Valuing happiness is associated with bipolar disorder

A multicomponent positive psychology intervention for euthymic patients with bipolar disorder to improve mental well-being and personal recovery: A pragmatic randomized controlled trial

OBJECTIVE

Mental well-being and personal recovery are important treatment targets for patients with bipolar disorder (BD). The goal of this study was to evaluate the effectiveness of an 8-week group multicomponent positive psychology intervention (PPI) for euthymic patients with BD as an adjunct to treatment as usual (TAU) compared to TAU alone.

METHODS

Patients with BD were randomized to receive TAU (n = 43) or the PPI in addition to TAU (n = 54). The primary outcome was well being measured with the Mental Health Continuum-Short Form. Personal recovery was measured with the Questionnaire about the Process of Recovery. Data were collected at baseline, mid-treatment, post-treatment and 6- and 12-month follow-up. Life chart interviews were conducted at 12 months to retrospectively assess recurrence of depression and mania.

RESULTS

Significant group-by-time interaction effects for well-being and personal recovery were found favouring the PPI. At post-treatment, between-group differences were significant for well-being (d = 0.77) and personal recovery (d = 0.76). Between-group effects for well-being were still significant at 6-month follow-up (d = 0.72). Effects on well-being and personal recovery within the intervention group were sustained until 12-month follow-up. Survival analyses showed no significant differences in time to recurrence.

CONCLUSIONS

The multicomponent PPI evaluated in this study is effective in improving mental well-being and personal recovery in euthymic patients with BD and would therefore be a valuable addition to the current treatment of euthymic BD patients. The fact that the study was carried out in a pragmatic RCT demonstrates that this intervention can be applied in a real-world clinical setting.

Readmission and associated clinical factors among individuals admitted with bipolar affective disorder at a psychiatry facility in Uganda

BACKGROUND

Bipolar affective disorder (BAD) is a common severe mental health condition with a relapsing course that may include periods of hospital re-admissions. With recurrent relapses and admissions, the course, prognosis, and patient's overall quality of life can be affected negatively. This study aims to explore the rates and clinical factors associated with re-admission among individuals with BAD.

METHOD

This study used data from a retrospective chart review of all records of patients with BAD admitted in 2018 and followed up their hospital records for four years till 2021 at a large psychiatric unit in Uganda. Cox regression analysis was used to determine the clinical characteristics associated with readmission among patients diagnosed with BAD.

RESULTS

A total of 206 patients living with BAD were admitted in 2018 and followed up for four years. The average number of months to readmission was 9.4 (standard deviation = 8.6). The incidence of readmission was 23.8% (n = 49/206). Of those readmitted during the study period, 46.9% (n = 23/49) and 28.6% (n = 14/49) individuals were readmitted twice and three times or more, respectively. The readmission rate in the first 12 months following discharge was 69.4% (n = 34/49) at first readmission, 78.3% (n = 18/23) at second readmission, and 87.5% (n = 12/14) at third or more times. For the next 12 months, the readmission rate was 22.5% (n = 11/49) for the first, 21.7% (n = 5/23) for the second, and 7.1% (n = 1/14) for more than two readmissions. Between 25 and 36 months, the readmission rate was 4.1% (n = 2/49) for the first readmission and 7.1% (n = 1/14) for the third or more times. Between 37 and 48 months, the readmission rate was 4.1% (n = 2/49) for those readmitted the first time. Patients who presented with poor appetite and undressed in public before admission were at increased risk of being readmitted with time. However, the following symptoms/clinical presentations, were protective against having a readmission with time, increased number of days with symptoms before admission, mood lability, and high energy levels.

CONCLUSION

The incidence of readmission among individuals living with BAD is high, and readmission was associated with patients' symptoms presentation on previous admission. Future studies looking at BAD using a prospective design, standardized scales, and robust explanatory model are warranted to understand causal factors for hospital re-admission and inform management strategies.

Do people who highly value happiness tend to ruminate?

Previous studies have suggested that an extremely strong desire for happiness might ironically reduce a person's well-being, particularly among Western people. According to the goal progress theory and the theory of valuing happiness, rumination might explain the relationship between valuing happiness and well-being. Based on these theoretical rationales, this study examined the following hypotheses: (1) valuing happiness is significantly associated with rumination, (2) people who experience low life stress have a stronger association between valuing happiness and rumination, and (3) people with more interdependent self-construal have a weaker association between valuing happiness and rumination. University students in Japan participated in a cross-sectional study (N = 350; Study 1) and a 4-weeks longitudinal study (N = 329; Study 2). They responded to a packet of questionnaires assessing valuing happiness, trait rumination, depressive symptoms, negative events, and interdependent self-construal. Consistent with our hypothesis, valuing happiness was concurrently and longitudinally associated with increased rumination after controlling for depressive symptoms. However, negative events did not moderate the association between valuing happiness and rumination. Furthermore, Study 1, but not Study 2, indicated that the association between valuing happiness and rumination was stronger among students with highly interdependent self-construal than those with less interdependent self-construal. The preset findings indicated that valuing happiness might be a factor that perpetuates rumination. More sophisticated evidence on the influence of valuing happiness on rumination can lead to effective psychotherapies for decreasing rumination and depression.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-04131-6.

Digital literacy and subjective happiness of low-income groups: Evidence from rural China

Improvements of the happiness of the rural population are an essential sign of the effectiveness of relative poverty governance. In the context of today's digital economy, assessing the relationship between digital literacy and the subjective happiness of rural low-income groups is of great practicality. Based on data from China Family Panel Studies, the effect of digital literacy on the subjective well-being of rural low-income groups was empirically tested. A significant happiness effect of digital literacy on rural low-income groups was found. Digital literacy promotes the subjective happiness of rural low-income groups through income increase and consumption growth effects. The observed happiness effect is heterogeneous among different characteristic groups, and digital literacy significantly positively impacts the subjective happiness of rural low-income groups. Decomposition of subjective happiness into life satisfaction and job satisfaction shows that digital literacy significantly positively affects the job and life satisfaction of rural low-income groups. This paper demonstrates that digital literacy induces a practical happiness effect. To further strengthen the subjective welfare effect of digital literacy in the construction of digital villages, the government should focus on cultivating digital literacy among low-income groups from the demand side. The construction of digital infrastructure should be actively promoted from the supply side.

Have a good day! An experience-sampling study of daily meaningful and pleasant activities

We organize our daily lives with a relatively high degree of freedom. Some things must be done; others are optional. Some we find meaningful, some pleasant, some both, and some neither. The present study looks at such evaluations of daily activities and how they relate to perceived meaning in life. Sixty-two students from an Austrian university first completed the meaningfulness scale from the Sources of Meaning and Meaning in Life Questionnaire (SoMe). They then participated in a 1-week experience-sampling assessment, wherein they completed a short questionnaire at five random time-points per day. They indicated their current activity and then reported, on a 6-point Likert scale, how pleasant and meaningful they perceived it to be. Activities could thus be categorized as meaningful, pleasant, both, or neither. Results reflected that activities grouped under culture/music, communication, intimacy, and sports are experienced as both highly meaningful and pleasant. A two-level hierarchical linear regression suggested that people with high trait meaningfulness experience their daily activities as more meaningful than people with lower trait meaningfulness if they also enjoy what they are doing. People with low trait meaningfulness, however, tended to experience their daily activities as rather meaningless, even if they enjoyed them very much. Thus, when looking for advice on how to have a good day, clarifying one’s meaning in life seems to represent the best starting point.

Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering

BACKGROUND

People with bipolar disorder (BD) frequently struggle with the recurrence of affective symptoms. However, the interplay between coping mechanism and positive mood state remains under-researched.

AIM

To explore the associations among behavioral approach system (BAS) sensitivity level, coping, and positive mood states among people with BD.

METHODS

Using a cross-sectional study design, 90 participants with BD were presented with four BAS-activating life event scenarios and assessed with regard to their BAS trait sensitivity, coping flexibility, and mood states. A hierarchical clustering method was used to identify different groups with different styles of coping. Multiple hierarchical regression analyses were conducted to examine the mediating and moderating roles of different components of coping on mood states.

RESULTS

A three-cluster solution was found to best fit the present data set. The findings showed that a low mass of coping combined with low BAS sensitivity level protects people with BD from detrimentally accentuating mood states when they encounter BAS-activating life events. Moreover, coping flexibility is demonstrated to mediate and moderate the relationships between BAS sensitivity level and mood states. Specifically, subduing the perceived controllability and reducing the use of behavioral-activation/emotion-amplifying coping strategies could help buffer the effect of positive affect.

CONCLUSION

The judicious use of coping in emotion regulation for people with BD when encountering BAS-activating life events was indicated. Practical applications and theoretical implications are highlighted.

Exploring factors associated with personal recovery in bipolar disorder

BACKGROUND

Personal recovery is increasingly recognized as important outcome for people with bipolar disorder (BD), but research addressing associated factors of personal recovery in this group remains scarce. This study aimed to explore the association of sociodemographic variables, social participation, psychopathology, and positive emotion regulation with personal recovery in BD.

METHODS

Baseline data from a randomized controlled trial and survey data were combined (N = 209) and split into a training (n = 149) and test sample (n = 60). Block-wise regression analyses and model training were used to determine the most relevant predictors. The final parsimonious model was cross-validated in the test sample.

RESULTS

In the final parsimonious model, satisfaction with social roles (β = .442, p < .001), anxiety symptoms (β = -.328, p < .001), manic symptoms (β = .276, p < .001), and emotion-focused positive rumination (β = .258, p < .001) were independently associated with personal recovery. The model explained 57.3% variance in personal recovery (adjusted R²  = .561) and performed well in predicting personal recovery in the independent test sample (adjusted R²  = .491).

CONCLUSIONS

Our findings suggest that especially social participation, anxiety and positive rumination might be relevant treatment targets when aiming to improve personal recovery.

PRACTITIONER POINTS

Personal recovery is considered an increasingly important outcome for people with chronic mental health conditions, including bipolar disorder. We found that anxiety and manic symptoms as well as positive rumination and social participation were independently associated with personal recovery in bipolar disorder. Therefore, these outcomes might be relevant treatment targets when aiming to improve personal recovery in bipolar disorder. Possible interventions to improve these outcomes are discussed, including supported employment and vocational rehabilitation for social participation and exercising with savoring strategies to increase positive rumination.

A new micro-intervention to increase the enjoyment and continued practice of meditation

New health behaviors are difficult to maintain and meditation is no different. We tested two key pathways of the upward spiral theory of lifestyle change (Fredrickson, 2013), which identifies positive emotions as critical ingredients for the maintenance of new health behaviors. The present experiment combined a laboratory session that introduced novices to meditation with a 3-week follow-up period to assess the extent to which study participants maintained this new health behavior. In a 2 × 2 experimental design, midlife adults (N = 240) were randomized to (a) learn about judicious ways to prioritize positivity (labeled "prioritizing positivity plus") or about a control topic that also featured the science of positive emotions and (b) follow a guided meditation based on either loving-kindness, which provided an opportunity to self-generate positive emotions, or mindfulness, which did not. All participants rated their emotions following the initial guided meditation and reported, week by week, whether they meditated during the ensuing 21 days. Analyses revealed that being exposed to the prioritizing positivity plus microintervention, relative to a control passage, amplified the effect of engaging in loving-kindness (vs. mindfulness) meditation on positive emotions. Additionally, the degree to which participants experienced positive emotions during first exposure to either meditation type predicted the frequency and duration at which they practiced meditation over the next 21 days. These findings show that the enjoyment of meditation can be experimentally amplified and that initial enjoyment predicts continued practice. Discussion spotlights the importance of differentiating effective and ineffective ways to pursue happiness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The dual-system theory of bipolar spectrum disorders: A meta-analysis

Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dualsystem theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.

General and contextualized emotion goals and its link with well-being across late, middle, and young adulthood

Prior research with young adults has shown how emotion goals (i.e., cognitive representations of preferred emotional states) can be instrumental (positive or negative) depending on the context and how this context sensitivity is linked to higher well-being. However, this research has overlooked older adults. We argue it is important looking at this age group as there is mixed evidence given that on one hand they have been described as exhibiting a positivity bias (hedonic orientation; preference for positive emotion goals), and on the other hand, being capable of suppressing this when it is adaptive to do so. Importantly, this bias towards positive emotion goals has been linked to better emotion regulation and higher well-being in older adults. In order to understand whether older adults can also exhibit instrumental emotion goals and whether this is linked to well-being, we conducted an exploratory study with older (N = 43, M_age  = 68.33), middle (N = 47, M_age  = 43.83), and young adults (N = 47; M_age  = 21.98) who reported about their general and contextual emotion goals (in collaboration and confrontation), their well-being, and their current positive and negative affect. Although older adults reported lower negative affect than young adults, there were no age differences for general and contextualized emotion goals. Across the three age groups, a higher preference for happiness in general and in collaboration was linked to higher well-being. The obtained results highlight the need to study emotion goals longitudinally to better understand their possible changes throughout the lifespan and their influence on well-being.

Peripherally Physiological Responses to External Emotions and Their Transitions in Bipolar I Disorder With and Without Hypersexuality

Hypersexuality is associated with psychiatric disorders such as mania; however, it remains unclear whether bipolar I disorder with (BW) or without (BO) hypersexuality demonstrates different responses to external emotional stimuli and their transitions that were composed of pictures and sounds of same domain. In 21 BW patients, 20 BO patients, and 41 healthy volunteers, we administered polygraph tests (electrocardiogram, electromyogram, electrooculogram, and galvanic skin response) to measure transitions from a primer emotion (i.e., external disgust, erotica, fear, happiness, neutral, and sadness) to a noncongruent emotion (out of the remaining five) and to the primer emotion again (repeat-primer). We also evaluated participants' concurrent states of mania, hypomania, and depression. With neutral as the noncongruent emotion, the heart rate difference in BW was greater than in controls when responses to the primer erotica were subtracted from responses to the repeat-primer erotica, or when to the primer sadness were subtracted from the repeat-primer sadness. The difference of the masseter electromyographic activity in BW was lower than in BO and controls when responses to the noncongruent happiness were subtracted from responses to the repeat-primer neutral, and was lower than in BO when to the noncongruent neutral were subtracted from the repeat-primer erotica. The eyeball movement difference was greater in BW than in BO and controls when responses to the noncongruent sadness were subtracted from responses to the repeat-primer neutral. The heart rate difference when responses to the primer happiness were subtracted from responses to the noncongruent neutral was negatively correlated with mania in BO. BW and BO patients behaved differently to external emotions and their transitions, particularly regarding erotica and sadness, which might characterize unique pathophysiological processes of the two bipolar I disorder subtypes.

Vulnerability to bipolar disorder is linked to sleep and sleepiness

Sleep impairments are a hallmark of acute bipolar disorder (BD) episodes and are present even in the euthymic state. Studying healthy subjects who are vulnerable to BD can improve our understanding of whether sleep impairment is a predisposing factor. Therefore, we investigated whether vulnerability to BD, dimensionally assessed by the hypomanic personality scale (HPS), is associated with sleep disturbances in healthy subjects. We analyzed participants from a population-based cohort who had completed the HPS and had either a 7-day actigraphy recording or a Pittsburgh sleep quality index (PSQI) assessment. In addition, subjects had to be free of confounding diseases or medications. This resulted in 771 subjects for actigraphy and 1766 for PSQI analyses. We found strong evidence that higher HPS scores are associated with greater intraindividual sleep variability, more disturbed sleep and more daytime sleepiness. In addition, factor analyses revealed that core hypomanic features were especially associated with self-reported sleep impairments. Results support the assumption of disturbed sleep as a possibly predisposing factor for BD and suggest sleep improvement as a potential early prevention target.

A positive emotion regulation intervention for bipolar I disorder: Treatment development and initial outcomes

OBJECTIVE

Dysfunction in positive affect is a defining symptom of bipolar I disorder (BD), both during and between mood episodes. We hypothesize that helping people with BD learn skills to create balance in their affective experiences by engaging in strategies that increase low activation positive emotion (LAP; e.g., relaxation) could help to improve well-being during periods of symptom remission. We discuss the development and preliminary outcomes of a positive emotion regulation (PER) group treatment for people with BD, designed as a supplement to pharmacological treatment.

METHOD

The Learning Affective Understanding for a Rich Emotional Life (LAUREL) intervention is a group-based intervention covering 10 empirically supported skills designed to increase LAP. Sixteen people with BD enrolled in the LAUREL intervention and twelve completed baseline and post-intervention assessments.

RESULTS

Participants who completed the study (n = 12) attended the majority of groups (87.96%) and reported practicing skills, on average, 16 times a week. We were unable to detect significant differences in mania symptoms following engagement in this PER intervention. Finally, participants reported increases in several areas associated with well-being post-intervention, including mindfulness, reappraisal, and self-compassion.

CONCLUSION

This study provides a theoretical framework and preliminary support for a PER intervention for BD.

How do I want to feel? The link between emotion goals and difficulties in emotion regulation in borderline personality disorder

OBJECTIVES

Appropriate contextualized emotion goals (i.e., desired emotional endpoints that facilitate goal attainment) are fundamental to emotion regulation, as they may determine the direction of regulation efforts. Given that difficulties in emotion regulation are prevalent in borderline personality disorder (BPD), we explored whether BPD traits (Study 1) and BPD diagnosis (Study 2) presented specific contextualized emotion goals, and whether these emotion goals may be linked to difficulties in emotion regulation.

METHODS

In Study 1, 358 individuals were recruited via Amazon Mechanical Turk and assessed on the presence of borderline traits, emotion regulation ability, and general and contextualized emotion goals. In Study 2, these measures were employed in a sample of 35 people with BPD and 35 matched controls who were also assessed on their current mood state and screened for Axis I and II disorders of the DSM-IV.

RESULTS

Study 1 showed that emotion dysregulation was positively predicted by borderline traits and contextualized emotion goals that impair goal attainment (i.e., greater preference for anger for collaboration and happiness for confrontation). Findings of Study 2 also showed that a higher preference for happiness for confrontation was linked to higher emotion dysregulation in both individuals with BPD and controls. Furthermore, individuals with BPD reported a lower preference for happiness for collaboration than controls.

CONCLUSIONS

These results support the importance of looking at emotion goals and its link with emotion dysregulation. Interventions targeting maladaptive contextualized goals may represent an important therapeutic window to enhance emotion regulation.

PRACTITIONER POINTS

Clinical implications BPD individuals' emotion regulation is linked to maladaptive emotion goals. Helping people at risk to manipulate their emotion goals to be more context sensitive may enhance well-being and serve as a therapeutic tool in practice. Limitations The present research only considered the context of collaboration and confrontation, but other contexts more relevant for individuals with BPD (i.e., self-harm situations) might provide valuable information about their difficulties in emotion regulation. To study contextualized emotion goals in clinical populations, longitudinal rather than cross-sectional designs should be considered.

Multivariate associations of ideal affect with clinical symptoms

Prior research has indicated that ideal affect (i.e., the affective states that people value and would ideally like to experience) may be relevant to mental health outcomes. Studies to date, however, have not used comprehensive multivariate models that account for covariation among facets of ideal affect and incorporate multiple clinical outcomes. In the present studies, we used structural equation modeling to examine the multivariate effects of ideal affect on symptoms of depression, anxiety, and alcohol abuse in 2 moderately large samples of undergraduates (N = 293 and N = 146). Exploratory results of Study 1 indicated that valuation of high arousal positive affective states was significantly associated with lower depression symptoms but higher anxiety and alcohol abuse symptoms and that valuation of high arousal negative states was specifically associated with greater anxiety symptoms. These results were shown to be structurally invariant across samples and ethnicities in Study 2, which also found that ideal-actual affect discrepancies were significantly associated with symptoms of depression and anxiety. These findings support and extend the hypothesis that ideal affect is implicated in clinical outcomes by highlighting the importance of jointly considering multiple facets of ideal and actual affect as they relate to a range of clinical syndromes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Interactive Effect of Happiness Emotion Goals and Emotion Regulation Self-Efficacy on Anxiety and Depression

Overvaluation of happiness might be a transdiagnostic risk factor for psychopathology. However, emotion regulation self-efficacy may influence the association between happiness emotion goals and psychopathology. The purpose of the present study was twofold. First, we sought to replicate prior findings showing that happiness emotion goals and depressive symptoms are positively related, but only among those with lower emotion regulation self-efficacy. Second, we examined whether the noted interaction effect would relate to generalized anxiety symptoms in a sample of general population adults (N = 504). Results from regression analyses were consistent with our predictions suggesting that individuals with unrealistic happiness emotion goals and low emotion regulation self-efficacy may be particularly prone to experiencing negative emotional states and psychological distress. Further, study findings suggest the possibility that the noted interaction has transdiagnostic value and it may be important to target emotion regulation self-efficacy in the service of alleviating internalizing psychopathology.

The Positivity Scale: Concurrent and Factorial Validity Across Late Childhood and Early Adolescence

Despite the well-established protective functions of positivity (i.e., a dispositional self-evaluative tendency to view oneself, life, and future under a positive outlook) from middle adolescence to old age, its reliable assessment and contribution to a proper psychological functioning have received little attention during previous developmental phases. In this article, we aimed to evaluate the psychometric properties and construct validity of the eight-item Positivity Scale (P Scale; Caprara et al., 2012) during late childhood and early adolescence in a sample of British students (N = 742; 48% boys) from both primary (M_age = 10.75, SD = 0.52) and secondary schools (M_age = 13.38 years, SD = 0.94). First, results from confirmatory factor analysis (CFA) attested to the plausibility of the hypothesized 1-factor structure of the P Scale in a revised CFA model including the correlation between the residuals of two items similar in their wording. Next, we found evidence for strong (scalar) measurement invariance of the P Scale across late childhood and early adolescence as well as for its concurrent validity as indicated by expected relations of positivity to indicators of adjustment (i.e., prosocial behavior) and maladjustment (i.e., externalizing and internalizing problems). Overall, these findings support the concurrent and factorial validity of the P Scale as a short self-report instrument to measure children’s tendency to view their experience from a positive stance. We discuss the implications of our results for improving the wording of the items composing P Scale as well as for understanding the dispositional mechanisms conducive to psychological health and wellbeing across late childhood and early adolescence.

Contra-Hedonic Attitudes Toward Pleasant Emotions in China: Links to Hedonism, Emotion Expression, and Depression

Introduction: Contra-hedonic attitudes toward pleasant emotions are culturally dominant in Chinese culture, but less is known about its links with hedonism, emotion expression and depression.

Method: We examined how attitudes toward pleasant emotions (measured by the Implicit Association Test) mediated the relation between hedonism and emotion expression (Study 1) and whether contra-hedonic attitudes toward pleasant emotions moderated the relation between emotion expression and depression (Study 2).

Results: Chinese implicitly evaluated pleasant emotions as negative and valued hedonism less important in daily lives. As less important in Chinese culture, hedonism may shape individual emotion expression through the influence of implicit attitudes toward pleasant emotions. In line with prior research, emotion expression was associated with higher level of depression. However, this relation was moderated by the extent to which individual evaluated pleasant emotions as negative.

Discussion: These findings highlight the importance of how people evaluate pleasant emotions to understand emotion expression and emotional states from a cultural perspective.

Why Beliefs About Emotion Matter: An Emotion-Regulation Perspective

The world is complicated, and we hold a large number of beliefs about how it works. These beliefs are important because they shape how we interact with the world. One particularly impactful set of beliefs centers on emotion, and a small but growing literature has begun to document the links between emotion beliefs and a wide range of emotional, interpersonal, and clinical outcomes. Here, we review the literature that has begun to examine beliefs about emotion, focusing on two fundamental beliefs, namely whether emotions are good or bad and whether emotions are controllable or uncontrollable. We then consider one underlying mechanism that we think may link these emotion beliefs with downstream outcomes, namely emotion regulation. Finally, we highlight the role of beliefs about emotion across various psychological disciplines and outline several promising directions for future research.

Haste or Speed? Alterations in the Impact of Incentive Cues on Task Performance in Remitted and Depressed Patients With Bipolar Disorder

A variety of evidence suggests that bipolar disorder is associated with disruptions of reward related processes, although the properties, and scope of these changes are not well understood. In the present study, we aimed to address this question by examining performance of patients with bipolar disorder (30 depressed bipolar; 35 euthymic bipolar) on a motivated choice reaction time task. We compared performance with a group of healthy control individuals (n = 44) and a group of patients with unipolar depression (n = 41), who were matched on several demographic variables. The task consists of an "odd-one-out" discrimination, in the presence of a cue signaling the probability of reward on a given trial (10, 50, or 90%) given a sufficiently fast response. All groups showed similar reaction time (RT) performance, and similar shortening of RT following the presentation of a reward predictive cue. However, compared to healthy individuals, the euthymic bipolar group showed a relative increase in commission errors during the high reward compared to low condition. Further correlational analysis revealed that in the healthy control and unipolar depression groups, participants tended either to shorten RTs for the high rather than low reward cue a relatively large amount with an increase in error rate, or to shorten RTs to a lesser extent but without increasing errors to the same degree. By contrast, reward-related speeding and reward-related increase in errors were less well coupled in the bipolar groups, significantly so in the BPD group. These findings suggest that although RT performance on the present task is relatively well matched, there may be a specific failure of individuals with bipolar disorder to calibrate RT speed and accuracy in a strategic way in the presence of reward-related stimuli.

The psychological health benefits of accepting negative emotions and thoughts: Laboratory, diary, and longitudinal evidence

Individuals differ in the degree to which they tend to habitually accept their emotions and thoughts without judging them-a process here referred to as habitual acceptance. Acceptance has been linked with greater psychological health, which we propose may be due to the role acceptance plays in negative emotional responses to stressors: acceptance helps keep individuals from reacting to-and thus exacerbating-their negative mental experiences. Over time, experiencing lower negative emotion should promote psychological health. To test these hypotheses, Study 1 (N = 1,003) verified that habitually accepting mental experiences broadly predicted psychological health (psychological well-being, life satisfaction, and depressive and anxiety symptoms), even when controlling for potentially related constructs (reappraisal, rumination, and other mindfulness facets including observing, describing, acting with awareness, and nonreactivity). Next, in a laboratory study (Study 2, N = 156), habitual acceptance predicted lower negative (but not positive) emotional responses to a standardized stressor. Finally, in a longitudinal design (Study 3, N = 222), acceptance predicted lower negative (but not positive) emotion experienced during daily stressors that, in turn, accounted for the link between acceptance and psychological health 6 months later. This link between acceptance and psychological health was unique to accepting mental experiences and was not observed for accepting situations. Additionally, we ruled out potential confounding effects of gender, ethnicity, socioeconomic status, and life stress severity. Overall, these results suggest that individuals who accept rather than judge their mental experiences may attain better psychological health, in part because acceptance helps them experience less negative emotion in response to stressors. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effectiveness of Teach-Back Self-Management Training Program on Happiness of Breast Cancer Patients

Self-management training is one of the ways to empower patients to cope with disease. The aim of this before-and-after quasi-experimental study was to determine effects of a teach-back self-management training method on breast cancer patient happiness. Fifty breast cancer patients who visited the Park-e Neshat Limited Surgery Clinic in Kerman, Iran were randomly divided into intervention and control groups after convenience sampling and checking for inclusion eligibility. Data were collected using a demographic questionnaire and the Oxford Happiness Inventory before and after teach-back training and analyzed using SPSS 23. Findings showed no significant difference between mean happiness scores in the two groups before the intervention. However, after the intervention, the mean happiness score in the intervention group increased from 37.2 to 62.9, while it decreased from 41.4 to 29.8 in the control group. These changes were statistically significant (p<0.001). Even after controlling for the effect of confounding factors such as residence location and history of cancer education, the observed differences between the groups were statistically significant (p<0.001). A teach-back self-management training program can increase happiness levels in breast cancer patients. Therefore, the use of this method is recommended to improve self-management and increase happiness.

Is Valuing Happiness Associated With Lower Well-Being? A Factor-Level Analysis using the Valuing Happiness Scale

Recent studies suggest that valuing happiness is negatively associated with well-being. Most of these studies used the Valuing Happiness Scale (Mauss, Tamir, et al., 2011). In the present paper, we examined the factor structure of this scale using data pooled from six independent samples (Ntotal = 938). Exploratory and confirmatory factor analysis showed that the Valuing Happiness Scale is not unidimensional and that only one of its three factors correlates negatively with various indicators of well-being, whereas non-significant or positive correlations were found for the other factors. These findings indicate that valuing happiness may not necessarily be bad for one's well-being, and call for a better definition, theoretical foundation, and operationalization of this construct.

Culture shapes whether the pursuit of happiness predicts higher or lower well-being

Pursuing happiness can paradoxically impair well-being. Here, the authors propose the potential downsides to pursuing happiness may be specific to individualistic cultures. In collectivistic (vs. individualistic) cultures, pursuing happiness may be more successful because happiness is viewed--and thus pursued--in relatively socially engaged ways. In 4 geographical regions that vary in level of collectivism (United States, Germany, Russia, East Asia), we assessed participants' well-being, motivation to pursue happiness, and to what extent they pursued happiness in socially engaged ways. Motivation to pursue happiness predicted lower well-being in the United States, did not predict well-being in Germany, and predicted higher well-being in Russia and in East Asia. These cultural differences in the link between motivation to pursue happiness and well-being were explained by cultural differences in the socially engaged pursuit of happiness. These findings suggest that culture shapes whether the pursuit of happiness is linked with better or worse well-being, perhaps via how people pursue happiness.