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Trudel-Fitzgerald C, Lee LO, Guimond AJ, Chen R, James P, Koga HK, Lee HH, Okuzono SS, Grodstein F, Rich-Edwards J, Kubzansky LD. A long and resilient life: the role of coping strategies and variability in their use in lifespan among women. ANXIETY, STRESS, AND COPING 2024; 37:473-486. [PMID: 38031408 PMCID: PMC11133228 DOI: 10.1080/10615806.2023.2288333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Associations of stress-related coping strategies with lifespan among the general population are understudied. Coping strategies are characterized as being either adaptive or maladaptive, but it is unknown the degree to which variability in tailoring their implementation to different contexts may influence lifespan. METHOD Women (N = 54,353; Mage = 47) completed a validated coping inventory and reported covariate information in 2001. Eight individual coping strategies (e.g., Acceptance, Denial) were considered separately. Using a standard deviation-based algorithm, participants were also classified as having lower, moderate, or greater variability in their use of these strategies. Deaths were ascertained until 2019. Accelerated failure time models estimated percent changes and 95% confidence intervals (CI) in predicted lifespan associated with coping predictors. RESULTS In multivariable models, most adaptive and maladaptive strategies were associated with longer and shorter lifespans, respectively (e.g., per 1-SD increase: Active Coping = 4.09%, 95%CI = 1.83%, 6.41%; Behavioral Disengagement = -6.56%, 95%CI = -8.37%, -4.72%). Moderate and greater (versus lower) variability levels were similarly and significantly related to 8-10% longer lifespans. Associations were similar across age, racial/ethnic, residential income, and marital status subgroups. CONCLUSIONS Findings confirm the adaptive and maladaptive nature of specific coping strategies, and further suggest benefits from both moderate and greater variability in their use for lifespan among women.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Psychology, Université du Québec à Trois-Rivières
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health
| | - Lewina O. Lee
- National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System
- Department of Psychiatry, Boston University School of Medicine
| | - Anne-Josée Guimond
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | - Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute
- Department of Environmental Health, Harvard T.H. Chan School of Public Health
| | - Hayami K. Koga
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | - Harold H. Lee
- Department of Epidemiology, University of North Carolina at Chapel Hill
- Department of Biobehavioral Health, Pennsylvania State University
| | - Sakurako S. Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | - Francine Grodstein
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health
- Rush Alzheimer’s Disease Center, Rush Medical College
| | - Janet Rich-Edwards
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital
- Department of Epidemiology, Harvard T.H. Chan School of Public Health
| | - Laura D. Kubzansky
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
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A Scoping Review and Field Guide of Theoretical Approaches and Recommendations to Studying the Decision to Adopt Hearing Aids. Ear Hear 2022; 44:460-476. [PMID: 36536499 DOI: 10.1097/aud.0000000000001311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Given the low rates of hearing aid adoption among individuals with hearing loss, it is imperative to better understand the decision-making processes leading to greater hearing aid uptake. A careful analysis of the existing literature on theoretical approaches to studying these processes is needed to help researchers frame hypotheses and methodology in studies on audiology. Therefore, we conducted a scoping review with two aims. First, we examine theories that have been used to study research on hearing aid adoption. Second, we propose additional theories from the behavioral sciences that have not yet been used to examine hearing aid uptake but that can inform future research. DESIGN We identified peer-reviewed publications whose research was driven by one or more theoretical approaches by searching through PubMed, ProQuest PsycINFO, CINHAL Plus, Web of Science, Scopus, and OVID Medline/Embase/PsycINFO. The publications were examined by two researchers for eligibility. RESULTS Twenty-three papers were included in the analysis. The most common theoretical approaches studied include the Health Belief Model, the Transtheoretical Model of Behavior Change, Self-Determination Theory, and the COM-B Model. Seven other theoretical frameworks based on cognitive psychology and behavioral economics have also appeared in the literature. In addition, we propose considering nudge theory, framing effect, prospect theory, social learning theory, social identity theory, dual process theories, and affective-based theories of decision making when studying hearing aid adoption. CONCLUSIONS We conclude that, although a number of theories have been considered in research on hearing aid uptake, there are considerable methodological limitations to their use. Furthermore, the field can benefit greatly from the inclusion of novel theoretical approaches drawn from outside of audiology.
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Trudel-Fitzgerald C, Chen R, Lee LO, Kubzansky LD. Are coping strategies and variability in their use associated with lifespan? J Psychosom Res 2022; 162:111035. [PMID: 36152346 PMCID: PMC10410682 DOI: 10.1016/j.jpsychores.2022.111035] [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: 05/05/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Some stress-related coping strategies contribute to survival among medical populations, but it is unclear if they relate to longevity in the general population. While coping strategies are characterized as being adaptive or maladaptive, whether capacity to tailor their implementation to different contexts (i.e., flexibility of use) may influence lifespan is unknown. METHOD In 2004-2006, participants from the Midlife Development in the United States study completed a validated coping inventory including 6 strategies and provided information on sociodemographics, health status, and biobehavioral factors (N = 4398). Deaths were ascertained from death registries with follow-up until 2018. Accelerated failure time models estimated percent changes and 95% confidence intervals (CI) in predicted lifespan associated with use of individual coping strategies. As a proxy for flexibility, participants were also classified as having lower, moderate, or greater variability in strategies used, using a standard deviation-based algorithm. RESULTS After controlling for sociodemographics and health status, maladaptive strategies (e.g., per 1-SD increase in Denial = -5.50, 95%CI = -10.50, -0.21) but not adaptive strategies (e.g., Planning) were related to shorter lifespan. Greater versus moderate variability levels were related to a 15% shorter lifespan. Estimates were somewhat attenuated when further controlling for lifestyle factors. CONCLUSION Although most associations were of modest magnitude, use of some maladaptive coping strategies appeared related to shorter lifespan. Compared to moderate levels, greater coping variability levels were also clearly detrimental for lifespan. Although adaptive strategies were unrelated to longevity, future work should examine other favorable strategies (e.g., acceptance) and more direct measures of flexibility (e.g., experience sampling methods).
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, United States.
| | - Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States.
| | - Lewina O Lee
- National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System, United States; Department of Psychiatry, Boston University School of Medicine, United States.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, United States.
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O’Leary D, Smith A, Salehi E, Gross JJ. Negative Affect, Affect Regulation, and Food Choice: A Value-Based Decision-Making Analysis. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2022. [DOI: 10.1177/19485506221079947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Maladaptive eating is one of the greatest threats to health and well-being in the 21st century. Psychological factors that drive maladaptive eating are of interest as they may offer low-cost intervention targets. One such factor is negative affect. If negative affect does lead to maladaptive eating, interventions that reduce negative affect should lead to improved eating and food choice. One relevant class of techniques is affect regulation strategies. In the present research, we use survey data and a value-based decision-making task to demonstrate that negative affect is associated with maladaptive eating and food choice. We find that negative affect decreases the weight that participants place on the health benefits of food. We also show that teaching participants to use reappraisal to downregulate negative affect leads to healthier food choices. These findings indicate that reappraisal applied to incidental negative affect may be an effective method for improving eating and food choice.
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Mason TB, Smith KE. Delineating the role of binge eating in cancer research. Eat Weight Disord 2021; 26:2109-2116. [PMID: 33201393 DOI: 10.1007/s40519-020-01066-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/26/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Binge eating is defined as consumption of a large amount of food accompanied by a sense of loss of control over eating. While binge eating is associated with poor physical, behavioral, and psychosocial health, it has not been studied in cancer research. Therefore, the overarching goal of this review is to delineate the role of binge eating in cancer research and to spur new research in this area. Specifically, in this review, we outlined (1) binge eating as a possible risk factor that contributes to cancer risk, (2) how binge eating may develop after cancer diagnosis, and (3) how binge eating may be associated with health and relapse during survivorship. CONCLUSIONS It is critical to elucidate the role of binge eating in the prevention of cancer and long-term cancer survivorship. This review suggested a number of ways that binge eating may increase risk for cancer as well as several pathways that may lead to the development of binge eating after cancer diagnosis. LEVEL OF EVIDENCE Level V: narrative review.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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O'Leary D, Uysal A, Rehkopf DH, Gross JJ. Subjective social status and physical health: The role of negative affect and reappraisal. Soc Sci Med 2021; 291:114272. [PMID: 34717282 DOI: 10.1016/j.socscimed.2021.114272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 11/19/2022]
Abstract
RATIONALE Having low subjective social status is associated with an array of negative health outcomes. However, the mechanisms linking subjective social status to health are not yet clear. One candidate mechanism is negative affect. Researchers have proposed that having low subjective social status may be associated with higher levels of negative affect, and these higher levels of negative affect may be associated with poor health. However, research demonstrating that status-related negative affect is prospectively associated with health in humans is limited. OBJECTIVE We examined whether negative affect prospectively mediates the relationship between subjective social status and physical health. In addition, we tested whether reappraisal - an affect regulation strategy used to downregulate negative affect - moderates the links among subjective social status, negative affect, and physical health. METHOD We used two-wave longitudinal data from the Midlife in the United States (MIDUS) project to conduct a series of regression, mediation, and moderated mediation analyses to examine the relationships among subjective social status, negative affect, reappraisal, and health (i.e., four outcomes, chronic conditions, somatic symptoms, self-reported health and mortality). RESULTS Negative affect mediates the relationship between status and change in morbidity (n = 3289; i.e., change in number of chronic conditions, somatic symptoms, self-reported health) and mortality (n = 4953), such that subjective social status is inversely associated with negative affect, and negative affect is positively associated with poor health. Reappraisal moderates each of these relationships, such that individuals who are low on subjective social status and have high scores on a novel measure of reappraisal experience lower levels of negative affect and better health than individuals who are low on subjective social status but who have low scores on this measure. CONCLUSION These results have important implications for our understanding of subjective social status and how it relates to physical health.
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Affiliation(s)
- Daniel O'Leary
- Department of Psychology, Stanford University Ahmet Uysal, Department of Psychology, Stanford University David H. Rehkopf, School of Medicine, Stanford University James J. Gross, Department of Psychology, Stanford University, USA.
| | - Ahmet Uysal
- Department of Psychology, Stanford University Ahmet Uysal, Department of Psychology, Stanford University David H. Rehkopf, School of Medicine, Stanford University James J. Gross, Department of Psychology, Stanford University, USA
| | - David H Rehkopf
- Department of Psychology, Stanford University Ahmet Uysal, Department of Psychology, Stanford University David H. Rehkopf, School of Medicine, Stanford University James J. Gross, Department of Psychology, Stanford University, USA
| | - James J Gross
- Department of Psychology, Stanford University Ahmet Uysal, Department of Psychology, Stanford University David H. Rehkopf, School of Medicine, Stanford University James J. Gross, Department of Psychology, Stanford University, USA
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Lopez RB, Cosme D, Werner KM, Saunders B, Hofmann W. Associations between use of self-regulatory strategies and daily eating patterns: An experience sampling study in college-aged women. MOTIVATION AND EMOTION 2021. [DOI: 10.1007/s11031-021-09903-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractPrevious theorizing suggests there are multiple means by which people regulate their emotions and impulses, but that these strategies vary in the degree to which they support goal attainment. Some have proposed that proactive strategies (e.g. situation selection, distraction) may be particularly effective, while interventive strategies (e.g. suppression) are less effective. Despite these diverging predictions, researchers have yet to examine spontaneous use of these strategies and their respective and combined efficacy when applied to momentary food desires experienced in daily life. In the present study, we assessed eating patterns for one week via ecological momentary assessment in college-aged women (N = 106). Results from pre-registered analyses indicated that using a variety of strategies, including preventative strategies such as situation selection and distraction, was associated with greater self-control success, as indexed by weaker desires, higher resistance, lower likelihood of enacting desires, and less food consumed. A similar pattern was observed when participants implemented additional strategies during desire episodes, which they were more likely to do when their desires conflicted with other self-regulatory goals. All associations were observed while controlling for momentary hunger levels, dieting status, age, and body mass index. These findings are consistent with a growing body of work assessing people’s spontaneous use of emotion regulation strategies in everyday contexts, suggesting potential meta-motivational tendencies marked by flexible and adaptive use of self-regulatory strategies.
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Hoge EA, Acabchuk RL, Kimmel H, Moitra E, Britton WB, Dumais T, Ferrer RA, Lazar SW, Vago D, Lipsky J, Schuman-Olivier Z, Cheaito A, Sager L, Peters S, Rahrig H, Acero P, Scharf J, Loucks EB, Fulwiler C. Emotion-related constructs engaged by mindfulness-based interventions: A systematic review and meta-analysis. Mindfulness (N Y) 2021; 12:1041-1062. [PMID: 34149957 PMCID: PMC8210838 DOI: 10.1007/s12671-020-01561-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined. METHODS Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. RESULTS Seventy-two studies (N=7,378) were included (MBSR k=47, MBCT k = 21, Modified k=4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d=0.58; k =36), and in all constructs assessed: depression (d=0.66; k=26), anxiety (d =0.63; k=19), combined mental health (d =0.75; k=7 ) and stress (d =0.44; k=11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population-type did not moderate results, but MBI-type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. CONCLUSIONS This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.
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Affiliation(s)
- Elizabeth A. Hoge
- Department of Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Ave NW Suite 200, Washington, DC 20007, USA
| | - Rebecca L. Acabchuk
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, 06269, USA
| | - Hannah Kimmel
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Willoughby B. Britton
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Travis Dumais
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Rebecca A. Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - David Vago
- Osher Center for Integrative Medicine, Vanderbilt University, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA
| | - Jonah Lipsky
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Zev Schuman-Olivier
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
| | - Aya Cheaito
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Lauren Sager
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Sarah Peters
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Hadley Rahrig
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Pamela Acero
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Jodi Scharf
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Eric B. Loucks
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Carl Fulwiler
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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Ferrer RA, Ellis EM. Moving beyond categorization to understand affective influences on real world health decisions. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2019; 13. [PMID: 33912229 DOI: 10.1111/spc3.12502] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This paper provides an overview of affect and health decision-making research, with a focus on identifying gaps, opportunities, and challenges to guide future research. We begin by defining common categorical distinctions of affective processes that influence health decisions: integral (i.e., related to the decision) and incidental (i.e., normatively unrelated to the decision) influences, and current (experienced in the moment) and anticipated ("cognitive representations" of future affect) affect. We then summarize key discoveries within the most common categories of affective influences on health decision making: current integral affect, current incidental affect, and anticipated integral affect. Finally, we highlight research gaps, challenges, and opportunities for future directions for research aimed at translating affective and decision science theory to improve our understanding of, and ability to intervene upon, health decision making.
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Affiliation(s)
- Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute
| | - Erin M Ellis
- Office of Disease Prevention, National Institutes of Health
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Williams DM, Rhodes RE, Conner MT. Conceptualizing and intervening on affective determinants of health behaviour. Psychol Health 2019; 34:1267-1281. [PMID: 31617431 DOI: 10.1080/08870446.2019.1675659] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- David M Williams
- Behavioral and Social Sciences, Brown University School of Public Health , Providence , RI , USA
| | - Ryan E Rhodes
- Exercise Science, Health and Physical Education, University of Victoria , Victoria , British Columbia , Canada
| | - Mark T Conner
- Psychology, Institute of Psychological Sciences, University of Leeds , Leeds , UK
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Karademas EC, Thomadakis C. The interpersonal impact of partner emotion regulation on chronic cardiac patients' functioning through affect. J Behav Med 2019; 43:262-270. [PMID: 31587122 DOI: 10.1007/s10865-019-00105-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/01/2019] [Indexed: 01/10/2023]
Abstract
In this prospective study, we examined whether physical and psychological functioning of patients with a cardiovascular disease is related to their partners' emotion regulation strategies through both persons' affect. The final sample consisted of 104 patients (25 women) and their partners. All couples were of the opposite sex and married. Two spouse emotion regulation strategies (i.e., cognitive reappraisal and expressive suppression) were assessed at baseline; patient and spouse positive and negative affect was assessed 2 months later; patient functioning were assessed 4 months later. Spouse cognitive reappraisal, but not expressive suppression, was associated with patient functioning in an indirect way, with spouse and patient affect serving as mediators in-sequence. Specifically, spouse cognitive reappraisal was related to spouse affect which was associated with patient affect. In turn, patient affect was related to patient functioning. This adds to our understanding of the dyadic relationships between chronic patients' and partners' self-regulation processes and may also guide relevant psychological interventions.
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Gross JJ, Uusberg H, Uusberg A. Mental illness and well-being: an affect regulation perspective. World Psychiatry 2019; 18:130-139. [PMID: 31059626 PMCID: PMC6502417 DOI: 10.1002/wps.20618] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Mental health crucially depends upon affective states such as emotions, stress responses, impulses and moods. These states shape how we think, feel and behave. Often, they support adaptive functioning. At other times, however, they can become detrimental to mental health via maladaptive affect generation processes and/or maladaptive affect regulation processes. Here, we present an integrative framework for considering the role of affect generation and regulation in mental illness and well-being. Our model views affect generation as an iterative cycle of attending to, appraising and responding to situations. It views affect regulation as an iterative series of decisions aimed at altering affect generation. Affect regulation decisions include identifying what, if anything, should be changed about affect, selecting where to intervene in the affect generation cycle, choosing how to implement this intervention, and monitoring the regulation attempt to decide whether to maintain, switch or stop it. Difficulties with these decisions, often arising from biased inputs to them, can contribute to manifestations of mental illness such as clinical symptoms, syndromes and disorders. The model has a number of implications for clinical assessment and treatment. Specifically, it offers a common set of concepts for characterizing different affective states; it highlights interactions between affect generation and affect regulation; it identifies assessment and treatment targets among the component processes of affect regulation; and it is applicable to prevention and treatment of mental illness as well as to promotion and restoration of psychological well-being.
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Affiliation(s)
- James J. Gross
- Department of PsychologyStanford UniversityStanfordCAUSA
| | - Helen Uusberg
- Institute of PsychologyUniversity of TartuTartuEstonia
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13
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Ferrer RA. Optimizing the utility of the ARC Framework. J Health Psychol 2018; 25:38-43. [PMID: 30080109 DOI: 10.1177/1359105318790074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This commentary concerns the Affect Regulation in Cancer Framework, which synthesizes theoretical perspectives and empirical evidence on emotion regulation and coping to posit that flexible use of a suite of strategies can result in optimal Affect Regulation in Cancer. The framework raises a number of questions that should be answered for it to reach its full potential. Here, I extend this framework by suggesting (1) outcomes to define adaptive regulation; (2) examples of research questions and hypotheses; (3) intervention development research; and (4) additional cancer contexts to which the framework should be applied.
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Affiliation(s)
- Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch (BBPSB), Behavioral Research Program, National Cancer Institute, USA
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Karademas EC, Dimitraki G, Papastefanakis E, Ktistaki G, Repa A, Gergianaki I, Bertsias G, Sidiropoulos P, Mastorodemos V, Simos P. Emotion regulation contributes to the well-being of patients with autoimmune diseases through illness-related emotions: A prospective study. J Health Psychol 2018; 25:2096-2105. [PMID: 29992828 DOI: 10.1177/1359105318787010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This prospective study aimed to examine whether illness-related negative emotions mediate the relationship of cognitive reappraisal and expressive suppression to the well-being of 99 patients with rheumatoid arthritis or multiple sclerosis. After adjusting for disease and patient-related parameters, only cognitive reappraisal was associated with physical and psychological well-being through emotions. Expressive suppression was associated with psychological well-being only for patients reporting less use of cognitive reappraisal. These results underscore the need for prospective studies that will investigate the long-term impact of emotion regulation on adaptation to chronic illness and the conditions under which this impact takes place.
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O'Leary D, Uusberg A, Gross JJ. Identity and Self-Control: Linking Identity-Value and Process Models of Self-Control. PSYCHOLOGICAL INQUIRY 2017. [DOI: 10.1080/1047840x.2017.1337404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Daniel O'Leary
- Department of Psychology, Stanford University, Stanford, California
| | - Andero Uusberg
- Department of Psychology, Stanford University, Stanford, California
- Institute of Psychology, University of Tartu, Tartu, Estonia
| | - James J. Gross
- Department of Psychology, Stanford University, Stanford, California
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