The process of emotion identification: Considerations for psychiatric disorders

The Role of Mindfulness Therapy in the Treatment of Chronic Pain

PURPOSE OF REVIEW

Mindfulness therapy is a widely used treatment for many diseases and has been shown to improve pain-related functions. There is growing support for the use of psychotherapy in the treatment of chronic pain. While studies have shown a positive effect of mindfulness therapy, it is important to consider psychosocial factors as there are still a small number of studies that question its effectiveness.

RECENT FINDINGS

Based on current studies, mindfulness therapy involves cognitive factors related to chronic pain, both in terms of cognitive production and its impact on cognitive control. Psychological and neurobasic studies were reviewed to provide a deeper understanding of these components, which include thought inhibition, attention deficit, pain catastrophizing, and self-efficacy. Mindfulness therapy has the potential to normalize psychology and nerves, and increase internal and external connectivity to work networks related to stress perception, cognition, and emotion. However, further research is needed to fully understand its effects. By exploring the relationship between mindfulness therapy and chronic pain. This review provides a new avenue for future research in psychotherapy for patients with chronic pain.

Cluster analysis of patients with alcohol use disorder featuring alexithymia, depression, and diverse drinking behavior

AIM

This study aimed to identify subgroups of alcohol use disorder (AUD) based on a multidimensional combination of alexithymia, depression, and diverse drinking behavior.

METHOD

We recruited 176 patients with AUD, which were initially divided into non-alexithymic (n = 130) and alexithymic (n = 46) groups using a cutoff score of 61 on the Toronto Alexithymia Scale (TAS-20). Subsequently, the profiles of the two groups were compared. Thereafter, a two-stage cluster analysis using hierarchical and K-means methods was performed with the Z-scores from the TAS-20, the Quick Inventory of Depressive Symptomatology Self-Report Japanese Version, the 12-item questionnaire for quantitative assessment of depressive mixed state, and the 20-item questionnaire for drinking behavior pattern.

RESULTS

In the first analysis, Alexithymic patients with AUD showed greater depressive symptoms and more pathological drinking behavior patterns than those without alexithymia. Cluster analysis featuring alexithymia, depression, and drinking behavior identified three subtypes: Cluster 1 (core AUD type) manifesting pathological drinking behavior highlighting automaticity; Cluster 2 (late-onset type) showing relatively late-onset alcohol use and fewer depressive symptoms or pathological drinking behavior; and Cluster 3 (alexithymic type) characterized by alexithymia, depression, and pathological drinking behavior featuring greater coping with negative affect.

CONCLUSION

The multidimensional model with alexithymia, depression, and diverse drinking behavior provided possible practical classification of AUD. The alexithymic subtype may require more caution, and additional support for negative affect may be necessary due to accompanying mood problems and various maladaptive drinking behaviors.

Abbreviated Dialectical Behavior Therapy Virtual Skills Group for Caregivers of Adolescents: An Exploratory Study of Service User and Clinical Outcomes

Prior work emphasizes involving caregivers in youth mental health services. To support youth with emotion dysregulation, dialectical behavior therapy for adolescents (DBT-A) includes a multi-family skills group, wherein adolescents and caregivers learn skills together. However, limited work has examined the impact of caregiver involvement within DBT-A. The current study examines outcomes of two caregiver-only DBT-A skills groups adapted for abbreviated telehealth delivery. We report on caregivers' (N = 11, 100% mothers, 55% Hispanic) service user outcomes (e.g. self-efficacy at skill usage, group cohesion, therapeutic alliance) and clinical outcomes (i.e. their own emotion functioning, criticism, responses to their adolescent's negative emotions). Results indicate caregiver-only groups were feasible and acceptable, and suggest preliminary efficacy, including improvements in caregiver emotion functioning, distress during interactions with their adolescents, and adolescent-reported criticism. Caregivers also reported reductions in unsupportive responses with their adolescents. Overall, while we caution interpretation due to a small sample size, findings support the preliminary feasibility and efficacy of modifying caregiver participation in DBT-A to be less time-consuming and administered via telehealth.

The relationship between emotional disorders and heart rate variability: A Mendelian randomization study

OBJECTIVE

Previous studies have shown that emotional disorders are negatively associated with heart rate variability (HRV), but the potential causal relationship between genetic susceptibility to emotional disorders and HRV remains unclear. We aimed to perform a Mendelian randomization (MR) study to investigate the potential association between emotional disorders and HRV.

METHODS

The data used for this study were obtained from publicly available genome-wide association study datasets. Five models, including the inverse variance weighted model (IVW), the weighted median estimation model (WME), the weighted model-based method (WM), the simple model (SM) and the MR-Egger regression model (MER), were utilized for MR. The leave-one-out sensitivity test, MR pleiotropy residual sum and outlier test (MR-PRESSO) and Cochran's Q test were used to confirm heterogeneity and pleiotropy.

RESULTS

MR analysis revealed that genetic susceptibility to broad depression was negatively correlated with HRV (pvRSA/HF) (OR = 0.380, 95% CI 0.146-0.992; p = 0.048). However, genetic susceptibility to irritability was positively correlated with HRV (pvRSA/HF, SDNN) (OR = 2.017, 95% CI 1.152-3.534, p = 0.008) (OR = 1.154, 95% CI 1.000-1.331, p = 0.044). Genetic susceptibility to anxiety was positively correlated with HRV (RMSSD) (OR = 2.106, 95% CI 1.032-4.299; p = 0.041). No significant directional pleiotropy or heterogeneity was detected. The accuracy and robustness of these findings were confirmed through a sensitivity analysis.

CONCLUSIONS

Our MR study provides genetic support for the causal effects of broad depression, irritable mood, and anxiety on HRV.

Subscales of alexithymia show unique pathways through reappraisal and suppression to anxiety, depression and stress

The goal of this work was to explore associations of constituent factors of alexithymia on mental health and potential mediating effects of emotion regulation strategies, specifically suppression and reappraisal. Data were collected through the crowd-sourcing platform Amazon Mechanical Turk (MTURK). Three hundred seventy-seven individuals completed questionnaires related to distress (Depression Anxiety Stress Scales [DASS]), emotion regulation (Emotion Regulation Questionnaire [ERQ]) and Alexithymia (Bermond-Vorst Alexithymia Questionnaire [BVAQ]). Three mediation models were constructed for depression, anxiety and stress, with BVAQ subscales (verbalizing, identifying, emotionalizing, fantasizing, and analyzing) as predictors and ERQ subscales (suppression and reappraisal) as mediators. Results indicated 37.3 % variance in depression, 25.2 % variance in anxiety, and 35.3 % variance in stress was explained by each model. Direct associations revealed emotionalizing and fantasizing were negatively associated with depression, anxiety, and stress, while verbalizing was additionally associated with depression, identifying was additionally associated with anxiety, and all four BVAQ subscales were associated with stress. BVAQ subscales demonstrated negative associations with reappraisal and positive associations with suppression that mediated anxiety and depression. However, suppression did not mediate relationships between BVAQ subscales with stress. Findings support the importance of examining multiple factors of alexithymia and associations with emotion regulation strategies and distress.

Psychometric properties of the Persian version of the cognitive emotion regulation questionnaire-short (CERQ-P-short): Reliability, validity, factor structure, treatment sensitivity, and measurement invariance

AIMS

This study aimed to examine the psychometric properties of a widely-used measure of emotion regulation, the short version of the Cognitive Emotion Regulation Questionnaire (CERQ-short), in the Persian language (CERQ-P-short) among Iranian populations.

METHODS

The CERQ-P-short was administered to 1825 participants (female = 974) including 436 adolescents, 834 adults from the general population, 45 patients each with generalized anxiety and obsessive-compulsive disorders, an additional 30 patients each with generalized anxiety and obsessive-compulsive disorders receiving treatment, 45 patients with substance use disorders (SUDs) and an additional 360 adult psychiatric patients. We tested reliability, factor structure, measurement invariance, convergent and discriminant validity, and treatment sensitivity (i.e., intervention response) by age, sex, and diagnostic group. The Depression Anxiety Stress Scale-21 was also administered.

RESULTS

Cronbach's alpha coefficient and test-retest coefficients suggested good reliability. Fit indices suggested that the 9-factor CERQ-P-Short model was good across groups. The CERQ-P-Short showed good measurement invariance in all four models (configural, metric, scalar, and strict) in all groups. Both adaptive and maladaptive cognitive emotion-regulation strategies demonstrated convergent and discriminant validity. Finally, treatment sensitivity of the CERQ-P-Short scale before and after the completion of treatment sessions was suggested for patients with generalized anxiety and obsessive-compulsive disorders.

CONCLUSIONS

While the present study has some limitations, it represents a significant contribution because it supports CERQ-P-Short scales usefulness, validity, and reliability in the general population and among psychiatric patients. The results of the current study can be beneficial to the both clinicians and researchers.

Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults

Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.

Roles for Alexithymia, Emotion Dysregulation and Personality Features in Gambling Disorder: A Network Analysis

Although there is a growing interest in exploring the specific role of both emotional regulation processes and alexithymia in gambling disorder (GD), evidence remains scarce. In order to delve deeper into the complex interactions between these factors, the present study aimed at exploring a network of the core GD-related features, including GD symptomatology and severity, emotion dysregulation, alexithymia, and personality features. The sample included N = 739 treatment-seeking patients with GD (691 men and 48 women), aged 18-78 years (mean age = 39.2, SD = 13.2). The DSM-5 diagnostic criteria were assessed in, and the South Oaks Gambling Screen, Difficulties in Emotion Regulation Scale (DERS), and Temperament and Character Inventory-Revised were administered to, participants. A network analysis was conducted to reveal inter-relationships between these elements. Three nodes related to emotion dysregulation showed the most critical position in the whole network of the present study: "lack of emotional awareness", "non-acceptance of emotional responses", and "difficulties engaging in goal-directed behaviors". When analyzing emotional dysregulation using the different DERS subscales, two independent clusters were identified. One cluster encompassed alexithymia dimensions ("lack of awareness" and "lack of clarity"), while the other cluster included all other emotion-dysregulation dimensions. Identification of the emotion-dysregulation- and GD-related features with the highest centrality/linkage may be particularly useful for developing valid measurement tools and precise management plans for individuals with GD.

Neural correlates of perceptual switching and their association with empathy and alexithymia in individuals with and without autism spectrum disorder

Individuals with autism spectrum disorder (ASD) often show limited empathy (poor recognition of others' emotions) and high alexithymia (poor recognition of own emotions and external thinking), which can negatively impact their social functioning. Previous experimental studies suggest that alterations in cognitive flexibility play key roles in the development of these characteristics in ASD. However, the underlying neural mechanisms that link cognitive flexibility and empathy/alexithymia are still largely unknown. In this study, we examined the neural correlates of cognitive flexibility via functional magnetic resonance imaging during perceptual task-switching in typical development (TD) adults and adults with ASD. We also investigated associations between regional neural activity and psychometric empathy and alexithymia scores among these populations. In the TD group, stronger activation of the left middle frontal gyrus was associated with better perceptual switching and greater empathic concern. Among individuals with ASD, stronger activation of the left inferior frontal gyrus was associated with better perceptual switching, greater empathy, and lower alexithymia. These findings will contribute to develop a better understanding of social cognition, and could be informative for the development of new ASD therapies.