Seeing the silver lining: cognitive reappraisal ability moderates the relationship between stress and depressive symptoms

Does working memory training improve emotion regulation and reduce internalizing symptoms? A pair of three-level meta-analyses

BACKGROUND

Emotional dysfunction is a core feature of many mental disorders. Working memory training (WM-T) is promising to improve emotion regulation and reduce internalizing symptoms (anxiety and depressive symptoms), but the results are mixed. Therefore, we conducted meta-analyses to clarify these mixed results.

METHODS

We searched Web of Science, PubMed, ScienceDirect, and EBSCO to identify relevant studies and screened the references. The effect size was calculated using Hedges' g. Three-level, random-effects models were run using metafor in R.

RESULTS

The current study included 44 articles, of which 29 were involved with emotion regulation, and 30 were involved with internalizing symptoms. The results showed that WM-T could yield emotional benefits, but the benefits were confined to enhancing explicit emotional regulation capacity and reducing anxiety symptoms. For the meta-analysis regarding the effect of WM-T on emotion regulation, there was no significant moderator. For the meta-analysis regarding the effect of WM-T on internalizing symptoms, the emotional valence of the material and control group were statistically significant moderators.

CONCLUSION

WM-T could yield certain emotional effects, but only to improve explicit emotion regulation capacity and reduce anxiety symptoms. In addition, some measures could enhance the effect, such as targeting specific populations, increasing the number of training sessions (≥15) or duration (>450 minutes), using negative material, and using n-back training tasks.

From Survival to Growth - The Coping Experience of Mothers of Children with Disabilities During a Global Crisis: The Case of COVID-19

This study explored the coping experiences of mothers of children with disabilities during the COVID-19 pandemic in Israel. Semi-structured in-depth interviews were conducted with 14 mothers. The data were thematically analyzed to gain in-depth understanding of their coping experiences. The findings indicated that COVID-related restrictions disrupted the family routine and added a significant burden for the mothers as primary caregivers, and for the family system as a whole. Three distinct types of coping experiences arose from the analysis: surviving the crisis, controlling the crisis, and growing out of the crisis. Three key elements differentiated these three types: the perceptions of the meaning of the pandemic for parental roles and of the response of the education and welfare systems to the children's needs - in routine and during COVID-19; coping with the different pandemic challenges; and the implications of both COVID-19 and the mothers' coping strategies for the functional and emotional status of their children, themselves, and family relations. The results are discussed in light of models of family stress and coping, focusing on the tension between the mothers' caregiving role and maternal roles as warranting particular attention by professionals and policymakers.

Neurobiology and systems biology of stress resilience

Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.

Fluctuations in emotion regulation as a mechanism linking stress and internalizing psychopathology among adolescents: An intensive longitudinal study

Stressful life events (SLEs) are tightly coupled with the emergence of anxiety and depression symptoms among adolescents, but the mechanisms underlying this relationship remain poorly understood. We investigated within-person fluctuations in emotion regulation as a mechanism linking SLEs and internalizing psychopathology in an intensive longitudinal study. We examined how monthly fluctuations in SLEs were related to engagement in three emotion regulation strategies-acceptance, reappraisal, and rumination-and whether these strategies were associated with changes in internalizing symptoms in adolescents followed for one year (N = 30; n = 355 monthly observations). Bayesian hierarchical models revealed that on months when adolescents experienced more SLEs than was typical for them, they also engaged in more rumination, which, in turn, was associated with higher anxiety and depression symptoms and mediated the prospective relationship between SLEs and internalizing symptoms. In contrast, greater use of acceptance and reappraisal selectively moderated the association between stressors and internalizing symptoms, resulting in stronger links between SLEs and symptoms. These results suggest that emotion regulation strategies play different roles in the stress-psychopathology relationship. Understanding how changes in emotion regulation contribute to increases in internalizing symptoms following experiences of stress may provide novel targets for interventions aimed at reducing stress-related psychopathology.

Social good reappraisal as a novel and effective emotion regulation strategy

Society asks individuals, such as front-line medical and emergency personnel or social media moderators, to help others under highly negative emotional circumstances, and those individuals need to regulate their emotions for their own well being. A well-studied form of emotion regulation is reappraisal, the use of cognitive processes used to reinterpret initial emotional responses to negative events. Distancing (pretending that a situation is distant in time or space) is well documented to be an effective form of emotion regulation, but it may not be applicable in social contexts where individuals must engage with distressing events to help others. Here, for the first time, we asked whether a novel reappraisal strategy focused on Social Good-imagining that an aversive event is also an opportunity to prevent harm to others-can be an effective form of reappraisal. In a pre-registered experiment, participants were randomly assigned to Distancing or Social Good conditions as they viewed neutral or highly aversive images and then reported their subjective emotional states with or without reappraisal. Both Distancing and Social Good reappraisals led to significantly less negative affect. Distancing yielded a stronger effect, but importantly, participants reported both Distancing and Social Good as equally easy to employ and both were effective across multiple demographic and personality characteristics, indicating the broad value of both as effective forms of reappraisal. Across both reappraisal conditions, effective reappraisal increased with age and positive affect. These findings indicate that Social Good is an effective reappraisal strategy and raise the possibility that it could be particularly valuable in contexts in which emotionally demanding tasks are completed on behalf of the good for other people.

Brief emotion regulation strategies to reduce alcohol craving: Mediating role of state difficulties in emotion regulation

OBJECTIVE

This study experimentally compared the effects of emotion regulation (ER) strategies on alcohol craving and examined the mediating effect of state difficulties in emotion regulation (S-DER) on the relationship between negative/positive emotion and alcohol craving.

METHOD

417 participants (76.74% women, Mage = 20.76 years) endorsing past-month heavy/binge drinking were randomly assigned to one of four ER conditions (positive reappraisal, distancing, distraction, and acceptance). Participants completed state assessments, including negative/positive emotion, S-DER, and alcohol craving, prior to (T0) and after (T1) engaging in a negative emotion induction task. Subsequently, participants completed an ER strategy task based on their assigned ER strategy condition and completed a third state assessment (T2).

RESULTS

Time had a significant quadratic effect on alcohol craving, such that craving increased from T0 to T1 and decreased from T1 to T2. There was no significant effect of ER strategy condition on craving. Change in S-DER mediated the relationship between the change in negative/positive emotion and the change in craving, with emotional modulation and emotional acceptance facets of S-DER dominating the mediating effect during negative emotion induction and ER strategy induction, respectively.

CONCLUSIONS

Results suggest interventions targeting S-DER's emotional modulation and acceptance facets could reduce acute craving when experiencing undesired emotions.

A Daily Diary Investigation of the Fear of Missing Out and Diminishing Daily Emotional Well-Being: The Moderating Role of Cognitive Reappraisal

With modern societies becoming ever-increasingly interconnected due to technology and media, we have gained unprecedented access and exposure to other people's lives. This has resulted in a greater desire to constantly be socially connected with the activities of others, or the fear of missing out (FoMO). While much of the present available research has established the association between FoMO and diminished emotional well-being, little has been done to identify protective factors that can help one cope with the negative psychological consequences of FoMO. Utilizing data from a 7-day diary study of a large sample of young adults (N = 261), the current study aimed to examine the moderating role of cognitive reappraisal in attenuating diminished emotional well-being associated with FoMO. Multilevel modeling showed that cognitive reappraisal attenuated the day-to-day within-person associations between daily FoMO and indicators of daily emotional well-being such as negative affectivity, anxiety, and depressive symptoms.

From lab to life: Evaluating the reliability and validity of psychophysiological data from wearable devices in laboratory and ambulatory settings

Despite the increasing popularity of ambulatory assessment, the reliability and validity of psychophysiological signals from wearable devices is unproven in daily life settings. We evaluated the reliability and validity of physiological signals (electrocardiogram, ECG; photoplethysmography, PPG; electrodermal activity, EDA) collected from two wearable devices (Movisens EcgMove4 and Empatica E4) in the lab (N = 67) and daily life (N = 20) among adults aged 18-64 with Mindware as the laboratory gold standard. Results revealed that both wearable devices' valid data rates in daily life were lower than in the laboratory (Movisens ECG 82.94 vs. 93.10%, Empatica PPG 8.79 vs. 26.14%, and Empatica EDA 41.16 vs. 42.67%, respectively). The poor valid data rates of Empatica PPG signals in the laboratory could be partially attributed to participants' hand movements (r = - .27, p = .03). In laboratory settings, heart rate (HR) derived from both wearable devices exhibited higher concurrent validity than heart rate variability (HRV) metrics (ICCs 0.98-1.00 vs. 0.75-0.97). The number of skin conductance responses (SCRs) derived from Empatica showed higher concurrent validity than skin conductance level (SCL, ICCs 0.38 vs. 0.09). Movisens EcgMove4 provided more reliable and valid HRV measurements than Empatica E4 in both laboratory (split-half reliability: 0.95-0.99 vs. 0.85-0.98; concurrent validity: 0.95-1.00 vs. 0.75-0.98; valid data rate: 93.10 vs. 26.14%) and ambulatory settings (split-half reliability: 0.99-1.00 vs. 0.89-0.98; valid data rate: 82.94 vs. 8.79%). Although the reliability and validity of wearable devices are improving, findings suggest researchers should select devices that yield consistently robust and valid data for their measures of interest.

The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic

Introduction

As a multidimensional stressor, the COVID-19 pandemic posed a significant threat to mental health, with studies showing younger age groups to be particularly vulnerable. Thus, this study aimed to monitor mental health, potential risk/protective factors, and pandemic-related variables among young university students during the pandemic.

Methods

Students of the University of Greifswald (M age = 23.0 years, 73.9% female) participated in five cross-sectional online surveys in December 2020 (N = 1,127), March 2021 (N = 760), June/July 2021 (N = 531), December 2021 (N = 1,226), and December 2022 (N = 814). Sociodemographic data, depression and anxiety severity, loneliness, quality of life, coping strategies, resilience, self-esteem, and emotion regulation were measured. First, results from December 2020 were compared to pre-pandemic normative data. Second, the time course during the pandemic was analyzed. Third, linear models were calculated to examine the influence of risk and protective factures on depression and anxiety severity.

Results

Higher levels of depression, anxiety, and loneliness, as well as lower levels of self-esteem, physical and mental health, social relationships and well-being were found in December 2020 compared to pre-pandemic. Levels of depression and anxiety severity peaked in December 2022. Female sex, loneliness, and previous mental treatment showed associations with higher depression and anxiety severity, while higher self-esteem, resilience and use of reappraisal strategies appeared to act as protective factors.

Discussion

The study indicates the pandemic's detrimental impact on students' mental health and quality of life. Identified risk and protective factors provide guidance for tailored prevention and treatment, as well as the design of measures for future pandemics and other crisis.

Investigating the role of emotion regulation in the relationship between childhood trauma and alcohol problems in American Indian adults

OBJECTIVE

To investigate whether use of cognitive reappraisal and expressive suppression interact with childhood trauma burden to predict alcohol problems in a sample of American Indian adults.

METHODS

Four hundred and twenty-nine American Indian adults (Mean age = 37.62, 59.5 % male) completed an online survey to measure childhood trauma exposure, perceived impact of childhood trauma, trait use of expressive suppression, and alcohol problems in adulthood.

RESULTS

Trait use of cognitive reappraisal and expressive suppression interacted with childhood trauma burden to predict alcohol problems in adulthood. American Indian adults who reported high levels of childhood trauma burden who also reported frequent use of both cognitive reappraisal and expressive suppression had significantly more alcohol problems compared to individuals who reported similarly high levels of childhood trauma burden who reported low use of these emotion regulation strategies.

CONCLUSIONS

These findings provide initial evidence that emotion regulation interventions which focus on different emotion regulation strategies could be an effective way to offset the risk for alcohol problems associated with childhood trauma.

Reminiscing and intergenerational advice giving during the COVID-19 pandemic

OBJECTIVES

Given that types of reminiscing consistently predict psychological well-being, the current study investigated how older adults' reminiscing related to their appraisal of the COVID-19 pandemic and to the advice letters they wrote for younger adults.

METHODS

The sample of 107 community-dwelling older adults (Mage = 74.55, SDage = 5.89) completed self-report questionnaires to report (a) level of life-disruption experienced due to the pandemic, (b) type and frequency of reminiscing during the pandemic, and (c) current positive and negative appraisals of the pandemic. Forty participants also produced essays providing advice to younger people about how to overcome a life challenge such as the pandemic.

RESULTS

Correlational analyses revealed that positive reminiscence functions positively correlated with both positive (mean r(105) = .42, p < .006) and negative pandemic appraisals (mean r(105) = .44, p < .006), whereas negative reminiscence functions correlated with negative pandemic appraisals (mean r(105) = .31, p < .006) but not with positive pandemic appraisals (mean r(105) = .15, p > .006). Individuals who reminisced more tended to produce advice that was more positively (r(38) =.36, p = .02) and negatively (r(38) = .34, p = .03) valanced; and those who reminisced more with the function of identity development also gave advice that focused on this issue (r(38) = .44, p = .004).

CONCLUSION

Overall, these results suggest that positive reminiscing is linked to older adults' capacity to view both positive and negative facets of challenging life situations.

Serotonin and emotion regulation: the impact of tryptophan depletion on emotional experience, neural and autonomic activity

The involvement of serotonin in emotion and psychopathology has been extensively examined. Studies using acute tryptophan depletion (ATD) have found limited effects on mood and aggression, and one of the explanations suggests that serotonin may be involved in higher-order functions, such as emotion regulation. However, there is very limited evidence for this hypothesis. The present study investigated the impact of ATD on emotion regulation in a double-blind, placebo-controlled, crossover design. A sample of psychiatrically healthy men (N = 28) completed a cognitive task assessing reappraisal ability (i.e., the success of using reappraisal, an emotion regulation strategy, to modulate emotional responses), following ATD and placebo. EEG frontal activity and asymmetry, as well as heart-rate variability (HRV), also were assessed in the reappraisal task. Both frequentist and Bayesian methods were employed for statistical analysis. Results indicated that ATD reduced plasma tryptophan, and reappraisal was effective in modulating emotional experience in the emotion regulation task. However, ATD had no significant effect on reappraisal ability, frontal activity, and HRV. These results offer direct and compelling evidence that decreasing serotonin synthesis through ATD does not alter an emotion regulation ability that is considered crucial in mood and aggression and has been linked with transdiagnostic risk of psychopathology.

Predicting real-world emotion and health from spontaneously assessed linguistic distancing using novel scalable technology

Individuals who are better at regulating their emotions have been shown to have better physical and mental health outcomes. One promising emotion regulation strategy is psychological distancing, which involves appraising a stimulus with objectivity or spatial/temporal distance. Language-based psychological distancing (linguistic distancing [LD]) refers to the degree to which one implements psychological distancing naturally via language. A crucial, underexamined mechanism that may account for real-world emotion and health self-reports is spontaneous (i.e., implicit) LD. Using HealthSense, a novel, scalable, mobile health assessment application, we collected lexical transcriptions for personally specific negative and positive events as well as emotion and health-relevant data over 14 days (data collected in 2021) and examined how implicit LD during negative and positive events relates to well-being over time. Primary analyses revealed that higher LD during negative events was associated with lower levels of stress as well as greater emotional and physical well-being within persons. LD during positive events on 1 day predicted greater reports of happiness 2 days later within persons. LD during positive events was associated with fewer symptoms of depression and LD during negative events was associated with greater physical well-being among persons. Exploratory analyses revealed that average depression, rumination, and perceived stress across the 2 weeks were significantly negatively associated with LD during negative events between persons. The present results expand understanding of the relationship between LD and mental and physical health risks and motivate future research on low-burden, scalable interventions involving LD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The impact of racial discrimination on the health of Asian Americans during the COVID-19 pandemic: a scoping review

ABSTRACTObjective: Cases of discrimination and hate crimes against Asian Americans have surged ever since the beginning of the COVID-19 pandemic, with deleterious effects. This scoping review synthesizes the literature on how pandemic-related discrimination is associated with the health of Asian Americans.Design: First, application search terms were entered into selected databases. Next, using a set of inclusion criteria, the articles were screened and assessed for eligibility. Data from the selected articles were extracted and summarized to answer the research questions.Results: Thirty-five studies were included. Almost all the studies examined psychological well-being. The remaining studies examined physical and workplace well-being. All the studies found that discrimination was associated with poorer health outcomes.Conclusion: Further research is needed to address the gaps in knowledge about how pandemic-related discrimination is associated with various domains of health among Asian Americans.

Sleep Deprivation Impairs Human Cognitive Reappraisal Ability: A Randomized Controlled Trial

Purpose

This study aims to examine the impact of sleep deprivation on individual cognitive reappraisal ability using a standardized behavioral paradigm.

Methods

A randomized pretest-posttest control group design was conducted. Thirty-nine participants were eventually enrolled and randomly assigned to receive either the sleep control (SC: n = 17) or the sleep deprivation (SD: n = 22). Both of them were required to perform a standardized behavioral paradigm of measuring cognitive reappraisal ability one time under sleep-rested condition and another time under the condition of different sleep manipulation a week later.

Results

Mean valence ratings of SD group were more negative than SC group's (p < 0.05) and mean arousal ratings of SD group were higher than SC group's (p < 0.01).

Conclusion

Sleep deprivation may impair individual cognitive reappraisal ability and could potentially undermine the efficacy of cognitive therapy in terms of emotion regulation.

Parents' emotion suppression exacerbates the effect of COVID-19 stress on youth internalizing symptomatology

The COVID-19 pandemic has resulted in heightened stress for families in the United States, and exposure to pandemic-related stress has been found to confer risk for mental health problems among both children and parents. To isolate risk and protective factors for children living through the ongoing pandemic, several studies have begun to examine family-level factors that may exacerbate or buffer the impact of exposure to COVID-19-related stress on children's symptomatology. Building upon the extant literature documenting associations between parents' emotion regulation and children's mental health, especially during times of stress, the present study aimed to examine parents' regulation of their own emotions as a potential moderator of the association between children's exposure to family-level COVID-19-related stress and internalizing and externalizing problems. Results suggest that parents' regulation of their own emotions using expressive suppression, specifically, may exacerbate the effect of exposure to pandemic-related stress on children's internalizing problems, but not externalizing problems. Results highlight the importance of prioritizing parents' mental health and self-regulation in prevention and intervention efforts aimed at improving family-wide mental health outcomes during public health crises that place family systems under significant stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cognitive reappraisal moderates the effect of combat or other exposures on negative behavioral health symptoms

Understanding the individual differences that can buffer the impact of combat and other adverse exposures on deleterious behavioral health outcomes could lead to more targeted prevention and intervention efforts. Cognitive reappraisal, an antecedent-focused emotion regulation strategy, is linked to positive health outcomes such as lower levels of post-traumatic stress disorder, anxiety, and depression. This study examined the moderating effect of individual differences in cognitive reappraisal use on the association between combat exposure and behavioral health outcomes in active-duty U.S. Soldiers (N = 2,290). This study utilized survey data collected approximately 18 months following a combat deployment to Afghanistan in 2014. Results showed that individual differences in cognitive reappraisal use significantly moderated the effect of combat exposure on anxiety and post-traumatic stress symptoms but not depressive symptoms. Specifically, increasing combat exposures predicted a steeper increase in negative behavioral health symptoms for Soldiers reporting lesser (versus greater) cognitive reappraisal use. These findings highlight a role for cognitive reappraisal as a targetable factor that can mitigate the behavioral health consequences of exposure to combat stressors.

Emotion regulation moderates the association between COVID-19 stress and mental distress: findings on buffering, exacerbation, and gender differences in a cross-sectional study from Norway

Background

Maintaining good mental health is important during a crisis. However, little attention has been given to how people achieve this, or how they evaluate emotions associated with stressors, such as the COVID-19 pandemic. This study aims to (1) investigate whether emotion regulation, in particular cognitive reappraisal and suppression, moderates the relationship between COVID-19 stress and general mental distress and (2) examine gender differences in the interrelations between COVID-19 stress, emotion regulation, and mental distress.

Methods

Data from a population in Norway (n = 1.225) were collected using a cross-sectional survey during the early months of the COVID-19 pandemic. Emotion regulation was measured using the Emotion Regulation Questionnaire Scale (ERQ), COVID-19 stress with the COVID-19 Stress Scale, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS.

Results

There was a strong association between COVID-19 stress and general mental distress (r = 0.61). The moderation analyses showed substantial moderation effects of cognitive reappraisal and suppression on the relationship between COVID-19 stress and mental distress. Cognitive reappraisal served as a buffer (p = 0.001) and suppression (p = 0.002) exacerbated the relation between COVID-19 stress and mental distress. Men had higher scores of suppression (p < 0.001), and women had higher scores of cognitive reappraisal (p = 0.025). The buffering effect of cognitive reappraisal presented itself only in women (p < 0.001), while the exacerbation effect of suppression appeared only in men (p < 0.001).

Conclusion

The current study suggests that COVID-19 pandemic-related stress is easier to deal with for those who have the tendency to cognitively reappraise. In contrast, suppression is associated with symptoms of depression and anxiety. The prevention of mental distress can be supported by guiding people about the importance of using healthy emotion regulation strategies, as well as helping them to become more aware of the way they interpret and regulate their emotions. Gender differences in emotion regulation suggest gender awareness, e.g., tailored programs for men and women.

Reappraisal capacity is unrelated to depressive and anxiety symptoms

Research suggests affective symptoms are associated with reduced habitual use of reappraisal as an emotion regulation strategy in individuals with mental health problems. Less is known, however, about whether mental health problems are related to reduced reappraisal capacity per se. The current study investigates this question using a film-based emotion regulation task that required participants to use reappraisal to downregulate their emotional response to highly evocative real-life film footage. We pooled data (N = 512, age: 18-89 years, 54% female) from 6 independent studies using this task. In contrast to our predictions, symptoms of depression and anxiety were unrelated to self-reported negative affect after reappraisal or to emotional reactivity to negative films. Implications for the measurement of reappraisal as well as future directions for research in the field of emotion regulation are discussed.

Life stressors and immune aging: Protective effects of cognitive reappraisal

Stressful life events may accelerate aspects of immune aging, but habitual use of an adaptive emotion regulation strategy, cognitive reappraisal, may attenuate these effects. This study examined whether cognitive reappraisal moderates the associations between life stressor frequency and stressor desirability on aspects of immune aging, including late-differentiated CD8+ T and natural killer (NK) cells and inflammatory markers (IL-6, TNF-α, and CRP), both between and within people in a longitudinal sample of 149 older adults (mean age = 77.8, range: 64-92 years). Participants reported stressful life events, use of cognitive reappraisal, and provided blood semiannually for up to 5 years to assess aspects of immune aging. Multilevel models, adjusted for demographic and health covariates, tested the between-person (stable, trait-like differences) and within-person associations (dynamic fluctuations) among life stressors and reappraisal on immune aging. Experiencing more frequent life stressors than usual was associated with higher levels of late-differentiated NK cells within person, but this effect was accounted for by experiencing health-related stressors. Unexpectedly, experiencing more frequent and less desirable stressors were associated with lower average levels of TNF-α. As expected, reappraisal moderated the associations between life stressors and late-differentiated NK cells between people and IL-6 within people. Specifically, older adults who experienced less desirable stressors but also used more reappraisal had significantly lower proportions of late-differentiated NK cells on average and lower levels of IL-6 within-person. These results suggest cognitive reappraisal may play a protective role in attenuating the effects of stressful life events on aspects of innate immune aging in older adults.

Effectiveness of emotion regulation strategies measured by self-report and EMG as a result of strategy used, negative emotion strength and participants' baseline HRV

We investigated how emotion regulation (ER) effectiveness-on both a self-reported rating as well as emotional expression (corrugator supercilii muscle activity) level-is affected by the characteristics of the situation (low vs. high negativity), the strategy used (reinterpretation, distraction, suppression, no regulation control condition) and individual dispositions (low vs. high baseline Heart Rate Variability) as well as their interaction. For this purpose, 54 adult women participated in a laboratory study. All the included factors significantly influenced both corrugator activity and appraisals of pictures' negativity (in specific experimental conditions). For example, for high HRV participants, (1) distraction, suppression and reinterpretation significantly decreased corrugator activity compared to the control condition, and (2) distraction decreased appraised picture negativity for high negativity photos. For low HRV participants, distraction and suppression were most effective in decreasing corrugator responses, while suppression was more effective than reinterpretation in decreasing perceived picture negativity in the high negativity condition. Subjectively reported effort and success in applying ER strategies were also dependent on manipulated and dispositional factors. Overall, our results lend support to the flexible emotion regulation framework, showing that emotion regulation effectiveness relies on situational context as well as individual dispositions and their interaction.

Emotion regulation strategies and mental health symptoms during COVID-19: the mediating role of insomnia

OBJECTIVES

COVID-19 has become a major source of stress for people around the world. Stressful life events play a role in the pathogenesis of sleep disorders such as insomnia which is considered a risk factor for anxiety and depression. Emotion regulation is an important factor linked with sleep and mental health problems. Therefore, the main goal of the present study was to examine whether insomnia could constitute a mediation mechanism that explains the relationship between emotion regulation strategies (rumination, reappraisal, suppression) and stress-induced mental health outcomes during the COVID-19 pandemic.

MATERIAL AND METHODS

The cross-sectional study was conducted among young (M±SD 24.8±2.24) individuals (N = 281, 85.4% women) during the time of the third wave of infections in Poland. Data were collected by means of selfreport questionnaires, including the Emotion Regulation Questionnaire; Cognitive Emotion Regulation Questionnaire; Athens Insomnia Scale; Depression, Anxiety and Stress Scale. The direct and indirect effects of emotion regulation strategies on depression, anxiety, and stress were calculated using a bootstrap estimation technique.

RESULTS

All analyzed indirect effects were significant. The results show that insomnia mediates the relationships between all 3 emotion regulation strategies and stress, anxiety and depression.

CONCLUSIONS

The presented results shed the light on the role of insomnia on the relationships between emotion regulation strategies and emotional states experienced during the COVID-19 pandemic. Additionally, the present study suggests that educational and therapeutic interventions aimed at improving emotion regulation might be useful for improving symptoms of insomnia and, through it, symptoms of affective disorders. Int J Occup Med Environ Health. 2023;36(1):151-59.

Excitatory brain stimulation over the left dorsolateral prefrontal cortex enhances voluntary distraction in depressed patients

BACKGROUND

While implicit distraction could ameliorate negative feelings in patients with major depressive disorders (MDD), it remains unclear whether patients could benefit from explicit, voluntary distraction. Meanwhile, though the dorsolateral prefrontal cortex (DLPFC) is established as a crucial brain region involved in attentional control, the causal relationship between the DLPFC and voluntary distraction is unexplored in patients.

METHODS

Combing explicit distraction and transcranial magnetic stimulation (TMS), this study investigated whether TMS-activated DLPFC facilitates voluntary distraction in MDD patients. Eighty patients diagnosed with current MDD underwent either active (n = 40) or sham (n = 40) TMS sessions, followed by receiving negative social feedback from other patients, during which they were requied to use distraction strategy to down-regulate their painful feelings. Electroencephalogram was recorded during the task.

RESULTS

Both the subjective emotional rating and the amplitude of late positive potential showed that depressed patients successfully down-regulate their negative emotions via voluntary distraction, and the TMS-activated left DLPFC produced a larger benefit of emotion regulation compared to the sham TMS group. Results also revealed that while emotion regulation effect was negatively associated with depressive symptoms in the sham TMS group, this correlation was largely diminished when patients' left DLPFC was activated by TMS during the voluntary distraction.

CONCLUSIONS

These findings demonstrated that distraction is valuable for emotion regulation in MDD patients and they could be beneficial in voluntary distraction by activating their left DLPFC using neural modulation techniques. This study has valuable implications for clinical treatement of emotional dysregulation in MDD patients.

A Pilot Randomized Controlled Trial to Evaluate a Cognitive Behavioral Videogame Intervention: empowerED

Objective: To design a cognitive behavioral videogame intervention and to evaluate its preliminary effect on improving youth's perceptions about themselves, their future, and their ability by incorporating skill development in cognitive reappraisal, an emotion regulation strategy to change perceptions. Materials and Methods: We conducted a pilot RCT to evaluate the preliminary efficacy of a videogame intervention, empowerED, in enhancing cognitive reappraisal skills. We also assessed beliefs/attitudes, self-efficacy, and emotional self-efficacy as well as user experience and feasibility. Youth (N = 100) aged 14-19 years from one school were enrolled in a pilot RCT assigned either to play empowerED or a control condition. Results: Improvements were noted in cognitive reappraisal in the empowerED group compared to the control group (LSM difference = 1.33, P = 0.01). There were no significant differences observed between treatment groups for beliefs/attitudes, self-efficacy, and emotional self-efficacy; however, the empowerED group reported improvements in beliefs/attitudes from pretest to posttest survey responses (M = 1.33, P = 0.01). Conclusion: Overall, the intervention was deemed easy to use and beneficial among youth, and feasibly delivered in a high school setting. Given the growing youth mental health needs in schools and the importance of school climate on healthy development, empowerED may offer an effective and innovative student-level approach to improve cognitive reappraisal and later empower youth to enact change in their school climate. Clinical Trials.gov Identifier: NCT04025294.

Psychological Resilience: An Affect-Regulation Framework

Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles,we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research.

A new understanding of the cognitive reappraisal technique: an extension based on the schema theory

Cognitive reappraisal is a widely utilized emotion regulation strategy that involves altering the personal meaning of an emotional event to enhance attention to emotional responses. Despite its common use, individual differences in cognitive reappraisal techniques and the spontaneous recovery, renewal, and reinstatement of negative responses across varying contexts may limit its effectiveness. Furthermore, detached reappraisal could cause distress for clients. According to Gross's theory, cognitive reappraisal is an effortless process that can occur spontaneously. When guided language triggers cognitive reappraisal as an emotion regulation strategy in laboratory or counseling settings, clients experience improved emotional states, but this induced strategy may not necessarily guide them in regulating emotions in similar future situations. Therefore, effectively applying cognitive reappraisal techniques in clinical practice to help clients alleviate emotional distress in daily life remains a significant concern. Exploring the mechanism of cognitive reappraisal reveals that reconstructing stimulus meaning is akin to extinction learning, which entails fostering cognitive contingency that the original stimulus provoking negative emotions will no longer result in negative outcomes in the current context. However, extinction learning is a new learning process rather than an elimination process. The activation of new learning relies on the presentation of critical cues, with contextual cues often playing a vital role, such as a safe laboratory or consulting room environment. We propose a new understanding of cognitive reappraisal based on the schema theory and the dual-system theory, emphasizing the significance of environmental interaction and feedback in constructing new experiences and updating schemata. This approach ultimately enriches the schema during training and integrates the new schema into long-term memory. Bottom-up behavioral experiences as schema enrichment training provide the foundation for top-down regulation to function. This method can assist clients in activating more suitable schemata probabilistically when encountering stimuli in real life, forming stable emotions, and achieving transfer and application across diverse contexts.

Similarities and differences in the induction and regulation of the negative emotions fear and disgust: A functional near infrared spectroscopy study

Affective processing, including induction and regulation of emotion, activates neural networks, induces physiological responses, and generates subjective experience. Dysregulation of these processes can lead to maladaptive behavior and even psychiatric morbidity. Multimodal studies of emotion thus not only help elucidate the nature of emotion, but also contribute to important clinical insights. In the present study, we compared the induction (EI) and effortful regulation (ER) with reappraisal of fear and disgust in healthy subjects using functional near infrared spectroscopy (fNIRS) in conjunction with electrodermal activity (EDA). During EI, there was significant activation in medial prefrontal cortex (PFC) for fear and more widespread activation for disgust, with right lateral PFC significantly more active during disgust compared to fear. ER was equally effective for fear and disgust reducing subjective emotion rating by roughly 45%. Compared to baseline, there was no increased PFC activity for fear during ER, while for disgust lateral PFC was significantly more active. Significant differences between the two negative emotions were also observed in sympathetic nerve activity as reflected in EDA during EI, but not during ER. Lastly, compared to men, women had higher emotion rating for both fear and disgust without corresponding differences in EDA. In conclusion, in the present study we show that emotion induction was associated with differential activation in both PFC and sympathetic nerve activity for fear and disgust. These differences were however less prominent during emotion regulation. We discuss the potential interpretation of our results and their implications regarding our understanding of negative emotion processing.

Low mental health literacy and its association with depression, anxiety and poor sleep quality in Chinese elderly

BACKGROUND

Mental health literacy (MHL) is rarely reported in the Chinese elderly. This study explored the pattern of MHL in the Chinese elderly in relation to depression, anxiety and poor sleep quality.

METHODS

A cross-sectional study was conducted among older adults in Guangzhou, south China. Participants were investigated face-to-face using the Chinese National Mental Health Literacy Scale, the Patient Health Questionnaire-9 item (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI). Mental Health Literacy Scale contains three dimensions: mental health knowledge, mental health skills (such as social support, cognitive reappraisal and attentional distraction) and mental health awareness. Multivariate logistic regression was used for examining the association between MHL and mental health.

RESULTS

A total of 506 older adults were recruited. The percentage of depression, anxiety, and poor sleep quality were 16.6%, 7.9% and 40.9%, respectively. MHL dimensions independently associated with depression included cognitive reappraisal (OR = 1.95, p < .001), attentional distraction (OR = 0.61, p = 0.044) and awareness (OR = 0.56, p = 0.027). MHL dimensions independently associated with anxiety symptoms included cognitive reappraisal (OR = 1.90, p = 0.011) and attentional distraction (OR = 0.44, p = 0.016). MHL dimensions independently associated with poor sleep quality included social support (OR = 0.75, p = 0.022), cognitive reappraisal (OR = 1.55, p = 0.003) and attentional distraction (OR = 0.65, p = 0.016).

CONCLUSION

Given the low MHL and its association with poor mental health in the Chinese elderly, policymakers and health professionals should improve the older adults' MHL, which could be conducive to the prevention and control of their mental health problems.

Successful implementation of cognitive reappraisal: effects of habit and situational factors

Reappraisal is an adaptive emotion regulation strategy associated with favourable mental health outcomes. It is unclear whether the adaptive outcomes of habitual reappraisal are associated with better implementation of reappraisal when faced with negative affective situations. The current study aimed to examine whether habitual reappraisal predicts the implementation of instructed reappraisal and to evaluate the potential moderating effects of situational factors, namely - emotional intensity and reappraisal affordance. To address this question, 100 participants reported their habitual reappraisal tendency and were asked to imagine themselves in different hypothetical interpersonal situations. Participants rated emotional intensity levels and reappraisal affordance for each situation, followed by instructions to implement reappraisal. Implementation success was measured by self-reported affect pre-and-post-implementation. Results indicated that habitual reappraisal was associated with greater reappraisal implementation success. While higher intensity scores predicted greater reappraisal implementation success, intensity did not moderate the association between habitual reappraisal and reappraisal implementation success. Reappraisal affordance did not predict reappraisal implementation success, nor did it moderate the association between habitual reappraisal and reappraisal implementation success. Our findings suggest that individual-centred factors play a significant role in reappraisal implementation success, while the effects of situation-centred factors demand further investigation.

Parental Assistance with Emotion Regulation Moderates Link Between COVID-19 Stress and Child Mental Health

OBJECTIVE

The COVID-19 pandemic has severely impacted children's mental health. All children have not been affected equally, however, and whether parental emotion socialization might buffer or exacerbate the impact of COVID-19 on children's mental health remains an important question.

METHOD

During the first peak of the COVID-19 pandemic in the U.S. N = 200 parents of children ages 0-17 (52.5% female) completed questionnaires related to parental assistance with children's emotion regulation, symptomatology, and exposure to COVID-19-related stress. Parents were 74% Non-Hispanic/Latino/a White, 13% Asian, 4.5% Hispanic/Latino/a, 4% Black/African American, 2.5% Native American, and 1.5% bi/multiracial; 0.5% of participants preferred not to state their race/ethnicity. In a series of linear regression analyses, we examined whether parental assistance with children's execution of emotion regulation strategies - across a variety of prototypically-adaptive and -maladaptive strategies - moderates the association between children's exposure to COVID-19-related stress and symptomatology.

RESULTS

Results suggest that parental assistance with the execution of prototypically-adaptive strategies (i.e., acceptance, problem solving, behavioral disengagement) and prototypically-maladaptive strategies (i.e., suppression, rumination) may buffer or exacerbate, respectively, the impact of COVID-19-related stress on youth mental health.

CONCLUSIONS

Though interpretation of findings is constrained by limitations inherent in collecting data during a pandemic, results highlight the importance of supporting parents - who play a critical role of supporting children - during public health emergencies that affect family life. Interventions designed to improve child wellbeing during the ongoing pandemic may benefit from training parents to assist their children with specific emotion regulation strategies.

Longitudinal predictors of depression, anxiety, and alcohol use following COVID-19-related stress

The COVID-19 pandemic imposed profound effects on health and daily life, with widespread stress exposure and increases in psychiatric symptoms. Despite these challenges, pandemic research provides unique insights into individual differences in emotion and cognition that predict responses to stress, with general implications for understanding stress vulnerability. We examined predictors of responses to COVID-19-related stress in an online sample of 450 emerging adults recruited in May 2020 to complete questionnaires assessing baseline stress and psychiatric symptoms, rumination, cognitive reappraisal use and intolerance of uncertainty. Stress and symptoms were re-assessed 3 months later (N = 200). Greater pandemic-related stressful events were associated with increases in symptoms of depression, anxiety and alcohol use severity. Additionally, individual differences in emotional and cognitive styles emerged as longitudinal predictors of stress responses. Specifically, greater rumination predicted increased depression. Reduced cognitive reappraisal use interacted with stress to predict increases in alcohol use. An unexpected pattern emerged for intolerance of uncertainty, such that stress was associated with increases in depression for those high in intolerance of uncertainty but increases in alcohol use at relatively low levels of intolerance of uncertainty. These results highlight unique vulnerabilities that predict specific outcomes following stress exposure and offer potential prevention targets.

Reappraising cognitive reappraisal: The taxing impact of emotion regulation on executive functioning in older adults

OBJECTIVE

Cognitive reappraisal (CR) and expressive suppression (ES) are two common emotion regulation strategies that share similar cognitive and neural underpinnings. Prior research has consistently shown that recent engagement in ES (both self-reported and experimentally manipulated) is associated with subsequent temporary decrements in executive functioning (EF). Thus far, only one study has examined the association between CR and EF, with null results. However, that study was limited by examining only zero-order correlations and by assessing only the speed, not accuracy, of EF performance. The present study examined multivariate relationships among recent CR, recent ES, and EF (both speed and accuracy), as well as the potential impacts of more chronic engagements in, and trait-level preferences between, the two emotion regulation strategies.

METHOD

Participants were 201 community-dwelling older adults aged 60 to 93 who had participated in three separate studies examining the relationship between self-reported emotion regulation and EF.

RESULTS

Recent CR was associated with EF performance accuracy above and beyond chronic CR. Both recent CR and ES contributed to EF performance accuracy uniquely beyond each other and beyond chronic and preferred emotion regulation.

CONCLUSIONS

Both recent ES and CR appear to have a deleterious impact on EF performance accuracy, potentially due to utilization of similar resources; both should be accounted for when assessing emotion regulation and its impacts on EF.

Trait Intolerance of Uncertainty Is Associated with Decreased Reappraisal Capacity and Increased Suppression Tendency

The COVID-19 pandemic has been a time of great uncertainty for the general population and highlights the need to understand how attitudes towards uncertainty may affect well-being. Intolerance of uncertainty is a trait associated with worry, anxiety, and mood disorders. As adaptive emotion regulation supports well-being and mental health, it is possible that intolerance of uncertainty is also associated with the ability and tendency to regulate emotions. However, the relationships between intolerance of uncertainty and widely studied cognitive emotion regulation strategies - such as reappraisal and suppression - have received little attention. In two studies that recruited participants online from the United States, we tested the hypotheses that higher trait intolerance of uncertainty would be associated with greater worry, decreased capacity and tendency to use reappraisal, and increased tendency to use suppression in daily life. Study 1 provided an initial test of our hypotheses. Study 2 was a confirmatory, preregistered study that replicated findings in a young adult sample, demonstrating that scores on the Intolerance of Uncertainty Scale (IUS) were associated with greater COVID-related worry, decreased capacity to regulate negative emotions on a task that manipulated the use of reappraisal, and greater self-reported use of suppression in daily life. Together, these results indicate that intolerance of uncertainty is associated with the capacity and tendency to use emotion regulation strategies important for well-being.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-022-00115-8.

"We're all we got is each other": Mixed-methods analysis of patient-caregiver dyads' management of heart failure

BACKGROUND

Individuals living with heart failure often require informal caregiving assistance for optimal self-care maintenance. The influence of caregiver burden and resilience on dyadic congruence is not well understood.

OBJECTIVE

To compare how dyadic congruence is influenced by level of burden and resilience expressed by caregivers of patients with heart failure.

METHODS

Mixed-methods analysis of individuals with heart failure and their caregivers, focusing on measures of caregiver burden (Zarit Burden Interview) and resilience (Brief Resilience Scale). Data were integrated using the Heart Failure Care Dyadic Typology.

RESULTS

Twelve dyads (n=24 participants) were classified as Type II (n=7) and Type III (n=5) dyads. Among Type II dyads, average caregiver burden was 19.43 (± 13.89) and resilience was 3.16 (± 1.04). For Type III dyads, average caregiver burden was 3.80 (± 4.27) and resilience 4.07 (± 1.36), respectively. Two key themes were derived: 1) caregivers' tendency to take the lead, and 2) the usefulness of cognitive reframing. Data integration elucidated that theme 1 was more common among Type II dyads and those with higher burden, and theme 2 was more prevalent among Type III dyads and those with higher resilience.

CONCLUSION

Findings highlight important variances in how dyads collectively manage heart failure. Future inquiry should involve tailored intervention development to bolster informal caregivers' quality of life and ability to better support patients throughout their heart failure trajectory.

The construction of a new Clinical Quality of Life Scale (CLINQOL)

Whilst the variables in quality of life and well-being can be separated into objective and subjective domains, there remains a dearth of multiple utility instruments that assess their impact upon quality of life. To address this, ten domains were identified in a preliminary exploratory literature search, and an exploratory review generated enough facets to represent each domain, with items developed to form a composite scale. A principal components analysis run on data collected from 210 participants produced seven factors: relationships, work, money, health, leisure, and life management, with the remaining four domains subsuming into a seventh composite subjective factor (mental state). Final items were collated into the new Clinical Quality of Life Scale (CLINQOL) and were tested against the Assessment of Quality of Life Instrument, the Personal Wellbeing Index-Adult, Positive and Negative Affect Scale, the Satisfaction with Life scale, and the Mindfulness Attention Awareness Scale. The CLINQOL demonstrated suitable reliability, with items within each category forming internally consistent subscales. The full scale score demonstrated satisfactory test-retest reliability and concurrent validity, correlating with all measures. Findings suggest that the CLINQOL captures critical clinical factors, and may be an acceptable instrument to assess quality of life and well-being.

Emotion control training enhances reappraisal success among individuals with reported ADHD symptoms

Previous research indicates that training individuals to recruit cognitive control before exposure to negative pictures can facilitate the propensity to use reappraisal and reappraisal success. Individuals with attention deficit hyperactivity disorder (ADHD) experience difficulties in cognitive control and emotion regulation, so they may especially benefit from such training. Individuals reporting high ADHD symptoms and controls were randomly assigned to one of two training conditions. In the high emotion control (H-EC) training condition, negative pictures were typically preceded by a stimulus that recruits cognitive control. In contrast, in the low emotion control (L-EC) training condition, negative pictures were typically preceded by a stimulus that does not recruit cognitive control. Participants were then asked to recall an adverse personal event and to reappraise the event. As predicted, instructed reappraisal was more effective in reducing negative mood in the H-EC training compared to the L-EC training. Furthermore, compared to controls, individuals with reported ADHD symptoms showed a greater propensity to use reappraisal after writing the event and a more considerable reduction in event significance and negativity following the instructed reappraisal assignment. We argue that employing cognitive control over emotional information has a causal role in reappraisal use and success among individuals with ADHD symptoms.

The antidepressant effect of cognitive reappraisal training on individuals cognitively vulnerable to depression: Could cognitive bias be modified through the prefrontal–amygdala circuits?

Cognitive reappraisal (CR) is one of the core treatment components of cognitive behavioral therapy (CBT) and is the gold standard treatment for major depressive disorders. Accumulating evidence indicates that cognitive reappraisal could function as a protective factor of cognitive vulnerability to depression. However, the neural mechanism by which CR training reduces cognitive vulnerability to depression is unclear. There is ample evidence that the prefrontal–amygdala circuit is involved in CR. This study proposes a novel cognitive bias model of CR training which hypothesizes that CR training may improve the generation ability of CR with altered prefrontal–amygdala functional activation/connectivity, thus reducing negative cognitive bias (negative attention bias, negative memory bias, negative interpretation bias, and/or negative rumination bias) and alleviating depressive symptoms. This study aims to (1) explore whether there is abnormal CR strategy generation ability in individuals who are cognitively vulnerable to depression; (2) test the hypothesis that CR training alleviates depressive symptoms through the mediators of cognitive bias (interpretation bias and/or rumination bias); (3) explore the neural mechanism by which CR training may enhance the ability of CR strategy generation; and (4) examine the short- and long-term effects of CR training on the reduction in depressive symptoms in individuals who are cognitively vulnerable to depression following intervention and 6 months later. The study is promising, providing theoretical and practical evidence for the early intervention of depression-vulnerable individuals.

Emotion Regulation, Parasympathetic Function, and Psychological Well-Being

The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability (HRV) may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time.

Positive Cognitive Reappraisal in Stress Resilience, Mental Health, and Well-Being: A Comprehensive Systematic Review

Stress-related psychopathology is on the rise, and there is a pressing need for improved prevention strategies. Positive appraisal style, the tendency to appraise potentially threatening situations in a positive way, has been proposed to act as a key resilience mechanism and therefore offers a potential target for preventive approaches. In this article, we review n  =  99 studies investigating associations of positive cognitive reappraisal, an important sub-facet of positive appraisal style, with outcome-based resilience and relevant other outcomes, which are considered resilience-related. According to the studies reviewed, positive cognitive reappraisal moderates the relation between stressors and negative outcomes and is positively related to several resilience-related outcomes. It also mediates between other resilience factors and resilience, suggesting it is a proximal resilience factor.

Coping with COVID Stress: Maladaptive and Adaptive Response Styles Predicting College Student Internalizing Symptom Dimensions

The COVID-19 pandemic significantly disrupted daily life for undergraduates and introduced new stressors (e.g., campus closures). How individuals respond to stressors can interact with stress to increase disorder risk in both unique and transdiagnostic ways. The current study examined how maladaptive and adaptive stress response styles moderated the perceived severity of COVID-related stressors effect on general and specific internalizing dimensions at the beginning of the COVID-19 pandemic in a combined undergraduate sample across two universities (N = 451) using latent bifactor modeling and LASSO modeling to identify optimal predictors. Results showed that perceived stress severity and maladaptive response styles (not adaptive response styles or interactions between stress and response styles) were associated with both common and specific internalizing dimensions. Results suggest additive associations of stress severity and maladaptive coping with internalizing symptoms during the pandemic’s beginning, and provide important insights for screening, prevention, and intervention during future public health crises.

Stress-related psychopathology during the COVID-19 pandemic

The COVID-19 pandemic has introduced widespread societal changes that have required ongoing adaptation. Unsurprisingly, stress-related psychopathology has increased during the pandemic, in both children and adults. We review these patterns through the lens of several leading conceptual models of the link between stress and psychopathology. Some of these models focus on characteristics of environmental stressors-including cumulative risk, specific stressor types, and stress sensitization approaches. Understanding the specific aspects of environmental stressors that are most likely to lead to psychopathology can shed light on who may be in most need of clinical intervention. Other models center on factors that can buffer against the onset of psychopathology following stress and the mechanisms through which stressors contribute to emergent psychopathology. These models highlight specific psychosocial processes that may be most usefully targeted by interventions to reduce stress-related psychopathology. We review evidence for each of these stress models in the context of other widescale community-level disruptions, like natural disasters and terrorist attacks, alongside emerging evidence for these stress pathways from the COVID-19 pandemic. We discuss clinical implications for developing interventions to reduce stress-related psychopathology during the pandemic, with a focus on brief, digital interventions that may be more accessible than traditional clinical services.

The psychological impact of the COVID-19 pandemic in Portugal: The role of personality traits and emotion regulation strategies

Recent evidence suggests that both personality traits (PT) and emotion regulation (ER) strategies play an important role in the way people cope with the COVID-19 pandemic. The aim of this study was two folded. First, to longitudinally investigate the psychological distress (depression, anxiety, and stress levels) taking in consideration PT and ER strategies in 3 different moments: during the first lockdown period (April/20), at the first deconfinement (May/20) and 1-month after the first deconfinement (Jun/20)-Experiment I. Second, to cross-sectionally evaluate the impact of the pandemic in psychological distress and the correlates with PT and ER 6-months after the first deconfinement November/20 to February/21 -Experiment II. A total of 722 volunteers (Experiment I = 180; Experiment II = 542) aged 18 years or older participated in this online survey. The findings from Experiment I show that psychological distress decreased after the lockdown period, however, neuroticism traits predicted higher levels of depression, anxiety and stress symptoms, while difficulties in ER strategies were identified as a risk factor for depression and stress. For experiment II, neuroticism traits and being infected with COVID-19 were associated to higher levels of symptomatology, while unemployment and the use of emotional suppression strategies to cope with emotional situations were associated to depressive and anxiety symptoms. Although the psychological impact of the COVID-19 outbreak decreased over time in our sample, the current findings suggest that difficulties in emotional regulation and high levels of neuroticism traits might be potential risk factors for psychiatric symptomatology during the COVID-19 pandemic. Thus, people with difficulties in ER and neuroticism traits would benefit from psychological interventions that provide personality-appropriate support and promote emotion regulation skills during stressful events, such as the case of the global pandemic.

The mediational role of emotion regulation in the relationship between personality and subjective well-being

In this research we examined relationships between Big Five personality traits, emotion regulation strategies and subjective well-being. In two studies we explored the mediational role of habitual use of two regulation strategies: reappraisal and suppression in the relationship between personality traits and two aspects of well-being (i.e., life satisfaction and experience of positive affect and negative affect). In Study 1 (n = 233) we found that the most robust predictors of higher life satisfaction were higher extraversion, conscientiousness, emotional stability (lower neuroticism) and reappraisal, as well as lower suppression of emotions. We obtained similar pattern of results in Study 2 (n = 265) which showed that higher positive affect was significantly predicted by higher extraversion, conscientiousness, emotional stability, and reappraisal. Negative affect was negatively predicted only by emotional stability. Additional analyses indicated that suppression mediated the link between extraversion and life satisfaction, whereas reappraisal mediated associations of emotional stability with life satisfaction and positive affect. The studies reveal the role of emotion regulation for extraversion and emotional stability and their association with well-being.

Maternal socioeconomic disadvantage, neural function during volitional emotion regulation, and parenting

The transition to becoming a mother involves numerous emotional challenges, and the ability to effectively keep negative emotions in check is critical for parenting. Evidence suggests that experiencing socioeconomic disadvantage interferes with parenting adaptations and alters neural processes related to emotion regulation. The present study examined whether socioeconomic disadvantage is associated with diminished neural activation while mothers engaged in volitional (i.e., purposeful) emotion regulation. 59 mothers, at an average of 4 months postpartum, underwent fMRI scanning and completed the Emotion Regulation Task (ERT). When asked to regulate emotions using reappraisal (i.e., Reappraise condition; reframing stimuli in order to decrease negative emotion), mothers with lower income-to-needs ratio exhibited dampened neural activation in the dorsolateral and ventrolateral PFC, middle frontal and middle temporal gyrus, and caudate. Without explicit instructions to down-regulate (i.e., Maintain condition), mothers experiencing lower income also exhibited dampened response in regulatory areas, including the middle frontal and middle temporal gyrus and caudate. Blunted middle frontal gyrus activation across both Reappraise and Maintain conditions was associated with reduced maternal sensitivity during a mother-child interaction task. Results of the present study demonstrate the influence of socioeconomic disadvantage on prefrontal engagement during emotion regulation, which may have downstream consequences for maternal behaviors.

Childhood maltreatment, emotion regulation strategies and depressive symptoms during spousal bereavement

BACKGROUND

Childhood maltreatment increases the risk of depression, especially after experiencing a stressful life event, such as bereavement. Employing emotion regulation strategies can mitigate the impact childhood maltreatment has on depression later in life following the loss of a spouse.

OBJECTIVE

We evaluated how cognitive reappraisal and expressive suppression moderated the impact of childhood maltreatment and depressive symptoms following spousal bereavement.

PARTICIPANTS AND SETTING

We examined 130 bereaved individuals 3 months after the death of a spouse, 4 months after the death of a spouse, and 6 months after the death of a spouse.

METHODS

We utilized a mixed model approach to test the interaction between childhood maltreatment and cognitive reappraisal and between childhood maltreatment and expressive suppression to predict depressive symptoms across 3 time points.

RESULTS

Cognitive reappraisal moderated the relationship between childhood maltreatment and depressive symptoms (b = - 0.17,p = .003); expressive suppression did not (b = 0.06,p = .452). Participants who used less cognitive reappraisal had a positive relationship between childhood maltreatment and depressive symptoms (b = 3.27,p < .001);participants who used more cognitive reappraisal did not (b = 1.09,p = .065).

CONCLUSIONS

Childhood maltreatment interacted with cognitive reappraisal, but not expressive suppression, to predict depressive symptoms following spousal bereavement. This study reveals how emotion regulation strategies can be utilized as a tool to buffer the impact of childhood maltreatment on mental health following a stressor later in life, which can serve as a target for future interventions for individuals experiencing a stressful life event.

Neural markers of emotion regulation difficulties moderate effects of COVID-19 stressors on adolescent depression

BACKGROUND

Stressful events, such as those imposed by the COVID-19 pandemic, are associated with depression risk, raising questions about processes that make some people more susceptible to the effects of stress on mental health than others. Emotion regulation may be a key process, but methods for objectively measuring emotion regulation abilities in youth are limited. We leveraged event-related potential (ERP) measures and a longitudinal study of adolescents oversampled for depression and depression risk to examine emotion regulation difficulties as prospective predictors of depressive symptoms in response to pandemic-related stress.

METHODS

Before the pandemic, adolescents with (n = 28) and without (n = 34) clinical depression (N = 62 total) completed an explicit emotion regulation task while ERP data were recorded and measures of depressive symptoms. Adolescents were re-contacted during the pandemic to report on COVID-19 related stressful events and depressive symptoms (n = 48).

RESULTS

Adolescents who had never experienced a depressive episode showed an increase in depressive symptoms during the pandemic, but adolescents who were clinically depressed before the pandemic did not exhibit significant changes in symptoms. Neural markers of emotion regulation abilities interacted with pandemic-related stressful events to predict depressive symptoms during the pandemic, such that stressors predicted increases in depressive symptoms only for adolescents with greater difficulty modulating responses to negative images before the pandemic.

CONCLUSIONS

Results provide insight into adolescent mental health during the COVID-19 pandemic and highlight the role of emotion regulatory brain function in risk and resilience for depression.