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Byllesby BM, Palmieri PA. The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment. J Trauma Stress 2024. [PMID: 39137125 DOI: 10.1002/jts.23092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 08/15/2024]
Abstract
Distress tolerance, or the perceived ability to tolerate negative emotional states, is often associated with posttraumatic stress disorder (PTSD) such that higher distress tolerance is generally associated with less severe PTSD symptom levels. As distress tolerance is often considered a risk and maintenance factor in distress disorders, examining the association between changes in distress tolerance and changes in PTSD symptoms may have clinical relevance. The present study examined the associations between PTSD symptom severity and distress tolerance across three assessment points over 12 weeks among 212 patients receiving outpatient psychotherapy services. Using random-intercept cross-lagged panel modeling (RI-CLPM), concurrent and prospective associations between PTSD and distress tolerance were examined. PTSD symptoms at Time 1 and Time 2 significantly predicted distress tolerance at Time 2, β = -.296, and Time 3, β = -.395, respectively. Distress tolerance did not predict subsequent PTSD symptom severity. Exploratory analyses examined distress tolerance and four PTSD symptom clusters over time. Patterns of results differed across clusters, though it was consistent that only PTSD symptom clusters predicted subsequent distress tolerance and not vice versa. The results support the interrelationship of changes in psychopathology and emotional distress tolerance and indicate that distress tolerance may be an important factor in symptom remission during PTSD treatment.
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Affiliation(s)
- Brianna M Byllesby
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
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Wang X, Shao S, Cai Z, Ma C, Jia L, Blain SD, Tan Y. Reciprocal effects between negative affect and emotion regulation in daily life. Behav Res Ther 2024; 176:104518. [PMID: 38492548 DOI: 10.1016/j.brat.2024.104518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
The extended process model of emotion regulation provides a framework for understanding how emotional experiences and emotion regulation (ER) mutually influence each other over time. To investigate this reciprocal relationship, 202 adults completed a ten-day experience-sampling survey capturing levels of negative affect (NA) experience and use of ten ER strategies in daily life. Residual dynamic structural equation models (DSEMs) were used to examine within-person cross-lagged and autoregressive effects of NA and ER (strategy use and between-strategy variability). Results showed that NA predicted lower between-strategy variability, lower subsequent use of acceptance and problem-solving, but higher subsequent use of rumination and worry. Moreover, reappraisal and between-strategy variability predicted lower subsequent NA levels, while expressive suppression and worry predicted higher subsequent NA levels. Stable autoregressive effects were found for NA and for maladaptive ER strategies (e.g., rumination and worry). Exploratory correlation analyses revealed positive associations between NA inertia and maladaptive ER strategies. Together, these findings provide evidence of a dynamic interplay between NA and ER. This work deepens how we understand the challenges of applying ER strategies in daily life. Future clinical and translational research should consider these dynamic perspectives on ER and affect.
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Affiliation(s)
- Xiaoqin Wang
- Department of Psychology, Zhejiang Normal University, Jinhua, 321004, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China.
| | - Shiyu Shao
- Department of Psychology, Zhejiang Normal University, Jinhua, 321004, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China
| | - Zhouqu Cai
- School of Psychology, Central China Normal University, Wuhan, 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China
| | - Chenyue Ma
- School of Psychology, Central China Normal University, Wuhan, 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China
| | - Lei Jia
- Department of Psychology, Zhejiang Normal University, Jinhua, 321004, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China
| | - Scott D Blain
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, 43210, United States
| | - Yafei Tan
- School of Psychology, Central China Normal University, Wuhan, 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, 430079, China.
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Del Giacco AC, Jones SA, Hernandez KO, Barnes SJ, Nagel BJ. Heightened adolescent emotional reactivity in the brain is associated with lower future distress tolerance and higher depressive symptoms. Psychiatry Res Neuroimaging 2023; 333:111659. [PMID: 37263126 PMCID: PMC10330591 DOI: 10.1016/j.pscychresns.2023.111659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 05/18/2023] [Indexed: 06/03/2023]
Abstract
Distress tolerance, the ability to persist while experiencing negative psychological states, is essential for regulating emotions and is a transdiagnostic risk/resiliency trait for multiple psychopathologies. Studying distress tolerance during adolescence, a period when emotion regulation is still developing, may help identify early risk and/or protective factors. This study included 40 participants (mean scan age = 17.5 years) and using an emotional Go-NoGo functional magnetic resonance imaging task and voxel-wise regression analysis, examined the association between brain response during emotional face processing and future distress tolerance (two ± 0.5 years), controlling for sex assigned at birth, age, and time between visits. Post-hoc analyses tested the mediating role of distress tolerance on the emotional reactivity and depressive symptom relationship. Whole-brain analysis showed greater inferior occipital gyrus activation was associated with less distress tolerance at follow-up. The mediating role of distress tolerance demonstrated a trend-level indirect effect. Findings suggest that individuals who allocate greater visual resources to emotionally salient information tend to exhibit greater challenges in tolerating distress. Distress tolerance may help to link emotional reactivity neurobiology to future depressive symptoms. Building distress tolerance through emotion regulation strategies may be an appropriate strategy for decreasing depressive symptoms.
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Affiliation(s)
- Amanda C Del Giacco
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Scott A Jones
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Kristina O Hernandez
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Samantha J Barnes
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Bonnie J Nagel
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America; Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, United States of America.
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Pugach CP, May CL, Wisco BE. Positive emotion in posttraumatic stress disorder: A global or context-specific problem? J Trauma Stress 2023; 36:444-456. [PMID: 36987701 PMCID: PMC10101918 DOI: 10.1002/jts.22928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 03/30/2023]
Abstract
Problems with positive emotion are an important component of posttraumatic stress disorder (PTSD), with competing perspectives as to why. The global model suggests that people with PTSD experience a relatively permanent shift in their capacity for positive emotion regardless of context, whereas the context-specific model posits access to the full repertoire of positive emotion that only becomes reduced during exposure to trauma reminders. We tested the global versus context-specific models using ecological momentary assessment (EMA). Trauma-exposed adult community members (N = 80) with (n = 39) and without diagnosed PTSD completed 3 days of EMA (n = 2,158 observations). Participants with PTSD reported lower average momentary levels of positive emotion, B = -0.947, 95% CI [-1.35, -0.54], p < .001, and positive situations, B = -0.607, 95% CI [-1.16, -0.05], p = .032, and more thinking about trauma reminders, B = 0.360, 95% CI [0.21, 0.51], p < .001. There was no between-group difference in positive emotion reactivity (degree of positive emotion derived from positive situations), B = 0.03, 95% CI [-0.09, 0.14], p = .635. Increased thinking about trauma reminders predicted lower momentary levels of positive emotion, B = -0.55, 95% CI [-0.83, -0.26], p < .001, but not reactivity, B = 0.02, 95% CI [-0.35, 0.40], p = .906, irrespective of PTSD status. Findings supported the global model and were inconsistent with the context-specific model. This study helps clarify positive emotional functioning in trauma-exposed adults and highlights future directions to better understand problems with positive emotion in PTSD.
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Affiliation(s)
- Cameron P Pugach
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Casey L May
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Blair E Wisco
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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Zhu JY, Plamondon A, Goldstein AL, Snorrason I, Katz J, Björgvinsson T. Dynamics of daily positive and negative affect and relations to anxiety and depression symptoms in a transdiagnostic clinical sample. Depress Anxiety 2022; 39:932-943. [PMID: 36372960 DOI: 10.1002/da.23299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite interest in transdiagnostic dimensional approaches to psychopathology, little is known about the dynamic interplay of affecting and internalizing symptoms that cut across diverse mental health disorders. We examined within-person reciprocal effects of negative and positive affect (NA, PA) and symptoms (depression and anxiety), and their between-person associations with affective dynamics (i.e., affect inertia). METHODS Individuals currently receiving treatment for psychological disorders (N = 776) completed daily assessments of affect and symptoms across 14 treatment days (average). We used dynamic structural equation modeling to examine daily affect-symptom dynamics. RESULTS Within-person results indicated NA-symptom reciprocal effects; PA only predicted subsequent depression symptoms. After accounting for changes in mean symptoms and affect over time, NA-anxiety and PA-depression relations remained particularly robust. Between-person correlations indicated NA inertia was positively associated with NA-symptom effects; PA inertia was negatively associated with PA-symptoms effects. CONCLUSIONS Results suggest that transdiagnostic affective treatment approaches may be more useful for reducing internalizing symptoms by decreasing NA compared to increasing PA. Individual differences in resistance to shifting out of affective states (i.e., high NA vs. PA inertia) may be a useful marker for developing tailored interventions.
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Affiliation(s)
- Joyce Y Zhu
- Department of Applied Psychology & Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - André Plamondon
- Department of Educational Fundamentals and Practices, Université Laval, Quebec City, Quebec, Canada
| | - Abby L Goldstein
- Department of Applied Psychology & Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Ivar Snorrason
- Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jasmin Katz
- Department of Applied Psychology & Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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Ariens S, Adolf JK, Ceulemans E. Collinearity Issues in Autoregressive Models with Time-Varying Serially Dependent Covariates. MULTIVARIATE BEHAVIORAL RESEARCH 2022:1-19. [PMID: 35917285 DOI: 10.1080/00273171.2022.2095247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
First-order autoregressive models are popular to assess the temporal dynamics of a univariate process. Researchers often extend these models to include time-varying covariates, such as contextual factors, to investigate how they moderate processes' dynamics. We demonstrate that doing so has implications for how well one can estimate the autoregressive and covariate effects, as serial dependence in the variables can imply predictor collinearity. This is a noteworthy contribution, since in current practice serial dependence in a time-varying covariate is rarely considered important. We first recapitulate the role of predictor collinearity for estimation precision in an ordinary least squares context, by discussing how it affects estimator variances, covariances and correlations. We then derive a general formula detailing how predictor collinearity in first-order autoregressive models is impacted by serial dependence in the covariate. We provide a simulation study to illustrate the implications of the formula for different types of covariates. The simulation results highlight when the collinearity issue becomes severe enough to hamper interpretation of the effects. We also show that the effect estimates can be biased in small samples (i.e., 50 time points). Implications for study design, the use of time as a predictor, and related model variants are discussed.
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Affiliation(s)
- Sigert Ariens
- Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven
| | - Janne K Adolf
- Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven
| | - Eva Ceulemans
- Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven
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Kyron MJ, Hooke GR, Bryan CJ, Page AC. Distress tolerance as a moderator of the dynamic associations between interpersonal needs and suicidal thoughts. Suicide Life Threat Behav 2022; 52:159-170. [PMID: 34741322 DOI: 10.1111/sltb.12814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/04/2021] [Accepted: 08/23/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Identifying the interaction between dispositional and dynamic risk factors is necessary in understanding, predicting, and managing suicide risk. Interpersonal factors have consistently been linked to suicidal ideation over short-term periods. Additionally, distress tolerance may be a relevant dispositional protective factor against stressful events. METHODS Seven hundred and seventeen psychiatric inpatients (Male = 30.31%, Average Age = 40.71 years, Min = 14, Max = 82) self-reported their distress tolerance at hospital admission, and interpersonal needs and suicidal ideation on a daily basis. Dynamic structural equation modelling was used to examine whether within-level dynamics were moderated by distress tolerance. RESULTS Both perceived burdensomeness and thwarted belongingness were significantly associated with same-day suicidal ideation. Higher distress tolerance was associated with weaker daily associations between suicidal ideation and both perceived burdensomeness and thwarted belongingness. Distress tolerance was also associated with lower variability in suicidal ideation. Moderating effects were also evident when lifetime suicide attempts were added as a covariate, which was associated with stronger associations between interpersonal dysfunction and suicidal ideation, and higher variability in ideation. CONCLUSIONS Distress tolerance may be important to consider when examining the dynamic relationships between suicidal ideation and proximal factors. Psychotherapy that specifically targets distress tolerance may be effective in reducing reactivity to interpersonal stressors.
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Affiliation(s)
- Michael J Kyron
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia.,Graduate School of Education, University of Western Australia, Crawley, WA, Australia
| | - Geoff R Hooke
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia.,Perth Clinic, Perth, WA, Australia
| | - Craig J Bryan
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Andrew C Page
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
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