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Claing A, Dugal C, Brassard A, Lafontaine MF, Savard C, Godbout N. Anxiety, Depression, and Comorbid Symptomatology: Different Forms and Severity of Intimate Partner Violence Perpetrated by Men Seeking Help. VIOLENCE AND VICTIMS 2024; 39:332-350. [PMID: 39107071 DOI: 10.1891/vv-2021-0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
Intimate partner violence (IPV) is a serious public health issue associated with numerous deleterious outcomes. Previous studies highlighted the relevance of documenting psychological predictors of IPV to identify prevention strategies. This study examined the links between anxious and depressive symptomatology and perpetrated physical, psychological, and sexual violence among 494 French-Canadian men seeking help for IPV-related difficulties. Differences in the frequency of perpetrated IPV were examined across four groups: (a) no anxious or depressive symptoms reaching a cutoff of high distress, (b) symptoms of anxiety, (c) symptoms of depression, and (d) comorbid symptoms. Results highlighted that men with comorbid symptoms perpetrated significantly more severe violent acts compared to the other groups. This study underscores the importance of targeting the reduction of psychological distress when treating men who perpetrated IPV.
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Li J, Hesketh T. A school-based intervention programme to prevent anxiety and depression among Chinese children during the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2024; 18:71. [PMID: 38886799 PMCID: PMC11184792 DOI: 10.1186/s13034-024-00758-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Child and adolescent mental health is a major public health concern worldwide. The development of children's social and emotional skills helps to improve mental health and wellbeing, and prevent anxiety and depression. The school-based social emotional learning (SEL) programmes have proved effective in a number of countries. But in Mainland China, there has been no empirical research of the effectiveness on children's mental health. The study conducted a SEL programme in China during the COVID-19 pandemic and aimed to determine whether: (1) a SEL programme can reduce anxiety and depression, (2) the intervention effect is influenced by sociodemographic characteristics, (3) the programme effects change children's emotion management and communication. METHODS Participants were 230 children aged 8-12 years in the intervention school and 325 in the control school in two poor villages in central China. The study was a quasi-experimental trial, comprising 16 weekly 90-minute sessions. It used a mixed-methods design, with a quantitative survey administered at baseline, post-intervention, and 5-month follow-up, and qualitative interviews. Linear mixed effects regression modeling was used to analyse the intervention effectiveness, linear models were conducted to examine the moderation effect of sociodemographic variables, and the inductive thematic analysis approach was used for interview data. RESULTS The intervention had no significant effect on anxiety or depression, except that intervention school children who lived with neither parent (left behind children) reported lower depression scores than control school at post-intervention and 5-month follow-up. Qualitative interviews showed after intervention children were more able to control tempers and better communicated their thoughts and feelings, improving their relationships with family and friends. CONCLUSIONS The programme was cheap, easy to implement, and warmly welcomed by children, schools and caregivers, suggesting it was feasible and potentially sustainable. More research is needed on the adaptation of the SEL programme in the Chinese context.
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Affiliation(s)
- Jiameng Li
- Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, Zhejiang Province, People's Republic of China
| | - Therese Hesketh
- Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, Zhejiang Province, People's Republic of China.
- The Institute for Global Health, UCL, 30 Guilford St, WC1NEH, London, UK.
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Bock RC, Baker LD, Kalantar EA, Berghoff CR, Stroman JC, Gratz KL, Tull MT. Clarifying relations of emotion regulation, emotional avoidance and anxiety symptoms in a community-based treatment-seeking sample. Psychol Psychother 2024. [PMID: 38411316 DOI: 10.1111/papt.12523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/13/2024] [Accepted: 02/08/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Anxiety is a global problem that is readily treatable with psychosocial interventions, though many individuals do not benefit following participation in extant treatment protocols. Accordingly, clarification of process-related variables that may be leveraged to enhance outcomes appears warranted. Emotion regulation (ER) is a robust correlate of anxiety symptoms and is often targeted in behavioural treatments applied to anxiety-related problems. Yet, some evidence suggests ER difficulties may be a proxy variable for emotional avoidance (EA). Clarifying the relative influence of ER and EA on anxiety symptom severity may improve specificity in targeting behavioural processes within psychosocial treatments designed to alleviate anxiety-related suffering. Accordingly, we examined relations of ER and EA to anxiety symptom severity after accounting for anxiety sensitivity and anxiolytic medication use in a community-based treatment-seeking sample. DESIGN A four-step hierarchical linear regression analysis of cross-sectional data provided by a community-based treatment-seeking sample. METHODS Totally, 120 participants (Mage = 39.18; Female = 58.3%) completed a questionnaire packet upon intake to an anxiety disorders clinic. RESULTS EA and ER were strongly correlated, and each accounted for significant variance over and above model covariates. EA was a dominant risk factor for anxiety symptom severity, as ER was not a significant predictor (p = .073) following the inclusion of EA in the model (p = .006). CONCLUSIONS EA appears to be a dominant risk factor, and ER a proxy risk factor, for anxiety symptom severity. EA may be an avenue for greater treatment specificity for those with anxiety symptoms.
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Affiliation(s)
- Rachel C Bock
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Lucas D Baker
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Emily A Kalantar
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | | | - Joel C Stroman
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Kim L Gratz
- Lyra Health, Burlingame, California, USA
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Matthew T Tull
- Lyra Health, Burlingame, California, USA
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
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GÖKDAĞ C, KIZILTEPE R. Risk Factors in Depression and Anxiety Disorders from the Framework of Developmental Psychopathology. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1118163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Depression and anxiety disorders are among the most prevalent psychiatric disorders that negatively affect individuals’ life in many ways. Understanding how these highly comorbid emotional disorders develop and persist might guide prevention, intervention, and treatment studies. Some common vulnerability factors underlie depression and anxiety disorders. Developmental psychopathology deals with these vulnerabilities and risk factors from a lifetime perspective. The aim of this review is to present the risk factors associated with depression and anxiety from the perspective of developmental psychopathology. For this purpose, we discussed genetic and biological factors, temperament, negative childhood experiences, family and peer relationships, and some cognitive and emotional factors as risk factors. Also, we discussed how these risk factors lead to depression and anxiety disorders. This review emphasizes that some common transdiagnostic risk factors underlie emotional disorders and highlights the importance of a developmental psychopathology perspective to understand the developmental pathways of depression and anxiety disorders.
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Edwards KM, Lim S, Huff M, Herrington R, Leader Charge L, Littleton H. Rates and Correlates of Intimate Partner Violence Among Indigenous College Students: A Multi-Campus Study. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7852-7866. [PMID: 36714950 DOI: 10.1177/08862605221150945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Research suggests that Indigenous girls, women, and LGBTQ+ Two-Spirit people experience disproportionately high rates of intimate partner violence (IPV), but there is a dearth of research on IPV among Indigenous college students. Therefore, the current study sought to explore rates of IPV victimization and perpetration among Indigenous college students, as well as correlates including depressive and anxious symptoms, emotion dysregulation, on-campus social support, and hazardous drinking. Participants were 230 undergraduate students who identified as American Indian/Alaska Native attending 20 medium- and large-sized universities across the contiguous U.S. Results indicated that 28.9% of Indigenous students reported any type of IPV victimization in the past 6 months (psychological: 24.5%; physical: 9.1%; sexual: 9.8%; coercive control: 12.4%). Further, 18.3% of Indigenous students reported any type of IPV perpetration in the past 6 months (psychological: 16.9%; physical: 4.5%; sexual: 2.6%; coercive control: 7.1%). Anxious and depressive symptoms were related to many forms of IPV victimization; emotion dysregulation was related to all forms of IPV victimization and sexual IPV perpetration; and hazardous drinking was related to most forms of IPV victimization and perpetration. These findings underscore the alarmingly high rates of IPV among Indigenous college students as well as the potential deleterious effects of IPV victimization on psychological functioning, as well as the need to concurrently address hazardous alcohol use in IPV prevention and response efforts.
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Ruan QN, Chen YH, Yan WJ. A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings. Child Adolesc Psychiatry Ment Health 2023; 17:29. [PMID: 36814344 PMCID: PMC9945357 DOI: 10.1186/s13034-023-00574-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Difficulties in emotion regulation (DER) are widely considered to underlie anxiety and depression. Given the prevalence of anxiety and depression in adolescents and the fact that adolescence is a key period for the development of emotion regulation ability, it is important to examine how DER is related to anxiety and depression in adolescents in clinical settings. METHODS In the present study, we assessed 209 adolescents in clinical settings using the Difficulties in Emotion Regulation Scale (DERS) and the Hospital Anxiety and Depression Scale (HADS) and examined the associations between six components of DER and 14 symptoms of anxiety and depression. We used network analysis, constructed circular and multidimensional scaling (MDS) networks, and calculated network centrality, bridge centrality, and stability of centrality indices. RESULTS The results showed that: (1) The global centrality index shows that the Strategy component (i.e., lack of access to strategies) is the center in the whole network, ranking highest in strength, closeness, betweenness, and expected influence. (2) The MDS network showed a closeness of anxiety and depression symptoms, while Awareness component (i.e., lack of emotional awareness) stayed away from other DER components, but Awareness is close to some depression symptoms. (3) The bridge nodes of three groups, Strategy from DERS, Worry and Relax from anxiety symptoms, and Cheerful and Slow from depression symptoms, had the strongest relationships with the other groups. CONCLUSION Lack of access to strategies remains in the center not only in DER but also in the DER-anxiety-depression network, while lack of awareness is close to depression but not to anxiety. Worrying thoughts and inability to relax are the bridging symptoms for anxiety, while lack of cheerful emotions and slowing down are the bridging symptoms for depression. These findings suggest that making emotion regulation strategies more accessible to patients and reducing these bridging symptoms may yield the greatest rewards for anxiety and depression therapy.
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Affiliation(s)
- Qian-Nan Ruan
- Wenzhou Seventh People’s Hospital, Wenzhou, 325006 China
| | - Yu-Hsin Chen
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, 325035 China
| | - Wen-Jing Yan
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China. .,Zhejiang Provincial Clinical Research Center for Mental Disorders, The affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, 325035, China.
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Shahidin SH, Midin M, Sidi H, Choy CL, Nik Jaafar NR, Mohd Salleh Sahimi H, Che Roos NA. The Relationship between Emotion Regulation (ER) and Problematic Smartphone Use (PSU): A Systematic Review and Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15848. [PMID: 36497921 PMCID: PMC9740505 DOI: 10.3390/ijerph192315848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Emotion Dysregulation (ED) and Problematic Smartphone Use (PSU) are two rising global issues requiring further understanding on how they are linked. This paper aims to summarize the evidence pertaining to this relationship. Five databases were systematically searched for published literature from inception until 29 March 2021 using appropriate search strategies. Each study was screened for eligibility based on the set criteria, assessed for its quality and its level of evidence was determined. The Comprehensive Meta-Analysis software program (CMA) was employed to run further analyses of the data. Twenty-one studies were included in the systematic review. Nine studies with extractable data for meta-analysis had high across-studies heterogeneity, hence subgroup analyses were performed that confirmed a significant moderate positive correlation between ED and PSU (pooled correlation coefficient, r = 0.416 (four studies, n = 1462) and r = 0.42 (three studies, n = 899), respectively) and a weak positive correlation between "expressive suppression" and PSU (pooled correlation coefficient, r = 0.14 (two studies, n = 608)). Meta-regression analysis showed a stronger correlation between ED and PSU (R2 = 1.0, p = 0.0006) in the younger age group. Further studies to establish and explore the mechanisms that contribute towards the positive link between ED and PSU are required to guide in the planning of targeted interventions in addressing both issues.
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Affiliation(s)
- Siti Hajar Shahidin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Bahagia Ulu Kinta, Tanjung Rambutan 31250, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Chia Lip Choy
- Department of Psychiatry and Mental Health, Hospital Keningau, Peti Surat 11 Jalan Apin-Apin, Keningau 89007, Malaysia
| | - Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Hajar Mohd Salleh Sahimi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Nur Aishah Che Roos
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur 57000, Malaysia
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8
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Geyer RB, Magee JC, Clerkin EM. Anxiety sensitivity and panic symptoms: the moderating influence of distress tolerance. ANXIETY, STRESS, & COPING 2022:1-18. [DOI: 10.1080/10615806.2022.2146102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Elise M. Clerkin
- Student Health and Wellness, University of Virginia, Charlottesville, VA, USA
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Furtado M, Frey BN, Green SM. Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety. BMC Pregnancy Childbirth 2021; 21:829. [PMID: 34903196 PMCID: PMC8670292 DOI: 10.1186/s12884-021-04296-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/24/2021] [Indexed: 11/11/2022] Open
Abstract
Background To date, there is a significant lack of research validating clinical tools for early and accurate detection of anxiety disorders in perinatal populations. Intolerance of uncertainty was recently identified as a significant risk factor for postpartum anxiety symptoms and is a key trait of non-perinatal anxiety disorders. The present study aimed to validate the Intolerance of Uncertainty Scale (IUS) in a perinatal population and evaluate its use as a screening tool for anxiety disorders. Methods Psychiatric diagnoses were assessed in a sample of perinatal women (n = 198), in addition to completing a self-report battery of questionnaires. Psychometric properties including internal consistency and convergent and discriminant validity were assessed. Determination of an optimal clinical cut-off score was measured through a ROC analysis in which the area under the curve, sensitivity, specificity, as well as positive and negative predictive values were calculated. Results The IUS demonstrated excellent internal consistency (α = 0.95) and an optimal clinical cut-off score of 64 or greater was established, yielding a sensitivity of 89%. The IUS also demonstrated very good positive (79%) and negative (80%) predictive values. Conclusions These findings suggest that the IUS represents a clinically useful screening tool to be used as an aid for the early and accurate detection of perinatal anxiety.
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Affiliation(s)
- Melissa Furtado
- Department of Psychology, Neuroscience and Behaviour, McMaster University, 1280 Main Street West, Ontario, Hamilton, L8S 4L8, Canada. .,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Level 1, 100 West 5th Street, Hamilton, Ontario, L8N 3K7, Canada.
| | - Benicio N Frey
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Level 1, 100 West 5th Street, Hamilton, Ontario, L8N 3K7, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Administration B3, 100 West 5th Street, Hamilton, Ontario, L8N 3K7, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Level 1, 100 West 5th Street, Hamilton, Ontario, L8N 3K7, Canada
| | - Sheryl M Green
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Level 1, 100 West 5th Street, Hamilton, Ontario, L8N 3K7, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Administration B3, 100 West 5th Street, Hamilton, Ontario, L8N 3K7, Canada
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Daros AR, Haefner SA, Asadi S, Kazi S, Rodak T, Quilty LC. A meta-analysis of emotional regulation outcomes in psychological interventions for youth with depression and anxiety. Nat Hum Behav 2021; 5:1443-1457. [PMID: 34545236 PMCID: PMC7611874 DOI: 10.1038/s41562-021-01191-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 07/28/2021] [Indexed: 02/08/2023]
Abstract
Difficulties in applying emotional regulation (ER) skills are associated with depression and anxiety symptoms, and are common targets of treatment. This meta-analysis examined whether improvements in ER skills were associated with psychological treatment outcomes for depression and/or anxiety in youth. A multivariate, random-effects meta-analysis was run using metafor in R. Inclusion criteria included studies that were randomized controlled trials (RCTs) of a psychological intervention for depression and/or anxiety in patients aged 14-24, were peer reviewed, were written in English, measured depression and/or anxiety symptoms as an outcome and measured ER as an outcome. Medline, Embase, APA PsycInfo, CINAHL and The Cochrane Library were searched up to 26 June 2020. Risk of bias (ROB) was assessed using the Cochrane Collaboration Risk of Bias 2.0 tool. The meta-analysis includes 385 effect sizes from 90 RCTs with total N = 11,652. Psychological treatments significantly reduced depression, anxiety, emotion dysregulation (k = 13, Hedges' g = 0.54, P < 0.001, 95% confidence interval (CI) = 0.30-0.78) and disengagement ER (k = 83, g = 0.24, 95% CI = 0.15-0.32, P < 0.001); engagement ER also increased (k = 82, g = 0.26, 95% CI = 0.15-0.32, P < 0.001). Improvements in depression and anxiety were positively associated with improved engagement ER skills, reduced emotion dysregulation and reduced disengagement ER skills. Sensitivity considered study selection and publication bias. Longer treatments, group formats and cognitive-behavioural orientations produced larger positive associations between improved ER skills and reduced symptoms. ER skill improvement is linked to depression and anxiety across a broad range of interventions for youth. Limitations of the current study include reliance on self-report measures, content overlap between variables and inability to test the directionality of associations.
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Affiliation(s)
- Alexander R Daros
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada.
| | - Sasha A Haefner
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Shayan Asadi
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sharifa Kazi
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Terri Rodak
- CAMH Library, Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Muratori P, Milone A, Levantini V, Pisano S, Spensieri V, Valente E, Thomaes S, Masi G. Narcissistic traits as predictors of emotional problems in children with oppositional defiant disorder: A longitudinal study. J Affect Disord 2020; 274:494-499. [PMID: 32663981 DOI: 10.1016/j.jad.2020.05.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children's self-views encompass two independent dimensions: self-esteem and narcissism, which recently have received growing attention from researchers and clinicians. The current study sought to test whether these dimensions might predict the developmental course of children with Oppositional Defiant Disorder diagnosis. METHOD The sample (N = 64, M age = 10.1 years, 57 boys) included children with Oppositional Defiant Disorder diagnosis. We examined longitudinal relationships between self-views (both self-esteem and narcissism) and parent-reported internalizing and externalizing behavioral problems. RESULTS The study spanned two time-points, spaced 12 months apart. None of the predictors were longitudinally associated with the levels of externalizing behavioral problems in children. However, narcissism predicted the levels of children's internalizing problems at the follow-up, whereas self-esteem did not. LIMITATIONS The relatively small sample and the lack of assessing causality limit the generalizability of the findings. Results need to be replicated in larger samples. CONCLUSIONS These findings illustrate the value of taking into account children's narcissistic traits in clinical assessment. By broadening knowledge of narcissistic traits in clinical samples of children, we hope to inform assessment procedures in standard clinical practice, as well as the development of tailored interventions to curb the emergence of later negative outcomes related to childhood narcissism, such as internalizing problems.
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Affiliation(s)
- Pietro Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy.
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
| | - Valentina Levantini
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
| | - Simone Pisano
- Department of Neuroscience, AORN Santobono-Pausilipon, Naples, Italy.2 Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Valentina Spensieri
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Italy
| | - Elena Valente
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
| | - Sander Thomaes
- Department of Psychology, Utrecht University, The Netherlands
| | - Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
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12
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Chiu HT, Yee LTS, Kwan JLY, Cheung RYM, Hou WK. Interactive association between negative emotion regulation and savoring is linked to anxiety symptoms among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:494-501. [PMID: 30908167 DOI: 10.1080/07448481.2019.1580712] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 12/13/2018] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
Objective: This study tested the interactive relationships between college students' perceived capability of regulating negative emotions and savoring positive emotions on mental health outcomes, including anxiety and depressive symptoms. Participants: Participants were healthy undergraduates (n = 167) recruited from two universities in Hong Kong. Methods: Students completed four scales assessing their perceived capability of using strategies to regulate negative and positive emotions and their anxiety and depressive symptoms. Results: Findings revealed that both anxiety and depressive symptoms were negatively linked to perceived capabilities of regulating negative emotions and savoring positive emotions. Furthermore, regulating negative emotions interacted with savoring positive emotions to predict anxiety symptoms. Conclusions: The need to simultaneously perform negative and positive emotion regulation is highlighted. The results suggest the priority of regulating negative emotions over savoring positive emotions in alleviating anxiety symptoms. Nevertheless, enhancing positive emotion shows greater benefits for those who are less adept at regulating negative emotions.
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Affiliation(s)
- Hey Tou Chiu
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lydia Ting Sum Yee
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong
- Centre for Psychosocial Health, The Education University of Hong Kong, New Territories, Hong Kong
- Centre for Educational and Developmental Sciences, The Education University of Hong Kong, New Territories, Hong Kong
| | - Joyce Lok Yin Kwan
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong
- Centre for Psychosocial Health, The Education University of Hong Kong, New Territories, Hong Kong
- Assessment Research Centre, The Education University of Hong Kong, New Territories, Hong Kong
| | - Rebecca Yuen Man Cheung
- Centre for Psychosocial Health, The Education University of Hong Kong, New Territories, Hong Kong
- Department of Early Childhood Education, The Education University of Hong Kong, New Territories, Hong Kong
- Centre for Child and Family Science, The Education University of Hong Kong, New Territories, Hong Kong
| | - Wai Kai Hou
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong
- Centre for Psychosocial Health, The Education University of Hong Kong, New Territories, Hong Kong
- Laboratory of Psychology and Ecology of Stress, The Education University of Hong Kong, New Territories, Hong Kong
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Mendez-Lopez M, Fidalgo C, Osma J, Juan MC. Wayfinding Strategy and Gender - Testing the Mediating Effects of Wayfinding Experience, Personality and Emotions. Psychol Res Behav Manag 2020; 13:119-131. [PMID: 32099489 PMCID: PMC6999780 DOI: 10.2147/prbm.s236735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/24/2019] [Indexed: 11/23/2022] Open
Abstract
Background Individual differences have been seen to play a key role in spatial orientation. Gender implications have been previously described but little is known about how other variables, such as wayfinding anxiety, emotional difficulties and wayfinding experience can mediate this relationship. Methods A group of 269 participants were involved in this study and completed questionnaires on their self-reported allocentric orientation strategy, wayfinding experience and satisfaction with the ability for wayfinding. Emotional outcomes were also investigated: spatial and trait anxiety, neuroticism, difficulties in emotion regulation, and personal safety. First, a principal component analysis was conducted and the studied variables were grouped into four components: outdoor wayfinding experience, wayfinding-related fear, emotional difficulties, and effective wayfinding skill. Afterwards, structural equation modelling was performed, using the MPLUS statistical program. Results The results showed that gender constitutes a predictor for using an effective wayfinding skill and for feeling wayfinding-related fear. However, outdoor wayfinding experience, wayfinding-related fear and emotional difficulties did not mediate the relationship between effective wayfinding skill and gender. Conclusion These results highlight the differential contribution of gender in the emotions that are experienced during spatial orientation and emotions that are related to other types of situations. The limitations, strengths and theoretical implications of the proposed model are discussed. Further investigation is needed in order to understand the role of emotions in spatial orientation.
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Affiliation(s)
- Magdalena Mendez-Lopez
- Departamento de Psicología y Sociología, Universidad de Zaragoza, IIS Aragón, Facultad de Ciencias Sociales y Humanas, Teruel, Spain
| | - Camino Fidalgo
- Departamento de Psicología y Sociología, Universidad de Zaragoza, IIS Aragón, Facultad de Ciencias Sociales y Humanas, Teruel, Spain
| | - Jorge Osma
- Departamento de Psicología y Sociología, Universidad de Zaragoza, IIS Aragón, Facultad de Ciencias Sociales y Humanas, Teruel, Spain
| | - M-Carmen Juan
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
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14
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Vaughan E, Koczwara B, Kemp E, Freytag C, Tan W, Beatty L. Exploring emotion regulation as a mediator of the relationship between resilience and distress in cancer. Psychooncology 2019; 28:1506-1512. [PMID: 31087804 DOI: 10.1002/pon.5107] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Distress in patients with cancer is a significant problem that affects up to 32% of patients. Yet research indicates that 35% of cancer patients do maintain high levels of well-being. Resilience is one psychological factor implicated as being protective against distress; however, the mechanisms for this relationship are currently unknown. The present study aimed to explore emotion regulation as a potential mediator of the relationship between resilience and distress. METHODS A cross-sectional survey examining emotional regulation, resilience, and distress was completed by 227 patients from two hospitals with heterogeneous cancer types. Measures included the Difficulties in Emotion Regulation Scale (DERS), the Connor Davidson Resilience Scale, and the Depression, Anxiety, Stress Scale. RESULTS Difficulties in emotion regulation and resilience explained 33.2% of the variance in distress. Resilience had a significant direct effect on distress, accounting for 15.8% of the variance. However, this effect was no longer significant when difficulties in emotion regulation were controlled for. The indirect effect through difficulties in emotion regulation was significant, b = 0.009, 95% CI [-0.013,-0.007], suggesting that the effect of resilience on distress was fully mediated by emotion regulation. Parallel mediation analyses also examined the differential effects of the six DERS subscales on the relationship between resilience and distress. CONCLUSION These findings suggest that emotion regulation is an important mediator of resilience in cancer. Hence, in patients with cancer, difficulties in emotion regulation (and the DERS specifically) might be a useful focus for screening for patients at risk of distress.
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Affiliation(s)
| | - Bogda Koczwara
- Flinders University, Adelaide, Australia.,Flinders Centre for Innovation in Cancer, Adelaide, Australia
| | - Emma Kemp
- Flinders University, Adelaide, Australia.,Flinders Centre for Innovation in Cancer, Adelaide, Australia
| | | | - Wilson Tan
- Flinders University, Adelaide, Australia
| | - Lisa Beatty
- Flinders University, Adelaide, Australia.,Flinders Centre for Innovation in Cancer, Adelaide, Australia
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15
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Havewala M, Felton JW, Lejuez CW. Friendship Quality Moderates the Relation Between Maternal Anxiety and Trajectories of Adolescent Internalizing Symptoms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019; 41:495-506. [PMID: 31983803 DOI: 10.1007/s10862-019-09742-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The current study examined the moderating role of friendship quality on the relation between maternal anxiety and internalizing symptoms in a 3-year prospective study of adolescent development. Participants included 177 adolescents (M age = 16.05, SD age = 0.91) and their mothers. Mothers reported their own levels of anxiety; youth completed self-reports of internalizing symptoms and friendship quality. Positive friendship quality moderated the relation between maternal anxiety and initial levels of internalizing symptoms. Maternal anxiety was associated with steeper increases in internalizing symptoms over time, but only for those with greater negative peer interactions. Findings underscore the important role of both parental and peer relationships in the development of internalizing symptoms and highlight specific avenues for clinical interventions.
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Affiliation(s)
- Mazneen Havewala
- Department of Psychology, University of Maryland, College Park, MD
| | - Julia W Felton
- Division of Public Health, Michigan State University, Flint, MI
| | - Carl W Lejuez
- Department of Psychology, University of Kansas, Lawrence, KS
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16
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Schultheis AM, Mayes LC, Rutherford HJ. Associations Between Emotion Regulation and Parental Reflective Functioning. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:1094-1104. [PMID: 31156323 PMCID: PMC6538273 DOI: 10.1007/s10826-018-01326-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Emotion regulation encapsulates the capability to successfully manage an ongoing emotional experience, particularly in social interactions, and thus may be especially significant to early parent-child relationships. In particular, the capacity to adjust emotions may support parental mentalization and reflective functioning - how parents think about their own and their child's mental states and how these mental states effect behavior. To examine this issue, we investigated the association between emotion regulation, emotion dysregulation, and parental reflective functioning in a maternal sample (N=97). We found that mothers with higher tendencies to suppress their emotions and who had more difficulties with emotion regulation engaged in greater levels of pre-mentalizing (i.e., a non-mentalizing mode). Mothers with poorer emotional awareness also evidenced less interest and curiosity in their child's mental states. Finally, mothers who reported greater difficulty setting goals also evidenced a reduced capacity to recognize that their infant's mental states are not directly observable. Taken together, our findings support the relationship between different aspects of emotion regulation and maternal reflective functioning, suggesting that emotion regulation should be integrated in empirical and intervention work that targets maternal mentalization.
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Affiliation(s)
| | - Linda C Mayes
- Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
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17
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Knorr AC, Ammerman BA, Hamilton AJ, McCloskey MS. Predicting status along the continuum of suicidal thoughts and behavior among those with a history of nonsuicidal self-injury. Psychiatry Res 2019; 273:514-522. [PMID: 30708203 DOI: 10.1016/j.psychres.2019.01.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 12/01/2022]
Abstract
Nonsuicidal self-injury (NSSI) and suicidal thoughts and behavior often co-occur, representing a growing public health concern. Despite extensive research examining suicidal thoughts and behavior among those who engage in NSSI, there is a lack of research investigating factors that, when considered together, can differentiate individuals along the continuum of suicidal thoughts and behavior (no history, suicidal ideation, suicide plan, suicide attempt). This study sought to address this question using a sample of 1178 college students with NSSI history (68.70% female). Discriminant function analysis was conducted including the following predictors: NSSI characteristics, negative affect difficulties, and behavioral and demographic risk factors for suicidal thoughts and behavior. Results suggest that self-disclosure of suicidal ideation, number of lifetime NSSI methods, NSSI frequency, depressive symptoms, and age most parsimoniously differentiate study groups. Those who use a greater number of NSSI methods and acts, paired with higher depressive symptoms and repeated self-disclosure of suicidal ideation are most likely to have a suicide attempt history; decreases in these variables suggest membership within less severe groups. Furthermore, older age may be related to greater suicidality. Findings suggest that the evaluation and co-occurrence of these variables may contribute to a more accurate suicide risk assessment.
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Affiliation(s)
- Anne C Knorr
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA.
| | - Brooke A Ammerman
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA
| | - Alexander J Hamilton
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA
| | - Michael S McCloskey
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA
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18
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Weiss NH, Darosh AG, Contractor AA, Forkus SR, Dixon-Gordon KL, Sullivan TP. Heterogeneity in emotion regulation difficulties among women victims of domestic violence: A latent profile analysis. J Affect Disord 2018; 239:192-200. [PMID: 30014959 DOI: 10.1016/j.jad.2018.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/23/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Research over the past two decades supports emotion regulation as a transdiagnostic factor related to the etiology, maintenance, and treatment of a wide range of psychiatric difficulties and risky behaviors. However, prior investigations are limited by their focus on difficulties regulating negative (but not positive) emotions. Further, research has not accounted for the heterogeneity in difficulties regulating emotions. METHODS Participants were 210 female victims of domestic violence (DV; M age = 36.14, 48.6% African American) who completed measures assessing emotion regulation (Difficulties in Emotion Regulation Scale; Difficulties in Emotion Regulation Scale - Positive), posttraumatic stress disorder (PTSD; Posttraumatic Stress Diagnostic Scale), depression (Center for Epidemiologic Studies-Depression Scale), alcohol misuse (Alcohol Use Disorder Identification Test) and drug misuse (Drug Abuse Screening Test). Latent profile analysis was utilized to identify subgroups of DV-victimized women who were similar in endorsed difficulties in regulating negative and positive emotions. Differences in psychiatric difficulties (i.e., PTSD and depressive symptom severity) and risky behaviors (i.e., alcohol and drug misuse) were examined across these classes. RESULTS Three classes of DV-victimized women differentiated by levels of difficulties regulating negative and positive emotions were identified. Greater psychiatric difficulties were found among classes defined by higher levels of difficulties regulating emotions, regardless of emotion valence. Risky behaviors were more prevalent among the class defined by higher levels of difficulties regulating both negative and positive emotions. LIMITATIONS Although results add to the literature on difficulties regulating emotions and their correlates, findings must be interpreted in light of limitations present including use of a cross-sectional and correlation design, reliance on self-report measures, and assessment of a select sample of women victims of DV. CONCLUSIONS Results highlight the potential importance of tailoring interventions accounting for the heterogeneity in negative and positive emotion regulation dimensions among DV-victimized women.
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19
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20
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The Role of Anxiety Sensitivity in the Relationship Between Emotion Dysregulation and Internalizing Psychopathology Among Trauma-Exposed Inpatient Adolescents. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9943-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Ebbert AM, Patock-Peckham JA, Luk JW, Voorhies K, Warner O, Leeman RF. The Mediating Role of Anxiety Sensitivity in Uncontrolled Drinking: A Look at Gender-Specific Parental Influences. Alcohol Clin Exp Res 2018; 42:914-925. [PMID: 29573434 PMCID: PMC5915872 DOI: 10.1111/acer.13631] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/12/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Anxiety sensitivity (AS) reflects an individual's belief that experiencing anxiety will cause illness or embarrassment, and may be a reason individuals self-medicate with alcohol. Harsh or indulgent parenting could contribute to the development of AS. We examined the direct and indirect associations between parenting styles and alcohol-related variables through AS and impaired control over drinking (IC; i.e., perceived failure to adhere to limits on alcohol consumption in the future). METHODS A multiple-group structural equation model with 614 university students (344 men; 270 women) was examined. Structural invariance tests were conducted to evaluate moderation by gender. We used a bias corrected bootstrap technique to obtain the mediated effects. RESULTS Father authoritarianism and mother permissiveness were directly linked to AS among women, whereas father permissiveness was directly linked to AS among men. This suggests unique parental influences based on gender regarding AS. While AS was directly linked to alcohol-related problems for both men and women, several gender-specific associations were found. AS was directly linked to IC for men but not for women. For men, father permissiveness was directly related to AS, and AS mediated the indirect link between father permissiveness and IC along both the heavy episodic drinking and alcohol-related problems pathways. Similar to other internalizing constructs (e.g., neuroticism and depression), higher AS was directly associated with less heavy episodic drinking but more alcohol-related problems. CONCLUSIONS Our findings highlight the dangers of AS for men as an important correlate of under-controlled drinking behaviors. Additionally, permissive parenting of the same-gender parent was associated with AS, which is consistent with the gender-matching hypothesis. Together, these results underscore the importance of measuring the independent influence of both parents.
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Affiliation(s)
- Ashley M Ebbert
- Department of Psychology, Arizona State University, Tempe, Arizona
| | | | - Jeremy W Luk
- Division of Intramural Population Health Research, Health Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Kirsten Voorhies
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Olivia Warner
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Robert F Leeman
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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22
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Rabany L, Diefenbach GJ, Bragdon LB, Pittman BP, Zertuche L, Tolin DF, Goethe JW, Assaf M. Resting-State Functional Connectivity in Generalized Anxiety Disorder and Social Anxiety Disorder: Evidence for a Dimensional Approach. Brain Connect 2018; 7:289-298. [PMID: 28478685 DOI: 10.1089/brain.2017.0497] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are currently considered distinct diagnostic categories. Accumulating data suggest the study of anxiety disorders may benefit from the use of dimensional conceptualizations. One such dimension of shared dysfunction is emotion regulation (ER). The current study evaluated dimensional (ER) and categorical (diagnosis) neurocorrelates of resting-state functional connectivity (rsFC) in participants with GAD and SAD and healthy controls (HC). Functional magnetic resonance imaging (fMRI) rsFC was estimated between all regions of the default mode network (DMN), salience network (SN), and bilateral amygdala (N = 37: HC-19; GAD-10; SAD-8). Thereafter, rsFC was predicted by both ER, (using the Difficulties in Emotion Regulation Scale [DERS]), and diagnosis (DSM-5) within a single unified analysis of covariance (ANCOVA). For the ER dimension, there was a significant association between impaired ER abilities and anticorrelated rsFC of amygdala and DMN (L.amygdala-ACC: p = 0.011, beta = -0.345), as well as amygdala and SN (L.amygdala-posterior cingulate cortex [PCC]: p = 0.032, beta = -0.409). Diagnostic status was significantly associated with rsFC differences between the SAD and HC groups, both within the DMN (PCC-MPFC: p = 0.009) and between the DMN and SN (R.LP-ACC: p = 0.010). Although preliminary, our results exemplify the potential contribution of the dimensional approach to the study of GAD and SAD and support a combined categorical and dimensional model of rsFC of anxiety disorders.
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Affiliation(s)
- Liron Rabany
- 1 Olin Neuropsychiatry Research Center, Institute of Living , Hartford, Connecticut
| | - Gretchen J Diefenbach
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut.,3 Yale University School of Medicine , New Haven, Connecticut
| | - Laura B Bragdon
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut
| | - Brian P Pittman
- 3 Yale University School of Medicine , New Haven, Connecticut
| | - Luis Zertuche
- 1 Olin Neuropsychiatry Research Center, Institute of Living , Hartford, Connecticut
| | - David F Tolin
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut.,3 Yale University School of Medicine , New Haven, Connecticut
| | - John W Goethe
- 2 Anxiety Disorders Center, Institute of Living , Hartford, Connecticut
| | - Michal Assaf
- 1 Olin Neuropsychiatry Research Center, Institute of Living , Hartford, Connecticut.,3 Yale University School of Medicine , New Haven, Connecticut
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23
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Zhang L, Li Z, Wu X, Zhang Z. Why People with More Emotion Regulation Difficulties Made a More Deontological Judgment: The Role of Deontological Inclinations. Front Psychol 2017; 8:2095. [PMID: 29234299 PMCID: PMC5712370 DOI: 10.3389/fpsyg.2017.02095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/16/2017] [Indexed: 11/21/2022] Open
Abstract
Previous studies have demonstrated the key role of emotion in moral judgment, and explored the relationship between emotion regulation and moral judgment. The present study investigated the influence of individual differences in emotion regulation difficulties on moral judgment. Study 1 examined whether individuals with high emotion regulation difficulties made a more deontological judgment. Study 2 explored the underlying mechanism using a process-dissociation approach, examining whether deontological inclinations and utilitarian inclinations separately or jointly accounted for the association. The results indicated that individuals with high emotion regulation difficulties rated the utilitarian actions less morally appropriate, and one’s deontological inclinations mediated the association between emotion regulation difficulties and moral judgment.
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Affiliation(s)
- Lisong Zhang
- School of Social and Behavior Sciences, Nanjing University, Nanjing, China.,Institute of Disability Research, Nanjing Normal University of Special Education, Nanjing, China
| | - Zhongquan Li
- School of Social and Behavior Sciences, Nanjing University, Nanjing, China
| | - Xiaoyuan Wu
- School of Social and Behavior Sciences, Nanjing University, Nanjing, China
| | - Ziyuan Zhang
- Department of Applied Foreign Language Studies, Nanjing University, Nanjing, China
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24
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Yang MJ, Zvolensky MJ, Leyro TM. The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation. Addict Behav 2017; 72:126-132. [PMID: 28395248 PMCID: PMC6532648 DOI: 10.1016/j.addbeh.2017.03.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/25/2017] [Accepted: 03/28/2017] [Indexed: 11/20/2022]
Abstract
Panic disorder (PD) and cigarette smoking are highly comorbid and associated with worse panic and smoking outcomes. Smoking may become an overlearned automatized response to relieve panic-like withdrawal distress, leading to corresponding smoking cognitions, which contribute to its reinforcing properties and difficultly abstaining. Difficulties in emotion regulation (ER) may underlie this relation such that in the absence of adaptive emotion regulatory strategies, smokers with PD may more readily rely upon smoking to manage affective distress. In the current study, the indirect relation between PD status and smoking cognitions through ER difficulties was examined among daily smokers (N=74). We found evidence for an indirect relation between PD status and negative affect, addictive and habitual smoking motives, and anticipating smoking will result in negative reinforcement and personal harm, through self-reported difficulties with ER. Our findings are aligned with theoretical models on anxiety and smoking, and suggest that reports of greater smoking cognitions may be due to ER difficulties.
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Affiliation(s)
- Min-Jeong Yang
- Rutgers, The State University of New Jersey, Department of Psychology, Tillett Hall, 53 Avenue E., Piscataway, NJ 08854, USA
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, 126 Fred J. Heyne Building, Suite 104, Houston, TX 77204, USA; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, 1155 Pressler Street, Houston, TX 77030, USA
| | - Teresa M Leyro
- Rutgers, The State University of New Jersey, Department of Psychology, Tillett Hall, 53 Avenue E., Piscataway, NJ 08854, USA.
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25
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Emotion regulation difficulties and moral judgment in different domains: The mediation of emotional valence and arousal. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.12.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Vasey MW, Chriki L, Toh GY. Cognitive Control and Anxious Arousal in Worry and Generalized Anxiety: An Initial Test of an Integrative Model. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9809-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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27
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Koerner N, Mejia T, Kusec A. What's in a name? Intolerance of uncertainty, other uncertainty-relevant constructs, and their differential relations to worry and generalized anxiety disorder. Cogn Behav Ther 2016; 46:141-161. [PMID: 27684470 DOI: 10.1080/16506073.2016.1211172] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A number of studies have examined the association of intolerance of uncertainty (IU) to trait worry and generalized anxiety disorder (GAD). However, few studies have examined the extent of overlap between IU and other psychological constructs that bear conceptual resemblance to IU, despite the fact that IU-type constructs have been discussed and examined extensively within psychology and other disciplines. The present study investigated (1) the associations of IU, trait worry, and GAD status to a negative risk orientation, trait curiosity, indecisiveness, perceived constraints, self-oriented and socially prescribed perfectionism, intolerance of ambiguity, the need for predictability, and the need for order and structure and (2) whether IU is a unique correlate of trait worry and of the presence versus absence of Probable GAD, when overlap with other uncertainty-relevant constructs is accounted for. N = 255 adults completed self-report measures of the aforementioned constructs. Each of the constructs was significantly associated with IU. Only IU, and a subset of the other uncertainty-relevant constructs were correlated with trait worry or distinguished the Probable GAD group from the Non-GAD group. IU was the strongest unique correlate of trait worry and of the presence versus absence of Probable GAD. Indecisiveness, self-oriented perfectionism and the need for predictability were also unique correlates of trait worry or GAD status. Implications of the findings are discussed, in particular as they pertain to the definition, conceptualization, and cognitive-behavioral treatment of IU in GAD.
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Affiliation(s)
- Naomi Koerner
- a Department of Psychology , Ryerson University , Toronto , M5B 2K3 , Canada
| | - Teresa Mejia
- a Department of Psychology , Ryerson University , Toronto , M5B 2K3 , Canada
| | - Andrea Kusec
- a Department of Psychology , Ryerson University , Toronto , M5B 2K3 , Canada
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28
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Bardeen JR, Fergus TA, Hannan SM, Orcutt HK. Addressing Psychometric Limitations of the Difficulties in Emotion Regulation Scale Through Item Modification. J Pers Assess 2015; 98:298-309. [DOI: 10.1080/00223891.2015.1091774] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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29
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Bjureberg J, Ljótsson B, Tull MT, Hedman E, Sahlin H, Lundh LG, Bjärehed J, DiLillo D, Messman-Moore T, Gumpert CH, Gratz KL. Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015; 38:284-296. [PMID: 27239096 DOI: 10.1007/s10862-015-9514-x] [Citation(s) in RCA: 344] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Difficulties in Emotion Regulation Scale (DERS) is a widely-used, theoretically-driven, and psychometrically-sound self-report measure of emotion regulation difficulties. However, at 36-items, the DERS may be challenging to administer in some situations or settings (e.g., in the course of patient care or large-scale epidemiological studies). Consequently, there is a need a briefer version of the DERS. The goal of the present studies was to develop and evaluate a 16-item version of the DERS - the DERS-16. The reliability and validity of the DERS-16 were examined in a clinical sample (N = 96) and two large community samples (Ns = 102 and 482). The validity of the DERS-16 was evaluated comparing the relative strength of the association of the two versions of the DERS with measures of emotion regulation and related constructs, psychopathology, and clinically-relevant behaviors theorized to stem from emotion regulation deficits. Results demonstrate that the DERS-16 has retained excellent internal consistency, good test-retest reliability, and good convergent and discriminant validity. Further, the DERS-16 showed minimal differences in its convergent and discriminant validity with relevant measures when compared to the original DERS. In conclusion, the DERS-16 offers a valid and brief method for the assessment of overall emotion regulation difficulties.
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Affiliation(s)
- Johan Bjureberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Matthew T Tull
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Erik Hedman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Sahlin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | | | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | | | - Kim L Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
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30
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Abraham A, Hermann C. Biases in probabilistic category learning in relation to social anxiety. Front Psychol 2015; 6:1218. [PMID: 26347685 PMCID: PMC4538570 DOI: 10.3389/fpsyg.2015.01218] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 08/03/2015] [Indexed: 12/22/2022] Open
Abstract
Instrumental learning paradigms are rarely employed to investigate the mechanisms underlying acquired fear responses in social anxiety. Here, we adapted a probabilistic category learning paradigm to assess information processing biases as a function of the degree of social anxiety traits in a sample of healthy individuals without a diagnosis of social phobia. Participants were presented with three pairs of neutral faces with differing probabilistic accuracy contingencies (A/B: 80/20, C/D: 70/30, E/F: 60/40). Upon making their choice, negative and positive feedback was conveyed using angry and happy faces, respectively. The highly socially anxious group showed a strong tendency to be more accurate at learning the probability contingency associated with the most ambiguous stimulus pair (E/F: 60/40). Moreover, when pairing the most positively reinforced stimulus or the most negatively reinforced stimulus with all the other stimuli in a test phase, the highly socially anxious group avoided the most negatively reinforced stimulus significantly more than the control group. The results are discussed with reference to avoidance learning and hypersensitivity to negative socially evaluative information associated with social anxiety.
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Affiliation(s)
- Anna Abraham
- School of Social, Psychological and Communication Sciences, Leeds Beckett University, Leeds UK ; Department of Clinical Psychology, Justus Liebig University of Giessen, Giessen Germany
| | - Christiane Hermann
- Department of Clinical Psychology, Justus Liebig University of Giessen, Giessen Germany
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31
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Masoudzadeh A, Bonab NM, Abbasi Z. Spouses of male psychiatric patients are more prone to intimate partner violence. Asian J Psychiatr 2015; 15:2-4. [PMID: 25998094 DOI: 10.1016/j.ajp.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/09/2015] [Accepted: 04/01/2015] [Indexed: 11/17/2022]
Abstract
Intimate partner violence (IPV) is a great public health concern. Most studies have evaluated different risk factors of IPV in general population, but few have evaluated the perpetration of IPV by subjects with psychological disease. We evaluated the prevalence of IPV among spouses of men with psychiatric disease. In this descriptive study, we questioned 119 women whose husbands were in-patient or out-patients of psychology clinic. A validated questionnaire was used for evaluation IPV and its different subtypes. All women reported to encounter some kind of IPV in some periods. Women reported emotional abuse in 100%, physical abuse in 99.2% and sexual abuse in 81.5%. None of the patients were eager to tell anyone about being victim of IPV due to religious beliefs, society culture and believing in their marital status and trying to keep their marriage. IPV is higher among families with men having psychological disease. Policy makers and clinicians should predominantly target these families. Also, empowering women may reduce the risk of intimate partner violence.
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Affiliation(s)
- Abbas Masoudzadeh
- Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nafiseh Moghaddasi Bonab
- Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran; Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeynab Abbasi
- Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Allan NP, Norr AM, Macatee RJ, Gajewska A, Schmidt NB. Interactive Effects of Anxiety Sensitivity and Emotion Regulation on Anxiety Symptoms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015. [DOI: 10.1007/s10862-015-9484-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Diffusivity of the uncinate fasciculus in heroin users relates to their levels of anxiety. Transl Psychiatry 2015; 5:e554. [PMID: 25918991 PMCID: PMC4462611 DOI: 10.1038/tp.2015.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/11/2015] [Accepted: 03/01/2015] [Indexed: 01/19/2023] Open
Abstract
Heroin use is closely associated with emotional dysregulation, which may explain its high comorbidity with disorders such as anxiety and depression. However, the understanding of the neurobiological etiology of the association between heroin use and emotional dysregulation is limited. Previous studies have suggested an impact of heroin on diffusivity in white matter involving the emotional regulatory system, but the specificity of this finding remains to be determined. Therefore, this study investigated the association between heroin use and diffusivity of white matter tracts in heroin users and examined whether the tracts were associated with their elevated anxiety and depression levels. A sample of 26 right-handed male abstinent heroin users (25 to 42 years of age) and 32 matched healthy controls (19 to 55 years of age) was recruited for this study. Diffusion tensor imaging data were collected, and their levels of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Our findings indicated that heroin users exhibited higher levels of anxiety and depression, but the heroin use-associated left uncinate fasciculus was only related to their anxiety level, suggesting that association between heroin and anxiety has an incremental organic basis but that for depression could be a threshold issue. This finding improves our understanding of heroin addiction and its comorbid affective disorder and facilitates future therapeutic development.
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Coelho CM, Balaban CD. Visuo-vestibular contributions to anxiety and fear. Neurosci Biobehav Rev 2014; 48:148-59. [PMID: 25451199 DOI: 10.1016/j.neubiorev.2014.10.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/25/2014] [Accepted: 10/28/2014] [Indexed: 12/30/2022]
Abstract
The interactive roles of the visual and vestibular systems allow for postural control within boundaries of perceived safety. In specific circumstances, visual vestibular and postural interactions act as a cue that trigger fear, similarly to what occurs in motion sickness. Unusual patterns of visuo-vestibular interaction that emerge without warning can elicit fear, which can then become associated to a certain stimuli or situation, creating a CS-US association, (i.e., phobia), or can emerge without warning but also without becoming associated to a particular concomitant event (i.e., panic). Depending on the individual sensitivity to visuo-vestibular unusual patterns and its impact in postural control, individuals will be more or less vulnerable to develop these disorders. As such, the mechanism we here propose is also sufficient to explain the lack of certain fears albeit exposure. Following this rationale, a new subcategory of anxiety disorders, named visuo-vestibular fears can be considered. This model brings important implications for developmental and evolutionary psychological science, and invites to place visuo-vestibular fears in a particular subtype or specification within the DSM-5 diagnostic criteria.
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Affiliation(s)
- Carlos M Coelho
- University of Minho, School of Engineering, Centro Algoritmi, Guimarães, Portugal; University of Queensland, Queensland Brain Institute, Brisbane, Australia.
| | - Carey D Balaban
- University of Pittsburgh, School of Med, Department of Otolaryngology, Eye & Ear Inst., Pittsburgh, PA, USA; University of Pittsburgh, Department of Neurobiology, Pittsburgh, PA, USA; University of Pittsburgh, Department of Communication Sciences & Disorders, Pittsburgh, PA, USA; University of Pittsburgh, Department of Bioengineering, Pittsburgh, PA, USA
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Goodman JH, Guarino A, Chenausky K, Klein L, Prager J, Petersen R, Forget A, Freeman M. CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Arch Womens Ment Health 2014; 17:373-87. [PMID: 24449191 PMCID: PMC4107206 DOI: 10.1007/s00737-013-0402-7] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 12/26/2013] [Indexed: 01/06/2023]
Abstract
Many women experience anxiety during pregnancy with potential negative effects on maternal, birth, and child outcomes. Because of potential risks of fetal exposure to psychotropic medications, efficacious non-pharmacologic approaches are urgently needed. However, no published studies of psychotherapeutic treatments for anxiety in pregnancy exist. Mindfulness-based cognitive therapy (MBCT) may substantially reduce anxiety and co-morbid symptoms in people with anxiety disorders. Coping with Anxiety through Living Mindfully (CALM) Pregnancy is an adaptation of MBCT designed to address anxiety in pregnant women. This study examined the feasibility, acceptability, and clinical outcomes of the CALM Pregnancy intervention in pregnant women anxiety. Twenty-four pregnant women with generalized anxiety disorder (GAD) or prominent symptoms of generalized anxiety participated in an open treatment trial of the CALM Pregnancy group intervention. Psychiatric diagnoses were determined by structured clinical interview, and self-report measures of anxiety, worry, depression, self-compassion, and mindfulness were completed at baseline and post-intervention. Qualitative feedback was elicited via questionnaire. Twenty-three participants completed the intervention with high attendance and good compliance with home practice. Completers showed statistically and clinically significant improvements in anxiety, worry, and depression, and significant increases in self-compassion and mindfulness. Of the 17 participants who met GAD criteria at baseline, only one continued to meet criteria post-intervention. Participants regarded their experience in the intervention to be overwhelmingly positive. MBCT in the form of the CALM Pregnancy intervention holds potential to provide effective, non-pharmacological treatment for pregnant women with anxiety. These promising findings warrant further testing of the intervention with a randomized controlled trial.
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Affiliation(s)
- Janice H Goodman
- MGH Institute of Health Professions, School of Nursing, 36 1st Ave, Boston, MA, 02129, USA,
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Heber E, Lehr D, Riper H, Berking M. Emotionsregulation: Überblick und kritische Reflexion des aktuellen Forschungsstandes. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2014. [DOI: 10.1026/1616-3443/a000265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Die Forschung zum Thema Emotionsregulation erfreut sich auch im Bereich der Klinischen Psychologie einer zunehmenden Beliebtheit. Allerdings stellt sich die Frage, inwieweit die Popularität des Konstrukts im Einklang mit dessen Validität und tatsächlicher heuristischer Fruchtbarkeit steht. Vor diesem Hintergrund ist es Ziel der vorliegenden Arbeit, einen aktuellen Überblick über Konzeptualisierungen, Erfassungsmethoden, Befunde zum Zusammenhang mit psychischen Störungen sowie Möglichkeiten der therapeutischen Nutzung des Konzeptes Emotionsregulation zu geben. Aufbauend auf einer kritischen Reflexion bisheriger Konzepte, Vorgehensweisen und Befunde werden Vorschläge gemacht, wie die Validität und die heuristische Fruchtbarkeit des Emotionsregulationsparadigmas weiter gefördert werden können.
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Affiliation(s)
| | | | - Heleen Riper
- Leuphana Universität Lüneburg
- Freie Universität Amsterdam
| | - Matthias Berking
- Leuphana Universität Lüneburg
- Friedrich-Alexander-Universität Erlangen-Nürnberg
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Bardeen JR, Fergus TA. An examination of the incremental contribution of emotion regulation difficulties to health anxiety beyond specific emotion regulation strategies. J Anxiety Disord 2014; 28:394-401. [PMID: 24726241 DOI: 10.1016/j.janxdis.2014.03.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 11/26/2022]
Abstract
Given the potential transdiagnostic importance of emotion dysregulation, as well as a lack of research examining emotion dysregulation in relation to health anxiety, the present study sought to examine associations among specific emotion regulation strategies (cognitive reappraisal and expressive suppression), emotion regulation difficulties, and health anxiety in a physically healthy sample of adults (N=482). As hypothesized, results of a series of hierarchical multiple regression analyses showed that emotion regulation difficulties provided a significant incremental contribution, beyond the specific emotion regulation strategies, in predicting each of the three health anxiety variables. Among the six dimensions of emotion regulation difficulties, the dimension representing perceived access to effective emotion regulation strategies was the only emotion regulation difficulty dimension that predicted all three health anxiety variables beyond the effects of the specific emotion regulation strategies. Results indicate that emotion regulation difficulties, and particularly one's subjective appraisal of his/her ability to effectively regulate emotions, may be of importance to health anxiety. Clinical implications are discussed.
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Affiliation(s)
- Joseph R Bardeen
- University of Mississippi Medical Center, Jackson, MS, United States.
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38
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A preliminary investigation of sex differences in associations between emotion regulation difficulties and higher-order cognitive abilities. PERSONALITY AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.paid.2013.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Hölzel BK, Hoge EA, Greve DN, Gard T, Creswell JD, Brown KW, Barrett LF, Schwartz C, Vaitl D, Lazar SW. Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training. NEUROIMAGE-CLINICAL 2013; 2:448-58. [PMID: 24179799 PMCID: PMC3777795 DOI: 10.1016/j.nicl.2013.03.011] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 03/13/2013] [Accepted: 03/17/2013] [Indexed: 12/14/2022]
Abstract
Mindfulness training aims to impact emotion regulation. Generalized anxiety disorder (GAD) symptoms can be successfully addressed through mindfulness-based interventions. This preliminary study is the first to investigate neural mechanisms of symptom improvements in GAD following mindfulness training. Furthermore, we compared brain activation between GAD patients and healthy participants at baseline. 26 patients with a current DSM-IV GAD diagnosis were randomized to an 8-week Mindfulness Based Stress Reduction (MBSR, N = 15) or a stress management education (SME, N = 11) active control program. 26 healthy participants were included for baseline comparisons. BOLD response was assessed with fMRI during affect labeling of angry and neutral facial expressions. At baseline, GAD patients showed higher amygdala activation than healthy participants in response to neutral, but not angry faces, suggesting that ambiguous stimuli reveal stronger reactivity in GAD patients. In patients, amygdala activation in response to neutral faces decreased following both interventions. BOLD response in ventrolateral prefrontal regions (VLPFC) showed greater increase in MBSR than SME participants. Functional connectivity between amygdala and PFC regions increased significantly pre- to post-intervention within the MBSR, but not SME group. Both, change in VLPFC activation and amygdala–prefrontal connectivity were correlated with change in Beck Anxiety Inventory (BAI) scores, suggesting clinical relevance of these changes. Amygdala–prefrontal connectivity turned from negative coupling (typically seen in down-regulation of emotions), to positive coupling; potentially suggesting a unique mechanism of mindfulness. Findings suggest that in GAD, mindfulness training leads to changes in fronto-limbic areas crucial for the regulation of emotion; these changes correspond with reported symptom improvements. GAD patients show higher amygdala activation to neutral faces than healthy subjects. In GAD patients, amygdala activation decreased after stress reduction interventions. Ventrolateral PFC activation during affect labeling increases following mindfulness. Amygdala–PFC functional connectivity increases following mindfulness. These changes following mindfulness correlate with improvements in anxiety symptoms.
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Affiliation(s)
- Britta K Hölzel
- Massachusetts General Hospital, 120 2nd Ave., Charlestown, MA, 02129, USA ; Bender Institute of Neuroimaging, Justus-Liebig University, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany
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40
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Marganska A, Gallagher M, Miranda R. Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2013; 83:131-141. [PMID: 23330631 DOI: 10.1111/ajop.12001] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Differences in attachment style have been linked to both emotion regulation and psychological functioning, but the emotion regulatory mechanism through which attachment style might impact symptoms of depression and anxiety is unclear. The present study examined the explanatory role of emotion dysregulation in the relation between adult attachment style and symptoms of depression and generalized anxiety disorder (GAD) in a sample of 284 adults. Secure attachment was associated with lower depression and GAD symptoms and lower emotion dysregulation, whereas insecure attachment styles were generally associated with higher depression and GAD scores and higher emotion dysregulation. Perceived inability to generate effective emotion regulation strategies mediated the relation between insecure attachment and both depression and GAD symptoms. Nonacceptance of negative emotions and inability to control impulsive behaviors emerged as additional mediators of the relation between insecure attachment styles and GAD symptoms. The differential contribution of attachment style and emotion regulation to the prediction of depression and GAD symptoms may reflect differences in vulnerability to depression and GAD.
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Affiliation(s)
- Anna Marganska
- Hunter College, City University of New York, NY 10065, USA
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41
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Distress Tolerance, Emotion Dysregulation, and Anxiety and Depressive Symptoms Among HIV+ Individuals. COGNITIVE THERAPY AND RESEARCH 2012. [DOI: 10.1007/s10608-012-9497-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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42
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Brandt CP, Gonzalez A, Grover KW, Zvolensky MJ. The Relation Between Emotional Dysregulation and Anxiety and Depressive Symptoms, Pain-Related Anxiety, and HIV-Symptom Distress Among Adults with HIV/AIDS. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9329-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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43
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Shorey RC, Febres J, Brasfield H, Stuart GL. The Prevalence of Mental Health Problems in Men Arrested for Domestic Violence. JOURNAL OF FAMILY VIOLENCE 2012; 27:741-748. [PMID: 23284227 PMCID: PMC3532855 DOI: 10.1007/s10896-012-9463-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The problem of male perpetrated intimate partner violence (IPV) is widespread. In an effort to identify risk factors for perpetrating IPV, researchers have examined mental health problems among perpetrators. However, the majority of research in this area has examined personality psychopathology and/or limited their investigation to posttraumatic stress disorder (PTSD) or depression. Thus, the present study examined self-reported Axis I psychopathology among men arrested for domestic violence (N = 308). Results replicated past research showing high rates of PTSD and depression. In addition, the prevalence of generalized anxiety disorder (GAD), panic disorder, social phobia, and alcohol and drug disorders were very high. All types of mental health problems were positively associated with aggression perpetration. Males meeting probable diagnostic classification reported significantly more frequent aggression than males not meeting diagnostic classification, even after controlling for social desirability. Directions for future research and implications of these findings are discussed.
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Affiliation(s)
- Ryan C Shorey
- Department of Psychology, University of Tennessee - Knoxville; Department of Psychology, University of Tennessee - Knoxville; Department of Psychology, University of Tennessee - Knoxville; Department of Psychology, University of Tennessee - Knoxville
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Maack DJ, Tull MT, Gratz KL. Examining the incremental contribution of behavioral inhibition to generalized anxiety disorder relative to other Axis I disorders and cognitive-emotional vulnerabilities. J Anxiety Disord 2012; 26:689-95. [PMID: 22750475 DOI: 10.1016/j.janxdis.2012.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 03/23/2012] [Accepted: 05/21/2012] [Indexed: 10/28/2022]
Abstract
The goal of the present study was to investigate the incremental contribution of behavioral inhibition system (BIS) sensitivity to the presence of a current generalized anxiety disorder (GAD) diagnosis relative to other Axis I disorders (e.g., major depression, other anxiety disorders) and cognitive-emotional vulnerabilities (e.g., anxiety sensitivity, emotion dysregulation) previously found to be associated with GAD. Participants were 91 individuals recruited from the local community who completed a diagnostic interview and self-report questionnaires. Consistent with expectations, BIS sensitivity emerged as a significant predictor of current GAD status above and beyond major depression, anxiety disorder diagnoses, anxiety sensitivity, emotion dysregulation, and behavioral activation system sensitivity. However, emotion dysregulation also emerged as a significant predictor of GAD status in the final model. Findings speak to the importance of considering BIS sensitivity in models of the development and maintenance of GAD.
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Affiliation(s)
- Danielle J Maack
- Department of Psychology, University of Mississippi, 205 Peabody Building, University, MS 38677, United States.
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45
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Viana AG, Gratz KL. The role of anxiety sensitivity, behavioral inhibition, and cognitive biases in anxiety symptoms: structural equation modeling of direct and indirect pathways. J Clin Psychol 2012; 68:1122-41. [PMID: 22777955 DOI: 10.1002/jclp.21890] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE(S) Limited research has examined how temperamental (i.e., behavioral inhibition, anxiety sensitivity) and cognitive (i.e., interpretive and judgment biases) risks for the development anxiety covary to influence anxiety symptoms. Thus, the present study aimed to advance understanding of the direct and indirect links between anxiety sensitivity, behavioral inhibition, and interpretive biases, and judgment biases (in the form of perceived control) to anxiety outcomes (i.e., worry and trait anxiety symptoms). METHOD 842 emerging adults (mean = 18.75 years, standard deviation = 1.05; age range = 18-24; 70% women) recruited from a university in the northeast participated in this study. Participants completed a battery of self-report measures assessing risk factors and anxiety outcomes of interest. RESULTS Structural equation modeling revealed anxiety sensitivity and behavioral inhibition were directly linked with anxiety outcomes. Anxiety sensitivity and behavioral inhibition were also indirectly linked with anxiety outcomes through interpretive and judgment biases. The hypothesized model was partially invariant across high-risk and low-risk groups for anxiety disorders. CONCLUSIONS Results of this study provide preliminary support for theoretical models hypothesizing a developmental progression from temperamental to cognitive risks and culminating in the expression of anxiety symptoms. Limitations and clinical implications of this research are discussed.
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Affiliation(s)
- Andres G Viana
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Abstract
A growing body of research suggests that the construct of emotion regulation is important for understanding the onset, maintenance, and treatment of anxiety disorders. In this review, we provide a selective overview of this emerging field and highlight the major sources of evidence. First, evidence suggests that the construct of emotion regulation can be differentiated from the construct of emotion. Second, there is a large and consistent body of research demonstrating that emotion regulation strategies can modulate emotional responding, and this finding is observed in both behavioral and neuroimaging studies. Third, measures of emotion regulation explain incremental variance in measures of anxiety disorder symptoms not accounted for by measures of negative affect. Although the research implicating emotion regulation in the anxiety disorders is promising, future research will be necessary to further clarify causal mechanisms explaining how emotion regulation confers vulnerability for anxiety disorders and to improve the clarity and consistency of definitions of emotion regulation.
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47
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Sarıtaş D, Gençöz T. Discrepancies between Turkish Mothers’ and Adolescents’ Reports of Adolescents’ Emotion Regulation Difficulties. J Clin Psychol 2012; 68:661-71. [DOI: 10.1002/jclp.21849] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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48
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Staples AM, Mohlman J. Psychometric properties of the GAD-Q-IV and DERS in older, community-dwelling GAD patients and controls. J Anxiety Disord 2012; 26:385-92. [PMID: 22306131 DOI: 10.1016/j.janxdis.2012.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 09/22/2011] [Accepted: 01/09/2012] [Indexed: 11/16/2022]
Abstract
Thirty-seven community-dwelling, older generalized anxiety disorder (GAD) patients and 37 nonanxious controls completed the Generalized Anxiety Disorder Questionnaire for DSM-IV (GAD-Q-IV; Newman et al., 2002), the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), and other measures of anxiety and depression. The GAD-Q-IV and DERS were assessed for internal consistency reliability, construct validity, and test-retest reliability, with results indicating good psychometric performance. Receiver operating characteristic (ROC) analysis conducted on the full sample suggested that the optimal GAD-Q-IV cutoff for classifying GAD cases was 3.71, with .97 sensitivity and .92 specificity. The cutoff score for classifying those participants with GAD and comorbid conditions was higher, however. ROC analysis with the full sample revealed an optimal DERS cutoff score of 62.5, with .76 sensitivity and .86 specificity. Findings support the use of the GAD-Q-IV and DERS as screening instruments for GAD in older, community-dwelling adults in a research setting.
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Affiliation(s)
- Alison M Staples
- Department of Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA.
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An Examination of the Latent Structure of the Difficulties in Emotion Regulation Scale. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9280-y] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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50
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Abstract
PURPOSE OF REVIEW In recent years, deficits in emotion regulation have been studied as a putative maintaining factor and promising treatment target in a broad range of mental disorders. This article aims to provide an integrative review of the latest theoretical and empirical developments in this rapidly growing field of research. RECENT FINDINGS Deficits in emotion regulation appear to be relevant to the development, maintenance, and treatment of various forms of psychopathology. Increasing evidence demonstrates that deficits in the ability to adaptively cope with challenging emotions are related to depression, borderline personality disorder, substance-use disorders, eating disorders, somatoform disorders, and a variety of other psychopathological symptoms. Unfortunately, studies differ with regard to the conceptualization and assessment of emotion regulation, thus limiting the ability to compare findings across studies. Future research should systematically work to use comparable methods in order to clarify the following: which individuals have; what kinds of emotion regulation difficulties with; which types of emotions; and what interventions are most effective in alleviating these difficulties. SUMMARY Despite some yet to be resolved challenges, the concept of emotion regulation has a broad and significant heuristic value for research in mental health.
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