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Gonzalez A, Rozenman M, Goger P, Velasco SE. Autonomic reactivity during acute social stress: exploratory investigation of an interaction by threat interpretation bias and emotion regulation difficulties. ANXIETY, STRESS, AND COPING 2024; 37:251-264. [PMID: 37453083 PMCID: PMC10788382 DOI: 10.1080/10615806.2023.2235283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Objective: This preliminary study examined the interactive influences of interpretation bias and emotion dysregulation in predicting autonomic stress response.Methods: Participants (N = 72 college students; ages 18-25, 70% female, 47% Hispanic/Latinx), completed a performance-based assessment of threat interpretation bias and self-report measures of emotion regulation difficulties. Electrodermal activity (EDA; skin conductance level) was collected while participants completed a standardized psychosocial stressor task.Results: Interpretation bias and emotion regulation difficulties interacted to predict EDA trajectories (β = 0.054, SE = .001, CI:.007, .002, p < .001) during acute stress: presence of either interpretation bias toward threat (β = 6.950, SE = 2.826, CI: 1.407, 12.488, p = .013) or emotion regulation difficulties (β = 9.387, SE = 3.685, CI: 2.141, 16.636, p = .011) was associated with greater reactivity and poorer recovery; presence of both was associated with the lowest resting state EDA and blunted reactivity (β = 1.340, SE = 3.085, CI: -4.721, 7.407, p = .66).Conclusions: Preliminary findings support interpretation bias and emotion regulation difficulties, and their distinct interactive patterns, as predictors of autonomic reactivity trajectories during stress. Interpretation bias modification and emotion regulation skills may be important intervention targets for common psychological conditions that are influenced by aberrant psychophysiological processes.
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Affiliation(s)
- Araceli Gonzalez
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | | | - Pauline Goger
- Teachers College, Columbia University, New York, NY, USA
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Wasp GT, Kaur-Gill S, Anderson EC, Vergo MT, Chelen J, Tosteson T, Barr PJ, Barnato AE. Evaluating Physician Emotion Regulation in Serious Illness Conversations Using Multimodal Assessment. J Pain Symptom Manage 2023; 66:351-360.e1. [PMID: 37433418 PMCID: PMC10574810 DOI: 10.1016/j.jpainsymman.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/13/2023]
Abstract
CONTEXT Emotion regulation by the physician can influence the effectiveness of serious illness conversations. The feasibility of multimodal assessment of emotion regulation during these conversations is unknown. OBJECTIVES To develop and assess an experimental framework for evaluating physician emotion regulation during serious illness conversations. METHODS We developed and then assessed a multimodal assessment framework for physician emotion regulation using a cross-sectional, pilot study on physicians trained in the Serious Illness Conversation Guide (SICG) in a simulated, telehealth encounter. Development of the assessment framework included a literature review and subject matter expert consultations. Our predefined feasibility endpoints included: an enrollment rate of ≥60% of approached physicians, >90% completion rate of survey items, and <20% missing data from wearable heart rate sensors. To describe physician emotion regulation, we performed a thematic analysis of the conversation, its documentation, and physician interviews. RESULTS Out of 12 physicians approached, 11 (92%) SICG-trained physicians enrolled in the study: five medical oncology and six palliative care physicians. All 11 completed the survey (100% completion rate). Two sensors (chest band, wrist sensor) had <20% missing data during study tasks. The forearm sensor had >20% missing data. The thematic analysis found that physicians': 1) overarching goal was to move beyond prognosis to reasonable hope; 2) tactically focused on establishing a trusting, supportive relationship; and 3) possessed incomplete awareness of their emotion regulation strategies. CONCLUSION Our novel, multimodal assessment of physician emotion regulation was feasible in a simulated SICG encounter. Physicians exhibited an incomplete understanding of their emotion regulation strategies.
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Affiliation(s)
- Garrett T Wasp
- Section of Oncology, Department of Medicine (G.T.W.), Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, USA; Dartmouth Cancer Center (DCC) (G.T.W., T.T., A.E.B.), Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, USA; The Dartmouth Institute for Health Policy & Clinical Practice (G.T.W., S.K.G., J.C., P.J.B., A.E.B.), Geisel School of Medicine, Lebanon, New Hampshire, USA.
| | - Satveer Kaur-Gill
- The Dartmouth Institute for Health Policy & Clinical Practice (G.T.W., S.K.G., J.C., P.J.B., A.E.B.), Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Eric C Anderson
- Center for Interdisciplinary Population and Health Research (E.C.A), Maine Health Institute for Research, Portland, Maine, USA; Tufts University School of Medicine (E.C.A.), Boston, MA, USA
| | - Maxwell T Vergo
- Section of Palliative Care, Department of Medicine (M.T.V., A.E.B.), Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, USA
| | - Julia Chelen
- The Dartmouth Institute for Health Policy & Clinical Practice (G.T.W., S.K.G., J.C., P.J.B., A.E.B.), Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Tor Tosteson
- Dartmouth Cancer Center (DCC) (G.T.W., T.T., A.E.B.), Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, USA; Biomedical Data Science (T.T., P.J.B.), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Paul J Barr
- The Dartmouth Institute for Health Policy & Clinical Practice (G.T.W., S.K.G., J.C., P.J.B., A.E.B.), Geisel School of Medicine, Lebanon, New Hampshire, USA; Biomedical Data Science (T.T., P.J.B.), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA; Center for Technology and Behavioral Health (P.J.B.), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Amber E Barnato
- Dartmouth Cancer Center (DCC) (G.T.W., T.T., A.E.B.), Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, USA; The Dartmouth Institute for Health Policy & Clinical Practice (G.T.W., S.K.G., J.C., P.J.B., A.E.B.), Geisel School of Medicine, Lebanon, New Hampshire, USA; Section of Palliative Care, Department of Medicine (M.T.V., A.E.B.), Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, New Hampshire, USA
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Sege CT, McTeague LM, Kegley M, Shacklewood C, Halliday CA, Calhoun CD, Joseph JE, Adams ZW, Hajcak G, Danielson CK. Neurophysiology of predictable unpleasant event processing in pre-adolescents and early adolescents, part II: Reflex and event-related potential markers of defensive reactivity and peripheral attention modulation. Dev Psychobiol 2023; 65:e22386. [PMID: 37073586 PMCID: PMC10948024 DOI: 10.1002/dev.22386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 04/20/2023]
Abstract
The ability to anticipate and process predictable unpleasant events, while also regulating emotional reactivity, is an adaptive skill. The current article and a companion in this issue test for potential changes in predictable event processing across the childhood-to-adolescence transition, a key developmental period for biological systems that support cognitive/ emotional abilities. While the companion article focuses on neurophysiology of predictable event processing itself, the present article examines peripheral emotional response regulation and attention modulation that coincides with event processing. A total of 315 third-, sixth-, or ninth-grade individuals saw 5-s cues predicting "scary," "every day," or uncertain pictures, and here, blink reflexes and brain event-related potentials (ERPs) elicited by peripheral noise probes are analyzed. During the cue, blink reflexes and probe ERP (P200) amplitudes were increased when the cue predicted scary, compared to everyday, content. After picture onset, reflex enhancement by scary content then disappeared for predictable images, whereas ERP modulation was similar regardless of predictability. Patterns are similar to those in adults and suggest (1) sustained defensive response priming and enhancement of peripheral attention during aversive anticipation, and (2) an ability, even in pre-adolescents, to downregulate defensive priming while maintaining attentional modulation once an awaited predictable aversive event occurs.
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Affiliation(s)
- Christopher T. Sege
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lisa M. McTeague
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Molly Kegley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Psychology, University of Tulsa, Tulsa, Oklahoma, USA
| | - Curtisha Shacklewood
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Colleen A. Halliday
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Casey D. Calhoun
- Department of Psychiatry, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jane E. Joseph
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zachary W. Adams
- Department of Psychiatry, Indiana University, Indianapolis, Indiana, USA
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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Salokivi M, Salanterä S, Ala-Ruona E. Scoping review and concept analysis of early adolescents’ emotional skills: Towards development of a music therapy assessment tool. NORDIC JOURNAL OF MUSIC THERAPY 2021. [DOI: 10.1080/08098131.2021.1903977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Maija Salokivi
- Department of Music, Art and Culture Studies, University of Jyväskylä, Jyvaskyla, Finland
| | - Sanna Salanterä
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Esa Ala-Ruona
- Department of Music, Art and Culture Studies, University of Jyväskylä, Jyvaskyla, Finland
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Duncan O, Cook EC, Pimental D, Wilkinson K, Champagne A. The Effect of Visual Stressors on Adolescents' Neural Response: A Review of Laboratory Research. ADOLESCENT RESEARCH REVIEW 2019; 4:341-356. [PMID: 32258366 PMCID: PMC7111510 DOI: 10.1007/s40894-018-0087-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/19/2018] [Indexed: 06/11/2023]
Abstract
Laboratory models that help us understand the neural mechanisms associated with how stress, particularly interpersonal stress, affects children's and adolescents' emotions are paramount but are limited if that understanding lacks validity in adolescents' daily lives. There is a lack of research that addresses the ecological validity of visual stimuli to induce stress in participants while measuring participants' neural response to that stimuli. This approach is needed if we are to identify the neural mechanisms that underlie the effect of stressful events on individuals' emotional functioning. The current study conducted a systematic literature review to identify visual tasks that have been used in laboratory settings to induce stress in participants. The most frequent tasks identified were developed to induce peer rejection/exclusion in youth (e.g., Chatroom and Cyberball). These tasks were generally effective at bringing about a neural response in areas of the brain traditionally associated with social cognitive processing, such as the cingulate cortex, prefrontal cortex, insula, and striatum. In particular, the cingulate cortex and prefrontal cortex are associated with the Social Information Processing Network. Almost entirely absent from the literature are systematic evaluations of ecological validity and parent-child based visual stimuli that approximate the stress that adolescents might experience in their relationships with parents. The present article highlights trends and gaps in the current research, and examines the ecological validity of current stimuli used as laboratory based stressors, which can be used to fuel further investigation into adolescent neural response to stimuli, and further evaluation of the ecological validity of tasks.
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Affiliation(s)
- Orianna Duncan
- Department of Psychology, Rhode Island College, 600 Mount Pleasant Ave., Providence, RI 02908, USA
| | - Emily C. Cook
- Department of Psychology, Rhode Island College, 600 Mount Pleasant Ave., Providence, RI 02908, USA
| | | | - Kristen Wilkinson
- Department of Psychology, Rhode Island College, 600 Mount Pleasant Ave., Providence, RI 02908, USA
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Young KS, Sandman CF, Craske MG. Positive and Negative Emotion Regulation in Adolescence: Links to Anxiety and Depression. Brain Sci 2019; 9:E76. [PMID: 30934877 PMCID: PMC6523365 DOI: 10.3390/brainsci9040076] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/15/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022] Open
Abstract
Emotion regulation skills develop substantially across adolescence, a period characterized by emotional challenges and developing regulatory neural circuitry. Adolescence is also a risk period for the new onset of anxiety and depressive disorders, psychopathologies which have long been associated with disruptions in regulation of positive and negative emotions. This paper reviews the current understanding of the role of disrupted emotion regulation in adolescent anxiety and depression, describing findings from self-report, behavioral, peripheral psychophysiological, and neural measures. Self-report studies robustly identified associations between emotion dysregulation and adolescent anxiety and depression. Findings from behavioral and psychophysiological studies are mixed, with some suggestion of specific impairments in reappraisal in anxiety. Results from neuroimaging studies broadly implicate altered functioning of amygdala-prefrontal cortical circuitries, although again, findings are mixed regarding specific patterns of altered neural functioning. Future work may benefit from focusing on designs that contrast effects of specific regulatory strategies, and isolate changes in emotional regulation from emotional reactivity. Approaches to improve treatments based on empirical evidence of disrupted emotion regulation in adolescents are also discussed. Future intervention studies might consider training and measurement of specific strategies in adolescents to better understand the role of emotion regulation as a treatment mechanism.
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Affiliation(s)
- Katherine S Young
- Social, Genetic and Development Psychiatry (SGDP) Centre, Institute of Psychology, Psychiatry and Neuroscience, King's College, London SE5 8AF, UK.
| | - Christina F Sandman
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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