Emotion regulation and anxiety disorders

Emotion dysregulation, performance concerns, and mental health among Canadian athletes

Competitive athletes report symptoms of depression and anxiety at rates similar to or higher than the general population. There is some initial evidence that difficulties in emotion regulation are positively associated with depression, anxiety, and stress among university student-athletes; however, research on emotion dysregulation in sport contexts is limited. Therefore, the purpose of the current study was to examine the associations between emotion dysregulation, sport performance concerns, and symptoms of depression and anxiety among competitive athletes. We hypothesized that: H1) emotion dysregulation and H2) sport performance concerns would be positively associated with symptoms of depression and anxiety; and H3) performance concerns would moderate the association between emotion dysregulation and symptoms of depression and anxiety. Competitive athletes (n = 272) completed online measures of emotion dysregulation, sport performance satisfaction, and symptoms of depression and anxiety. Emotion dysregulation and sport performance concerns were directly positively associated with symptoms of depression and anxiety, supporting H1 and H2. The association between emotion dysregulation and mental health symptoms was not reliably moderated by sport performance concerns; thus, H3 was only partially supported. The results suggest that emotion dysregulation is linked to mental health symptoms and may be a useful target for intervention among competitive athletes.

Anxiety and body-focused repetitive behaviors: A systematic review and meta-analysis of comorbidity rates and symptom associations

Body-focused repetitive behavior (BFRB) disorders, including hair pulling disorder (trichotillomania [TTM]) and skin picking disorder (SPD), frequently co-occur with anxiety disorders, but reported comorbidity rates vary widely. Additionally, research on the relationship between anxiety and BFRB symptoms has yielded inconsistent findings. This meta-analysis and systematic review examined (1) the prevalence of comorbid anxiety disorders in individuals with BFRB disorders and (2) correlations between anxiety and BFRB symptom measures. The study protocol was pre-registered on PROSPERO. A systematic search of PsycInfo, PubMed, and Web of Science identified 119 studies (N=15,902) reporting anxiety prevalence rates in BFRB disorders and/or correlations between anxiety and BFRBs. Random-effects meta-analyses were conducted, including subgroup analyses for TTM and SPD, and meta-regression to examine potential moderators. Results indicated that comorbid anxiety disorders, including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), social anxiety, panic disorder, and specific phobia, were relatively common in BFRBs. Current prevalence rates were 19.2% for GAD, 12.8% for OCD, 10.6% for social anxiety, and 27.5% for 'any anxiety disorder.' Lifetime prevalence rates were 22.4% for GAD, 13.8% for OCD, 11.0% for social anxiety, and 35.9% for 'any anxiety disorder.' Pooled correlations between anxiety and BFRB severity were low to moderate (all BFRBs r=.29; TTM r=.27; SPD r=.34). Anxiety symptoms showed stronger correlations with focused BFRB measures (r=.42) than automatic (r=.15). These findings highlight a nuanced relationship between anxiety and BFRBs. While comorbid anxiety disorders are frequently observed in BFRB populations, anxiety severity is only modestly associated with BFRB severity. Implications for future research and clinical practice are discussed.

Irritability in Children with Rasopathies, Insights into Emotional Dysregulation and Social Skills Impairments

Rasopathies, including Noonan Syndrome (NS) and Neurofibromatosis type 1 (NF1), are developmental disorders caused by germline mutations in genes of the RAS/mitogen-activated protein kinase pathway (RAS-MAPK). This study investigates irritability, a highly prevalent transdiagnostic construct, in children with Rasopathies and the impact of Rasopathy status on the associations between irritability, emotional dysregulation-related disorders, and social skills impairments. The sample comprise 174 children aged 4-17 (age mean = 9.49; 98 females), including 113 children with Rasopathies (NS n = 85, NF1 n = 28) and 61 age-sex-matched typically developed (TD) children. We used parent questionnaires (CBCL, SRS) to assess irritability, symptoms of ADHD, defiance, anxiety/depression, and social skills impairments while controlling for cognitive measures (IQ). Children with Rasopathies exhibited higher irritability than TD children (mean difference = 1.09; p < 0.001). Children with NS showed a weaker association between irritability and ADHD symptoms compared to TD children (p = .032, ηp 2 = .03) and a stronger association between irritability and social skills impairments compared to both TD (p = .033, ηp 2 = .03), and NF1 groups (p = .009, ηp 2 = .06). We present novel and clinically significant findings showing high irritability in children with Rasopathies. Our study provides syndrome-specific results, suggesting differences in the mechanisms involved in irritability, ADHD, and social processes in children with NS and NF1. In essence, children with Rasopathies showed a highly irritable profile associated with ADHD symptoms and social skills impairments, with a significantly stronger association between irritability and social processes in NS. Our results suggest that developing prevention and treatments targeting irritability can distinctly affect the trajectories of neurodevelopmental disorders in children with Rasopathies.

Altered Functional Coupling of the Bed Nucleus of the Stria Terminalis and Amygdala in Spider Phobic Fear

Background: Individuals with spider phobic (SP) fear show hypervigilance and amygdala hyperactivity toward fear-associated stimuli, which may promote the development of other anxiety disorders. The amygdala is a key region within the fear network, which is connected to the anxiety system, where the bed nucleus of the stria terminalis (BNST) plays a crucial role. However, the BNST's involvement in phobic fear is unknown. Therefore, this study investigated the association of phobic fear and anxiety on these regions' functional connectivity (FC) in SP compared to healthy controls (HC). Methods: 7T-functional MRI resting-state FC of 30 individuals with SP and 45 HC was assessed to detect network differences between these groups. The association of phobic fear severity, trait anxiety, and social anxiety on FC was explored using linear regressions combined with seed-to-voxel analyses with amygdala and BNST as primary seeds, corrected for age and sex. Results: In SP, phobic fear was associated with reduced FC between the left amygdala and the right supramarginal gyrus. In contrast, anxiety severity was related to increased FC between the right BNST and the left inferior frontal gyrus. Moreover, social anxiety was related to decreased FC between bilateral BNST and left precuneus. Conclusions: These findings show changes in FC in SP, connecting fear with altered activity in the BNST and amygdala. The results suggest that persistent anxiety in phobic fear is associated with abnormal brain function in these regions, potentially explaining susceptibility to anxiety disorders and processes involved in phobic fear, such as threat perception, avoidance, and salience.

Comorbidity between internalizing symptoms and disordered eating is primarily driven by genetic influences on emotion regulation in adult female twins

Internalizing (e.g., anxiety, depression) and disordered eating (DE; e.g., binge eating, dietary restraint) are highly comorbid, but the mechanisms underlying their comorbidity remain unknown. This was the first twin study to examine whether their co-occurrence may be driven by genetic and/or environmental influences on emotion regulation (ER; ability to modulate duration/intensity of emotions). Analyses included 688 adult female twins from the MSU Twin Registry. Cholesky decomposition twin models showed comorbidity between dimensionally-modeled internalizing and DE was due to overlapping genetic (r = .55; 69.3% of shared variance) and nonshared environmental influences (r = .26; 30.7% of shared variance). When ER was added into the model, all genetic influences shared between internalizing and DE were attributable to ER, suggesting genetic influences on ER are the primary driver of comorbidity between internalizing and DE. Shared genes may shape affective processing, interoceptive sensitivity, or other brain-based processes (e.g., cognitive control) implicated in ER.

Effect of an early music intervention on emotional and neurodevelopmental outcomes of preterm infants at 12 and 24 months

Background

Few studies have found long-term effects of early musical environmental enrichment in the NICU on preterm infant's development. This study examines how early music enrichment affects emotional development and effortful control abilities in 12- and 24-month-old very preterm (VPT) infants.

Methods

One hundred nineteen newborns were recruited, including 83 VPTs and 36 full-term (FT) infants. The VPT infants were randomly assigned to the music intervention (44 VPT-Music) or control (39 VPT-control) groups. VPT-Music infants listened specifically designed music intervention from the 33rd week of gestation until hospital discharge. At 12 and 24 months, children were clinically evaluated using the Bayley-III Scales of Infant and Toddler Development and the Laboratory Temperament Assessment Battery, and at 24 months, with 3 additional episodes of the Effortful Control Battery.

Results and discussion

Our analysis showed that during a fear eliciting task, the VPT-Music group expressed lower level of fear reactivity and higher positive motor actions than VPT-controls and FT infants. At 24 months, the VPT-music group had lower scores for negative motor actions in the joy task, compared to both VPT-control and FT groups. In addition, both FT and VPT-music had higher scores of sustained attention compared to VPT-controls, but the contrasts were not significant. No significant effects on mental, language and motor outcomes were identified and for all three dimensions of the ECBQ.

Conclusion

The present study suggests that an early music intervention in the NICU might influence preterm children's emotional processing at 12 and 24 months. Limitations and suggestions for future research are highlighted.

Application of life history theory to explain the association between childhood maltreatment and adulthood sleep problems in Chinese men with drug abuse: multiple mediating roles of emotion regulation, future-oriented coping, and anxiety

Background: Despite the practical importance of addressing the drug user's sleep problems to enhance the efficacy of treatment and rehabilitation, little is known about whether and how history of childhood maltreatment relates to this issue. This study takes an evolutionary perspective to investigate the associations between history of childhood maltreatment and sleep problems in adults with drug abuse via their emotion regulation difficulties, future-oriented coping, and anxiety.Methods: Participants were 604 male adults with drug abuse between the ages of 18-58 years (M = 36.20, SD = 8.17) in a drug rehabilitation centre in China. In addition to bivariate correlation analysis, path analysis was conducted to examine goodness-of-fit of the conceptual model, controlling for the effect of demographic characteristics.Results: Thirty-two percent of participants (n = 194) reported poor sleep quality (PSQI > 5), whereas sleep disturbance (81.3%), daytime dysfunction (77.3%), and sleep latency (66.5%) were the three most common problems among them. Correlation analysis supported the hypothesised positive correlations between poor sleep quality and childhood maltreatment, emotion regulation difficulties, and anxiety, and a negative correlation with future-oriented coping. Results of path analysis showed a significant indirect effect of childhood maltreatment on sleep problems via both emotion regulation difficulties and anxiety, whereas such effects via both future-oriented coping and anxiety were statistically nonsignificant.Conclusions: The findings suggest life history theory is applicable to understanding drug users' sleep problems, and interventions regarding both emotion regulation difficulties and anxiety can lessen the risk posed by childhood maltreatment on sleep problems.

Effects of physical activity on anxiety levels in college students: mediating role of emotion regulation

Objectives

To explore the effects of physical activity on anxiety levels in college students, as well as to examine the mediating role of emotion regulation.

Methods

A convenience sample of 1,721 college students from Shanghai, Jiangsu, Shandong, Guangxi, and Hunan was used to conduct an evaluation and a survey through the Physical Activity Rating Scale (PARS-3), the Anxiety Self-Rating Scale (SAS), and the Emotion Regulation Scale (ERQ).

Results

College students' anxiety level, cognitive reappraisal, and expression inhibition scores were (44.72 ± 10.37), (30.16 ± 6.51), and (16.96 ± 4.99), respectively. There were significant grade and physical activity level differences in anxiety levels and cognitive reappraisal, and significant gender and physical activity level differences in expression inhibition among college students. Process model 4 mediated effect regression analysis showed that physical activity had a significant positive effect on cognitive reappraisal (R 2 = 0.14, β = 0.04, P < 0.001), and physical activity did not have a significant expression inhibition effect (R 2 = 0.17, β = 0.01, P = 0.27). Physical activity (β = -0.03, P = 0.012), cognitive reappraisal (β = -0.59, P < 0.001), and expression inhibition had a significant effect on (β = 0.57, P < 0.001) anxiety levels (R 2 = 0.37). In the model effect relationship, the direct and indirect effects of physical activity on anxiety levels were -0.028 and -0.019, respectively.

Conclusion

Physical activity has a significant negative effect on college students' anxiety levels. Cognitive reappraisal is a mediating variable for the effect of physical activity on anxiety levels. The higher the level of physical activity and the higher the intensity of the activity, the lower the level of anxiety.

Mentalized Affectivity, Helicopter Parenting, and Psychopathological Risk in Emerging Adults: A Network Analysis

Emerging adulthood represents a critical stage characterized by heightened risks for anxiety, depression, and somatization symptoms development. Research has shown that difficulties in emotional identification, expression, and processing, as well as dysfunctional parenting styles, may exacerbate symptoms in emerging adults. The present study aimed at examining the interplay between mentalized affectivity (i.e., emotional identification, processing, and expression), helicopter parenting, and psychopathological risk in 913 Italian cisgender emerging adults (M = 24.34, SD = 2.81; 71.20% assigned female at birth), using network analysis. The results indicated moderate to strong associations between psychopathological symptoms, with emotional processing difficulties significantly associated with general anxiety, depression, and, to a lesser extent, somatization. Additionally, increased degrees of helicopter parenting from mothers were linked to increased psychopathology and higher emotional processing difficulties. These findings emphasize the importance of addressing the interconnection between symptoms and emotional processing to prevent and treat psychopathological risks in emerging adults. Moreover, interventions targeting intrusive and overprotecting parenting behaviors may promote well-being among emerging adults.

Predicting Pornography Use Based on Mental Health and Quality of Communication with Parents

Background

Pornography, encompassing explicit images, videos, audio, and written content, has adverse impacts on individuals' well-being. We aimed to explore the relationship between mental health and communication quality with parents and the use of pornography, considering the moderating effect of gender.

Methods

Quantitative data collection and descriptive-correlation analysis were employed. The study included university students in Tehran, Iran during the 2021-2022 academic year. Through purposive sampling, 210 participants completed an online questionnaire on Porsline. The survey assessed pornography use, quality of communication with parents, and general health. SPSS 23 software facilitated correlation and hierarchical regression analysis.

Results

Gender significantly influenced pornography use (β=0.557). Anxiety symptoms (β=0.45) and social dysfunction (β=0.351) had significant positive effects on pornography use. Moreover, quality of relationships with parents, both mother (β=-0.47) and father (β=-0.27), exhibited negative associations with pornography use (P=0.01).

Conclusion

High quality relationships with parents, lower anxiety and social dysfunction could potentially decrease the likelihood of pornography use on the internet. It is recommended that educational efforts and cultural interventions focus on protecting young adults from the negative effects of pornography use. Such interventions may include psychoeducational training on effective communication skills, mental health literacy, and stress management skills.

Regulation of negative emotions through directed attention in high-trait-anxious women: Evidence from event-related potentials and eye-tracking

Abnormal emotional responses in high-trait-anxious (HTA) individuals may be related to the use of emotion regulation strategies. Directed attention is a substrategy of attention deployment, which has been proven to be effective in regulating individual negative emotions. The present study investigated whether HTA women can effectively utilize directed attention to decrease negative emotions. Two studies were conducted using the same directed attention paradigm, with one focusing on event-related potentials (ERPs) and the other utilizing eye-tracking techniques. Participants viewed negative and neutral pictures and rated their negative emotions experienced during viewing. During directed attention, attention was directed towards highly arousing aspects, less arousing aspects of negative pictures, or less arousing aspects of neutral pictures. In study 1, late positive potentials (LPP) were recorded in 26 HTA and 24 low-trait-anxious (LTA) women. In study 2, the latency of first fixation, the proportion of gaze duration and fixations in the specific area were recorded in 27 HTA and 23 LTA women. Both the HTA and LTA groups revealed a decrease in negative emotional ratings and LPP amplitudes when their attention was directed towards the less arousing aspects of negative pictures. Furthermore, in this condition, the HTA group had a shorter latency of first fixation on highly arousing aspects and a higher proportion of gaze duration on less arousing aspects of negative pictures compared to the LTA group. These results indicate that when confronted with negative pictures, HTA women are able to regulate their emotional responses through directed attention, which may be accompanied by attentional vigilance and avoidance tendencies.

Linking a latent variable trait-state-occasion model of emotion regulation to cognitive control

Emotion dysregulation (ED) is a vulnerability factor for affective disorders that may originate from deficits in cognitive control (CC). Although measures of ED are often designed to assess trait-like tendencies, the extent to which such measures capture a time-varying (TV) or state-like construct versus a time-invariant (TI) or trait-like personality characteristic is unclear. The link between the TV and TI components of ED and CC is also unclear. In a 6-wave, 5-month longitudinal study, community participants (n = 1281) completed the Difficulties in Emotion Regulation Scale (DERS-16), a commonly used measure of ED and measures of CC. A latent variable (trait-state-occasion) model showed that the proportion of TI factor variance (.80) was greater than the TV factor variance (.19). Although TV factor stability was significant, the coefficients were small in magnitude. Furthermore, regression weights for the ED TI factor (average β  = -.62) were significant and larger than those for the TV factor (average β  = -.10) in predicting latent CC at each of the six-time points. These findings suggest that ED, as assessed by the DERS-16, is largely TI and this TI component is more strongly linked to CC than the TV component.

An Examination of Perceived Stress and Emotion Regulation Challenges as Mediators of Associations Between Camouflaging and Internalizing Symptomatology

Background

Camouflaging involves the masking of autism traits, potentially creating an outer impression of "non-autisticness." Although associations of camouflaging with anxiety and depression in autistic adults are widely reported, factors that mediate these associations are unclear. We examined two potential mediators of the association between camouflaging and anxiety/depression: perceived stress and emotion regulation (ER) challenges.

Methods

Seven hundred eighty-seven autistic adults (18.2-78.2 years) recruited through Simons Powering Autism Research (SPARK) Research Match completed questionnaires, including the Camouflaging Autistic Traits Questionnaire (CAT-Q), and measures of autistic traits, depressive and anxious symptomatology, perceived stress, and ER challenges. Four moderated mediation models were tested. In all models the independent variable was CAT-Q total score, and the moderator variable was sex designated at birth. The dependent variable was depressive or anxious symptomatology, and the mediator variable was perceived stress or ER challenges.

Results

We found that more camouflaging, increased ER challenges, and higher levels of perceived stress were associated with greater depressive and anxious symptomatology. We also found that perceived stress and ER challenges significantly mediated the associations between camouflaging and both depression and anxiety. In the model with perceived stress and anxiety, sex moderated the mediation, with females showing a stronger mediation. There was no significant moderation in any of the other models.

Conclusion

We contextualize the findings within the broader literature on camouflaging as a response to stigma and other facets of minority stress. We discuss how the results of this study support the idea that the day-to-day stress of living in a neurotypical world, the cognitively demanding nature of camouflaging, and the constraints that camouflaging place on autistic people's behaviors in social contexts (e.g., contributing to suppressing ER strategies such as stimming), create a cycle that contributes to elevated rates of anxiety and depression in autistic people.

An investigation into symptoms of depression and anxiety and emotion regulation among older adolescents from low-income settings in South Africa

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.

Development of a self-report screening instrument for emotional dysregulation: the Reactivity, Intensity, Polarity and Stability questionnaire, screening version (RIPoSt-SV)

BACKGROUND

Emotional dysregulation (ED) refers to the inability to manage emotional experiences or expressions hindering goal-oriented behavior. Moderate impairment on at least two domains among temper control, affective lability, and emotional over-reactivity has been proposed to identify ED in adults with attention-deficit/hyperactivity disorder (ADHD). No screening measure designed for use in diverse psychiatric samples exists. We aimed to develop a self-report screening tool for ED based on the 40-item version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-40).

METHODS

150 adult outpatients with non-psychotic conditions were enrolled between February and July 2023 at the Second Psychiatry Unit of Pisa University Hospital. Clinically significant ED (CSED) was defined based on the previously suggested approach for ADHD. Differences between patients with and without CSED were tested. To develop our screening instrument, a decision tree algorithm was trained by hyperparameter tuning through 5-fold cross-validation in 120 subjects and tested on the remaining 30.

RESULTS

75 subjects met criteria for CSED (50 %). CSED was associated with lower age and higher prevalence of psychiatric conditions, including minor mood disorders, ADHD, cannabis use disorders, and eating disorders. We identified a decision tree consisting of six items from RIPoSt-40 that effectively detected CSED, with accuracy, sensitivity, specificity, positive and negative predictive values of 80 % or higher in both the training and testing sets.

LIMITATIONS

Tertiary-level; no consensus on criteria; sample size.

CONCLUSION

The screening version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-SV) demonstrates promise as a valuable tool for ED screening in clinical settings.

Emotion regulation across psychiatric disorders

OBJECTIVE

Difficulties with emotion regulation have been associated with multiple psychiatric conditions. In this study, we aimed to investigate emotional regulation difficulties in young adults who gamble at least occasionally (ie, an enriched sample), and diagnosed with a range of psychiatric disorders using the validated Difficulties in Emotion Regulation Scale (DERS).

METHODS

A total of 543 non-treatment-seeking individuals who had engaged in gambling activities on at least 5 occasions within the previous year, aged 18-29 were recruited from general community settings. Diagnostic assessments included the Mini International Neuropsychiatric Inventory, Minnesota Impulsive Disorders Interview, attention-deficit/hyperactivity disorder World Health Organization Screening Tool Part A, and the Structured Clinical Interview for Gambling Disorder. Emotional dysregulation was evaluated using DERS. The profile of emotional dysregulation across disorders was characterized using Z-scores (those with the index disorder vs. those without the index disorder).

RESULTS

Individuals with probable ADHD displayed the highest level of difficulties in emotional regulation, followed by intermittent explosive disorder, social phobia, and generalized anxiety disorder. In contrast, participants diagnosed with obsessive-compulsive disorder showed relatively lower levels of difficulties with emotional regulation.

CONCLUSIONS

This study highlights the importance of recognizing emotional dysregulation as a trans-diagnostic phenomenon across psychiatric disorders. The results also reveal differing levels of emotional dysregulation across diagnoses, with potential implications for tailored treatment approaches. Despite limitations such as small sample sizes for certain disorders and limited age range, this study contributes to a broader understanding of emotional regulation's role in psychiatric conditions.

Disentangling associations between impulsivity, compulsivity, and performance monitoring

Disorders marked by high levels of impulsivity and compulsivity have been linked to changes in performance monitoring, specifically the error-related negativity (ERN). We investigated the relationship between performance monitoring and individual differences in impulsivity and compulsivity. A total of 142 participants were recruited into four groups, each with different combinations of impulsivity and compulsivity, and they performed a flanker task to assess error-related brain activity. We defined error-related brain activity as ERN amplitude and theta power. Single-trial regression was employed to analyze the amplitude differences between incorrect and correct trials within the ERN time window. The findings revealed that impulsivity, compulsivity, and different measures of response processing exhibited distinct interactions, which were influenced by the configuration of impulsivity and compulsivity, but also depended on the measure of response processing. Specifically, high compulsivity predicted larger ERN amplitudes in individuals with low impulsivity, whereas high impulsivity had no significant effect on ERN amplitude in individuals with low compulsivity. Furthermore, when both impulsivity and compulsivity were high, no significant increase in ERN amplitude was observed; instead, there was a reduced difference between incorrect and correct trials. No significant differences were found for theta power. While the association between error-related brain activity and transdiagnostic markers or psychopathology may be smaller than generally assumed, considering the interaction between different transdiagnostic markers and their facets can enhance our understanding of the complex associations that arise during the investigation of neural correlates of performance monitoring, specifically the ERN.

Ketamine for mood disorders, anxiety, and suicidality in children and adolescents: a systematic review

Mood disorders, anxiety, and suicidality in youth are increasing and rapid-acting treatments are urgently needed. One potential is ketamine or its enantiomer esketamine, which was FDA approved in 2019 to treat major depressive disorder with suicidality in adults. This systematic review evaluated the evidence for the clinical use of ketamine to treat mood disorders, anxiety, and suicidality in youth. The PRISMA guidelines were used, and a protocol registered prospectively ( https://osf.io/9ucsg/ ). The literature search included Pubmed/MEDLINE, Ovid/MEDLINE, Scopus, CINAHL, PsychInfo, and Google Scholar. Trial registries and preprint servers were searched, and authors contacted for clarification. Studies reported on the clinical use of ketamine to treat anxiety, depression, bipolar disorder, or suicidality in youth ≤19 years old and assessed symptoms before and after ketamine use. Study screening and data extraction were conducted independently by 2-4 authors. Safety, tolerability, and efficacy data were collected. The Cochrane Risk of Bias guidelines assessed the quality of the evidence. Twenty-two published reports based on 16 studies were identified: 7 case studies, 6 observational studies, 3 randomized trials, and 6 secondary data analyses. Studies reported immediate improvements in depression, anxiety, and suicidality. Improvements were maintained for weeks-months following treatment. Ketamine was well-tolerated with the most common side effects being dizziness, nausea, and mild dissociation. Transient hemodynamic changes were reported, all of which resolved quickly and did not require medical intervention. Initial evidence suggests ketamine is safe and may be effective for mood disorders, anxiety, and suicidality in youth. Further randomized trials are warranted.

The relationship between motivation profiles for health-oriented physical activity, basic psychological needs and emotional regulation

The study of motivation toward health-oriented physical activity helps to know the reasons that guide people to practice physical activity. Moreover, different types and levels of motivation may coexist. As such, this paper aimed to analyze the combination of motivation for health-oriented physical activity profiles and examine whether profiles differed in emotional regulation and basic psychological needs. A sample of 808 Spanish adults between 18 and 65 years old (Mage = 33.90; Standard Deviation = 12.91; 366 men) participated in a cross-sectional study. Results revealed the existence of three different motivational profiles: (a) Low scores in self-determined motivation and average-high scores in non-self-determined motivation; (b) Average scores in self-determined and non-self-determined motivation; (c) High scores in self-determined motivation and average-high in non-self-determined motivation. Furthermore, participants differed in the satisfaction of basic psychological needs and cognitive-emotional regulation strategies depending on the profiles combination that they perceive. In conclusion, practitioners need to enhance an optimal combination of motivation profiles to satisfy better basic psychological needs and the use of functional cognitive-emotional regulation strategies since this could help improve psychological and emotional health in adults.

Behavioural and ERP evidence of a contrary effect between active and passive suppression of facial expressions

There has been disagreement regarding the relationship among the three components (subjective experience, external performance, and physiological response) of emotional responses. To investigate this issue further, this study compared the effects of active and passive suppression of facial expressions on subjective experiences and event-related potentials (ERPs) through two experiments. The two methods of expression suppression produced opposite patterns of ERPs for negative emotional stimuli: compared with the free-viewing condition, active suppression of expression decreased, while passive suppression increased the amplitude of the late positive potential (LPP) when viewing negative emotional stimuli. Further, while active suppression had no effect on participants' emotional experience, passive suppression enhanced their emotional experience. Among the three components of emotional responses, facial expressions are more closely related to the physiological response of the brain than to subjective experience, and whether the suppression was initiated by participants determines the decrease or increase in physiological response of the brain (i.e. LPP). The findings revealed the important role of individual subjective initiative in modulating the relationship among the components of emotional response, which provides new insights into effectively emotional regulation.

Specific emotion regulation difficulties and executive function explain the link between worry and subsequent stress: A prospective moderated mediation study

BACKGROUND

Worry is a transdiagnostic risk factor for stress-related mental health complaints such as anxiety, depression, and insomnia. Although worry may function as a form of avoidance of unwanted emotions and accordingly interfere with adaptive emotion regulation, the specific domains of emotion regulation that are perturbed by excessive worry to confer risk for stress-related symptoms are unclear. Further, it is unknown if cognitive control mechanisms that underlie successful emotion regulation influence the effect of worry on stress. The present study addressed these gaps in the literature by examining specific emotion regulation difficulties as mediators of the relationship between worry and subsequent stress, as well as executive function as a moderator of the mediated effects.

METHOD

656 community adults were assessed for trait worry, emotion dysregulation, stress, and executive dysfunction once per month for three months (time 1 - time 3).

RESULTS

The effect of worry (time 1) on subsequent stress (time 3) was partially mediated by difficulties with emotional clarity and difficulty engaging in goal-directed behavior when upset (time 2) after controlling for age, gender, and baseline stress. Moderated mediation models revealed that the indirect effect of worry on stress via difficulty with goal-directed behavior was significantly moderated by executive dysfunction, such that fewer executive function difficulties acted as a buffer against the harmful effects of worry.

LIMITATIONS

Limitations include reliance on self-report measures, lack of experimental manipulation, and a nonclinical sample.

CONCLUSIONS

Findings point to specific domains of emotion regulation as treatment targets for individuals with high worry proneness.

Multiple mediation of the association between childhood emotional abuse and adult obesity by anxiety and bulimia - a sample from bariatric surgery candidates and healthy controls

Bulimia, which means a person has episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over their eating, is the most primitive reason for being overweight and obese. The extended literature has indicated that childhood emotional abuse has a close relationship with adverse mood states, bulimia, and obesity. To comprehensively understand the potential links among these factors, we evaluated a multiple mediation model in which anxiety/depression and bulimia were mediators between childhood emotional abuse and body mass index (BMI). A set of self-report questionnaires, including the Childhood Trauma Questionnaire (CTQ), Beck Anxiety Inventory, Beck Depression Inventory (BDI), and Eating Disorder Inventory (EDI), was sent out. Clinical data from 37 obese patients (age: 29.65 ± 5.35, body mass index (BMI): 37.59 ± 6.34) and 37 demographically well-matched healthy people with normal body weight (age: 31.35 ± 10.84, BMI: 22.16 ± 3.69) were included in the investigation. We first performed an independent t-test to compare all scales or subscale scores between the two groups. Then, we conducted Pearson correlation analysis to test every two variables' pairwise correlation. Finally, multiple mediation analysis was performed with BMI as the outcome variable, and childhood emotional abuse as the predictive variable. Pairs of anxiety, bulimia, and depression, bulimia were selected as the mediating variables in different multiple mediation models separately. The results show that the obese group reported higher childhood emotional abuse (t = 2.157, p = 0.034), worse mood state (anxiety: t = 5.466, p < 0.001; depression: t = 2.220, p = 0.030), and higher bulimia (t = 3.400, p = 0.001) than the healthy control group. Positive correlations were found in every pairwise combination of BMI, childhood emotional abuse, anxiety, and bulimia. Multiple mediation analyses indicate that childhood emotional abuse is positively linked to BMI (β = 1.312, 95% CI = 0.482-2.141). The model using anxiety and bulimia as the multiple mediating variables is attested to play roles in the relationship between childhood emotional abuse and obesity (indirect effect = 0.739, 95% CI = 0.261-1.608, 56.33% of the total effect). These findings confirm that childhood emotional abuse contributes to adulthood obesity through the multiple mediating effects of anxiety and bulimia. The present study adds another potential model to facilitate our understanding of the eating psychopathology of obesity.

Evaluation of a Modified Mindfulness-Based Stress Reduction Intervention for Adults with Cerebral Palsy and Anxiety and/or Emotion Regulation Difficulties-A Randomised Control Trial

Mindfulness-Based Stress Reduction (MBSR) has not yet been evaluated for people with cerebral palsy (CP). The aims of this randomised control trial were to investigate whether a modified telehealth MBSR program could improve mindfulness and reduce depression, anxiety, and emotion regulation difficulties among adults with CP with elevated anxiety and/or emotional regulation difficulties. Participants (n = 31) with elevated anxiety and/or emotion regulation difficulties and no/mild intellectual impairment were randomised to a modified telehealth MBSR program (90 min weekly, 9 weeks) group or a wait-list group. Measurements were collected prior to (T1), after (T2), and 8 weeks post-intervention (T3). The primary outcome was the mean between-group difference in the change in Cognitive and Affective Mindfulness Scale-R (CAMS-R) scores in T1-T2. The secondary outcomes included mean within-group differences over time for the CAMS-R total scores, Depression Anxiety and Stress Scale-21 subscales, and Difficulties in Emotion Regulation Scale (DERS) total t-score. We found no statistically significant between-group difference in mean change in mindfulness scores for T1-T2 (primary outcome). Secondary outcomes: The MBSR intervention group had improved CAMS-R scores with respect to T1-T2 and T1-T3; improved mean scores for Depression and Stress subscales for T1-T2; and improved DERS t-scores for T1-T2 and T1-T3. In conclusion, this study found no significant between-group difference for the primary outcome of mindfulness. The MBSR program was successfully modified for adults with CP and was effective in improving depression, stress, and emotion regulation. ACTRN12621000960853.

An Examination of the Association between Emotion Regulation and Emetophobia Symptoms

BACKGROUND

Specific phobia of vomiting, referred to as emetophobia, is a specific phobia characterized by persistent and severe fear of vomit. Individuals with emetophobia engage in a variety of emotional and behavioral avoidance strategies to distance themselves from perceived vomit-related threat. As such, individuals may struggle to effectively use emotion regulation (ER) skills; however, to date, limited work has examined the association between emotion regulation and emetophobia symptoms. The present study aimed to address this gap in the literature and examine the association between ER and emetophobia symptoms.

METHODS

Participants (N = 508) were a remote, clinical sample of individuals recruited via social media forums dedicated to the disorder who self-identified as experiencing emetophobia. Hierarchical linear regressions were used to assessed unique contributions of ER to emetophobia symptoms. Age, gender, and depressive symptoms were entered as covariates in the hierarchical regression.

RESULTS

Results demonstrated ER was significantly related to emetophobia symptoms above and beyond the effects of depressive symptoms, age and gender in the current sample.

CONCLUSIONS

The findings provide initial support for an association between ER and emetophobia, and suggest future directions for refining the conceptualization of emetophobia. Limitations and considerations include the recruitment strategy via social media websites for individuals with emetophobia, limited diversity of the sample, and cross-sectional nature.

A Cross-Sectional Association Between Screen-Based Sedentary Behavior and Anxiety in Academic College Students: Mediating Role of Negative Emotions and Moderating Role of Emotion Regulation

Purpose

The study aims to explore the relationship and potential mechanisms between screen time and anxiety and have a clear understanding of the role of negative emotions and emotion regulation, thus providing guidance for Chinese college students to improve mental health.

Methods

We conducted a questionnaire survey by selecting 1721 academic college students from 6 colleges and universities in 5 provinces in China, and the data were analyzed through the Process program of SPSS for mediating effect and moderating effect.

Results

There is a significant positive relationship between screen time and anxiety, negative emotions play a mediating role between the two (indirect effect = 0.32, p < 0.001), mediating effect accounts for 59.88% of the total effect, and emotion regulation regulates the direct relationship between screen time and anxiety (interaction effect = 0.027, p < 0.001).

Conclusion

This study sheds light on the potential mechanisms by which screen time affects anxiety in academic college students, providing a fresh perspective on anxiety reduction. Screen time positively affects anxiety levels, where negative emotions have a mediating role and emotion regulation has a moderating role. In the future, we can control screen ++time, increase physical activities, reduce negative emotions, and improve the emotional regulation ability to relieve anxiety, so as to improve the mental health of academic college students, and expect to have a positive impact on future learning, life, and planning.

Effects of high-definition transcranial direct current stimulation on implicit emotion regulation of social pain in healthy individuals

BACKGROUND

Implicit emotion regulation (ER), a form of ER, is essential for protecting mental health in the process of social interaction. Both the ventrolateral prefrontal cortex (VLPFC) and the dorsolateral prefrontal cortex (DLPFC) have been shown to be involved in ER processes, including explicit ER of social pain, but whether they play a role in implicit ER is unclear.

METHODS

We investigated whether anodal high-definition transcranial direct current stimulation (HD-tDCS) of the right VLPFC (rVLPFC) or the right DLPFC (rDLPFC) influences implicit ER. In total, 63 healthy participants completed an emotion priming task, which measures the implicit ER of social pain, before and after receiving active or sham HD-tDCS (2 mA for 20 min, 10 consecutive days). Event-related potentials (ERPs) were recorded during task performance.

RESULTS

Combined with the results of the behavioral and electrophysiological indices indicated that stimulation of both the rVLPFC and the rDLPFC by anodic HD-tDCS could significantly reduce the affective responses caused by social exclusion. The further results also suggested that rDLPFC activation may contribute to promoting the involvement of early cognitive resources in the implicit ER process of social pain, thus helping to reduce the subjective negative experience of individuals.

LIMITATIONS

There were no dynamic interactive emotional stimuli to induce social pain, and only static images of social exclusion were used.

CONCLUSION

Our study provides cognitive and neurological evidence that expands our knowledge of the role of the rDLPFC and the rVLPFC in social ER. It can also serve as a reference for targeted intervention of implicit ER in social pain.

The Influence of Emotional Regulation and Cognitive Flexibility on Sleep Habits in Spanish Children and Adolescents through the Lens of Parents

BACKGROUND

Previous research studies have suggested the importance of studying the relationship between emotional regulation and sleep habits. Some investigations have especially focused on how emotional regulation could impact sleep habits in children and adolescents. Therefore, these researchers have stated there exists a two-way direction in this relationship.

OBJECTIVE

This study aimed to analyze the influence of emotional regulation on sleep habits in Spanish children and adolescents and the mediating role of anxiety in this relationship.

METHOD

Participants were 953 Spanish parents who completed the assessment protocol according to their children and adolescents' information.

RESULTS

The results revealed moderate-strong correlations between emotional regulation problems and sleep habit disturbances (r = 0.375, p < 0.001), trait (r = 0.488, p < 0.001) anxiety, and state (r = 0.589, p < 0.001) anxiety. Additionally, emotional regulation showed a direct impact on sleep habits (β = 0.011, p = 0.005). Trait and state anxiety demonstrated a significant mediating role in the relationship between emotional regulation and sleep habits.

CONCLUSIONS

Emotional regulation may have an impact on sleep habits during childhood and adolescence, suggesting the importance of early intervention focused on the emotions management and the prevention of sleep habit disturbances.

The associations between interoceptive awareness, emotion regulation, acceptance, and well-being in patients receiving multicomponent treatment: a dynamic panel network model

Mechanisms of change represent the cornerstone of the therapeutic process. This study aimed to investigate how network models could be used to test mechanisms of change at a group level. A secondary aim was to investigate which of the several hypothesized mechanisms (emotion regulation, interoceptive awareness, and acceptance) are related to changes in psychological well-being. The sample comprised adult patients suffering from psychological disorders (N=444; 70% women) from 7 clinical sites in the Czech Republic who were undergoing groupbased multicomponent treatment composed mainly of psychodynamic psychotherapy (lasting from 4 to 12 weeks depending on the clinical site). Data were collected weekly using the multidimensional assessment of interoceptive awareness, emotion regulation skills questionnaire, chronic pain acceptance questionnaire-symptoms and outcome rating scale. A lag-1 longitudinal network model was employed for exploratory analysis of the panel data. The pruned final model demonstrated a satisfactory fit. Three networks were computed, i.e., temporal, contemporaneous, and between-person networks. The most central node was the modification of negative emotions. Mechanisms that were positively associated with well-being included modification, readiness to confront negative emotions, activity engagement, and trust in bodily signals. Acceptance of negative emotions showed a negative association with well-being. Moreover, noticing bodily sensations, not worrying, and self-regulation contributed indirectly to changes in well-being. In conclusion, the use of network methodology to model panel data helped generate novel hypotheses for future research and practice; for instance, well-being could be actively contributing to other mechanisms, not just a passive outcome.

Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-16) with an older Norwegian population

Emotion regulation is proposed to have a salient role in optimal aging. However, currently used measures of emotion regulation have not been validated for older adults. Therefore, we evaluated the psychometric properties of the Difficulties in Emotion Regulation Scale-short form (DERS-16) in a large Norwegian sample consisting of individuals between 70 and 95 years (n = 2525). Tests of internal consistency, reliability, assessment of intra-domain correlations, and confirmatory factor analyses were performed. Construct validity was further investigated by assessing concurrent associations between DERS-16 and well-established measures of psychological disorders, psychological health, and well-being (five-item version of Geriatric Depression Scale, Geriatric Anxiety Inventory-short form, and OECD guidelines on measuring subjective well-being). All subscales derived from the instrument showed adequate internal consistency. Furthermore, we obtained a theoretically consistent factor structure, in which a bifactor model combining a general emotion regulation factor and five additional domain-specific facet-factors had superior model fit. As expected, difficulties in emotion regulation correlated positively with symptoms of depression and anxiety, and negatively with psychological health and well-being. Associations were generally of moderate strength. We can thus conclude that the DERS-16 demonstrates excellent psychometric properties when used in samples with older adults and may safely be employed in studies of emotion regulation difficulties in the older segment of our population.

The Role of Pediatric Sensory Over-responsivity and Anxiety Symptoms in the Development of Family Accommodations

Sensory over-responsivity (SOR) is linked with elevated anxiety and reduced family wellbeing. Family accommodation of anxiety relates with greater symptom severity and reduced intervention outcome. This study examined the contribution of child SOR and co-occurring anxiety symptoms to family accommodation and its consequences. Ninety families of typically developing children (ages 4-13 years), completed an online survey including the Sensory Profile 2, Screen for Child Anxiety Related Emotional Disorders (SCARED), and Family Accommodation Sensory Scale (FASENS). FASENS scores include frequency of accommodation, child impact, and family impact.Children with elevated anxiety symptoms had significantly higher sensory and FASENS scores. Stepwise linear regression indicated that only SOR symptoms significantly predicted the frequency of sensory family accommodation, while both SOR and anxiety symptoms predicted the impact of family accommodation upon child and family well-being.Both SOR and anxiety symptoms in children predict the impact of sensory family accommodations on child and family well-being.

The moderating effect of emotion regulation in the association between social support and religiosity and psychological distress in adults

BACKGROUND

Lebanese adults face daily obstacles due to their numerous responsibilities and non-ending external pressures to the extent that Lebanon has been ranked second among highest negative experiences countries worldwide. A sparse number of international studies showed that positive social support, religiosity and cognitive reappraisal would decrease psychological distress, but none in Lebanon. This study aimed to evaluate the association between social support, religiosity and psychological distress among Lebanese adults, taking into consideration the moderating role of emotion regulation.

METHODS

387 adult participants enrolled in this cross-sectional study between May and July 2022. Participants were chosen from five different governorates in Lebanon, using the snowball sampling technique, and were asked to complete a structured questionnaire, which included the following scales: the Mature Religiosity Scale, the Emotional Regulation Scale, the Depression Anxiety Stress Scale, and the Multidimensional Scale of Perceived Social Support.

RESULTS

The interaction social support by cognitive reappraisal was significantly associated with psychological distress; at high levels of cognitive reappraisal and low levels of expressive suppression, higher social support (Beta = - 0.07; p = .007) was significantly associated with lower psychological distress. The same was found at high levels of cognitive reappraisal and moderate levels of expressive suppression (Beta = - 0.08; p = .021). Social support alone was not significantly associated with psychological distress in the model (Beta = 0.15; t = 1.04; p = .300; 95% CI - 0.14; 0.44).

CONCLUSION

This cross-sectional study has provided evidence that the adequate use of emotional regulation skills such as high level of cognitive reappraisal and low level of expressive suppression with presence of social support would remarkably decrease psychological distress. This result casts a new light on clinical approaches to tackle this association between the emotional regulation of a patient in interpersonal psychotherapy.

The relations between real-time use of emotion regulation strategies and anxiety and depression symptoms

OBJECTIVE

How individuals differentially implement specific emotion regulation (ER) strategies is a critical indicator of the progression of depressive and anxiety disorders. Symptoms of anxiety and depression may be associated with differences in ER, but little evidence to date had examined whether anxiety and depression were associated with individual differences in the real-time use of ER strategies.

METHODS

This study used ecological momentary assessment (EMA) in two samples (n = 276) of undergraduate students from a single university who were assessed for 8-10 days. Baseline surveys captured participant self-reported anxiety symptoms and depressive symptoms using the PROMIS-Anxiety scale and the PROMIS-Depression scale, respectively. We measured ER through EMA-adapted prompts from the Cognitive Emotion Regulation Questionnaire (CERQ), which participants received on their internet-enabled cell phones. In pre-registered analyses, we tested the associations between anxiety symptoms with the use of discrete ER strategies in EMA using generalized estimating equations with a log-link function to account for nesting of EMA observations within participants, and further tested whether the findings generalized to depression (not pre-registered).

RESULTS

Symptoms of anxiety and depression were associated with greater odds of using both maladaptive and adaptive ER strategy use during the EMA period, and with lower odds of reporting no strategy use. Moreover, associations were generally stronger for maladaptive than adaptive ER strategies.

CONCLUSION

Anxiety and depressive symptoms are related to increased regulatory efforts overall, and results suggest that individuals with anxiety and depressive symptoms may be especially prone to use maladaptive ER strategies. Tracking ER strategies in a natural environment can further inform our understanding of how anxious and depressed individuals attempt to regulate emotions.

Meta-analysis of the relationship between university students' anxiety and academic performance during the coronavirus disease 2019 pandemic

Introduction

The COVID-19 pandemic has had a profound impact on the mental health and academic performance of university students worldwide. Anxiety is one of the most commonly reported mental health issues among this population, but its relationship with academic performance during the pandemic has not been fully explored.

Methods

A meta-analysis was conducted following the PRISMA-P guidelines to synthesize existing research on the relationship between anxiety and academic performance in university students during the COVID-19 pandemic. Four databases were searched (PsycINFO, Web of Science, PubMed, and Scopus) for articles published between December 2019 and June 2022, and studies from five different countries were included in the analysis. A heterogeneity test was performed, and a fixed-effects model was used to calculate the main results.

Results

The meta-analysis revealed a negative correlation between university students' anxiety and academic performance (r = -0.211, k = 5, N = 1,205). Subgroup analysis found no significant regulatory effects for the year of publication, country development level, student type, or anxiety type. The results suggest that negative emotions induced by the pandemic are the most significant factor linking anxiety to poor academic performance.

Discussion

During pandemics with severe global consequences, such as COVID-19, interventions against and for the prevention of university students' negative emotions are important ways to improve university students' mental health and academic achievement.

Pathophysiological aspects of complex PTSD - a neurobiological account in comparison to classic posttraumatic stress disorder and borderline personality disorder

Despite a great diagnostic overlap, complex posttraumatic stress disorder (CPTSD) has been recognised by the ICD-11 as a new, discrete entity and recent empirical evidence points towards a distinction from simple posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). The development and maintenance of these disorders is sustained by neurobiological alterations and studies using functional magnetic resonance imaging (fMRI) may further contribute to a clear differentiation of CPTSD, PTSD and BPD. However, there are no existing fMRI studies directly comparing CPTSD, PTSD and BPD. In addition to a summarization of diagnostic differences and similarities, the current review aims to provide a qualitative comparison of neuroimaging findings on affective, attentional and memory processing in CPTSD, PTSD and BPD. Our narrative review alludes to an imbalance in limbic-frontal brain networks, which may be partially trans-diagnostically linked to the degree of trauma symptoms and their expression. Thus, CPTSD, PTSD and BPD may underlie a continuum where similar brain regions are involved but the direction of activation may constitute its distinct symptom expression. The neuronal alterations across these disorders may conceivably be better understood along a symptom-based continuum underlying CPTSD, PTSD and BPD. Further research is needed to amend for the heterogeneity in experimental paradigms and sample criteria.

Communication style drives emergent leadership attribution in virtual teams

Leader selection plays a key role in how human social groups are formed and maintained. Leadership is either assigned through formal processes within an organization, or emerges informally through interactions with other group members-particularly in novel contexts. COVID-19 has accelerated the adoption of virtual meetings and more flexible team structures. However our understanding of how assigned leadership influences subsequent leadership emergence in virtual settings is limited. Here we examine the relationship between assigned leadership within an existing organization and subsequent emergent leadership attributions as members engage in virtual interactions. To do so, we created and implemented a novel virtual group decision-making task designed to support quantification of a more comprehensive set of communication style elements, such as speech dynamics and facial expressions, as well as task behaviors. Sixteen members of a real world organization engaged four repeated rounds of a group decision making task with new team members each time. We found participants made novel attributions of emergent leadership rather than relying solely on existing assigned leadership. While assigned leadership did influence leadership attributions, communication style, including amount of speech but also variability in facial expressions, played a larger role. The behavior of these novel emergent leaders was also more consistent with expectations of leadership behavior: they spoke earlier, more often, and focused more on the correct decision than did assigned leaders. These findings suggest that, even within existing social networks, virtual contexts promote flexible group structures that depend more on communication style and task performance than assigned leadership.

Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa

Se analizan de forma narrativa las relaciones entre comportamiento sensorial atípico, intolerancia a la incertidumbre y regulación emocional como generadores de los trastornos de ansiedad en niños y niñas autistas. El objetivo es estudiar el origen de la ansiedad en los niños y niñas autistas con la finalidad de determinar cuál o cuáles pueden ser los procedimientos de intervención más adecuados. Se han revisado algunos de los programas de intervención cognitivo-conductuales más utilizados en niños y niñas autistas y las adaptaciones realizadas a los mismos. Se observa un divorcio entre los programas psicoeducativos escolares y los programas clínicos de intervención para el tratamiento de la ansiedad. Como conclusión, se recomienda que en los programas psicoeducativos escolares se incorporen acciones proactivas en forma de programas de intervención cognitivo-conductuales para evitar o aminorar los efectos negativos de la ansiedad en el aprendizaje e inclusión escolar de los niños y las niñas autistas.

Identifying latent profiles of emotion dysregulation in a sample of primarily Black women with trauma exposure

BACKGROUND

Emotion dysregulation (ED) is a heterogenous, multi-dimensional transdiagnostic risk factor relevant to the development and maintenance of both internalizing and externalizing psychopathology, especially for those who have experienced trauma. The goals of the current study were to use person-centered analyses to identify distinct profiles of individuals characterized by unique patterns of ED dimensions, and to examine differences in internalizing and externalizing symptoms in a community sample.

METHODS

Participants (n = 783, 97% Black, 93% women) were recruited from an urban safety net hospital with high rates of trauma exposure. Latent profile analysis was used to uncover unique patterns of ED and multinomial logistic regression to evaluate the conditional distribution of our correlates across profiles.

RESULTS

The best-fitting model uncovered four classes: Low ED (42%), Low Awareness/Clarity (34%), Low Impulse Control (17%), and High ED (6%). All classes differed in terms of internalizing symptoms (anxiety sensitivity, depression, PTSD), with classes characterized by higher ED reporting more severe symptoms. For externalizing symptoms (food addiction behaviors, alcohol and drug abuse, aggressive behavior), the Low ED class reported fewer symptoms than all other profiles, while Low Awareness/Clarity, Low Impulse Control, and High ED did not differ from each other.

CONCLUSIONS

Patterns of emotion dysregulation ought to be assessed and considered as treatment targets for those experiencing both internalizing and externalizing psychopathology symptoms.

Neural indices of performance monitoring are associated with daily emotional functioning in youth with anxiety disorders: An ERP and EMA study

Excessive monitoring of one's performance is a characteristic of anxiety disorders that has been linked to alterations in implicit emotion regulation (ER), including elevations in neural measures of performance monitoring (i.e., error- and correct-related negativity; ERN and CRN). Elevations in ERN and CRN amplitudes have been reported consistently in anxiety disorders, suggesting that an overactive performance monitoring system is linked to ER difficulties in anxiety. Yet, the relevance of these lab-based neural measures for day-to-day emotional functioning remains poorly understood. This study examined the degree to which ERN and CRN amplitudes are associated with measures of daily ER difficulties in youth with anxiety disorders. Youth (N = 100, Mage = 11.14, SDage = 1.46) completed a computerized flanker task assessing the ERN and CRN. They then completed a 5-day ecological momentary assessment (EMA) protocol assessing their daily ER (i.e., intensity of momentary and peak negative affect, intensity of worry, reliance on maladaptive ER strategies). Results showed that more negative mean CRN amplitudes were associated with higher levels of negative emotional reactivity and more intense worries. There were no significant associations between ERN amplitude and EMA measures. Furthermore, elevations in CRN were linked to more frequent use of maladaptive ER strategies (i.e., rumination, physiological reactivity, avoidance). Together, results indicate that among youth with anxiety, individual differences in CRN, but not ERN, amplitudes are related to daily ER difficulties. Findings highlight the clinical utility of a lab-based neural measure of ER, suggesting that the CRN, rather than the ERN, reflects individual ER differences in the context of daily life among youth with pediatric anxiety disorders. As such, the CRN might serve as an important dimensional index of a treatment target that can be tracked with a validated, multi-method measure.

Physical Violence Perpetration Among College Students: Prevalence and Associations With Substance Use and Mental Health Symptoms

The aims of this study were to, first, report the prevalence of physical violence perpetration among a sample of college students and, second, to identify associations between physical violence perpetration, substance use, and mental health symptoms. We analyzed survey data from the Healthy Minds Study. We examined the 12-month prevalence of physical violence perpetration by gender identity from 2014-2019 (n = 181,056). We used multivariable logistic regression analyses to estimate associations between physical violence perpetration, substance use, and mental health symptoms from the 2018-2019 survey year (n = 43,563). Results revealed that 12-month prevalence rates of physical violence perpetration increased from 2014-2019 among male, female, and transgender/gender nonconforming college students. Results from multivariable logistic regression analyses using the 2018-2019 survey year revealed higher odds of physical violence perpetration in the previous 12 months among students who reported substance use and mental health symptoms, including vaping or e-cigarette use, illicit drug use, and nonsuicidal self-injury, among others. Our findings highlight steadily rising prevalence of physical violence perpetration from 2014-2019 among college students, indicating a growing need for more research and prevention efforts to address this problem in higher education settings. Efforts to prevent violence on college campuses should consider how to reduce substance use and improve mental health to reduce this form of violence.

The bidirectional effects of obsessive-compulsive symptoms and difficulties in emotion regulation in Chinese adults during the COVID-19 pandemic-a dynamic structural equation model

Background

With the accumulation of negative emotions brought by COVID-19-related dysfunctional beliefs, individuals adopted obsessive–compulsive (OC) symptoms (e.g., over-checking the wearing of masks) and formed difficulties in emotion regulation (DER). This study focused on the temporal dynamics of the bidirectional relation between OC symptoms and DER, which had a devastating effect on the individual's mental health. As an extension, we further explored whether OC and DER and their relationship affect sleep problems.

Methods

In February 2020, a 14-day (twice a day, of 28 measurement intervals) online questionnaire survey was conducted on 122 Chinese adults (aged 18–55 years; 63 females). Subsequently, this research applied a dynamic structural equation model with a cross-lagged relationship and a time series. Health anxiety, anxiety, and depression were controlled as covariates.

Results

Both OC symptoms and DER had a significant autoregressive and cross-lagged effect. Comparatively speaking, DER was a stronger predictor of OC symptoms than OC’s prediction of DER. Moreover, both higher levels of OC symptoms and DER were related to the severity of sleep problems.

Conclusions

More guidance on intervening in OC symptoms and identifying emotion regulation should be added to reduce the negative impact of the COVID-19 pandemic on public mental health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00841-5.

Prefrontal Cortical Thickness, Emotion Regulation Strategy use and Covid-19 Mental Health

Coronavirus disease 2019 (COVID-19) and associated restrictions have been linked to negative mental health outcomes across the globe. Cognitive emotion regulation strategies, neurally supported by prefrontal and limbic regions, constitute means to mitigate negative affects resulting from adverse life experiences. Variations in cognitive emotion regulation strategy use, anxiety, and depression were assessed in 43 adults (31♀/12♂, age = 35.14 ± 9.20 years) during the first months following COVID-19 onset and at the end of 2020 (seven assessments). Direct and indirect effects of emotion regulatory brain structures assessed prior to the pandemic and emotion regulation strategy use during the pandemic were assessed in relation to mental well-being. Varying levels of anxiety and depression were observed. While adaptive emotion regulation strategies were most frequently employed, maladaptive strategies explained the highest variation in anxiety and depression scores. The effectiveness of specific emotion regulation strategies varied. Momentary emotion regulation strategy use mediated the association between cortical thickness in right lateral prefrontal cortex assessed prior to the pandemic and mental health during the pandemic. Early mental health measures impacted later mental well-being. Maladaptive strategies have a negative effect on mental health during prolonged stress as induced by pandemics, providing possible targets for intervention.

When expanding training from working memory to emotional working memory: not only improving explicit emotion regulation but also implicit negative control for anxious individuals

BACKGROUND

The effect of working memory training (WM-T) has been found to transfer to emotional wellbeing, despite some debate on whether an affective component in training is necessary to achieve specific emotion-related benefits. These novel cognitive trainings have not yet been tested in highly anxious individuals, who have deficits in implicit and explicit emotional regulation and should be the potential beneficiaries of these trainings.

METHODS

We designed two types of mobile phone-based training applications: (1) WMT and (2) an emotional working memory training (EWM-T) that comprised negative face distraction. Ninety-eight participants (33, WM-T; 35, EWM-T; 30, Control group) with high trait anxiety completed the 21-day intervention or placebo program and conducted pre- and post-test procedures, including questionnaires, emotional regulation and emotional Stroop tasks alongside electroencephalogram recording. Late positive potential (LPP) in emotion regulation task and P3 in the emotional Stroop task were adopted as neutral indicators for the explicit and implicit affective regulation/control processing.

RESULTS

Those who had received training (WM-T and EWM-T) showed enhanced explicit regulation (indexed by reduced LPP during reappraisal) compared with the control. Besides, individuals in EWM-T showed reduced behavioral attention bias and a decline of P3 in response to negative faces in an emotional Stroop task. The altered neural indicators were correlated with corresponding behavior indexes that contributed to the anxiety alleviation.

CONCLUSIONS

The general WM-T was effective in enhancing explicit emotional regulation, while training with emotional add-in further improved implicit emotional control. (E)WM-T shows potential as a beneficial intervention for the anxiety population.

The prefrontal cortex, pathological anxiety, and anxiety disorders

Anxiety is experienced in response to threats that are distal or uncertain, involving changes in one's subjective state, autonomic responses, and behavior. Defensive and physiologic responses to threats that involve the amygdala and brainstem are conserved across species. While anxiety responses typically serve an adaptive purpose, when excessive, unregulated, and generalized, they can become maladaptive, leading to distress and avoidance of potentially threatening situations. In primates, anxiety can be regulated by the prefrontal cortex (PFC), which has expanded in evolution. This prefrontal expansion is thought to underlie primates' increased capacity to engage high-level regulatory strategies aimed at coping with and modifying the experience of anxiety. The specialized primate lateral, medial, and orbital PFC sectors are connected with association and limbic cortices, the latter of which are connected with the amygdala and brainstem autonomic structures that underlie emotional and physiological arousal. PFC pathways that interface with distinct inhibitory systems within the cortex, the amygdala, or the thalamus can regulate responses by modulating neuronal output. Within the PFC, pathways connecting cortical regions are poised to reduce noise and enhance signals for cognitive operations that regulate anxiety processing and autonomic drive. Specialized PFC pathways to the inhibitory thalamic reticular nucleus suggest a mechanism to allow passage of relevant signals from thalamus to cortex, and in the amygdala to modulate the output to autonomic structures. Disruption of specific nodes within the PFC that interface with inhibitory systems can affect the negative bias, failure to regulate autonomic arousal, and avoidance that characterize anxiety disorders.

Community resilience and anxiety among Chinese older adults during COVID-19: The moderating role of trust in local government

The worldwide spread of COVID-19 has resulted in an enormous threat to public health, causing global panic, especially older adults suffering severe anxiety due to their vulnerability. With a questionnaire survey on 213 Chinese older adults in April 2020, we examined the role of community resilience in protecting older adults from anxiety during the COVID-19 pandemic, and simultaneously considered the moderating role of trust in local government. The results indicated that community resilience was negatively associated with older adults' anxiety, and this association was weakened for older adults with low trust in local government. This study has implications for intervention designs that combine resilient factors related to communities and local governments to relieve older adults' anxiety during the pandemic. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

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

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

Internet memes related to the COVID-19 pandemic as a potential coping mechanism for anxiety

This study examined whether significantly anxious individuals differed from non-anxious individuals in their perceptual ratings of internet memes related to the Covid-19 pandemic, whilst considering the mediating role of emotion regulation. Eighty individuals presenting clinically significant anxiety symptoms (indicating ≥ 15 on the GAD-7) and 80 non-anxious controls (indicating ≤ 4) rated the emotional valance, humour, relatability, shareability, and offensiveness of 45 Covid-19 internet memes. A measure of emotion regulation difficulties was also completed. The perception of humour, relatability, and shareability were all greater amongst anxious individuals relative to non-anxious controls. These differences were not mediated by emotion regulation deficits. Internet memes related to the current Covid-19 pandemic may tentatively serve as coping mechanism for individuals experiencing severe symptoms of anxiety.

EEG Neurofeedback for Anxiety Disorders and Post-Traumatic Stress Disorders: A Blueprint for a Promising Brain-Based Therapy

PURPOSE OF REVIEW

This review provides an overview of current knowledge and understanding of EEG neurofeedback for anxiety disorders and post-traumatic stress disorders.

RECENT FINDINGS

The manifestations of anxiety disorders and post-traumatic stress disorders (PTSD) are associated with dysfunctions of neurophysiological stress axes and brain arousal circuits, which are important dimensions of the research domain criteria (RDoC). Even if the pathophysiology of these disorders is complex, one of its defining signatures is behavioral and physiological over-arousal. Interestingly, arousal-related brain activity can be modulated by electroencephalogram-based neurofeedback (EEG NF), a non-pharmacological and non-invasive method that involves neurocognitive training through a brain-computer interface (BCI). EEG NF is characterized by a simultaneous learning process where both patient and computer are involved in modifying neuronal activity or connectivity, thereby improving associated symptoms of anxiety and/or over-arousal. Positive effects of EEG NF have been described for both anxiety disorders and PTSD, yet due to a number of methodological issues, it remains unclear whether symptom improvement is the direct result of neurophysiological changes targeted by EEG NF. Thus, in this work we sought to bridge current knowledge on brain mechanisms of arousal with past and present EEG NF therapies for anxiety and PTSD. In a nutshell, we discuss the neurophysiological mechanisms underlying the effects of EEG NF in anxiety disorder and PTSD, the methodological strengths/weaknesses of existing EEG NF randomized controlled trials for these disorders, and the neuropsychological factors that may impact NF training success.