Lower cognitive reappraisal capacity is related to impairments in attachment and personality structure in poly-drug use: an fMRI study

The Role of Emotion Regulation and Awareness in Psychosocial Stress: An EEG-Psychometric Correlational Study

BACKGROUND

In stressful situations, to overcome unpleasant emotions, individuals try to manage stress through emotion regulation strategies such as cognitive reappraisal, interoception, and mindfulness.

METHOD

26 healthy adults underwent a modified version of the Trier Social Stress Test (named the Social Stress Test, SST) while their electrophysiological (EEG) activity was monitored. Participants also completed self-report questionnaires prior to this, including the Five-Facet Mindfulness Questionnaire (FFMQ), Multidimensional Assessment of Interoceptive Awareness (MAIA), Emotional Regulation of Others and Self (EROS), and the Interpersonal Reactivity Index (IRI). Three brain regions of interest (ROIs) were considered in the EEG data processing: frontal, temporo-central, and parieto-occipital. Correlational analyses were performed between psychometric scales and EEG band power spectral values for each ROI.

RESULTS

The results showed positive correlations between interoceptive awareness, mindfulness, and high-frequency EEG bands (beta, alpha, gamma) over frontal ROI, indicating enhanced cognitive processing and emotional regulation. Conversely, emotion regulation and empathy measures correlated positively with low-frequency EEG bands (delta, theta), associated with improved social cognition and top-down regulatory processes.

CONCLUSIONS

These findings suggest that EEG correlations of the stress response are connected to emotion regulation mechanisms, emphasizing the importance of body state awareness in managing stress and emotions for overall well-being and quality of life.

Emotion regulation in substance use disorders: a systematic review and meta-analysis

BACKGROUND AND AIMS

The ability to regulate emotions effectively has been associated with resilience to psychopathology. Individuals with substance use disorders (SUDs) have been shown to have higher levels of negative emotionality, with some evidence suggesting impairment in emotion regulation compared with individuals without SUDs. However, no previous attempt has been made to systematically review the literature to assess the magnitude of this difference. We aimed to assess the association between SUD diagnosis and emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ) through a systematic review and meta-analysis of existing findings.

METHODS

The systematic review was conducted using PubMed, PsycINFO and Embase. We examined cross-sectional studies that compared a SUD group with a control group and measured emotion regulation using the DERS or the ERQ. The primary analysis focused on papers using the DERS, as this was the predominant instrument in the literature.

RESULTS

Twenty-two studies met our primary analysis criteria, representing 1936 individuals with a SUD and 1567 controls. Individuals with SUDs relative to controls had significantly greater DERS scores, with a mean difference of 21.44 [95% confidence interval (CI) = 16.49-26.40, P < 0.001] and Hedges' g = 1.05 (95% CI = 0.86-1.24, P < 0.001). The difference was robust, remaining significant after removing outliers and studies with high risk of bias. Individuals with SUDs demonstrated poorer emotion regulation on each subscale of the DERS, with the largest deficits in the Strategies and Impulse subscales. The ERQ analysis revealed greater use of expressive suppression in those with SUDs relative to controls (Hedges' g = 0.76, 95% CI = 0.25-1.28, P = 0.004).

CONCLUSIONS

People with substance use disorders appear to have greater difficulties in emotion regulation than people without substance use disorders.

Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community

Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology. Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER). Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology. Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.