of emotional tolerance: anxiety sensitivity, distress intolerance, and hurricane-specific distress intolerance.

METHODS

Participants (N = 358) were Florida residents who experienced Hurricane Irma. Participants were presented with two hypothetical storm forecasts that varied in level of uncertainty: 5-day forecast (high uncertainty) and 3-day forecast (low uncertainty). Participants rated their anticipated worry and preparation for each forecast.

RESULTS

Significant interactions between forecast uncertainty and both anxiety sensitivity and hurricane-specific distress intolerance emerged on anticipated worry, such that there was a stronger relationship in the high uncertainty condition. Forecast uncertainty also moderated the relationship between anxiety sensitivity and anticipated preparation in the same direction. There were no significant interactions between forecast uncertainty and distress intolerance on either anticipated worry or preparation.

CONCLUSIONS

Specific aspects of emotional intolerance appear to have a stronger influence on anticipated worry and preparatory behavior in high uncertainty situations. These findings suggest that distinct emotional tolerance factors may influence these responses.

Negative expectations regarding interpersonal interactions in daily life are associated with subclinical depressive symptoms in a student sample: A prospective experience sampling study

Dysfunctional expectations and interpersonal problems are associated with depression, so we measured expected emotions towards interaction partners and compared them with actual emotions. We hypothesized that, between persons, individuals with higher subclinical depression would display stronger, more stable, and less accurate negative expectations. Within persons, we hypothesized that momentary negative expectations would predict subsequent negative affect. Fifty-three students completed 6 days of Experience Sampling, consisting of one morning expectation-assessment (9 am), three assessments on actual interpersonal emotions (1 pm, 5 pm, 9 pm), and six random affect-assessments. We regressed expected emotions, experienced emotions, expectation fluctuations, and expectation violations on subclinical depression. Using mixed model analyses, we further examined whether negative expectations preceded negative affect, and whether expectation violations preceded adjustments of expectations. Higher subclinical depression predicted more negative expectations. Within persons, worse-than-expected interpersonal interactions preceded negative affect whereas better-than-expected interactions preceded reductions of negative expectations. Despite problems with skewed data, our approach appears well-suited to examine interpersonal expectations in vivo.

Worry and Positive Episodes in the Daily Lives of Individuals With Generalized Anxiety Disorder: An Ecological Momentary Assessment Study

Worry is a central feature of generalized anxiety disorder (GAD). Although worry is related to anxiety and maintained by beliefs that worry is uncontrollable, there is scarce research on how individuals with GAD react to worry episodes in their daily life and how their positive experiences might impact reactions to worry episodes. The current study examined the level and variability of anxiety and controllability during high worry periods and positive experiences in GAD. Moreover, it investigated the influence of worry and positive experiences on later anxiety and perceived controllability within-persons. Finally, it examined change in anxiety level from previous to current episodes depending on previous episodes type. In the current study, 49 individuals with GAD (514 observations) registered their worry and positive episodes (i.e., episodes in which they had positive experiences) and reported on several variables during these episodes (i.e., anxiety and controllability of episodes and episode duration) using smartphone-based ecological momentary assessment for 7days. Results show anxiety and controllability differed by episode type (higher anxiety, lower controllability in worry episodes, and the opposite in positive episodes), and notable within-person variability in anxiety and controllability in both episode types. The time-lagged multilevel models showed episode type did not predict later anxiety during either episode type, although previous anxiety predicted current anxiety in worry episodes (but not positive episodes). Moreover, worry episodes did predict later controllability in worry episodes (but not positive episodes) and previous controllability predicted current controllability in both episode types. Furthermore, we obtained the increase in anxiety from t₀₋₁ to t₀ in a current worry episode to be significantly smaller when preceded by a worry (vs. positive) episode. Likewise, the reduction in anxiety from t₀₋₁ to t₀ in a current positive episode was significantly larger when preceded by a worry (vs. positive) episode. The novel findings in the current study that perceptions of controllability and anxiety vary within individuals with GAD, that greater controllability is experienced in positive episodes than worry episodes, and that worry may confer a sense of controllability at a later time could be seen as important contributions to the GAD literature.

Addressing anhedonia to increase depression treatment engagement

Anhedonia, or reward system dysfunction, is associated with poorer treatment outcomes among depressed individuals. The role of anhedonia in treatment engagement, however, has not yet been explored. We review research on components of reward functioning impaired in depression, including effort valuation, reward anticipation, initial responsiveness, reward learning, reward probability, and reward delay, highlighting potential barriers to treatment engagement associated with these components. We then propose interventions to improve treatment initiation and continuation by addressing deficits in each component of reward functioning, focusing on modifications of existing evidence-based interventions to meet the needs of individuals with heightened anhedonia. We describe potential settings for these interventions and times at which they can be delivered during the process of referring individuals to mental health treatment, conducting intakes or assessments, and providing treatment. Additionally, we note the advantages of using screening processes already in place in primary care, workplace, school, and online settings to identify individuals with heightened anhedonia who may benefit from these interventions. We conclude with suggestions for future research on the impact of anhedonia on treatment engagement and the efficacy of interventions to address it. PRACTITIONER POINTS: Many depressed individuals who might benefit from treatment do not initiate it or discontinue early. One barrier to treatment engagement may be anhedonia, a core symptom of depression characterized by loss of interest or pleasure in usual activities. We describe brief interventions to improve treatment engagement in individuals with anhedonia that can be implemented during the referral process or early in treatment. We argue that interventions aiming to improve treatment engagement in depressed individuals that target anhedonia may be particularly effective.

Biased Affective Forecasting: A Potential Mechanism That Enhances Resilience and Well-Being

According to a growing body of studies, people's ability to forecast future emotional experiences is generally biased. Nonetheless, the existing literature has mainly explored affective forecasting in relation to specific events, whereas little is still known about the ability to make general estimations of future emotional states. Based on existing evidence suggesting future-oriented disposition as a key factor for mental health, the aims of the current study were (1) to investigate the relationship between negative (NA) and positive (PA) affective forecasting biases and perceived psychological well-being, and (2) to explore whether positively biased predictions are associated with resilience and foster one's skills to cope with stressful events. To do so, we asked 85 undergraduate students to forecast PA and NA over 2 weeks, as well as to report their daily affect through a web-based Ecological Momentary Assessment. According to the results, positively biased PA forecasting (i.e., overestimating positive emotional states) was associated with greater perceived psychological well-being and higher resilience. When high levels of stress were experienced, participants holding an optimistic, yet biased, estimation of future PA were more likely to successfully manage stressors, thus maintaining lower levels of NA and higher levels of positive emotions. We suggest that positively biased PA forecasting is an adaptive cognitive distortion that boosts people's resilience and mental health, thus opening new avenues for the promotion of psychological well-being.