Regulation of emotions in the community: suppression and reappraisal strategies and its psychometric properties

The burden of substance use and (mental) distress among asylum seekers: a cross sectional study

Background

Asylum seekers are a particularly vulnerable population due to a wide range of external stressors. Traumatic events and difficult social/economic prospects can lead to an elevated susceptibility for substance use disorders. The aim of the present study was to determine whether asylum seekers suffering from mental or physical distress present higher levels of substance use disorder (SUD) in a state reception center in Germany and whether there are identifiable risk or protective factors.

Methods

We performed a hierarchical logistic regression on data of N = 238 people who had applied for asylum in Germany to analyze the SUD variance explanation by (1) sociodemographic, (2) flight-specific, and (3) psychometric (ERQ, SOC-9 L, SCL-K9) variables. On level (4), we included the location of data collection (walk-in clinic or accommodation,) as an indicator of individual's need for a psychologist's or General practitioner's help in order to assess for the participant's (mental) distress.

Results

Low educational level, lower sense of coherence, and mental distress (location of data collection in the psychosocial or general medical outpatient clinic) were associated with SUD. Those suffering from SUD seemed to be less aware of external stressors as SUD was also associated with low levels of reported post-migratory stress.

Discussion

The association of SUD with psychological distress and lower education reaffirms the concept that some vulnerable groups are at a higher risk for substance-related difficulties. Strengthening the sense of coherence with targeted interventions might enable at-risk groups to cope better with forthcoming burdens and help with abstaining from current or future consumption.

First validation of the model of sustainable mental health: Structural model validity and the indirect role of adaptation

OBJECTIVES

There is a growing interest in mental well-being as a vital outcome in clinical practice in addition to mental illness. The model of sustainable mental health (SMH) was recently introduced to delineate how interventions can improve mental health by targeting barriers and resources of adaptation to life stressors, improving the ability to adapt and thereby reducing mental illness and improving mental well-being. The aim of the current study is to empirically validate the conceptual model of SMH as well as the assumed indirect role of ability to adapt.

METHODS

This study used an existing dataset of the general population with self-reported reduced well-being due to the corona crisis (n = 849, mean age 53 years, SD = 15). Measurements of mental illness (depression and anxiety), mental well-being, ability to adapt, a specific barrier for adaptation (i.e., repetitive negative thinking), and a specific resource for adaptation (i.e., positive reframing) were included. Structural equation modeling was used to assess both the structural validity of the model and the indirect effect of ability to adapt.

RESULTS

An acceptable to good fit was found for the model of SMH and all paths between the proposed elements of the model were significant and in the hypothesized direction. Ability to adapt served as an indirect pathway trough which repetitive negative thinking (B = 0.149, 95% confidence interval [CI] = 0.016-0.028) and positive reframing (B = 0.163, 95% CI = 0.065-0.123) were linked with mental illness and mental well-being.

CONCLUSION

The current study provides the first empirical support of the internal validity of the model of SMH in a sample of the general population with reduced well-being, suggesting that barriers and resources to adaptation have an effect on mental illness and mental well-being through the ability to adapt. The model of SMH may therefore be a good model to use in research and clinical practice for developing, implementing, and evaluating a balanced treatment approach targeting both barriers and resources for adaptation.

Evaluating the Factor Structure of the Emotion Dysregulation Scale-Short (EDS-s): A Preliminary Study

Emotion dysregulation (ED) can be considered a psychopathological transdiagnostic dimension, the presence of which should be reliably screened in clinical settings. The aim of the current study was to validate the Italian version of the Emotion Dysregulation Scale-short (EDS-s), a brief self-report tool assessing emotion dysregulation, in a non-clinical sample of 1087 adults (768 women and 319 men). We also assessed its convergent validity with scales measuring binge eating and general psychopathology. Structural equation modeling suggested the fit of a one-factor model refined with correlations between the errors of three pairs of items (χ² = 255.56, df = 51, p < 0.001, RMSEA = 0.08, CFI = 0.94, TLI = 0.93, SRMR = 0.04). The EDS-s demonstrated satisfactory internal consistency (ordinal alpha = 0.94). Moreover, EDS-s scores partly explained the variance of both binge eating (0.35, p < 0.001) and general psychopathology (0.60, p < 0.001). In conclusion, the EDS-s can be considered to be a reliable and valid measure of ED.

Reappraisal-but not Suppression-Tendencies Determine Negativity Bias After Laboratory and Real-World Stress Exposure

Higher reactivity to stress exposure is associated with an increased tendency to appraise ambiguous stimuli as negative. However, it remains unknown whether tendencies to use emotion regulation strategies—such as cognitive reappraisal, which involves altering the meaning or relevance of affective stimuli—can shape individual differences regarding how stress affects perceptions of ambiguity. Here, we examined whether increased reappraisal use is one factor that can determine whether stress exposure induces increased negativity bias. In Study 1, healthy participants (n = 43) rated the valence of emotionally ambiguous (surprised) faces before and after an acute stress or control manipulation and reported reappraisal habits. Increased negativity ratings were milder for stressed individuals that reported more habitual reappraisal use. In Study 2 (n = 97), we extended this investigation to real-world perceived stress before and during the COVID-19 pandemic. We found that reappraisal tendency moderates the relationship between perceived stress and increased negativity bias. Collectively, these findings suggest that the propensity to reappraise determines negativity bias when evaluating ambiguity under stress.

An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial

BACKGROUND

A cancer diagnosis can cause severe emotional distress and affect quality of life as well as social relationships. The transition from inpatient to outpatient treatment is burdened by stressful uncertainties and a gap of psycho-oncological care. In addition, further barriers, such as information deficits or fear of stigmatization, might hinder cancer patients to use psycho-oncological face-to-face interventions. Online interventions can be a low-threshold adjunct to existing face-to-face services. This study aims to evaluate the effect of the online self-help program epos (emotion-based psycho-oncological online self-help) on improving symptoms of anxiety and depression in German-speaking cancer patients.

METHODS

A randomized controlled trial (RCT) is carried out in a parallel group design. N = 325 patients will be enrolled in the trial, randomly assigned to an intervention and a control group. While the intervention group has access to nine modules of epos, the control group gets access to an informational website. Participants will complete online questionnaires at baseline (T0), after the intervention (T1) and three-month follow-up (T2). Primary outcome is a combined measure of depression and anxiety. Secondary outcomes include psychological distress, anxiety, depression, quality of life, emotional control, posttraumatic growth, and satisfaction with epos. Participants are at least 18 years old, have a cancer diagnosis, currently receive cancer treatment or aftercare, have sufficient German language competence, and have access to the Internet. Exclusion criteria are severe mental comorbidities (i.e. severe depression, suicidality) or somatic comorbidities (i.e. visual disabilities).

DISCUSSION

The results of this study will provide information about acceptability, feasibility, and efficacy of epos in improving symptoms of depression and anxiety in cancer patients and thus contribute to the research on web-based interventions. If found efficacious, epos will improve psycho-oncological care in cancer patients in transition from inpatient to outpatient care and in those who struggle to find adequate psycho-oncological support due to other (perceived) barriers.

Psychometric properties and measurement invariance of the emotion regulation questionnaire in Chinese left-behind children

Left-behind children (LBC) is a group of children who live without their parents and receive less parental care and education. Compared with non-left-behind children (NLBC), LBC are more likely to develop emotional or behavior problems. This study aimed to explore the psychometric properties and measurement invariance of the Chinese version of the Emotion Regulation Questionnaire (ERQ) in Chinese LBC. A sample of 2960 middle school students (44.35% male, 55.28% female; age: 12 to 20 years) including LBC (n = 1365) and NLBC (n = 1595) was used. The exploratory factor analysis (EFA); confirmatory factor analyses (CFA); tests of measurement invariance; t-tests of gender and left-behind experience differences; tests of reliability and convergent, discriminant, and criterion validity were conducted. The results showed that two factors were extracted, and the CFA replicated the original two-factor structure (S-Bχ2/df ≈ 106.778/34, P < .001, CFI = .948, TLI = .932, RMSEA = .056 [.044, .068]). The measurement invariance of the ERQ across genders, LBC and NLBC was also confirmed. Males use expressive suppression (ES) significantly more than females (t = 2.63, p < .01), and LBC use ES significantly more than NLBC (t = 2.11, p < .05). The internal consistency coefficients for ES and cognitive reappraisal (CR) were acceptable, and the test-retest reliability was .62 and .68, respectively. Good convergent, discriminant and criterion validity were also demonstrated. It can be concluded that the ERQ is a valid measure for investigating the use of two different emotion regulation strategies among Chinese left-behind children.

Emotion Regulation Questionnaire for Cross-Gender Measurement Invariance in Chinese University Students

OBJECTIVES

Emotion regulation has been extensively studied in various areas of psychology. The Emotion Regulation Questionnaire (ERQ) was developed to assess two specific constructs associated with emotion control-cognitive reappraisal and expression suppression (Gross and John, 2003). The instrument displayed sound psychometric properties; however, to date, inquiry regarding the measure's characteristics has been limited. This study aims to measure cross-gender invariance [measurement invariance (MI)] in Chinese undergraduates using the ERQ.

METHODS

This study measured the psychometric properties of the ERQ in a sample of 847 Mainland China undergraduates (401 males and 446 females) through confirmatory factor analysis. The tests of MI were used to examine potential structural differences based on gender.

RESULTS

The findings supported the measure's original structure with all demographic groups and demonstrated exceptional fit. Additional normative data for gender and ethnic groups are included as well. The results also supported the use of the instrument in future research.

CONCLUSION

The two-factor structure in the ERQ establishes a cross-gender equivalence between males and females in Chinese college students. This study supports the use of the instrument in future research.

Predictors of Asylum Seekers' Health Care Utilization in the Early Phase of Resettlement

BACKGROUND

Asylum seekers display high prevalence rates of posttraumatic stress disorder, depression, anxiety, and panic disorder due to pre-, peri-, and post-migration stressors. In contrast to the high mental health burden, health care utilization among asylum seekers in the early phase of resettlement is low. However, the early stages after migration are a particularly vulnerable phase in which psychosocial support measures are needed to prevent mental disorders from becoming chronic.

OBJECTIVE

To identify predictors of asylum seekers' health care utilization in the early stages of resettlement.

METHODS

Using hierarchical logistic regression analysis, the variance explanation of the (1) general utilization of health care services as well as the individual utilization of (2) outpatient psychiatrists, (3) counselling centers, and (4) general practitioners was analyzed in n = 65 asylum seekers. A structured interview on health care utilization took place between three to five months after assessment of possible predictors. We defined the following three groups of predictors a) the sociodemographic variables gender, age, number of children, religion, language proficiency, b) the psychological variables sense of coherence and emotion regulation as well as c) the asylum seekers' psychiatric diagnoses.

RESULTS

Individual sociodemographic factors, such as gender, age, and number of children as well as the emotion regulation strategy of expressive suppression and sense of coherence were shown to be predictive for the utilization of health care services among asylum seekers.

CONCLUSIONS

Low-threshold, culture-sensitive treatment offers for asylum seekers should be established in the early phase after migration. General practitioners should be a central hub for further referrals to disorder-specific treatments.

The Complex Interplay Between Emotion Regulation and Work Rumination on Exhaustion

This study examined the interplay between emotion regulation strategies (reappraisal and suppression) and work-related rumination (affective work rumination and detachment from work) on exhaustion. In all, 1985 participants from three human service occupations (psychologists, teachers, and ministers) completed the web-based survey. The results showed that reappraisal and detachment from work had a negative relation to exhaustion, whereas the relation between suppression and affective work rumination to exhaustion were positively directed. Moreover, results of mediation analyses showed that the associations between emotion regulation strategies and exhaustion were mediated by work-ruminative tendencies. However, results of moderation analyses did not support that work-ruminative tendencies have a conditional effect (i.e., moderate) on the relationship between emotion regulation strategies and exhaustion. The results suggest that work-ruminative tendencies are best understood as a mediator of the emotion regulation strategies - exhaustion relationship. Thus, the study contribute to the understanding of the strategies (and combination of strategies) people use to reduce exhaustion by adding novel insights into the role of person characteristics in the recovery process. We discuss our results in relation to previous research, provide recommendations for future research, and note possible practical implications.

Parental Educational Attainment and Offspring Subjective Well-being and Self-Beliefs in Older Adulthood

This research examines whether parental educational attainment and subjective childhood socioeconomic status (SES) is associated with adult offspring well-being and self-beliefs (broadly defined). Participants from the Health and Retirement Study were included if they completed the leave-behind questionnaire in 2006 or 2008 (N=10,827; M_age=68.38; SD=9.81; range=50-101). Participants reported on their own and both parents educational attainment, subjective childhood financial situation, and financial difficulties in childhood at study entry and on well-being in 2006/2008. Linear regression was used to examine the association between offspring education, parental education, childhood SES and three aspects of well-being and self-beliefs: positive affect (e.g., positive emotions, optimism), negative affect (e.g., loneliness, hostility), and cognitive evaluation (e.g., life satisfaction). Participants with more education reported higher well-being (median β=.12). Parental educational attainment, subjective childhood SES, and a significant financial event during childhood were associated with more positive affect, less negative affect, and higher life satisfaction (median β=.05); these associations held controlling for offspring education. The educational and financial environment of childhood may hamper well-being into older adulthood; the offspring's own experiences and achievements do not completely attenuate the association with these aspects of the childhood environment.

Parental educational attainment and adult offspring personality: An intergenerational life span approach to the origin of adult personality traits

Why do some individuals have more self-control or are more vulnerable to stress than others? Where do these basic personality traits come from? Although a fundamental question in personality, more is known about how traits are related to important life outcomes than their developmental origins. The present research took an intergenerational life span approach to address whether a significant aspect of the childhood environment-parental educational attainment-was associated with offspring personality traits in adulthood. We tested the association between parents' educational levels and adult offspring personality traits in 7 samples (overall age range 14-95) and meta-analytically combined the results (total N > 60,000). Parents with more years of education had children who were more open, extraverted, and emotionally stable as adults. These associations were small but consistent, of similar modest magnitude to the association between life events and change in personality in adulthood, and were also supported by longitudinal analyses. Contrary to expectations, parental educational attainment was unrelated to offspring Conscientiousness, except for a surprisingly negative association in the younger cohorts. The results were similar in a subsample of participants who were adopted, which suggested that environmental mechanisms were as relevant as shared genetic variants. Participant levels of education were associated with greater conscientiousness, emotional stability, extraversion, and openness and partially mediated the relation between parent education and personality. Child IQ and family income were also partial mediators. The results of this research suggest that parental educational attainment is 1 intergenerational factor associated with offspring personality development in adulthood. (PsycINFO Database Record

Criterion and incremental validity of the emotion regulation questionnaire

Although research on emotion regulation (ER) is developing, little attention has been paid to the predictive power of ER strategies beyond established constructs. The present study examined the incremental validity of the Emotion Regulation Questionnaire (ERQ; Gross and John, 2003), which measures cognitive reappraisal and expressive suppression, over and above the Big Five personality factors. It also extended the evidence for the measure's criterion validity to yet unexamined criteria. A university student sample (N = 203) completed the ERQ, a measure of the Big Five, and relevant cognitive and emotion-laden criteria. Cognitive reappraisal predicted positive affect beyond personality, as well as experiential flexibility and constructive self-assertion beyond personality and affect. Expressive suppression explained incremental variance in negative affect beyond personality and in experiential flexibility beyond personality and general affect. No incremental effects were found for worry, social anxiety, rumination, reflection, and preventing negative emotions. Implications for the construct validity and utility of the ERQ are discussed.

How is emotional awareness related to emotion regulation strategies and self-reported negative affect in the general population?

Objective

The Levels of Emotional Awareness Scale (LEAS) as a performance task discriminates between implicit or subconscious and explicit or conscious levels of emotional awareness. An impaired awareness of one's feeling states may influence emotion regulation strategies and self-reports of negative emotions. To determine this influence, we applied the LEAS and self-report measures for emotion regulation strategies and negative affect in a representative sample of the German general population.

Sample and Methods

A short version of the LEAS, the Hospital Anxiety and Depression Scale (HADS) and the Emotion Regulation Questionnaire (ERQ), assessing reappraisal and suppression as emotion regulation strategies, were presented to N = 2524 participants of a representative German community study. The questionnaire data were analyzed with regard to the level of emotional awareness.

Results

LEAS scores were independent from depression, but related to self-reported anxiety. Although of small or medium effect size, different correlational patters between emotion regulation strategies and negative affectivity were related to implict and explict levels of emotional awareness. In participants with implicit emotional awareness, suppression was related to higher anxiety and depression, whereas in participants with explicit emotional awareness, in addition to a positive relationship of suppression and depression, we found a negative relationship of reappraisal to depression. These findings were independent of age. In women high use of suppression and little use of reappraisal were more strongly related to negative affect than in men.

Discussion

Our first findings suggest that conscious awareness of emotions may be a precondition for the use of reappraisal as an adaptive emotion regulation strategy. They encourage further research in the relation between subconsious and conscious emotional awareness and the prefarance of adaptive or maladaptive emotion regulation strategies The correlational trends found in a representative sample of the general population may become more pronounced in clinical samples.