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Ames ME, Robillard CL, Turner BJ, Garcia-Barrera M, Rush J, Craig SG. Associations between physical activity, affect regulation difficulties, and mental health among Canadian adolescents at two different points of the COVID-19 pandemic. Psychol Health 2024; 39:1042-1058. [PMID: 36184947 DOI: 10.1080/08870446.2022.2127718] [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] [Received: 01/18/2022] [Revised: 08/09/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022]
Abstract
Objective. Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two independent adolescent samples (T1: Summer 2020; T2: Winter 2020/21). Methods and Measures. Six hundred sixty-two Canadian adolescents (T1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (T2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation difficulties, and measures of anxious and depressive symptoms. Results. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms through affect dysregulation, but only at T1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both T1 and T2 and had an indirect effect through affect dysregulation and suppression. Conclusion. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities.
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Affiliation(s)
- Megan E Ames
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Centre for Youth and Society, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | - Christina L Robillard
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
| | - Brianna J Turner
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Centre for Youth and Society, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | | | - Jonathan Rush
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | - Stephanie G Craig
- York University, LaMarsh Centre for Child and Youth Research, Toronto, Ontario, Canada
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Ye Y, Li Y, Wu X, Zhou X. Longitudinal Associations Between Depression, Suicidal Ideation, and Lack of Certainty in Control among Adolescents: Disaggregation of Within-Person and Between-Person Effects. J Adolesc Health 2024; 75:288-297. [PMID: 38739050 DOI: 10.1016/j.jadohealth.2024.03.008] [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] [Received: 09/19/2023] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Depression and suicidal ideation (SI) are common in adolescents. However, the relation between the two is unclear. According to the cognitive model of suicidal behavior and learned helplessness theory, lack of certainty in control (LCC), referring to individuals' deficiency in predictability, certainty, and control of life, may be an important factor linking the two. Thus, the current study aimed to investigate the temporal relation between depression and SI in adolescents and to assess the mediating role of LCC in this relation. METHODS A three-wave survey was carried out at intervals of 1 and 1.5 years among 516 adolescents at several middle schools in Sichuan Province, China. The random-intercept cross-lagged panel model was used to examine the temporal relations between depression, SI, and LCC among adolescents, which can effectively distinguish between-person and within-person differences. RESULTS The results revealed that depression, SI, and LCC had positive intercorrelations at the between-person level. At the within-person level, early depression predicted subsequent depression and SI via LCC among adolescents. Additionally, early LCC promoted later SI through depression. DISCUSSION These findings highlight the mediating role of LCC, clarify the temporal relation between depression and SI, and provide theoretical support for interventions to address depression and suicide.
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Affiliation(s)
- Yingying Ye
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Yifan Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China.
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Howard R, Manohar H, Seshadri S, Sharma A. Coping strategies in young people during the COVID-19 pandemic: rapid review. BJPsych Bull 2024:1-10. [PMID: 39075765 DOI: 10.1192/bjb.2024.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
AIMS AND METHOD To better understand factors supporting young people's (age <18 years) mental health during pandemic-type conditions, we aimed to identify whether coping strategies adopted during the COVID-19 pandemic could be dichotomised according to manifesting positive or negative psychological outcomes. Medline, EMBASE, CINAHL, PsycINFO, Scopus and ASSIA databases were used to identify empirical studies that examined coping strategies used by young people experiencing psychological challenges during COVID-19. RESULTS Twenty-five international studies were included, identifying that coping strategies adopted could be significantly dichotomised according to reducing or exacerbating psychological challenges. Positive coping strategies were proactive and solutions-oriented, whereas negative coping strategies were more avoidant and emotion-oriented. CLINICAL IMPLICATIONS An internal locus of control may account for why adolescents exercised more proactive coping compared with their younger counterparts, although parents of younger children may offset the impact of stressors by drawing on a proposed coping framework emphasising proactivity and engagement. This would be an invaluable addition to future pandemic preparedness planning cycles.
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Affiliation(s)
- Ranjita Howard
- NHS England Education North East, Newcastle upon Tyne, UK
| | - Harshini Manohar
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Shekhar Seshadri
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Aditya Sharma
- Translational and Clinical Research Institute, Newcastle University, UK
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Alacha HF, Walbridge FC, Harton HC, Vasko JM, Bodalski EA, Rother Y, Lefler EK. Cognitive emotion regulation and learning effectiveness in college students with ADHD symptoms. ANXIETY, STRESS, AND COPING 2024:1-17. [PMID: 39021066 DOI: 10.1080/10615806.2024.2379986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND College students with ADHD have difficulties with emotion regulation and have poorer academic skills than peers without ADHD; however, less is known regarding the relation between ADHD symptoms, maladaptive cognitive emotion regulation strategies (CERS), and learning effectiveness. OBJECTIVES We examined whether maladaptive CERS predicted learning effectiveness, and whether this relation was moderated by ADHD symptoms. DESIGN A cross-sectional online survey. METHODS College students (N = 4,183; Mage = 19.24; 70.1% female) at eight universities completed a battery as part of a larger study. RESULTS College students in our elevated ADHD group used significantly more maladaptive CERS and performed worse in three domains of learning effectiveness (i.e., Academic Self-Efficacy [ASE], Organization and Attention to Study [OAS], Stress and Time Press [STP]) than college students in our non-ADHD group. Further, ADHD symptoms moderated the relation between maladaptive CERS and OAS, such that individuals with the highest levels of ADHD symptoms were less impacted by maladaptive CERS. CONCLUSION Increased use of maladaptive CERS is unique to ADHD rather than lack of adaptive CERS. Also, maladaptive CERS and low ADHD symptoms interact to predict poor OAS. Interventions for college students, regardless of ADHD status, should incorporate emotion regulation components to improve learning effectiveness.
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Affiliation(s)
- Helena F Alacha
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Fayth C Walbridge
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Helen C Harton
- Department of Psychology, University of Northern Iowa, Cedar Falls, Iowa, USA
| | - John M Vasko
- Department of Wyoming, University of Wyoming, Laramie, Wyoming, USA
| | - Elizabeth A Bodalski
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Yvette Rother
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Elizabeth K Lefler
- Department of Psychology, University of Northern Iowa, Cedar Falls, Iowa, USA
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Kim E, Kim J, Sung S, Park S. Violence against parents perpetrated by adolescent siblings of individuals with intellectual disability in South Korea. CHILD ABUSE & NEGLECT 2024; 154:106875. [PMID: 38970859 DOI: 10.1016/j.chiabu.2024.106875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Few studies have focused on the daily hassles among adolescent siblings living with individuals with intellectual disability (IwID) and the resulting conflicts between family members. The pathway from stress (hassles) to adolescents' violent acts has been largely ignored. OBJECTIVE This study examined the link between hassles (independent variable) and violence against parents (dependent variable), with aggression as a mediator and social support as a moderator. PARTICIPANTS Data were collected from November 2018 to February 2019 in Seoul, Gyeonggi Province, and Incheon City. Participants were 303 adolescent siblings of IwID (male: 47.2 %; female: 52.1 %). METHODS Descriptive analysis was conducted using SPSS 24.0 and mediating pathways were determined using SPSS Macro 25.0. To verify the moderating role of social support, the entire sample was divided into two groups based on the mean value of social support and the mediating model was analyzed. RESULTS In the low social support group (n = 140), the direct effect was not significant (β = 0.0111, 95 % CI = -0.0044 to 0.0266), but the indirect effect was maintained (β = 0.0096, 95 % CI = 0.0005 to 0.0234). However, in the high support group (n = 118), neither the direct effect (β = 0.0106, 95 % CI = -0.0162 to 0.0373) nor the indirect effect (β = 0.0126, 95 % CI = -0.0013 to 0.0301) was significant. Social support as a moderator was statistically significant compared with different paths in the two-group analysis. CONCLUSIONS Counselling interventions are needed to alleviate the link between hassles and adolescent violence against parents through aggression.
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Affiliation(s)
- Eunkyung Kim
- Yonsei University Graduate School of Social Welfare, South Korea
| | - Jaeyop Kim
- Yonsei University, Dept. of Social Welfare, South Korea.
| | | | - Sunwon Park
- Yonsei University Graduate School of Social Welfare, South Korea
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Tu S, Zeng X, Liu T, Zeng J. Emotion Regulation Can Effectively Improve Decision-Making Behaviors of Individuals Who Use Methamphetamine. J Psychosoc Nurs Ment Health Serv 2024:1-8. [PMID: 38950356 DOI: 10.3928/02793695-20240612-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
PURPOSE Negative emotions can cause people to make irrational decisions, and decision-making disorders may lead individuals who use methamphetamine (meth) to relapse. Therefore, the current study was performed to investigate whether emotion regulation (ER) can improve negative emotions and thus improve decision-making behavior of individuals who use meth. METHOD Based on the Iowa Gambling Task, a three-factor mixed experimental design was used to examine the effects of cognitive reappraisal and expressive suppression strategies on negative emotions and decision-making behaviors of 157 individuals who use meth. RESULTS Cognitive reappraisal and expressive suppression were effective in reducing participants' negative emotions and improving decision-making behaviors. Specifically, two types of ER strategies were effective in improving decision-making abilities of participants with negative emotional distress, and cognitive reappraisal was more effective than expressive suppression. CONCLUSION Regarding cognitive reappraisal, female participants showed better decision-making behavior than males, which predicts that females who use meth might be more adept at using cognitive reappraisal. This finding suggests that mental health providers should aid substance users in managing their negative emotions and also pay attention to gender differences during the nursing process. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Ward-Smith C, Sorsdahl K, van der Westhuizen C. An investigation into symptoms of depression and anxiety and emotion regulation among older adolescents from low-income settings in South Africa. Compr Psychiatry 2024; 132:152476. [PMID: 38552349 DOI: 10.1016/j.comppsych.2024.152476] [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] [Received: 10/19/2023] [Revised: 02/20/2024] [Accepted: 03/16/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Mental health conditions (MHC) among adolescents in low- and middle-income countries, including South Africa, are estimated to be high. Adaptive emotion regulation (ER) skills can protect against MHC among adolescents. In South Africa, there is limited adolescent mental health prevalence data as well as little understanding of the associations between MHC and ER among adolescents. This study aimed to address these gaps by describing the psychosocial characteristics of older South African adolescents from low-income settings as well as investigating associations between depression and anxiety symptoms and ER. METHODS We selected 12 schools in collaboration with two NGOs. Learners aged 15-18-years were recruited to complete a tablet-based survey. ER, depression, anxiety, and other psychosocial measures were included. Two multiple linear regression models were used to determine associations between depression symptoms, anxiety symptoms, other psychosocial factors, and ER. RESULTS Of the 733 participants from 12 Western Cape schools, 417 (56.90%) screened at risk for clinically significant anxiety symptoms, 423 (57.70%) participants for depression symptoms, 229 (31.40%) participants for PTSD symptoms and 263 (35.90%) for risky alcohol use. Depression and anxiety scores were found to be significantly positively correlated with ER difficulties and adolescents struggled most with identifying and utilizing adaptive ER strategies. The adjusted linear regression model reported that female gender, clinically significant depressive, anxiety, post-traumatic stress symptoms and risky-alcohol use were all significantly associated with poorer ER scores, while self-esteem was significantly associated with better ER scores. CONCLUSION These findings contribute to the South African adolescent mental health literature and to the research gap on the links between depression and anxiety and ER. Future research should consider further exploration of the relationships between psychosocial factors and ER to inform the urgent development and testing of appropriate adolescent interventions in this setting.
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Affiliation(s)
- C Ward-Smith
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, South Africa.
| | - K Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, South Africa
| | - C van der Westhuizen
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, South Africa
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Gadassi-Polack R, Paganini G, Zhang AK, Dworschak C, Silk JS, Kober H, Joormann J. It's a balancing act: The ratio of maladaptive (vs. All) emotion regulation strategies is associated with depression. Behav Res Ther 2024; 180:104600. [PMID: 38950508 DOI: 10.1016/j.brat.2024.104600] [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: 08/10/2023] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/03/2024]
Abstract
Research on emotion regulation (ER) has increasingly recognized that people use multiple strategies simultaneously, often referred to as ER repertoire. Prior research found that ER repertoire is associated with psychopathology, but results have been mixed. Indeed, research from recent years suggests that it is the quality of ERs, more than their quantity, that needs to be considered. Based on the combination of the literatures on ER repertoire, polyregulation, and ER flexibility, we propose a novel metric: the ratio of using putatively maladaptive (vs. all) ER strategies. Using this metric, we examine (1) maladaptive ER ratio changes during the transition to adolescence, a developmental period in which the prevalence of depression sharply increases, and (2) whether changes in maladaptive ER ratio are associated with depressive symptoms. One-hundred and thirty-nine youths (baseline age: 8-15) reported ER strategies and depression daily for 21 days. One year later, 115 completed another 28-day daily-diary (Nassessments = 5631). Our results show that almost all youth use at least some maladaptive ERs. Importantly, maladaptive ER ratio decreases over a year of adolescence for most youths. Conversely, an increased maladaptive ER ratio predicted depression increases on the daily and on the yearly level. These results shed light on typical and atypical development of ER flexibility and emphasize the need to consider the balance between ERs in relation to psychopathology.
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Christ C, van Schaik DJF, Kikkert MJ, de Waal MM, Dozeman E, Hulstijn HL, Koomen LM, Krah IM, Schut DM, Beekman ATF, Dekker JJM. Internet-based emotion regulation training aimed at reducing violent revictimization and depressive symptoms in victimized depressed patients: Results of a randomized controlled trial. J Affect Disord 2024; 355:95-103. [PMID: 38521137 DOI: 10.1016/j.jad.2024.03.028] [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] [Received: 08/29/2023] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Depressed patients who have become victim of violence are prone to revictimization. However, no evidence-based interventions aimed at reducing revictimization in this group exist. METHODS This multicenter randomized controlled trial evaluated the effectiveness of an internet-based emotion regulation training (iERT) added to TAU in reducing revictimization, emotion dysregulation, and depressive symptoms in recently victimized, depressed patients compared to TAU alone. Adult outpatients (N = 153) with a depressive disorder who had experienced threat, physical assault, or sexual assault within the previous three years were randomly allocated to TAU+iERT (n = 74) or TAU (n = 79). TAU involved psychotherapy (mainly cognitive behavioral therapy [77.8 %]). iERT comprised six guided online sessions focused on the acquisition of adaptive emotion regulation skills. The primary outcome measure was the number of revictimization incidents at 12 months after baseline, measured with the Safety Monitor. Analyses were performed according to the intention-to-treat principle. RESULTS Both groups showed a large decrease in victimization incidents. Mixed-model negative binomial regression analyses showed that TAU+iERT was not effective in reducing revictimization compared to TAU (IRR = 0.97; 95%CI = 0.64,1.46; p = .886). Linear mixed-model analyses demonstrated that TAU+iERT yielded a larger reduction of emotion dysregulation (B = -7.217; p = .046; Cohens d = 0.33), but not depressive symptoms (B = -1.041; p = .607) than TAU. LIMITATIONS The study was underpowered to detect small treatment effects. Additionally, uptake of iERT was quite low. CONCLUSIONS Although TAU+iERT resulted in a larger decrease of emotion dysregulation than TAU alone, it was not effective in reducing revictimization and depressive symptoms. Patients' revictimization risk substantially decreased during psychotherapy.
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Affiliation(s)
- C Christ
- Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Department of Psychiatry, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Department of Research and Innovation, Amsterdam, the Netherlands; Arkin Mental Health Care, Department of Research, Amsterdam, the Netherlands.
| | - D J F van Schaik
- Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Department of Psychiatry, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Department of Research and Innovation, Amsterdam, the Netherlands
| | - M J Kikkert
- Arkin Mental Health Care, Department of Research, Amsterdam, the Netherlands
| | - M M de Waal
- Arkin Mental Health Care, Department of Research, Amsterdam, the Netherlands
| | - E Dozeman
- Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Department of Psychiatry, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Department of Research and Innovation, Amsterdam, the Netherlands
| | - H L Hulstijn
- PuntP, Department of Affective Disorders, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - L M Koomen
- Arkin BasisGGZ, Department of Primary Mental Health Care, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - I M Krah
- GGZ Breburg, Department of Anxiety and Depressive Disorders, Breda, the Netherlands
| | - D M Schut
- Altrecht Mental Health Institute, Department of Anxiety and Depressive Disorders, Zeist, the Netherlands
| | - A T F Beekman
- Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Department of Psychiatry, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Department of Research and Innovation, Amsterdam, the Netherlands
| | - J J M Dekker
- Arkin Mental Health Care, Department of Research, Amsterdam, the Netherlands; Vrije Universiteit Amsterdam, Department of Clinical Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health research institute, Amsterdam, Netherlands
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Pössel P, Seely HD, Marchetti I. Similarities and Differences in the Architecture of Cognitive Vulnerability to Depressive Symptoms in Black and White American Adolescents: A Network Analysis Study. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01218-5. [PMID: 38850463 DOI: 10.1007/s10802-024-01218-5] [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] [Accepted: 05/23/2024] [Indexed: 06/10/2024]
Abstract
The hopelessness theory, Beck's cognitive theory, and the response styles theory dominate our understanding and the treatment of depression in adolescents. However, research supporting them is largely based on White individuals. Further, the associations between stressors, cognitive vulnerabilities, and depressive symptoms in Black adolescents are not as one would expect based on the predictions from those theories. Both raise the question of if and to what degree these theories and previous findings can be generalized to Black adolescents. Additionally, without a theoretical basis, clinicians regularly use interventions developed based on one theory to influence vulnerabilities described in another theory. Thus, the purpose of our study was to examine the structure of an integrated cognitive stress-vulnerability model as well as the strengths of associations between stressors, cognitive vulnerabilities, and depressive symptoms in Black and White adolescents. In our study, 295 Black (37% female) and 213 White (49% female) ninth-grade students from a public high school participated. Network analyses demonstrated that the three original cognitive theories of depression can and should be integrated and that each variable we examined is comparably relevant for Black and White adolescents. At the same time, the structure of the two integrated networks differed significantly among Black and White adolescents, exhibiting specific distinctions at four edge levels. Furthermore, the predictability of the network is notably lower for Black adolescents than for White adolescents. Important theoretical and clinical implications can be derived.
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Affiliation(s)
- Patrick Pössel
- Department of Counseling and Human Development, University of Louisville, 2301 S. Third Street, Louisville, KY, 40292, USA.
| | - Hayley D Seely
- Department of Counseling and Human Development, University of Louisville, 2301 S. Third Street, Louisville, KY, 40292, USA
| | - Igor Marchetti
- Department of Life Sciences, Psychology Unit, University of Trieste, Trieste, Italy
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Theodorou C, Karekla M, Panayiotou G. Enhancing Emotion Regulation Skills in High-Risk Adolescents Due to the Existence of Psychopathology in the Family: Feasibility and Uncontrolled Pilot Study of a Group Intervention in a Naturalistic School Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:738. [PMID: 38928984 PMCID: PMC11204122 DOI: 10.3390/ijerph21060738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Emotion regulation skills form part of many interventions for youth with internalizing and externalizing difficulties. This pilot study examines a prevention program delivered at school to improve adolescents' emotion regulation skills, focusing on those at risk for mental health problems. METHODS Adolescents 12-18 years old were referred to a six-session group program by their school counselors, based on inclusion criteria related to family sociodemographic and mental health characteristics. Group sessions took place during school hours to facilitate participation and reduce dropout. The intervention targeted emotion regulation skills, drawing from central components of different cognitive behavioral approaches. To assess clinical outcomes, participants answered questionnaires before and after the program, which covered emotion regulation strategies, addictive behaviors, and internalizing and externalizing symptoms. The acceptability of the program was also assessed. RESULTS Emotion regulation skills improved after the program, and there was a significant reduction in internalizing and externalizing problems. The program was evaluated as useful by participants. Counsellors reported satisfaction with the program. CONCLUSIONS Targeted emotion regulation skills training is a potentially useful transdiagnostic intervention to prevent mental health problems in youth. Bringing the intervention to the school setting and involving counsellors in referring at-risk students can facilitate uptake and reduce dropout.
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Affiliation(s)
| | - Maria Karekla
- Department of Psychology, University of Cyprus, 2109 Nicosia, Cyprus;
| | - Georgia Panayiotou
- Center for Applied Neuroscience, University of Cyprus, 1678 Nicosia, Cyprus;
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David OA, Tomoiagă C, Fodor LA. Gamified Assessment of the Emotion Regulation Abilities in Youth: Validation of the REThink Online System. Games Health J 2024; 13:184-191. [PMID: 38265781 DOI: 10.1089/g4h.2023.0011] [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] [Indexed: 01/25/2024] Open
Abstract
Objective: Emotional problems in the youth population are a major issue that can have a significant negative impact for their future development as adults. Their emotion regulation (ER) abilities represent a preventive measure for those emotional problems. REThink is an online therapeutic game that was proved to be effective in rigorous studies, and is based on the rational emotive behavioral therapy, with seven levels built to train various emotional regulation skills. Each level has a section that can be used for the assessment of the targeted skills within the level. The present study aimed at investigating the reliability and validity of the evaluation modules from the REThink game regarding the assessment of ER abilities in children/adolescents. Methods: In accordance with established guidelines, 110 children and adolescents aged 8-14 years old were recruited. Following parental informed consent, the participants filled out the standard questionnaires and, subsequently, they played the evaluation module of the REThink game. The reliability aspect was investigated by evaluating internal consistency, while validity was evaluated by using concurrent and predictive validity analyses. Results: The results revealed statistically significant positive associations between the game scores obtained by the participants and the emotion regulation scale. In terms of predictive validity, there were significant negative associations between game scores and the presence of emotional and behavioral problems. Moreover, in terms of the reliability of the REThink game, an acceptable value for the internal consistency was observed. Conclusion: In conclusion, the REThink therapeutic game was proved to be a valid measure for assessing emotion regulation abilities in children and adolescents. Clinical Trial Registration No. NCT04788901.
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Affiliation(s)
- Oana A David
- DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Cristina Tomoiagă
- DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Liviu A Fodor
- DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
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Voltmer K, von Salisch M. Longitudinal prediction of primary school children's COVID-related future anxiety in the second year of the pandemic in Germany. PLoS One 2024; 19:e0302065. [PMID: 38718073 PMCID: PMC11078412 DOI: 10.1371/journal.pone.0302065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 03/27/2024] [Indexed: 05/12/2024] Open
Abstract
Although research has confirmed that the first COVID-19-related lockdown has increased stress and mental health problems in children, less is known about the longer-term effects of the pandemic on children's COVID-related future anxiety (CRFA). Because of CRFA's potentially debilitating effects, risk and resilience factors against this anxiety were investigated. To this end, n = 140 children (49% female) in 3rd and 4th grade classrooms in Germany were asked to perform a working memory task and to self-report about their CRFA and emotion regulation in December 2020 and in May 2021. More maladaptive emotion regulation in December 2020 contributed to the explanation of a high CRFA score in May 2021, whereas a better performance on working memory updating contributed a lower CRFA score later when controls were in place. These results were confirmed when children's CRFA in December 2020 was included in the prediction of their later CRFA. They suggest that maladaptive strategies of emotion regulation, such as rumination, may explain higher or increasing levels of CRFA, whereas efficient working memory updating may be an indicator of processing information in a way which shields children from CRFA-related thoughts. The concepts underlying these variables should be included in prevention and intervention efforts.
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Affiliation(s)
- Katharina Voltmer
- Institute for Sustainability Psychology, Leuphana University Lueneburg, Lueneburg, Lower Saxony, Germany
| | - Maria von Salisch
- Institute for Sustainability Psychology, Leuphana University Lueneburg, Lueneburg, Lower Saxony, Germany
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14
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Kaplan G, Mikulincer M, Ginzburg K, Ohry A, Solomon Z. To reappraise or not to reappraise? Emotion regulation strategies moderate the association of loneliness during COVID-19 with depression and anxiety. ANXIETY, STRESS, AND COPING 2024; 37:305-317. [PMID: 38124292 DOI: 10.1080/10615806.2023.2296935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The COVID-19 pandemic resulted in heightened feelings of loneliness due to lockouts and social restrictions. OBJECTIVE In the present study, we examined the association of loneliness during the pandemic with anxiety and depression, while exploring the moderating role of the tendency to use two emotion-regulation strategies (expressive suppression, cognitive reappraisal). DESIGN We chose to examine these associations in a sample of older adults, because they faced higher risk for loneliness and health problems during the COVID-19 pandemic. METHODS Specifically, 174 Israeli veterans and ex-prisoners of wars from the 1973 Yom Kippur war (mean age = 69) completed self-report scales tapping loneliness, depression, anxiety, and emotion regulation strategies at the beginning of the COVID-19 outbreak (April-May 2020). RESULTS Findings revealed a stronger association between loneliness and depression among participants who had a greater tendency of using suppression. The tendency to use suppression did not significantly moderate the link between loneliness and anxiety. Additionally, a weaker association between loneliness and depression was found among participants who has a greater tendency of using reappraisal. However, these participants showed a stronger association between loneliness and anxiety. CONCLUSIONS These findings highlight the complexity of reappraisal and adds to the growing body of work on emotion regulation.
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Affiliation(s)
- Gal Kaplan
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - Mario Mikulincer
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - Karni Ginzburg
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Avi Ohry
- Faculty of Medicine, Tel Aviv University and the Reuth Medical and Rehabilitation Center, Tel Aviv, Israel
| | - Zahava Solomon
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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15
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Demkowicz O, Panayiotou M, Qualter P, Humphrey N. Longitudinal relationships across emotional distress, perceived emotion regulation, and social connections during early adolescence: A developmental cascades investigation. Dev Psychopathol 2024; 36:562-577. [PMID: 36734229 DOI: 10.1017/s0954579422001407] [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] [Indexed: 02/04/2023]
Abstract
Early adolescence is a vulnerable period for emotional distress. Both emotion regulation and social connection to peers and family adults are understood to be associated with distress. However, existing longitudinal work has not explored these constructs jointly in a way that estimates their reciprocal relationships over adolescence. We present a three-wave random-intercepts cross-lagged panel model of reciprocal relationships between emotional distress, perceived emotion regulation, and social connections during early adolescence, among 15,864 participants from education settings in disadvantaged areas of England, over three annual waves (at ages 11/12, 12/13, and 13/14 years). Findings showed that emotional distress and perceived emotion regulation share a negative relationship over time, and that higher perceived emotion regulation predicts greater family connection in the initial stages of early adolescence (from age 11-12 to 12-13 years). Findings also indicated that connection to peers is positively associated with family connection, but also positively predicts slightly greater distress in the later stages of early adolescence (from age 12-13 to 13-14 years). Findings indicate a risk of negative spiral between emotional distress and perceived emotion regulation in early adolescence, and that social connection may not necessarily play the role we might expect in reducing distress.
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Affiliation(s)
- Ola Demkowicz
- Manchester Institute of Education, The University of Manchester, UK
| | | | - Pamela Qualter
- Manchester Institute of Education, The University of Manchester, UK
| | - Neil Humphrey
- Manchester Institute of Education, The University of Manchester, UK
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16
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Wang J, Li C, Yu X, Zhao Y, Shan E, Xing Y, Li X. Effect of emotional stimulus on response inhibition in people with mild cognitive impairment: an event-related potential study. Front Neurosci 2024; 18:1357435. [PMID: 38745934 PMCID: PMC11091389 DOI: 10.3389/fnins.2024.1357435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background A few studies are emerging to explore the issue of how aging promotes emotional response inhibition. However, there is a lack of empirical study concerning the impact of pathological cognitive impairment on emotional response inhibition. The present study investigated the effect of emotion on response inhibition in people with mild cognitive impairment, the stage of cognitive impairment before dementia. Methods We used two emotional stop-signal tasks to explore whether the dual competition framework considering limited cognitive resources could explain the relationship between emotion and response inhibition in mild cognitive impairment. Results The results showed that negative emotions prolonged N2 latency. The Go trial accuracy was reduced in the high-arousal negative conditions and the stop-signal reaction time was prolonged under high-arousal conditions. This study also verified impaired response inhibition in mild cognitive impairment and found that negative emotions prolonged P3 latency in mild cognitive impairment. Conclusion Emotional information interferes with response inhibition in mild cognitive impairment populations, possibly because emotional information captures more attentional resources, thus interfering with response inhibition that relies on common-pool resources.
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Affiliation(s)
| | | | | | | | | | | | - Xianwen Li
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
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17
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Luczejko AA, Hagelweide K, Stark R, Weigelt S, Christiansen H, Kieser M, Otto K, Reck C, Steinmayr R, Wirthwein L, Zietlow AL, Schwenck C. Empathy and psychopathology in children and adolescents: the role of parental mental illness and emotion regulation. Front Psychiatry 2024; 15:1366366. [PMID: 38651008 PMCID: PMC11033424 DOI: 10.3389/fpsyt.2024.1366366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Objective Although empathy is known to be a strength, recent studies suggest that empathy can be a risk factor for psychopathology under certain conditions in children. This study examines parental mental illness as such a condition. Further, it aims to investigate whether maladaptive emotion regulation (ER) mediates the relationship between empathy and psychopathological symptoms of children. Methods Participants were 100 children of parents with a mental illness (55% female) and 87 children of parents without a mental illness (50% female) aged 6 - 16 years and their parents. Results Greater cognitive empathy was related to more psychopathological symptoms in COPMI, but not in COPWMI. In addition, in COPMI maladaptive ER mediated this relationship. In contrast, greater affective empathy was associated with more psychopathological symptoms regardless of whether parents had a mental illness. Conclusion Our findings highlight the importance of implementing preventive programs for COPMI that specifically target the reduction of maladaptive ER.
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Affiliation(s)
- Arleta A. Luczejko
- Department of Clinical Child and Adolescent Psychology, Justus Liebig University Giessen, Giessen, Germany
| | - Klara Hagelweide
- Department of Rehabilitation Sciences, Technical University Dortmund, Dortmund, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig University Giessen, Giessen, Germany
| | - Sarah Weigelt
- Department of Rehabilitation Sciences, Technical University Dortmund, Dortmund, Germany
| | - Hanna Christiansen
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Kathleen Otto
- Department of Work and Organizational Psychology, Philipps-University Marburg, Marburg, Germany
| | - Corinna Reck
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ricarda Steinmayr
- Department of Psychology, Technical University Dortmund, Dortmund, Germany
| | - Linda Wirthwein
- Department of Psychology, Technical University Dortmund, Dortmund, Germany
| | - Anna-Lena Zietlow
- Clinical Child and Adolescent Psychology, Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Christina Schwenck
- Department of Clinical Child and Adolescent Psychology, Justus Liebig University Giessen, Giessen, Germany
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18
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Smorti M, Milone A, Fanciullacci L, Ciaravolo A, Berrocal C. Parenting and Emotional and Behavioral Difficulties in a General Population Sample of Adolescents: The Mediating Role of Emotional Dysregulation. CHILDREN (BASEL, SWITZERLAND) 2024; 11:435. [PMID: 38671652 PMCID: PMC11049627 DOI: 10.3390/children11040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/14/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Martina Smorti
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.S.); (L.F.); (A.C.); (C.B.)
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, 56128 Calambrone, Italy
| | - Luisa Fanciullacci
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.S.); (L.F.); (A.C.); (C.B.)
| | - Alessia Ciaravolo
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.S.); (L.F.); (A.C.); (C.B.)
| | - Carmen Berrocal
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.S.); (L.F.); (A.C.); (C.B.)
- International Lab of Clinical Measurements, University of Florence, Viale Pieraccini, 6, 50139 Florence, Italy
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19
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Ghiggia A, Castelli L, Adenzato M, Di Tella M. Emotional competencies and psychological distress: Is loneliness a mediating factor? Scand J Psychol 2024; 65:359-368. [PMID: 37986626 DOI: 10.1111/sjop.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Emotional competencies, such as emotion regulation and empathy, are essential for social interaction. Impairment of these skills has been associated with increased rates of anxiety/depressive symptoms and loneliness, which has been defined as the discrepancy between the desired and actual quality and quantity of social relationships a person maintains. The aim of the present study was to shed light on the associations between these constructs and to examine the possible mediating role of loneliness in the relationship between emotional competencies and anxiety/depressive symptoms in a sample of non-clinical individuals. A total of 298 participants were recruited for this study and were asked to complete a series of measures assessing difficulties in emotion regulation, empathy, loneliness, and anxiety/depressive symptoms. Regression and mediation models were tested to analyze the associations between these variables. Results showed that reduced emotional competencies in emotion regulation and empathy were both directly and indirectly associated with increased anxiety/depressive symptoms and emotional loneliness, which in turn was related to higher levels of psychological distress (with a partial mediation of loneliness). Overall, the present findings seem to indicate that emotional competencies play a key role in the experience of loneliness and psychological distress. Therefore, individuals reporting high levels of loneliness in combination with anxious/depressive symptoms should receive appropriate assessment and treatment of emotion regulation and empathic skills.
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Affiliation(s)
- Ada Ghiggia
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Mauro Adenzato
- Department of Psychology, University of Turin, Turin, Italy
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20
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Clapham R, Brausch A. Internalizing and Externalizing Symptoms Moderate the Relationship Between Emotion Dysregulation and Suicide Ideation in Adolescents. Child Psychiatry Hum Dev 2024; 55:467-478. [PMID: 36066655 PMCID: PMC9986343 DOI: 10.1007/s10578-022-01413-9] [Citation(s) in RCA: 2] [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] [Received: 02/14/2022] [Revised: 04/14/2022] [Accepted: 08/02/2022] [Indexed: 01/09/2023]
Abstract
The relationship between emotion dysregulation and suicide ideation may depend on the level of internalizing and externalizing symptoms. It was expected that both internalizing and externalizing symptoms would moderate the relationship between emotion dysregulation and suicide ideation, such that greater symptoms would strengthen the relationship between emotion dysregulation and suicide ideation. Adolescent participants (n = 559, Mage = 15.40, 85.0% white, 57.2% female) completed self-report measures that assessed emotion dysregulation, internalizing and externalizing symptoms, and recent suicide ideation. Both internalizing and externalizing symptoms moderated the relationship between emotion dysregulation and suicide ideation; this relationship strengthened as internalizing and externalizing symptoms increased. The results of this study indicate that internalizing and externalizing symptoms may both affect the connection between emotion dysregulation and suicide ideation. Future research should focus on targeting both internalizing and externalizing symptoms in treatment to help reduce emotion dysregulation and suicide ideation in adolescents.
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Affiliation(s)
- Rebekah Clapham
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd., 42101, Bowling Green, KY, USA
| | - Amy Brausch
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd., 42101, Bowling Green, KY, USA.
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21
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Liu W, Guo X, Liu F, Sun Y. The Role of Emotion Regulation Strategies in the Relationship Between Temperament and Depression in Preadolescents. Child Psychiatry Hum Dev 2024; 55:439-452. [PMID: 36063256 DOI: 10.1007/s10578-022-01423-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/03/2022]
Abstract
This study explored the relationship between temperament-i.e., negative affectivity (NA) and effortful control (EC)-and depression in preadolescents, considering emotion regulation (ER) strategies as mediating mechanisms in this relationship. We examined data from 535 children aged 8-12 years (M ± SD = 10.01 ± 1.42) who completed self-report measures related to NA, EC, ER strategies, depressive symptoms, and depressive mood. The results demonstrated that NA was significantly positively related to both depressive symptoms and depressive mood, while EC was significantly negatively related to both depressive symptoms and depressive mood. The structural equation model of latent variable analysis showed that cognitive reappraisal mediated the relationship between NA and depressive symptoms and depressive mood. Moreover, cognitive reappraisal was also identified as a mediator of the association between EC and depressive symptoms and depressive mood. However, expressive suppression only mediated the relationship between NA and depressive symptoms. Interventions aimed at ER strategies would be an effective program for preadolescents with depression and further improve preadolescents' social-emotional development.
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Affiliation(s)
- Wen Liu
- College of Psychology, Liaoning Normal University, Dalian, Liaoning Province, China
| | - Xin Guo
- College of Psychology, Liaoning Normal University, Dalian, Liaoning Province, China
| | - Fang Liu
- Department and Institute of Psychology, Ningbo University, 818# Fenghua Road, Jiangbei District, Ningbo, Zhejiang Province, China.
| | - Yan Sun
- College of Psychology, Liaoning Normal University, Dalian, Liaoning Province, China
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22
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Knowles KA, Tolin DF. Reductions in Anxiety are Associated with Decreased Expressive Suppression and Increased Cognitive Reappraisal After Cognitive-Behavioral Treatment: A Naturalistic Study in Youth. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01684-4. [PMID: 38530590 DOI: 10.1007/s10578-024-01684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/28/2024]
Abstract
Broad deficits in emotion regulation skills have been observed in children with anxiety-related disorders. These deficits typically improve during cognitive-behavioral therapy (CBT), but few studies have examined changes in expressive suppression and cognitive reappraisal in youth with anxiety disorders and/or obsessive-compulsive disorder (OCD) during CBT, especially in real-world settings. In a naturalistic treatment-seeking sample, 123 youth completed measures of anxiety, depression, and emotion regulation strategy use before and after 15 sessions of CBT. For anxious youth, anxiety and expressive suppression decreased over treatment, while cognitive reappraisal increased. Reductions in expressive suppression and increases in cognitive reappraisal were significantly associated with improvements in anxiety and remained significantly associated with post-treatment anxiety after accounting for baseline anxiety and depression. Changes in expressive suppression and cognitive reappraisal over the course of treatment were not found for youth with primary OCD. Thus, CBT improves emotion regulation abilities in anxious youth, and these improvements are associated with anxiety reduction; improvements in emotion regulation do not appear to drive changes in OCD symptoms. Further research is needed to determine whether changes in emotion regulation strategies mediate changes in anxiety among youth receiving CBT.
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Affiliation(s)
- Kelly A Knowles
- Anxiety Disorders Center, The Institute of Living/Hartford Hospital, 200 Retreat Avenue, Hartford, CT, 06106, USA.
| | - David F Tolin
- Anxiety Disorders Center, The Institute of Living/Hartford Hospital, 200 Retreat Avenue, Hartford, CT, 06106, USA
- Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
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23
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Volkaert B, Wante L, Wiersema JR, Braet C. Depressive symptoms in early adolescence: the dynamic interplay between emotion regulation and affective flexibility. Front Psychol 2024; 15:1165995. [PMID: 38586295 PMCID: PMC10996852 DOI: 10.3389/fpsyg.2024.1165995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 01/29/2024] [Indexed: 04/09/2024] Open
Abstract
Individual differences in affective flexibility may be an important factor in understanding how emotion regulation is associated with adolescents’ depressive symptoms. The current study explored the role of affective flexibility as a moderator in the relationship between the use of both adaptive and maladaptive emotion regulation strategies and depressive symptoms in 65 young adolescents (11–13 years). Affective flexibility was indicated by the reaction time and accuracy index on the Emotional Flexible Items Selection Task. Emotion regulation strategies and depressive symptoms were assessed by the use of self-report questionnaires. Contrary to the hypotheses, affective flexibility did not moderate the relationship between emotion regulation and adolescents’ depressive symptoms. Instead, only a direct effect of the use of adaptive emotion regulations strategies on adolescents’ depressive symptoms was found. Additionally, post-hoc analyses revealed that there may exist an indirect relationship between affective flexibility and adolescents’ depressive symptoms through the use of adaptive emotion regulation strategies. These findings help to formulate a better understanding of how emotion regulation and affective flexibility in early adolescents are related to depressive symptoms.
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Affiliation(s)
- Brenda Volkaert
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Laura Wante
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Jan R. Wiersema
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Qiao Z, Poppelaars ES, Li X. In the anticipation of threat: Neural regulatory activity indicated by delta-beta correlation and its relation to anxiety. Biol Psychol 2024; 187:108769. [PMID: 38447860 DOI: 10.1016/j.biopsycho.2024.108769] [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] [Received: 07/06/2023] [Revised: 11/16/2023] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
The anticipation of oncoming threats is emotionally challenging and related to anxiety. The current study aimed to investigate the neural regulatory processes during the anticipatory preparations in stressful situations in relation to trait anxiety, especially in an uncertainty-related stressful situation. To this end, we measured within-subjects delta-beta amplitude-amplitude correlation (AAC) and phase-amplitude coupling (PAC) with electroencephalography using a well-defined stress-inducing paradigm in 28 high-trait-anxiety (HTA) and 29 low-trait-anxiety (LTA) college students. Specifically, a threat probability task was conducted, where participants anticipated the future stimuli under the uncertain (i.e., an average of 50% electric shocks), certain (i.e., 100% electric shocks) and no threat conditions, as well as a resting state task. Results showed a generally larger delta-beta AAC in the LTA group relative to the HTA group across conditions, supporting the hypothesis that delta-beta AAC reflects the efficiency of stress regulation and trait anxiety could compromise this adaptive regulatory activity. Furthermore, a larger delta-beta PAC was found under the uncertain threat condition relative to the no threat condition, indicating the sensitivity of delta-beta PAC in reflecting state anxiety. These findings indicate that while delta-beta AAC is more related to trait anxiety and could distinguish between high and low trait anxiety irrespective of conditions, delta-beta PAC is more related to state anxiety and is sensitive enough to detect the uncertainty-related anxious state.
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Affiliation(s)
- Zhiling Qiao
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China; Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven 3000, Belgium
| | | | - Xuebing Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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25
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Lyons L. Hypnosis with depressed children and teens: Building skills, creating connection. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2024; 66:70-82. [PMID: 37205748 DOI: 10.1080/00029157.2023.2208624] [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] [Indexed: 05/21/2023]
Abstract
Depression in children and teens has been on the rise for several years. Recent increases in anxiety and loneliness, both contributors to the development of depression, are putting more young people at risk for chronic and comorbid mental health struggles. The use of hypnosis with depressed children offers the opportunity to target the identified skills depressed and anxious children need and is a modality clinicians should embrace. This article describes how to create hypnotic interventions focusing on improved emotional and cognitive management, better sleep, and the ability to make positive social connections. Such interventions serve to not only build the resources depressed children need for recovery, but also support a paradigm shift toward prevention in children and families.
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Gong X, Zhang L. Childhood Maltreatment and Non-Suicidal Self-Injury in Adolescents: Testing a Moderated Mediating Model. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:925-948. [PMID: 38229266 DOI: 10.1177/08862605231197747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
There is a wealth of evidence to suggest that childhood maltreatment is a major risk factor contributing to non-suicidal self-injury (NSSI) among adolescents. However, how and under what conditions childhood maltreatment is related to NSSI remains largely unclear. This study examined the indirect effect of depressive symptoms in the relation between childhood maltreatment and non-suicidal self-injury, as well as the moderating role of cognitive reappraisal and emotion reactivity in those associations. A sample of 1,984 Chinese adolescents (Mage = 12.84, SD = 1.27, 47.9% girls) completed self-report questionnaires. The results of path analysis showed that childhood maltreatment was significantly related to NSSI and that depressive symptoms play an indirect effect in the relation between them. Cognitive reappraisal mitigated the effect of childhood maltreatment on depressive symptoms, and emotion reactivity strengthened the effect of depressive symptoms on non-suicidal self-injury. The results further showed that the indirect effect of depressive symptoms was more prominent for youths with lower levels of cognitive reappraisal and greater emotion reactivity. Interventions that enhance cognitive reappraisal and reduce emotion reactivity may interrupt the pathway from childhood maltreatment to NSSI via depressive symptoms.
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27
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Lin SC, Kehoe C, Pozzi E, Liontos D, Whittle S. Research Review: Child emotion regulation mediates the association between family factors and internalizing symptoms in children and adolescents - a meta-analysis. J Child Psychol Psychiatry 2024; 65:260-274. [PMID: 37803878 DOI: 10.1111/jcpp.13894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Parental influence on children's internalizing symptoms has been well established; however, little is known about the underlying mechanisms. One possible mechanism is child emotion regulation given evidence (a) of its associations with internalizing symptoms and (b) that the development of emotion regulation during childhood and adolescence is influenced by aspects of the family environment. This meta-analysis aimed to systematically investigate the mediating role of child emotion regulation in the relationship between various family factors and internalizing symptoms in children and adolescents. METHODS We searched Medline, Embase, PsychInfo, and Web of Science for English articles up until November 2022. We included studies that examined child emotion regulation as a mediator between a family factor and child/adolescent internalizing symptoms. Random-effects models were used to calculate pooled indirect effects and total effects for nine family factors. Heterogeneity and mediation ratio were also calculated. RESULTS Of 49 studies with 24,524 participants in this meta-analysis, family factors for which emotion regulation mediated the association with child/adolescent internalizing symptoms included: unsupportive emotion socialization, psychological control, secure attachment, aversiveness, family conflict, parent emotion regulation and parent psychopathology, but not supportive emotion socialization and behavioral control. CONCLUSIONS Various family factors impact children's emotion regulation development, and in turn, contribute to the risk of internalizing symptoms in young people. Findings from this study highlight the need for interventions targeting modifiable parenting behaviors to promote healthy emotion regulation and better mental health in children and adolescents.
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Affiliation(s)
- Sylvia Chu Lin
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Vic., Australia
| | - Christiane Kehoe
- Mindful, Centre for Training and Research in Developmental Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Elena Pozzi
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Vic., Australia
| | - Daniel Liontos
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Vic., Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Vic., Australia
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Rådman G, Claréus B, Daukantaitė D. Adolescents' Emotion Regulation Strategies Questionnaire-Extended: Further Development and Associations With Mental Health Problems in Adolescence. Assessment 2024; 31:482-501. [PMID: 37056041 PMCID: PMC10822064 DOI: 10.1177/10731911231164619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Emotion regulation (ER) is implicated in a range of psychopathologies and behavioral problems that are prevalent or have their initial onset in adolescence. In this study, we aim to evaluate the psychometric properties (factor structure, internal consistency, and construct validity) of the Adolescents' Emotion Regulation Strategies Questionnaire-Extended (AERSQ-E), a modified and extended version of an ER instrument developed by Zhou et al. Across six sub-studies using data from different Swedish adolescent community samples (1,104 students in total), we generated and validated a 23-item version containing six subscales: rumination/negative thinking, positive reorientation, creative expression, aggressive outlet, social support, and distraction. Assessing test-retest reliability, internal consistency, measurement invariance as well as convergent and discriminant validity, we could establish, with some limitations, the general reliability and validity of the AERSQ-E as a valid measure of ER strategies for use in adolescence.
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Murayama Y, Ito H, Hamada M, Takayanagi N, Nakajima T, Myogan M, Tsujii M. Longitudinal associations between response-style strategies and abnormal eating behaviors/attitudes in adolescents: a cross-lagged panel model. J Eat Disord 2024; 12:33. [PMID: 38414032 PMCID: PMC10900678 DOI: 10.1186/s40337-024-00991-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Previous studies have suggested that response-style strategies (rumination, problem-solving, and distraction) can be risk or protective factors for the development of abnormal eating behaviors/attitudes (AEB) during adolescence. However, due to limited empirical data regarding the prospective effects of these strategies on AEB, further research is needed to clarify their role in developing AEB in adolescence. METHODS This study investigated the one-year lagged effects of response-style strategies on AEB in 24,883 fourth- to eighth-grade students in Japan between 2015 and 2019 using a cross-lagged panel model. Depressive symptoms and body mass index (BMI), which are reported to relate to AEB, were also included in the analytic model. The students self-reported their levels of response-style strategies, AEB, and depressive symptoms. We also evaluated BMI based on teachers' reports. RESULTS We found that greater rumination significantly predicted more severe AEB in the following year among students from all grades, with small to moderate effect sizes. In addition, distraction significantly predicted more severe binge eating/purging behaviors, but with very weak small effect sizes. Problem-solving did not predict any level of AEB. Furthermore, we observed significant reciprocal relationships between response-style strategies, AEB, and depressive symptoms. Positive reciprocal associations between BMI and AEB were also found except for some intervals. CONCLUSIONS We concluded that a decrease in rumination is critical to alleviating mental health problems, such as AEB and depressive symptoms, during adolescence. This suggests that interventions to reduce the level of rumination should be conducted in the early stages of adolescence. TRIAL REGISTRATION NUMBER Not Applicable.
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Affiliation(s)
- Yasuo Murayama
- Institute of Human and Social Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan.
| | - Hiroyuki Ito
- Faculty of Core Research Human Science Division, Ochanomizu University, 2-1-1, Otsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Megumi Hamada
- School of Psychology, Chukyo University, 101-2, Yagoto Honmachi, Showa-ku, Nagoya, Aichi, 466-8666, Japan
| | - Nobuya Takayanagi
- Department of Psychology, Aichi University of Education, 1 Hirosawa, Igaya-Cho, Kariya, Aichi, 448-8542, Japan
| | - Takahiro Nakajima
- School of Human Care Studies, Nagoya University of Arts and Sciences, 57, Takenoyama, Iwasaki-Cho, Nisshin, Aich, 470-0196, Japan
| | - Mitsunori Myogan
- School of Psychology, Chukyo University, 101-2, Yagoto Honmachi, Showa-ku, Nagoya, Aichi, 466-8666, Japan
| | - Masatsugu Tsujii
- School of Contemporary Sociology, Chukyo University, 101, Tokodachi, Kaizu-Cho, Toyota, Aichi, 470-0393, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1, Hadayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
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30
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Qiao T, Sun Y, Ye P, Yan J, Wang X, Song Z. The association between family functioning and problem behaviors among Chinese preschool left-behind children: the chain mediating effect of emotion regulation and psychological resilience. Front Psychol 2024; 15:1343908. [PMID: 38476393 PMCID: PMC10927802 DOI: 10.3389/fpsyg.2024.1343908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Objective The family environment has a significant impact on the psychological and behavioral development of children, especially those who are left behind in preschool and experience parent-child separation at a young age. These children face a greater risk of family dysfunction, which can lead to internalizing and externalizing problem behaviors. While numerous studies have established a connection between family functioning and problem behaviors, few have explored the underlying mechanisms driving this relationship. Our study seeks to address this gap by examining how emotion regulation and psychological resilience mediate the link between family functioning and problem behavior. Methods The sample consisted of 940 preschool children (51.5% male, 48.5% female) with a mean age of 5.07 ± 0.80. The main guardians of the children were given the Family Assessment Device, Preschool Children's Emotion Regulation Scale, the Devereux Early Childhood Assessment for Preschoolers (2nd edition), and the Social Skills Improvement System-Rating Scales to assess their family functioning, emotion regulation, psychological resilience, and problem behavior respectively. Results Lower family functioning was associated with more severe problem behaviors in preschool left-behind children, and emotion regulation and psychological resilience partially mediated the relationship between family functioning and problem behaviors, respectively. In addition, emotion regulation and psychological resilience were also chain mediators between family functioning and problem behaviors. Conclusion The study's findings highlighted the crucial role of emotional regulation and psychological resilience in the correlation between family functioning and problem behaviors. It is recommended that policymakers and educators place a high priority on the cultivation of internal psychological resources, such as emotional regulation and resilience, in preschool-aged children when designing interventions to address problem behaviors.
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Affiliation(s)
- Tianqi Qiao
- College of Education, Guangzhou University, Guangzhou, China
| | - Yan Sun
- College of Teacher Education, Shaoxing University, Shaoxing, China
| | - Pingzhi Ye
- College of Education, Guangzhou University, Guangzhou, China
| | - Jingfeng Yan
- College of Education, Wenzhou University, Wenzhou, China
| | - Xinxin Wang
- College of Education, Guangzhou University, Guangzhou, China
| | - Zhanmei Song
- College of International Education, Wenzhou University, Wenzhou, China
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Winds K, Marka T, Salcher B, Rieser N, Skrivanek C, Hochrainer M, Trost-Schrems J, Rainer LJ, Hitzl W, Augner C, Plattner B. Glow up: does a professional photoshoot intervention affect self-esteem and emotions among adolescent psychiatric patients?-A longitudinal intervention study. Front Psychiatry 2024; 15:1310252. [PMID: 38463433 PMCID: PMC10920346 DOI: 10.3389/fpsyt.2024.1310252] [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: 10/09/2023] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
Background Today, online communication is shaped by a billion-dollar social media (SM) and social networking site (SNS) industry. Visual content consumed by children and adolescents has been shown to influence behavioral patterns, state emotions, and self-esteem (SE). In this study, we introduced a novel intervention creating visual content through a professional photoshoot and investigated its impact on state emotions and SE in child and adolescent psychiatric (CAP) patients. Methods Standardized and validated self-rating questionnaires were used to assess SE, state emotions, coping mechanisms, psychopathological symptoms, and internet use behavior at baseline. SE and state emotions were monitored at different time points around a professional photoshoot within 45 CAP patients (30 female patients; mean age, 15.1 years) using a longitudinal design. Results Within-subject repeated-measures ANOVA and bootstrapped paired-sample t-tests showed a significant fluctuation in state emotions and SE throughout the intervention. Spearman correlations and univariate logistic regressions revealed that internalizing symptomatology and maladaptive coping significantly worsened the outcome of the intervention on state emotions and SE in girls. Internet-related variables heightened the positive effect of the intervention in boys and lowered SE in girls during the intervention. Conclusion The photo intervention had various gender-specific effects. Boys did benefit from the intervention in terms of longitudinal outcome on positive state emotions (PE) and SE, even positively influenced by SNS and SM. Thus, it might be concluded that online social comparison was processed more beneficial in boys. In contrast, when working with visual content in girls, psychopathology and coping must be considered. Internet consumption in general, especially SM and SNS, was related to low SE in girls. Nevertheless, when therapeutically accompanied, the "glow up moment" during the shoot (high on PE and SE; low on negative state emotions) could be used as an index moment for therapeutic reflection.
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Affiliation(s)
- Kornelius Winds
- University Clinics for Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience Salzburg, Paris Lodron University Salzburg, Salzburg, Austria
| | - Theresa Marka
- University Clinics for Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience Salzburg, Paris Lodron University Salzburg, Salzburg, Austria
| | - Bernhard Salcher
- Department of Environment and Biodiversity, Paris Lodron University Salzburg, Salzburg, Austria
| | - Nicole Rieser
- University Clinics for Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
| | - Christine Skrivanek
- University Clinics for Psychiatry, Psychotherapy and Psychosomatics, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
| | - Michelle Hochrainer
- University Clinics for Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Julia Trost-Schrems
- University Clinics for Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
| | - Lucas J. Rainer
- University Clinics for Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience Salzburg, Paris Lodron University Salzburg, Salzburg, Austria
- University Clinics for Psychiatry, Psychotherapy and Psychosomatics, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
- University Clinics for Neurology, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Hitzl
- Research Office Biostatistics, Paracelsus Medical University, Salzburg, Austria
| | - Christoph Augner
- University Clinics for Psychiatry, Psychotherapy and Psychosomatics, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
- Institute for Human Resources Research in Health Care, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
| | - Belinda Plattner
- University Clinics for Child and Adolescent Psychiatry and Psychotherapeutic Medicine, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria
- Centre for Cognitive Neuroscience Salzburg, Paris Lodron University Salzburg, Salzburg, Austria
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McKone KMP, Edershile EA, Ladouceur CD, Silk JS. Real-world flexibility in adolescent girls' emotion regulation strategy selection: An investigation of strategy switching. Dev Psychopathol 2024; 36:181-195. [PMID: 36503633 PMCID: PMC10258216 DOI: 10.1017/s0954579422001079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Adolescence is an important stage for the development of emotion regulation skills, especially for adolescent girls who are at elevated risk for the development of depression and anxiety. Although some emotion regulation strategies are more effective at helping adolescents regulate negative affect on average, research indicates strategy effectiveness varies with the context in which a strategy is deployed. Yet less work has been done examining which contextual factors are associated with adolescents switching emotion regulation strategies in their daily lives. This study examined individual and contextual factors related to negative interpersonal events that are associated with strategy effectiveness, including age, emotional intensity, perceived controllability, and co-regulatory support, and their association with adolescent emotion regulation strategy switching in daily life via ecological momentary assessment. Results indicated that adolescent girls differed in the degree to which they altered their emotion regulation strategies throughout their daily lives, and that switching strategies was associated with age as well as individual and within-person differences in perceived controllability, emotional intensity, and co-regulatory support. This study provides critical proof-of-concept of the utility of emotion regulation strategy switching as a measure of regulatory flexibility and highlights regulatory processes that may hold clues to the mechanisms of developmental psychopathology.
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Affiliation(s)
| | | | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Wirkner J, Brakemeier EL. The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic. Front Psychol 2024; 15:1283919. [PMID: 38356763 PMCID: PMC10864646 DOI: 10.3389/fpsyg.2024.1283919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction As a multidimensional stressor, the COVID-19 pandemic posed a significant threat to mental health, with studies showing younger age groups to be particularly vulnerable. Thus, this study aimed to monitor mental health, potential risk/protective factors, and pandemic-related variables among young university students during the pandemic. Methods Students of the University of Greifswald (M age = 23.0 years, 73.9% female) participated in five cross-sectional online surveys in December 2020 (N = 1,127), March 2021 (N = 760), June/July 2021 (N = 531), December 2021 (N = 1,226), and December 2022 (N = 814). Sociodemographic data, depression and anxiety severity, loneliness, quality of life, coping strategies, resilience, self-esteem, and emotion regulation were measured. First, results from December 2020 were compared to pre-pandemic normative data. Second, the time course during the pandemic was analyzed. Third, linear models were calculated to examine the influence of risk and protective factures on depression and anxiety severity. Results Higher levels of depression, anxiety, and loneliness, as well as lower levels of self-esteem, physical and mental health, social relationships and well-being were found in December 2020 compared to pre-pandemic. Levels of depression and anxiety severity peaked in December 2022. Female sex, loneliness, and previous mental treatment showed associations with higher depression and anxiety severity, while higher self-esteem, resilience and use of reappraisal strategies appeared to act as protective factors. Discussion The study indicates the pandemic's detrimental impact on students' mental health and quality of life. Identified risk and protective factors provide guidance for tailored prevention and treatment, as well as the design of measures for future pandemics and other crisis.
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Affiliation(s)
| | - Eva-Lotta Brakemeier
- Department for Clinical Psychology and Psychotherapy, Institute for Psychology, University of Greifswald, Greifswald, Germany
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Etemadi Shamsababdi P, Dehshiri GR. Self-Compassion, Anxiety and Depression Symptoms; the Mediation of Shame and Guilt. Psychol Rep 2024:332941241227525. [PMID: 38251880 DOI: 10.1177/00332941241227525] [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: 01/23/2024]
Abstract
Self-compassion is related to psychological well-being and can improve mental health problems. The present study aimed to examine the relationship of self-compassion with anxiety and depression symptoms considering the mediating effects of shame and guilt. Two hundred forty-three participants in Iran completed the measures of Depression, Anxiety, Stress Scale (DASS), self-compassion Scale-Short Form (SCS-SF), and personal feelings questionnaire-2 (PFQ-2 Brief). The result showed that there was a significant negative correlation between self-compassion and shame, guilt, depression, and anxiety. The correlation between shame and guilt with depression and anxiety was also positive and significant. Mediation analysis was used to examine whether self-compassion predicted decreased symptoms of depression and anxiety through decreased shame and guilt. The results showed that self-compassion has a negative direct effect on depression symptoms. The direct effect of self-compassion on anxiety symptoms was not significant. Moreover, we found that shame and guilt mediate the relationship between self-compassion and depressive symptoms. However, the indirect effect of guilt on anxiety symptoms was not significant. The findings of the current study demonstrate that Self-compassion is linked to more psychological strengths and efficient emotional regulations, leading to less self-conscious emotions (shame and guilt) and decreased depression and anxiety symptoms.
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Kökönyei G, Kovács LN, Szabó J, Urbán R. Emotion Regulation Predicts Depressive Symptoms in Adolescents: A Prospective Study. J Youth Adolesc 2024; 53:142-158. [PMID: 37985558 PMCID: PMC10761508 DOI: 10.1007/s10964-023-01894-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023]
Abstract
Emotion regulation as a proximal factor has been linked with depressive symptoms. However, studies have mainly focused on a limited number of strategies and have mostly been cross-sectional in design. This is particularly evident when examining the protective effects of adaptive strategies. This study aimed to investigate the prospective relationship between putatively adaptive and maladaptive emotion regulation strategies and depressive symptoms among adolescents. Additionally, a person-oriented approach was applied to identify latent classes of adolescents based on their depressive symptoms and compared these classes in terms of their adaptive and maladaptive strategies. Two waves of data from a prospective study, which included 1371 youth (mean age: 15.66 years; SD = 0.49 years; 55.1% girls), were analysed. The two points of data collection were spaced approximately half a year apart. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale, and putatively adaptive and maladaptive emotion regulation strategies were assessed with the Cognitive Emotion Regulation Questionnaire. Seven strategies (acceptance, positive refocusing, positive reappraisal, putting into perspective, self-blame, rumination, and catastrophizing) were categorised into adaptive and maladaptive factors using exploratory structural equation modeling. After controlling for gender, age, and depressive symptoms at Time 1, both maladaptive and adaptive emotion regulation strategies at Time 1 predicted depressive symptoms at Time 2. Three subgroups emerged based on the intensity of depressive symptoms across the waves: the stable low, stable moderate, and stable high depressive symptom groups. The use of maladaptive emotion regulation strategies (such as rumination, self-blame, and catastrophizing) at Time 1 was more pronounced in the stable moderate and high symptom groups compared to the stable low depressive symptom group. The comparable prospective associations between putatively adaptive and maladaptive strategies with symptoms suggest the need to identify factors that may mitigate the negative impact of maladaptive emotion regulation and/or promote adaptive emotion regulation to buffer the effects of everyday stressors.
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Affiliation(s)
- Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.
| | - Lilla Nóra Kovács
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Judit Szabó
- National Institute of Criminology, Budapest, Hungary
| | - Róbert Urbán
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Wang J, Wang M, Du X, Viana KMP, Hou K, Zou H. Parent and Friend Emotion Socialization in Early Adolescence: Their Unique and Interactive Contributions to Emotion Regulation Ability. J Youth Adolesc 2024; 53:53-66. [PMID: 37684429 DOI: 10.1007/s10964-023-01855-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
During early adolescence, parental influence diminishes, whereas friends' influence increases in shaping emotion regulation abilities. However, it is unclear how parents and friends jointly contribute to emotion regulation abilities and how their joint effects vary by gender. This study examines fathers, mothers, and friends as simultaneous emotional socializers and considers the young adolescents' gender. The analysis drew on 438 young Chinese adolescents (55.7% girls, Mage = 11.39, SD = 1.28) who participated in a longitudinal survey over one year. Results showed that parental and friend emotion socialization have both distinct and joint effects. Friends' responses provided a unique contribution to emotion regulation abilities across gender, whereas parents' responses displayed unique contributions among girls. In predicting girls' emotion regulation abilities, mothers' supportive responses explained the additional variance beyond friends' responses, whereas fathers' unsupportive responses moderated the predictive power of friends' responses. These findings clarify emotion-related socialization theories and emphasize the importance of gender specific prevention programs focusing on emotion socialization from both parents and friends in early adolescence.
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Affiliation(s)
- Juan Wang
- Institute of Developmental Psychology, Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Mingzhu Wang
- Faculty of Education, Shaanxi Normal University, Xi'an, China
| | - Xiaopeng Du
- Department of Psychology, School of Sociology and Psychology, Central University of Finance and Economics, Beijing, China.
| | | | - Ke Hou
- Journal of Beijing Normal University, Beijing Normal University, Beijing, China
| | - Hong Zou
- Institute of Developmental Psychology, Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
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Kung PH, Davey CG, Harrison BJ, Jamieson AJ, Felmingham KL, Steward T. Frontoamygdalar Effective Connectivity in Youth Depression and Treatment Response. Biol Psychiatry 2023; 94:959-968. [PMID: 37348804 DOI: 10.1016/j.biopsych.2023.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/26/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Emotion regulation deficits are characteristic of youth depression and are underpinned by altered frontoamygdalar function. However, the causal dynamics of frontoamygdalar pathways in depression and how these dynamics relate to treatment prognosis remain unexplored. This study aimed to assess frontoamygdalar effective connectivity during cognitive reappraisal in youths with depression and to test whether pathway dynamics are predictive of individual response to combined cognitive behavioral therapy plus treatment with fluoxetine or placebo. METHODS One hundred seven young people with moderate to severe depression and 94 healthy control participants completed a functional magnetic resonance imaging cognitive reappraisal task. After the task, 87 participants with depression were randomized and received 12 weeks of cognitive behavioral therapy plus either fluoxetine or placebo. Dynamic causal modeling was used to map frontoamygdalar effective connectivity during reappraisal and to assess the predictive capacity of baseline frontoamygdalar effective connectivity on depression diagnosis and posttreatment depression remission. RESULTS Young people with depression showed weaker inhibitory modulation of ventrolateral prefrontal cortex to amygdala connectivity during reappraisal (0.29 Hz, posterior probability = 1.00). Leave-one-out cross-validation demonstrated that this effect was sufficiently large to predict individual diagnostic status (r = 0.20, p = .003). Posttreatment depression remission was associated with weaker excitatory ventromedial prefrontal cortex to amygdala connectivity (-0.56 Hz, posterior probability = 1.00) during reappraisal at baseline, though this effect did not predict individual remission status (r = -0.02, p = .561). CONCLUSIONS Frontoamygdalar effective connectivity shows promise in identifying youth depression diagnosis, and circuits responsible for negative affect regulation are implicated in responsiveness to first-line depression treatments.
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Affiliation(s)
- Po-Han Kung
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher G Davey
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Alec J Jamieson
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
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Mihailescu I, Efrim-Budisteanu M, Andrei LE, Buică AM, Moise M, Nicolau IG, Iotu AD, Grădilă AP, Costea T, Priseceanu AM, Rad F. Cognitive Coping Strategies among Inpatient Adolescents with Depression and Psychiatric Comorbidity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1870. [PMID: 38136072 PMCID: PMC10742032 DOI: 10.3390/children10121870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
The aim of the present study is to describe and measure the cognitive emotion regulation strategies of inpatient adolescents with clinical depression, aged 13-18, and to analyse these coping strategies in relation to different comorbidities of Major Depressive Disorder (MDD). METHODS There were 112 adolescents with MDD who were admitted to hospital and 78 healthy adolescents included in the study. The Cognitive Emotion Regulation Questionnaire (CERQ) was used to assess nine specific cognitive coping strategies. A cognitive coping style model for depression in adolescents was described by analysing the differences between the two groups. The CERQ scores in MDD participants, grouped by comorbidity, were also assessed. RESULTS Adolescents with MDD had significantly higher scores for Self-Blame and Catastrophising strategies, and significantly lower scores for Positive Refocusing, Refocusing on Planning, and Positive Reappraisal. Adolescents with MDD and Borderline Personality Disorder (BPD) traits had significantly higher scores for Rumination, Catastrophising, and Blaming Others than adolescents with MDD and anxiety or with no comorbidity. CONCLUSIONS Clinical depression in adolescents is associated with a cognitive profile that consists of an increased use of maladaptive coping styles and low employment of adaptive strategies. Early identification can contribute to the development of specific, individualised prevention and intervention programmes, while further longitudinal studies are necessary to adequately measure the outcome of these interventions.
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Affiliation(s)
- Ilinca Mihailescu
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.M.); (L.E.A.); (A.M.B.); (M.M.); (F.R.)
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
| | - Magdalena Efrim-Budisteanu
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Lucia Emanuela Andrei
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.M.); (L.E.A.); (A.M.B.); (M.M.); (F.R.)
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
| | - Alexandra Mariana Buică
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.M.); (L.E.A.); (A.M.B.); (M.M.); (F.R.)
| | - Mihaela Moise
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.M.); (L.E.A.); (A.M.B.); (M.M.); (F.R.)
| | - Ingrid Georgiana Nicolau
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
| | - Alexandra Diana Iotu
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
| | - Adriana Petruța Grădilă
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
| | - Teodora Costea
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
| | | | - Florina Rad
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.M.); (L.E.A.); (A.M.B.); (M.M.); (F.R.)
- Child and Adolescent Psychiatry Department, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (I.G.N.); (A.D.I.); (A.P.G.)
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Do QB, McKone KMP, Hamilton JL, Stone LB, Ladouceur CD, Silk JS. The link between adolescent girls' interpersonal emotion regulation with parents and peers and depressive symptoms: A real-time investigation. Dev Psychopathol 2023:1-15. [PMID: 37933501 DOI: 10.1017/s0954579423001359] [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: 11/08/2023]
Abstract
Adolescents often experience heightened socioemotional sensitivity warranting their use of regulatory strategies. Yet, little is known about how key socializing agents help regulate teens' negative emotions in daily life and implications for long-term adjustment. We examined adolescent girls' interpersonal emotion regulation (IER) with parents and peers in response to negative social interactions, defined as parent and peer involvement in the teen's enactment of emotion regulation strategies. We also tested associations between rates of daily parental and peer IER and depressive symptoms, concurrently and one year later. Adolescent girls (N = 112; Mage = 12.39) at temperamental risk for depressive disorders completed a 16-day ecological momentary assessment protocol measuring reactivity to negative social interactions, parental and peer IER, and current negative affect. Results indicated that adolescents used more adaptive strategies with peers and more maladaptive strategies with parents in daily life. Both parental and peer IER down-regulated negative affect, reflected by girls' decreased likelihood of experiencing continued negative affect. Higher proportions of parental adaptive IER predicted reduced depressive symptoms one year later. Findings suggest that both parents and peers effectively help adolescent girls down-regulate everyday negative emotions; however, parents may offer more enduring benefits for long-term adjustment.
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Affiliation(s)
- Quyen B Do
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Lindsey B Stone
- Department of Psychology, Georgia Southern University, Statesboro, GA, USA
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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40
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Su L, Lin Z, Li Y, Wang X, Lin Z, Dong L, Wei L. Own-Age Effects in a Face-Emotion Recognition Intervention for Children With ASD--Evidence From Eye Movements. Psychol Res Behav Manag 2023; 16:4479-4490. [PMID: 37942440 PMCID: PMC10629357 DOI: 10.2147/prbm.s427006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
Background The own-age effect is the phenomenon in which individuals perceive and recognize faces of their own age better than others in terms of cognitive processing. Previous eye movement studies on children with autism spectrum disorders (ASD) have reported that children with ASD have an attentional bias toward own-age faces and own-age scenes. Methods The present study used own-age faces as the intervention material and examined the application of the own-age effect in the emotional recognition of faces in ASD. The length of the intervention was 12 weeks, and 2 sessions were conducted each week. Results The results revealed that the own-age face intervention group gazed at children's faces significantly more often than before the intervention, gazed at children's angry faces significantly longer than before the intervention, and gazed at adults' happy faces significantly longer and more often than before the intervention; the other-age faces intervention group did not differ significantly from the preintervention in gazing at children's and adults' faces after the intervention. Conclusion The results suggest that own-age faces as teaching materials can better promote the emotion recognition ability of children with ASD than other-age faces.
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Affiliation(s)
- Linfei Su
- Department of Psychology, School of Health, Fujian Medical University, Fuzhou, People’s Republic of China
- Institute of Psychology, School of Education Science, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Zehui Lin
- Department of Psychology, School of Health, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Youyuan Li
- Department of Psychology, School of Health, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiaoyan Wang
- Fuzhou Xingyu School, Fuzhou, People’s Republic of China
| | - Zengping Lin
- Fuzhou Xingyu School, Fuzhou, People’s Republic of China
| | - Lanjuan Dong
- Fuzhou Xingyu School, Fuzhou, People’s Republic of China
| | - Ling Wei
- Department of Psychology, School of Health, Fujian Medical University, Fuzhou, People’s Republic of China
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Stavish CM, Lengua LJ. Parent Behaviors as Predictors of Preadolescent Appraisal and Coping. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023; 89:101599. [PMID: 37981997 PMCID: PMC10655564 DOI: 10.1016/j.appdev.2023.101599] [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: 11/21/2023]
Abstract
Preadolescent appraisal and coping are significant predictors of youth psychopathology. However, little research examines how parenting behaviors relate to the development of these skills by forming a key context in which children learn to manage stressors. This study examined how observed maternal and paternal behaviors derived from a parent-child interaction task relate to levels of and growth in child appraisal (threat, positive) and coping (active, avoidant) across three years in preadolescence (n = 214, ages 8-12 years old at Time 1). Greater maternal warmth predicted lower threat appraisal and avoidant coping, and greater maternal negativity predicted greater increases in avoidance. Increased paternal warmth predicted lower initial levels of threat appraisal. Boys showed less growth in active coping than girls. These findings suggest parenting behaviors relate to preadolescents' utilization of maladaptive coping strategies such as avoidance and may be important intervention targets for supporting youth managing stressors.
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Muniandy M, Richdale AL, Lawson LP. Stress and well-being in autistic adults: Exploring the moderating role of coping. Autism Res 2023; 16:2220-2233. [PMID: 37698532 DOI: 10.1002/aur.3028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
The wider stress literature points to negative associations between stress and well-being. Similarly, the use of engagement coping strategies and disengagement coping strategies in the face of stress are related to improved and reduced well-being respectively. However, in the autistic population stress and coping research is limited to date, and the extent to which coping may moderate the relationship between stress and well-being is not known. Using data from an Australian online study, we explored the potential moderating (i.e. buffering or exacerbating) role of coping in the relationship between stress and well-being in a sample of autistic adults (N = 86). Our findings indicated that increased stress was associated with lower well-being. Further, moderation analyses showed that while both engagement coping (e.g. problem solving, positive appraisal) and disengagement coping (e.g., self-distraction, being in denial) strategies had significant positive and negative direct effects on well-being respectively; engagement coping also moderated the relationship between stress and well-being, buffering the impact of stress on well-being. Our results illustrate the different underlying mechanisms by which coping strategies may be associated with stress and well-being. They also highlight the potential protective role of engagement coping strategies, which can be incorporated into the promotion and maintenance of well-being in autistic adults.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Lauren P Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Victoria, Australia
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Bonduelle SLB, De Raedt R, Braet C, Campforts E, Baeken C. Parental criticism affects adolescents' mood and ruminative state: Self-perception appears to influence their mood response. J Exp Child Psychol 2023; 235:105728. [PMID: 37390784 DOI: 10.1016/j.jecp.2023.105728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/12/2023] [Accepted: 06/02/2023] [Indexed: 07/02/2023]
Abstract
Feeling and/or being criticized is a known risk factor for various psychiatric disorders in adolescents. However, the link between the experience of social stressors and the development of psychopathological symptoms is not yet fully understood. Identifying which adolescent subgroups are more vulnerable to parental criticism could be of great clinical relevance. In this study, 90 nondepressed 14- to 17-year-old adolescents were exposed to a sequence of auditory segments with a positive, neutral, and finally negative valence, mirroring parental criticism. Their mood and ruminative states were assessed before and after exposure to criticism. We observed an overall increase in mood disturbance and ruminative thoughts. Self-perception appeared to influence these mood changes, whereas no significant influence by perceived criticism, self-worth, or the general tendency to ruminate was found. Emotional awareness seemed to account for some of the variance in positive mood state changes. These findings point to the importance of adolescent self-perception (and emotional awareness) in dealing with parental criticism.
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Affiliation(s)
- Sam L B Bonduelle
- Department of Child and Adolescent Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), 1090 Brussels, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, 9000 Ghent, Belgium.
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Universiteit Gent, 9000 Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality, and Social Psychology, Universiteit Gent, 9000 Ghent, Belgium
| | - Edward Campforts
- Department of Child and Adolescent Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), 1090 Brussels, Belgium
| | - Chris Baeken
- Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, 9000 Ghent, Belgium; Department of Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), 1090 Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands
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Zhou T, Wang Q, Wang Y, Cheng L. Coping with Epidemic-Related Job Stressors in Healthcare Workers During the Late Stage of the COVID-19 Pandemic: Effects of Reflective Functioning and Cognitive Emotion Regulation. Psychol Res Behav Manag 2023; 16:4377-4388. [PMID: 37908681 PMCID: PMC10615099 DOI: 10.2147/prbm.s429109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
Background Healthcare workers encountered novel job stressors during the late stage of the COVID-19 pandemic. These stressors possessed potential deleterious effects on mental health outcomes, yet the underlying mediating and moderating mechanisms remained relatively unexplored. Objective The current study aimed to examine the role of cognitive emotion regulation as a mediator in the association between pandemic-related job stressors and the psychological symptoms of healthcare professionals in the late stage of the COVID-19 pandemic, and the role of reflective functioning as a resilience factor moderating both the associations of pandemic-related job stressors and cognitive emotion regulation, as well as psychological symptoms. Methods This cross-sectional survey conducted in October 2020 included 2393 healthcare professionals working in departments with a high risk of exposure to COVID-19 from 22 hospitals in Beijing, China. Participants were asked to complete questionnaires measuring pandemic-related job stressors, anxiety, depression, reflective functioning, and cognitive emotion regulation strategies. Path analyses were performed to examine the hypothesized model. Results Epidemic-related job stressors had significant direct effects on depression (β=0.31, p<0.001) and anxiety symptoms (β=0.29, p<0.001) and the indirect effects through mediation of maladaptive cognitive regulation were also significant (for depression, indirect effect=0.06, SE=0.01, CI=[0.04, 0.07]; for anxiety, indirect effect=0.06, SE=0.01, CI=[0.04, 0.08]). The dimension of certainty about mental states in the reflective functioning questionnaire (RFQc) moderated the direct effect of pandemic-related job stressors on depression (β=-0.05, p<0.001) and moderated the effect of job stressors on maladaptive cognitive regulation (β=0.06, p<0.001). Conclusion The results shed light on the roles of cognitive emotion regulation and reflective functioning in coping with pandemic-related job stressors in frontline healthcare workers in periods of dealing with major infectious diseases. The findings have implications for developing interventions for healthcare workers in need.
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Affiliation(s)
- Ting Zhou
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, 100191, People’s Republic of China
| | - Qian Wang
- National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of China
| | - Youyang Wang
- National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of China
| | - Lizhi Cheng
- National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of China
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Wang Y, Guang Z, Zhang J, Han L, Zhang R, Chen Y, Chen Q, Liu Z, Gao Y, Wu R, Wang S. Effect of Sleep Quality on Anxiety and Depression Symptoms among College Students in China's Xizang Region: The Mediating Effect of Cognitive Emotion Regulation. Behav Sci (Basel) 2023; 13:861. [PMID: 37887511 PMCID: PMC10603987 DOI: 10.3390/bs13100861] [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: 08/18/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND While the exact mechanisms are not fully understood, there are significant links between sleep quality, anxiety, depressive symptoms, and cognitive emotion regulation. This research examines how sleep quality affects anxiety and depressive symptoms, as well as the potential of cognitive emotion regulation strategies (CERS) to moderate the impact of sleep quality on these symptoms. METHODS The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), the Cognitive Emotion Regulation Questionnaire (CERQ), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7) were all completed online by students from two colleges in China's Xizang region. RESULTS The study included 4325 subjects. The prevalence of poor sleep quality, anxiety symptoms, and depression symptoms was 45.69%, 36.81%, and 51.86%, respectively. We observed significant direct effects on poor sleep and severity of anxiety/depression: c'1 = 0.586 (0. 544-0.628), and c'2 = 0.728 (0.683-0.773). Adaptive CERS only had a mediating effect on the relationship between sleep quality and depression symptoms, with a1b3 = -0.005 (-0.011--0.001). The link between poor sleep quality and the intensity of anxiety and depression was significantly affected by the indirect effects of maladaptive CERS: effect a2b2 = 0.126 (0.106-0.147), and effect a2b4 = 0.145 (0.123-0.167). CONCLUSIONS Individuals who experience poor sleep quality are more likely to have increased levels of anxiety and depression. However, enhancing sleep quality led to a decrease in anxiety and depression levels. Adaptive CERS did not predict anxiety, but they did predict depression. Multiple maladaptive CERS could increase levels of anxiety and depression. To prevent mental stress, it is crucial to examine sleep problems among college students, understand their cognitive strategies, promote the adoption of adaptive CERS, and reduce the reliance on maladaptive CERS.
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Affiliation(s)
- Yingting Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Zixuan Guang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Jinjing Zhang
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Lixin Han
- School of Public Health, Xi’an Jiaotong University Health Science Center, No.76 Yanta West Road, Xi’an 710049, China
- Disease Control and Prevention Division, Shaanxi Provincial Health Commission, No.112 Lianhu Road, Xi’an 710003, China
| | - Rongqiang Zhang
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Yichun Chen
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Qi Chen
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Zhenjia Liu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Yuan Gao
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Ruipeng Wu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Shaokang Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
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Klinge JL, Warschburger P, Busching R, Klein AM. Self-regulation facets differentially predict internalizing symptom trajectories from middle childhood to early adolescence: a longitudinal multimethod study. Child Adolesc Psychiatry Ment Health 2023; 17:120. [PMID: 37848960 PMCID: PMC10583422 DOI: 10.1186/s13034-023-00670-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Internalizing symptoms are among the most common psychological symptoms in childhood and adolescence, are highly stable and can cause severe impairment. Current research discusses lower capacities of self-regulation (SR) as risk factors for the development of internalizing symptoms. The present study identifies trajectories of internalizing symptoms in the transition phase from middle childhood to adolescence and examines multiple SR facets as predictors of potentially unfavorable trajectories, also in the presence of other established risk factors. METHODS The study utilized a community sample of N = 1453 (52.2% female) German children, who provided data at up to three measurement points (t1: 6-11 years, t2: 7-11 years, t3: 9-13 years). Trajectories of internalizing symptoms were based on parents' ratings of the emotional problems scale of the Strengths and Difficulties Questionnaire. SR facets were assessed using multiple methods and informants. Two multinomial regression analyses were conducted to predict class membership by (1) SR facets and gender and (2) SR facets, gender, and other established risk factors (education status, family adversity, peer problems). RESULTS Using growth mixture modelling, we identified three trajectory classes with stable low (n = 1200), increasing (n = 124), and early high decreasing internalizing symptoms (n = 129). In the regression analysis controlling for risk factors, membership in the increasing trajectory was significantly predicted by higher emotional reactivity (OR = 2.65, p < .001), higher cognitive flexibility/set-shifting (OR = 1.48, p = .032), and higher family adversity (OR = 1.38, p = .046). Membership in the early high decreasing trajectory was significantly predicted by higher emotional reactivity (OR = 4.15, p < .001), higher inhibitory control (OR = 1.47, p = .045), lower working-memory updating (OR = 0.69, p = .016), lower delay of gratification (OR = 0.75, p = .028), and higher family adversity (OR = 1.63, p = .001). CONCLUSIONS SR facets incrementally and differentially predict potentially unfavorable trajectories of internalizing symptoms from age 6 to 13, surpassing the predictive value of gender or education status. Higher emotional reactivity emerged as the most influential factor, which could therefore be addressed in future prevention and intervention efforts.
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Affiliation(s)
- Johanna L Klinge
- International Psychoanalytic University Berlin, Stromstr. 1, 10555, Berlin, Germany.
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany
| | - Robert Busching
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany
| | - Annette M Klein
- International Psychoanalytic University Berlin, Stromstr. 1, 10555, Berlin, Germany
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Zhu Y, Deng W. Moderating the link between discrimination and adverse mental health outcomes: Examining the protective effects of cognitive flexibility and emotion regulation. PLoS One 2023; 18:e0282220. [PMID: 37815988 PMCID: PMC10564165 DOI: 10.1371/journal.pone.0282220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023] Open
Abstract
Discrimination is associated with mental health problems. While prior research has demonstrated the significance of emotion regulation in explaining the onset and development of discrimination-related anxiety, few studies investigated this dynamic with cognitive flexibility among sexual and/or racial minority individuals. The current study incorporated cognitive flexibility to investigate its potential buffering effects on discrimination-related anxiety. 221 individuals, 37.6% of whom (n = 83) identified as sexual and/or racial minorities, responded to an online questionnaire about their levels of cognitive flexibility and emotion regulation, perceived discrimination, and anxiety. Moderated mediation analyses were conducted with these variables. Our findings indicated that emotion regulation difficulty (ERD) mediated the relationship between discrimination and anxiety, while cognitive flexibility had a strong moderating effect on the relationship between ERD and anxiety. These results suggested new research directions and implied the therapeutic potential of advancing cognitive flexibility skills with emotion regulation training in depression and anxiety intervention and treatments. Future research is needed to investigate cognitive flexibility as a transdiagnostic mechanism underlying the onset and development of anxiety, to potentially lead to novel prevention or intervention for marginalized people facing additional stressors like discrimination.
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Affiliation(s)
- Yutong Zhu
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
| | - Wisteria Deng
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
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Yang CC, Llamas-Díaz D, Bahena YA, Cabello R, Dahl RE, Magis-Weinberg L. Emotion regulation difficulties and sleep quality in adolescence during the early stages of the COVID-19 lockdown. J Affect Disord 2023; 338:92-99. [PMID: 37230269 PMCID: PMC10204279 DOI: 10.1016/j.jad.2023.05.036] [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] [Received: 11/09/2022] [Revised: 04/26/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Adolescence is a period of vulnerability for emotion regulation and sleep difficulties, risks that might be compounded by intense COVID-19 lockdowns and challenges. The aim of this study was to investigate how sleep quality related to emotion regulation difficulties in adolescents during lockdown in Perú. METHODS Participants were 2563 adolescents enrolled in Innova school in Perú (11 - -17 years) in May 2020. Hypotheses were derived from exploring one half of the sample, preregistered at https://osf.io/fuetz/, and then confirmed in the second half of the sample. Participants completed subjective surveys of sleep quality (short PSQI) and the Difficulties in Emotion Regulation Scale Short Form (DERS-SF). RESULTS Worse sleep quality was robustly associated with more difficulties in emotion regulation across both samples. The association was found particularly for emotion regulation subscales related to the ability to engage in goal directed behavior in the face of distress, emotional clarity and strategies to deal with feeling distressed. In contrast, there was no robust association between sleep and the ability to regulate impulses in the context of negative emotions, and no association with the ability to accept emotions. Girls and older adolescents robustly endorsed worse sleep quality and more difficulties in emotion regulation. LIMITATIONS The cross-sectional nature of this study prevents us from determining the direction of the association. Data were collected using adolescent self-report which, while informative of adolescent perceptions, might diverge from objective measures of sleep or emotion regulation difficulties. CONCLUSIONS Our findings with adolescents in Perú contribute to our understanding of the association between sleep and emotion regulation at a broader global scale.
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Affiliation(s)
- Chun-Chi Yang
- School of Education, University of California, Berkeley; Institute of Human Development, University of California, Berkeley, United States of America.
| | | | - Yailin Alvarez Bahena
- Institute of Human Development, University of California, Berkeley, United States of America.
| | - Rosario Cabello
- Department of Developmental and Educational Psychology, University of Malaga.
| | - Ronald E Dahl
- Institute of Human Development, University of California, Berkeley, United States of America.
| | - Lucía Magis-Weinberg
- Department of Psychology, University of Washington, Seattle, United States of America.
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Wergeland GJH, Haaland ÅT, Fjermestad KW, Öst LG, Gjestad R, Bjaastad JF, Hoffart A, Husabo E, Raknes S, Haugland BSM. Predictors of school-based cognitive behavior therapy outcome for youth with anxiety. Behav Res Ther 2023; 169:104400. [PMID: 37690362 DOI: 10.1016/j.brat.2023.104400] [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] [Received: 12/09/2022] [Revised: 08/08/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
Meta-analyses of school-based CBT have shown that prevention for anxiety symptoms typically report small but significant effects. There is limited knowledge regarding which youths may benefit most and least from such programs, and characteristics of youth who respond differentially to interventions of different intensity. The present study examined predictors of school-based CBT outcomes among 302 youths (mean age 14.0 years, SD 0.8, 84% female) who participated in a randomized waitlist-controlled trial comparing a 10-session and a 5-session group intervention. Potential predictors included youth and parental factors, and credibility and expectancy of the interventions. Pre-intervention anxiety and depression levels, and clinician rated severity were examined as moderators of intervention effects. Outcomes were youth-, and parent-reported youth anxiety and depressive symptoms at post-intervention and 1-year follow-up. Higher parent-reported impairment from youth anxiety predicted larger parent-reported anxiety and depressive symptom change, whereas higher caregiver strain was associated with less symptom change. Higher parent rated credibility and expectancy was associated with improved outcomes at post-intervention. At 1-year follow-up, no predictors of outcome were identified. No moderators were identified. Families with high levels of caregiver strain associated with youth anxiety may need extra support regardless of length of intervention program. Parents' credibility and expectancy of interventions should be targeted to optimize school-based CBT.
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Affiliation(s)
- Gro Janne H Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway.
| | - Åshild T Haaland
- Department of Child and Adolescence Mental Health, Sørlandet Hospital, Kristiansand, Norway
| | | | | | - Rolf Gjestad
- Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Jon F Bjaastad
- Division of Psychiatry, Stavanger University Hospital, Norway
| | - Asle Hoffart
- Research Institute, Modum Bad Psychiatric Centre, Vikersund, Norway
| | - Elisabeth Husabo
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian Research Center, NORCE, Norway
| | | | - Bente S M Haugland
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian Research Center, NORCE, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Norway
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Daros AR, Wardell JD, Quilty LC. Multilevel associations of emotion regulation strategy use during psychotherapy for depression: A longitudinal study. J Affect Disord 2023; 338:107-118. [PMID: 37290525 DOI: 10.1016/j.jad.2023.06.014] [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] [Received: 08/02/2022] [Revised: 03/24/2023] [Accepted: 06/04/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with depression select avoidant emotion regulation (ER) strategies more often than engagement strategies. While psychotherapy improves ER strategies, examining the week-to-week changes in ER and their relationship to clinical outcomes is warranted to understand how these interventions work. This study examined the changes in six ER strategies and depressive symptoms during virtual psychotherapy. METHODS Treatment-seeking adults (N = 56) with moderate depression severity completed a baseline diagnostic interview and questionnaires and were followed for up to 3 months as they completed virtual psychotherapy in an unrestricted format (e.g., individual) and orientation (e.g., cognitive-behavioral therapy; CBT). Participants completed weekly assessments of depression and six ER strategies along with assessments of CBT skills and participant-rated CBT components for each psychotherapy session. Multilevel modeling was used to examine associations between within-person changes in ER strategy use and weekly depression scores, controlling for between-person effects and time. RESULTS Depressive symptoms, rumination, and experiential avoidance decreased non-linearly over time while cognitive reappraisal and acceptance increased non-linearly. Controlling for CBT skills, within-person increases in acceptance and cognitive reappraisal, as well as within-person decreases in experiential avoidance, were associated with fewer depressive symptoms over time. People who reported greater CBT components in their sessions also reported fewer depressive symptoms over time. LIMITATIONS The study was unable to make more causal inferences or standardize the type, baseline, or length of psychotherapy received. CONCLUSIONS Improvements in ER strategies were associated with depression symptom reduction during psychotherapy. Future research to elucidate ER strategies as mediators of treatment response is warranted.
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Affiliation(s)
- Alexander R Daros
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychology, York University, Canada.
| | - Jeffrey D Wardell
- Department of Psychology, York University, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada
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