Implicit beliefs of emotion and anxiety in psychotherapy

The association between emotion malleability beliefs and severe psychological distress stratified by sex, age, and presence of any psychiatric disorders

Background

Recent studies have shown an association between psychological distress and emotion malleability beliefs, meaning mindsets about whether one's emotions are fixed or changeable. However, most studies have not examined the association between these beliefs and sociodemographic factors.

Methods

A nationwide cross-sectional Internet survey of residents of Japan aged 15-79 years was conducted using sampling weights for national estimates to investigate the association between emotion malleability beliefs and sociodemographic factors and between fixed beliefs and severe psychological distress (SPD). SPD was defined as a Kessler 6 Scale score of ≥13. Adjusted odds ratios for SPD were calculated considering potential confounders. Further analyses were stratified by sex, age and presence of any psychiatric disorder.

Results

The analysis included 23,142 participants (female, 48.64%). Fixed beliefs were associated with female sex, age < 45 years, and presence of psychiatric disorders. These beliefs were associated with SPD, and additional analysis showed stronger associations with SPD among female respondents, respondents aged 45-59 years, and those aged ≥60 years.

Conclusion

Results indicate that female sex, age < 45 years, and current mental disorders were associated with fixed emotion malleability beliefs. Associations between fixed emotion malleability beliefs and SPD were particularly strong among female respondents and people aged ≥45 years compared with the general population. Our study extends the association between emotion malleability beliefs and psychological health to the general population. Future studies should explore mechanisms underlying individual differences in emotion beliefs.

How do fundamental emotion beliefs affect the rapid emotional processing? An ERP study

Beliefs about whether emotions are good or bad, controllable or uncontrollable are two fundamental emotion beliefs. Studies have confirmed the link between the two beliefs and emotional responses, but how emotion beliefs affect the process from emotional stimulus perception to emotion generation and automatic regulation is unclear. Answering this question helps to understand the role of emotion beliefs in emotional dysfunction and dysregulation and can provide a basis for effective emotion regulation. Therefore, the current study used event-related potential (ERP) measures to examine the time course and neural mechanisms by which emotional beliefs influence the processing of emotional pictures. One hundred participants were divided into four groups (25 per group) according to controllable or uncontrollable beliefs about emotions and good or bad beliefs about negative emotions, and viewed emotional negative and neutral pictures. Results showed that P2 was more positive in participants with emotion controllable vs. uncontrollable belief. The early posterior negativity (EPN) was more negative for unpleasant than neutral images in participants with emotion good and controllable beliefs as well as with bad and uncontrollable beliefs. On late positive potential (LPP), middle LPP (500-1000ms) was more positive in emotion good vs. bad belief holders and the late LPP (1000-2000 ms) was more positive for negative than neutral images in emotion uncontrollable belief holders. The findings suggest that fundamental emotion beliefs can affect individuals' early attention and late meaning evaluation towards unpleasant stimuli. Furthermore, they provide insight into altered beliefs about emotion in people with emotion dysfunction or dysregulation.

The Role of Beliefs About Emotions in Emotion-Focused Therapy for Binge-Eating Disorder

Individuals with binge-eating disorder (BED) often experience emotion regulation deficits, including negative beliefs about emotions and low emotional expressivity. The current exploratory study examined whether emotion-focused therapy (EFT) for BED could change negative beliefs about emotions and emotional expressivity. Twenty participants were randomly allocated to either immediate treatment of 12 weekly one-hour sessions of EFT for BED, or a waitlist control group. Beliefs about emotions and emotional expressivity were assessed before and after 12 sessions of EFT or 12 weeks on the waitlist. A repeated measures ANOVA was used to examine beliefs about emotions and emotional expressivity changes. EFT for BED resulted in significant changes in particular beliefs about emotions (Overwhelming and uncontrollable, shameful and irrational, invalid and meaningless, and total score on the beliefs about emotions questionnaire) but not emotional expressivity treatment outcomes. This pilot study provides preliminary evidence that EFT may be effective in improving maladaptive beliefs about emotions in adults with BED.

Trial registration ACTRN12620000563965, 14 May 2020, retrospectively registered.

Emotion Malleability Beliefs and Emotion Experience and Regulation in the Daily Lives of People with High Trait Social Anxiety

Background

The extent to which a person believes they can change or control their own emotions is associated with trait-level symptoms of mood and anxiety-related psychopathology. Method: The present study examined how this belief relates to momentary and daily self-reports of affect, emotion regulation tendencies, and perceived effectiveness of emotion regulation attempts throughout a five-week experience sampling study conducted in N = 113 high socially anxious people (https://osf.io/eprwt/).

Results

Results suggest that people with relatively stronger beliefs that their emotions are malleable experienced more momentary and daily positive affect (relative to negative affect), even after controlling for social anxiety symptom severity (although only daily positive affect, and not momentary positive affect, remained significant after correcting for false discovery rate). However, emotion malleability beliefs were not uniquely associated with other emotion regulation-related outcomes in daily life, despite theory suggesting malleability beliefs influence motivation to engage in emotion regulation.

Conclusion

The paucity of significant associations observed between trait malleability beliefs and momentary and daily self-reports of emotion regulation (despite consistent findings of such relationships at trait levels) calls for additional research to better understand the complex dynamics of emotion beliefs in daily life.

Mindsets in the clinic: Applying mindset theory to clinical psychology

Beliefs about the malleability of attributes, also known as mindsets, have been studied for decades in social-personality psychology and education. Here, I review the many applications of mindset theory to clinical psychology and psychotherapy. First, I review social psychological and cognitive neuroscience evidence that mindsets and mindset-related messages are, to a large extent, focused on emotional tolerance. Specifically, the growth mindset, or the belief that attributes are malleable, encourages confronting and tolerating anxiety, frustration, and disappointment in healthy and adaptive ways that promote resilience, whereas the fixed mindset and related messages discourage the experience of these emotions and often leads to helplessness. Second, I review the emerging research on the anxiety mindset and discuss its relevance to clinical work. A model is proposed illustrating connections between mindsets, emotion regulation strategies, treatment preferences, and outcomes. Case examples are used to illustrate practical applications. I conclude that mindsets can inform psychotherapy, research, and public policy.