Cognitive Emotion Regulation Strategies in Anxiety and Depression Understood as Types of Personality

Microaggression and discrimination exposure on young adult anxiety, depression, and sleep

BACKGROUND

Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups.

METHODS

Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure.

RESULTS

Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (ORMicro = 1.42, ORDiscrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (ORDepress = 1.24, ORSleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents.

LIMITATIONS

Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences.

CONCLUSIONS

The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.

Investigation of the Role of Cognitive Emotion Regulation Strategies on Depressive Symptoms in Mothers of Children Given A Diagnosis of Cancer

BACKGROUND

The role of cognitive emotion regulation on depressive symptoms in mothers of children given a diagnosis of cancer is not yet well understood.

OBJECTIVE

The aim of this study was to investigate the effect of cognitive emotion regulation strategies on depressive symptoms in mothers of children with cancer.

METHODS

This study was conducted with a cross-sectional correlational design. The study included 129 participants. Participants completed the sociodemographic characteristics form, Beck Depression Inventory, and Cognitive Emotion Regulation Questionnaire. Hierarchical regression analysis was performed to determine the effect of cognitive emotion regulation strategies on depressive symptoms.

RESULTS

Hierarchical multiple regression revealed that depressive symptoms were independently associated with self-blame (β = 0.279, P = .001) and catastrophizing (β = 0.244, P = .003) after controlling for sociodemographic characteristics of mothers. Emotion regulation strategies explained approximately 39.9% of the variance in depressive symptoms.

CONCLUSION

The results of the study indicate that more frequent engagement of self-blame and catastrophizing were associated with more depressive symptoms.

IMPLICATIONS FOR PRACTICE

Nurses should screen mothers of children with cancer for depressive symptoms and identify mothers of children with cancer who use maladaptive cognitive emotion regulation strategies, such as self-blame and catastrophizing, as a risk group. Furthermore, nurses need to be involved in developing psychosocial interventions including adaptive cognitive emotion regulation strategies to help mothers coping with adverse emotions during a childhood cancer journey.

The impact of cognitive emotion regulation strategies on math and science anxieties with or without controlling general anxiety

It is well-established that general anxiety associates with the lower use of adaptive emotion regulation and the higher use of maladaptive emotion regulation. However, no study has previously investigated the impact of cognitive emotion regulation on academic anxieties. Using a sample of secondary school students (N = 391), this study examined the impact of cognitive emotion regulation on math and science anxieties. Math anxiety showed stronger correlations with adaptive than maladaptive emotion regulation, whereas general anxiety showed stronger correlations with maladaptive than adaptive emotion regulation. Hierarchical regression analyses showed that math anxiety was associated with the high uses of acceptance, rumination and other-blame and the low uses of positive reappraisal and putting into perspective. However, with controlling science and general anxieties, math anxiety was associated with the high use of rumination and the low use of positive reappraisal. In contrast, science anxiety was associated with the high uses of acceptance and other-blame and the low use of positive reappraisal. Importantly, however, with controlling math and general anxieties, those science anxiety associations did not remain. Accordingly, these results might provide important insights for the specificity, etiology, and intervention of math anxiety.

Adverse Childhood Experience, Parental Bonding, and Fatherhood as Parenting Vulnerabilities to Social Anxiety Severity

Background: The present study aims to elucidate the association between adverse childhood experiences, parental bonding, fatherhood, and social anxiety symptoms among emerging adults within an Iranian context. Methods: This prospective cross-sectional study utilized self-reported assessments to evaluate fatherhood, parental bonding, anxious thoughts, and childhood trauma. The study was administered to 242 university students exhibiting social anxiety symptoms. Among the participants, 181 (74.8%) were boys and 61 (25.2%) were girls between the ages of 18 and 29. In terms of educational background, 64.9% of them held a bachelor's degree, and 35.1% held a master's degree. A majority of them (84.3%) were of middle-class socio-economic status, 6.6% were of low income, and 9.1% were of high income. Results: Analysis via multiple linear regression revealed that individuals with adverse childhood experiences exhibited heightened levels of social anxiety symptoms (R2 = 0.32) compared to their counterparts without such experiences. Furthermore, fatherhood (R2 = 0.28), paternal bonding (R2 = 0.26), and maternal bonding (R2 = 0.26) were all significantly and equally associated with variance in social anxiety symptoms. The findings underscored the substantial correlation between ACEs, fatherhood, and both maternal and paternal bonding with social anxiety symptoms in adulthood. Conclusions: Accordingly, the study emphasizes the importance of thoroughly assessing the multifaceted contributors to social anxiety. Such insights are pivotal for the design and implementation of community-based preventive interventions aimed at reducing the societal burden of social anxiety disorders.

The role of cognitive emotion regulation strategies in predicting the resilience, symptom severity, and quality of life of patients with irritable bowel syndrome

BACKGROUND

Psychosocial stressors contribute to the development of irritable bowel syndrome (IBS) and exacerbate the symptoms. The capability to cope with stress is an essential element in the management of IBS. This study assessed nine cognitive emotion regulation strategies (CERS) and their role in predicting symptom severity, quality of life (QOL), and resilience in IBS subjects.

METHODS

The scores regarding nine subscales of CERS were obtained by cognitive emotion regulation questionnaire (CERQ) and compared between study patients based on the severity and subtypes of IBS using one-way ANOVA. To evaluate the predictive role of CERS, logistic regression was performed. The correlation between CERS and the QOL was assessed by Pearson correlation analysis. The score of resilience was measured by Connor-Davidson Resilience Scale (CD-RISC).

RESULTS

We recruited 100 patients diagnosed with IBS based on ROME IV criteria. Among nine subscales of CERS, patients with more severe symptoms scored higher in catastrophizing (p < 0.001) and blaming others (p = 0.015) while lower in positive reappraisal (p = 0.028). Blaming others was the only predictor of resilience and severity of IBS in our patients (odds ratio (OR): -2.103, p=0.028, and OR:1.715, p = 0.049, respectively). We observed significant negative correlations between the quality of life and rumination (r= -0.202, p=0.044), self-blame (r= -0.241, p=0.016), catastrophizing (r= -0.342, p<0.001), and blaming others (r= -0.219, p=0.028).

CONCLUSION

Maladaptive strategies are more common in IBS patients with more severe symptoms and have negative correlations with the QOL. Blaming others has the potential to predict the resilience and severity of symptoms in IBS patients.

Mental toughness in adolescents: bridging family relationships and depression across personality traits

BACKGROUND

Adolescence is a pivotal stage vulnerable to mental health issues like anxiety and depression. While family relationships, mental toughness, and personality traits are known to impact adolescent mental health, their interactive and moderating roles are not fully understood.

AIM

This study aims to investigate the mediating role of mental toughness in the relationship between family relationships and depression among high school students, and to examine the varying impacts of personality traits on this mediation.

METHOD

A cross-sectional study was conducted on a sample of 734 adolescents. Participants completed measures assessing family relationships, mental toughness, personality traits, and mental health outcomes (depression). Latent Profile Analysis, Multiple Regression Analysis, and Structural Equation Modeling, to investigate these relationships.

RESULTS

The study found that mental toughness significantly mediates the relationship between family relationships and depression. Notably, this mediating effect varied between personality type; it was more pronounced in the moderate-reserved type compared to the proactive-engaged type. LPA identified two distinct personality types of students based on their personality traits, with differential patterns of family relationships, mental toughness, and depression. Multiple regression analysis indicated that character and adaptability, components of mental toughness, were significant negative predictors of depression.

CONCLUSION

The study contributes to understanding the dynamics of adolescent mental health, particularly in the context of Chinese high school students. It underscores the importance of considering family dynamics, personality traits, and mental toughness in developing effective mental health interventions for adolescents.

The influence of emotion regulation strategies and sleep quality on depression and anxiety

Chronic stress is a major risk factor for a number of mental health disorders, including depression and pathological anxiety. Adaptive cognitive emotion regulation (CER) strategies (i.e. positively-focused thought processes) can help to prevent psychiatric disturbance when enduring unpleasant and stressful experiences, but little is known about the inter-individual factors that govern their success. Sleep plays an important role in mental health, and may moderate the effectiveness of adaptive CER strategies by maintaining the executive functions on which they rely. In this study, we carried out a secondary analysis of self-reported mental health and sleep data acquired during a protracted and naturally-occurring stressor - the COVID-19 pandemic - to firstly test the hypothesis that adaptive CER strategy use is associated with positive mental health outcomes and secondly, that the benefits of adaptive CER strategy use for mental health are contingent on high-quality sleep. Using established self-report tools, participants estimated their depression (N = 551) and anxiety (N = 590)2 levels, sleep quality and tendency to engage in adaptive and maladaptive CER strategies during the Spring and Autumn of 2020. Using a linear mixed modelling approach, we found that greater use of adaptive CER strategies and higher sleep quality were independently associated with lower self-reported depression and anxiety. However, adaptive CER strategy use was not a significant predictor of self-reported anxiety when accounting for sleep quality in our final model. The positive influence of adaptive CER strategy use on depression was observed at different levels of sleep quality. These findings highlight the importance of adaptive CER strategy use and good sleep quality in promoting resilience to depression and anxiety when experiencing chronic stress.

Thought Believability and Anxious Feelings about COVID-19: A Case-Control Study in Northeastern Iran

Background

Believability and thoughts are considered as the pillars of behaviors over time, and anxious feelings are a risk factor for mental disorders, especially during the coronavirus disease (COVID-19) pandemic. This study aimed to explore the thought believability and anxious feelings of COVID-19 among infected and healthy families.

Methods

In this hospital-based matched case-control study, health surveillance files of COVID-19 patients were collected from January to June 2021 and were analyzed statistically. In this study, two questionnaires of demographic characteristics and the Believability of Anxious Feelings and Thoughts (BAFT) were used. Data were analyzed using the One-way ANOVA.

Results

Of 600 participants, 300 (50%) were PCR-confirmed and 300 (50%) were non-infected. Overall, 163 (54.33%) of infected people were male, 146 (48.67%) single, and 156 (52.00%) government employees. The results showed that the mean scores of physical anxiety (PA) and negative evaluation (NE) in the case group is significantly higher than the control group (P = 0.001); while emotional regulation (ER) in the control group was significantly higher than the case group (P = 0.001).

Conclusion

Having high believability to the risks of COVID-19 may be a predictor of preventive behaviors in individuals. Worrying about COVID-19 can increase the perceived risk of a pandemic in societies and consequence, increase the general public health.

Risk and Protective Factors Affecting Drug Craving among Patients with Substance Use Disorders Undergoing Opioid Agonists Maintenance Therapy

Background: In this study, the purpose was to investigate the risk and protective factors affecting craving among patients with substance use disorders (SUDs) on buprenorphine, methadone, or opium maintenance treatment in Isfahan, Iran. Methods: In the current cross-section path analysis model, the statistical population was all SUD patients in Isfahan who were under treatment with Methadone or Buprenorphine in 2018. The study sample included 482 people who were on maintenance treatment in Isfahan who were selected by random sampling in two stages. The Franken, Hendriks, and Brink Opiate Craving Questionnaire (OCQ), Substance Related Beliefs Questionnaire (SRBQ), Cognitive Emotion Regulation Questionnaire (CERQ), Patient Health Questionnaire, Sixbey Family Resilience Assessment Scale (FRAS) and the Self-Resiliency Scale (SRS) were used to collect data. A path analysis method and PLS software were used to analyze the data. Results: The results showed that the direct impacts of self-resilience (β=-0.147, p = 0.009) and uncompromising strategies (β = 0.249, p = 0.0001) on depression are significant. Also, the direct effects of belief in drugs (β = 0.518, p = 0.0001) and depression (β = 0.219, p = 0.0001) on craving are significant. Conclusion: Substance-related beliefs play an essential role in craving both directly and indirectly. The results of the present study can be used to carry out educational and therapeutic interventions for drug SUD patients.

Psychological flexibility, cognitive emotion regulation and mental health outcomes among patients with asthma in Pakistan

Background/Objective

Adults with asthma who experience difficulties in emotion regulation are prone to developing psychopathological symptoms that may affect their self-management activities and symptom control. The current research investigated the role of psychological flexibility and cognitive emotion regulation strategies in relation to mental health outcomes (psychological distress and quality of life) among patients with asthma in Pakistan.

Method

A sample of 200 adults, diagnosed with asthma (32% men, 68% women; M_age = 42.32, SD_age = 16.99), completed the acceptance and action questionnaire (AAQ-II) cognitive emotion regulation questionnaire (CERQ), depression, anxiety, stress scale-21 (DASS-21), asthma-related quality of life questionnaire (AQLQ) and a self-structured demographic sheet.

Results

Results of Pearson product moment correlation showed that most of the adaptive cognitive emotion regulation strategies (positive refocusing, refocus on planning, and positive reappraisal) were positively correlated with psychological flexibility and quality of life, whereas negatively correlated with psychological distress. All the maladaptive strategies of cognitive emotion regulation had a significant inverse relationship with psychological flexibility and quality of life, while positively correlated with psychological distress. Results of serial mediation analysis through PROCESS MACRO showed that catastrophising and anxiety fully mediated the relationship between psychological flexibility and asthma-related quality of life.

Conclusion

Evidence-based interventions should focus on developing psychological flexibility and identifying maladaptive patterns of cognitive emotion regulation strategies for improved mental health and quality of life outcomes for adults with asthma.

Relationship between adult attachment and cognitive emotional regulation style in women and men

Cognitive emotion regulation (CER) strategies are useful in evaluating the risk of developing emotional disorders and that they may define subjects' styles. This study aims to explore the extent to which specific styles of CER strategies relate to the anxious and avoidant attachment dimensions in adults and whether such relationships operate similarly for women and men. Two hundred and fifteen adults (between 22 and 67 years old) completed the Spanish versions of the Cognitive Emotion Regulation Questionnaire and the Experiences in Close Relationships instrument. Cluster analysis, ANOVA and Student's t-test were used. Our results show that women and men can be successfully classified into two CER clusters (Protective and Vulnerable), distinguished by the higher use in the protective cluster of the CER strategies considered most adaptive and complex (Acceptance, Positive Refocusing, Refocus on Planning, Positive Reappraisal, and Putting into Perspective). However, only in women were the anxious and avoidant attachment dimensions significantly associated with CER style. In conclusion, from a clinical and interpersonal perspective, it is interesting to be able to predict the belonging to a Protective or Vulnerable coping style by analysing the CER strategies and to know their relationship with the adult affective system.

Longitudinal Relations Between Emotion Regulation and Internalizing Symptoms in Emerging Adults During the Covid-19 Pandemic

Background

Maladaptive and adaptive emotion regulation are putative risk and protective factors for depression and anxiety, but most prior research does not differentiate within-person effects from between-person individual differences. The current study does so during the early part of the Covid-19 pandemic when internalizing symptoms were high.

Methods

A sample of emerging adult undergraduate students (N = 154) completed online questionnaires bi-weekly on depression, anxiety, and emotion regulation across eight weeks during the early days of the Covid-19 pandemic (April 2nd to June 27th, 2020).

Results

Depression demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, catastrophizing, and self-blame, and negative correlations with overall adaptive emotion regulation and reappraisal. Anxiety demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, rumination, and catastrophizing, and a negative correlation with reappraisal. After controlling for these between-person associations, however, there were generally no within-person associations between emotion regulation and internalizing symptoms.

Conclusions

Emotion regulation and internalizing symptoms might be temporally stable individual differences that cooccur with one another as opposed to having a more dynamic relation. Alternatively, these dynamic mechanisms might operate over much shorter or longer periods compared to the two-week time lag in the current study.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10366-9.

The effectiveness of dialectical behavior group therapy on stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students: A randomized clinical trial

INTRODUCTION

This study aimed to evaluate the effectiveness of dialectical behavior group therapy (DBGT) regarding stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students.

MATERIAL AND METHODS

This was an experimental study with a pretest-posttest design and a control group. The statistical population included 133 mothers with intellectually disabled children divided into wait-list control and experimental groups. Then, DBGT was performed on the treatment subjects. Data collection tools included the Emotion Regulation Questionnaire, Beck Depression Inventory-II, Depression-Anxiety-Stress Scale, Clinical Global Improvement Scale, Client Satisfaction Questionnaire, and Working Alliance Inventory-Short Form. A p-value less than 0.05 was considered statistically significant.

RESULTS

A significant difference in depression, stress, and cognitive emotion regulation was observed between the intervention and control groups (p < 0.001). In the post-test, the adjusted mean of depression and stress in the intervention group showed a significant decrease compared to the control group mothers. Also, cognitive reappraisal, expressive suppression, and total cognitive emotion regulation scores increased following DBGT. Participants in DBGT had a good therapeutic relationship, were satisfied with the treatment, and showed notable improvements.

CONCLUSION

The results indicated that DBGT might affect stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students.

Anxious Brains: A Combined Data Fusion Machine Learning Approach to Predict Trait Anxiety from Morphometric Features

Trait anxiety relates to the steady propensity to experience and report negative emotions and thoughts such as fear and worries across different situations, along with a stable perception of the environment as characterized by threatening stimuli. Previous studies have tried to investigate neuroanatomical features related to anxiety mostly using univariate analyses and thus giving rise to contrasting results. The aim of this study is to build a predictive model of individual differences in trait anxiety from brain morphometric features, by taking advantage of a combined data fusion machine learning approach to allow generalization to new cases. Additionally, we aimed to perform a network analysis to test the hypothesis that anxiety-related networks have a central role in modulating other networks not strictly associated with anxiety. Finally, we wanted to test the hypothesis that trait anxiety was associated with specific cognitive emotion regulation strategies, and whether anxiety may decrease with ageing. Structural brain images of 158 participants were first decomposed into independent covarying gray and white matter networks with a data fusion unsupervised machine learning approach (Parallel ICA). Then, supervised machine learning (decision tree) and backward regression were used to extract and test the generalizability of a predictive model of trait anxiety. Two covarying gray and white matter independent networks successfully predicted trait anxiety. The first network included mainly parietal and temporal regions such as the postcentral gyrus, the precuneus, and the middle and superior temporal gyrus, while the second network included frontal and parietal regions such as the superior and middle temporal gyrus, the anterior cingulate, and the precuneus. We also found that trait anxiety was positively associated with catastrophizing, rumination, other- and self-blame, and negatively associated with positive refocusing and reappraisal. Moreover, trait anxiety was negatively associated with age. This paper provides new insights regarding the prediction of individual differences in trait anxiety from brain and psychological features and can pave the way for future diagnostic predictive models of anxiety.

COVID-19 Related Negative Life Events and Psychological Distress: The Role of Emotion and Cognitive Emotion Regulation Strategies

This cross-sectional study was conducted to determine the potential role of hopelessness, helplessness, and cognitive emotion regulation strategies in the relationship between adverse life events and psychological distress among Turkish adults. Participants' ages ranged from 18 to 64 years old. The majority were female. From June 21, 2021, to August 18, 2021, 432 participants responded to an online questionnaire that included the Negative Life Events List (NLEs), the Helplessness, and Hopelessness, and the Cognitive Emotion Regulation Strategies Scale (CERS) and General Health Questionnaire-12. The findings suggest that the NLEs, directly and indirectly, predict psychological distress through helplessness and hopelessness. The direct and indirect predictive effects of the NLEs on psychological distress varied depending on the level of CERS. The current study's findings have contributed to our understanding of the mechanisms underlying the relationship between the NLEs and psychological distress during pandemics.

Effectiveness of educational intervention-based compassion therapy on emotional regulation and self-control after discharge of patients With COVID-19

BACKGROUND

One of the important causes of anxiety in COVID-19 disease is the inability to regulate emotion and lack of self-control during threatening conditions. The psychotherapy technique has been effective in reducing these symptoms. Therefore, this study attempted to evaluate the effectiveness of compassion-based therapy on emotion regulation and self-control in patients with COVID-19 after discharge.

MATERIALS AND METHOD

It was a quasi-experimental pretest-posttest study with a control group. The statistical population consisted of 30 men (15 in each group) who were in the quarantine period of COVID-19 disease. Available sampling was used and the participants were randomly assigned to experimental and control groups. In the experimental group, compassion-based treatment was performed in 10 sessions of 90 min. Tanji's self-control questionnaire and Garnofsky's Emotion Regulation questionnaires were used. Data analysis were performed using SPSS 21 software and multivariate analysis of covariance.

RESULTS

There was a significant difference between the mean scores of emotion regulation and self-control variables in the experimental and control groups (P < 0.001). The effect of this treatment on increasing the emotion regulation score was 49% and on increasing the self-control score was 37%.

CONCLUSION

Compassion-based therapy can increase cognitive regulation and improve self-control in patients with COVID-19 disease. It is suggested that this intervention can be used in psychological treatment programs.

Personality coherence as a personality dynamics-related concept

Extant theoretical models of personality coherence/incoherence do not sufficiently address the challenge of explaining personality coherence dynamics and the role of psychological mechanisms, including temperament and attention. To overcome these limitations, the Complex-System Approach to Personality (C-SAP) postulates that personality coherence is a within-person structure that arises from the functional consistency/inconsistency between personality traits/types, underlain by specific attentional and temperament mechanisms that have integrative and regulatory potential. The dominant (reactive, regulative) function of stimulation processing in temperament types is the foundation for assessing personality coherence. This paper presents a revised, fine-grained model of personality coherence - originally arising from the C-SAP - that is enriched by a focus on personality coherence dynamics in relation to behavioral consistency. The methodological principles necessary for studying personality coherence dynamics are outlined in detail. This paper also addresses: (i) research methods for relating personality coherence/incoherence to behavioral consistency/inconsistency, and (ii) situational contexts that are important to these personality dynamics. In addition, personality coherence dynamics in relation to the self and character and the impact of the C-SAP assumption that behaviors are more stable than traits/types on the relation between personality coherence and behavioral consistency are discussed.

A meta-analysis of emotional regulation outcomes in psychological interventions for youth with depression and anxiety

Difficulties in applying emotional regulation (ER) skills are associated with depression and anxiety symptoms, and are common targets of treatment. This meta-analysis examined whether improvements in ER skills were associated with psychological treatment outcomes for depression and/or anxiety in youth. A multivariate, random-effects meta-analysis was run using metafor in R. Inclusion criteria included studies that were randomized controlled trials (RCTs) of a psychological intervention for depression and/or anxiety in patients aged 14-24, were peer reviewed, were written in English, measured depression and/or anxiety symptoms as an outcome and measured ER as an outcome. Medline, Embase, APA PsycInfo, CINAHL and The Cochrane Library were searched up to 26 June 2020. Risk of bias (ROB) was assessed using the Cochrane Collaboration Risk of Bias 2.0 tool. The meta-analysis includes 385 effect sizes from 90 RCTs with total N = 11,652. Psychological treatments significantly reduced depression, anxiety, emotion dysregulation (k = 13, Hedges' g = 0.54, P < 0.001, 95% confidence interval (CI) = 0.30-0.78) and disengagement ER (k = 83, g = 0.24, 95% CI = 0.15-0.32, P < 0.001); engagement ER also increased (k = 82, g = 0.26, 95% CI = 0.15-0.32, P < 0.001). Improvements in depression and anxiety were positively associated with improved engagement ER skills, reduced emotion dysregulation and reduced disengagement ER skills. Sensitivity considered study selection and publication bias. Longer treatments, group formats and cognitive-behavioural orientations produced larger positive associations between improved ER skills and reduced symptoms. ER skill improvement is linked to depression and anxiety across a broad range of interventions for youth. Limitations of the current study include reliance on self-report measures, content overlap between variables and inability to test the directionality of associations.

Links between cognitive distortions and cognitive emotion regulation strategies in non-clinical young adulthood

This study examined the possible link between cognitive distortions (CDs), which involve erroneous information processing in normal reasoning, and cognitive emotion regulation strategies (CERS), which are strategies implemented at the cognitive level to modulate the emotional response following a negative or unpleasant event, in a non-clinical young adult population. Ninety-six participants (age 18-39 years; 48 women) completed the French version of the Cognitive Emotion Regulation Questionnaire and the French Cognitive Distortions Inventory for adults. Overall, negative distortions were positively correlated with the use of non-adaptive strategies of cognitive emotion regulation, while positive distortions were negatively correlated with the use of adaptive strategies. The CDs most associated with the use of adaptive CERS were positive dichotomous reasoning, minimization and neutral omission in favour of the positive. Selective abstraction was the CD most associated with the use of non-adaptive CERS. We observed a negative correlation effect between education level and several distortions and catastrophizing, and a positive correlation with acceptance. Men used more positive maximization, requalification as negative, acceptance and blaming others than women. The discussion of the results focuses on explaining the observed relationships between the variables in this non-clinical sample.

Problem Orientation and Psychological Distress Among Adolescents: Do Cognitive Emotion Regulation Strategies Mediate Their Relationship?

Adolescence is a critical period for the development of attitudes and skills crucial in determining vulnerability for psychological distress. The current study aimed to focus on the association of problem orientation and cognitive emotion regulation strategies with psychological distress and demonstrate the mediator roles of adaptive and maladaptive cognitive emotion regulation strategies in the association of problem orientation with psychological distress. Data were collected from 335 adolescents (167 female) aged 14-to-18 years (M= 14.7, SD= .95) via measures of problem orientation, cognitive emotion regulation, and psychological distress. The results revealed that maladaptive emotion regulation strategies (self-blame and other-blame) mediated the association of negative problem orientation with psychological distress. The findings emphasize the crucial roles of blaming-focused strategies in this relationship.

Findings regarding emotion regulation strategies and quality of life's domains in families having children with spinal muscular atrophy

The severity of motor impairment and the psycho-emotional and social consequences of spinal muscular atrophy (SMA) impact both children and their families, who must adapt using cognitive-emotional strategies. We aimed to determine whether the domains of quality of life and the consequent emotion regulation strategies could be related, and if so, to what quantitative, at a statistically significant level. This study was conducted at the Dr. N. Robanescu National Clinical Center of Neurorehabilitation for Children and included 33 mothers questioned using the PedsQL-Family Impact Module (PedsQL-FIM) and Cognitive Emotion Regulation Questionnaire (CERQ). Statistical analysis of PedsQL-FIM data showed high positive Spearman's rho correlations between communication and social functioning (p=0.719), daily activities and cognitive functioning (p=0.704), family relationships and daily activities (p=0.705). The analysis of the Spearman's rho correlation coefficients reflected some moderate positive correlations between CERQ subscales: self-blame and catastrophizing (p=0.577), acceptance and refocus on planning (p=0.577), acceptance and putting into perspective (p=0.532), refocus on planning and positive reappraisal (p=0.630), positive reappraisal and putting into perspective (p=0.609). Maladaptive strategies affect family relationships, cognitive and social functioning, emotional functioning, and communication inside the family. Positive correlations were found between the adaptive strategies (acceptance, refocus on planning, putting into perspective, positive reappraisal) in the participants within our study group, showing their interest in attitude changing and actively solving the family tasks related to children's illness.

Association of opioid misuse with anxiety and depression: A systematic review of the literature

The opioid epidemic is a public health problem associated with a host of negative outcomes. Although clinicians recognize covariation between opioid misuse with anxiety and depressive symptoms and disorders, research on this topic has only recently accumulated. Progress in this domain is impeded by the lack of systematic and integrative research to better understand and treat these co-occurring problems. This paper represents the first attempt to systematically review the empirical literature examining relations between opioid use and misuse, and anxiety and depression. In the first section, we define key terms and describe the article selection strategy. In the second section, we review the prevalence of anxiety and depressive symptoms among individuals who use and misuse prescription and illicit opioids. In the third section, we review the magnitude of associations between anxiety and depressive symptoms and disorders with opioid misuse, as well as highlight studies examining the longitudinal and temporal sequence of the relations between these variables. In the fourth section, we focus on experimental therapeutics, reviewing what is known about individual difference and transdiagnostic vulnerability factors for anxiety and depression that might contribute to opioid misuse and its symptoms. Finally, we discuss current knowledge gaps and present a heuristic model to guide future research.

A dynamic causal model on self-regulation of aversive emotion

Cognitive regulation of emotion has been proven to be effective to take control the emotional responses. Some cognitive models have also been proposed to explain the neural mechanism that underlies this process. However, some characteristics of the models are still unclear, such as whether the cognitive regulation will be spontaneously employed by participants implicitly. The present study recruited the fMRI experiment to focus on the discomfort induced by viewing aversive pictures, and the emotional self-regulation during picture viewing. By using the dynamic causal modeling (DCM), 50 putative models of brain functional networks were constructed, one optimal model that fitted the real data best won the comparison from the candidates. As a result, the optimal model suggests that both the ventral striatum (VS)-centric bottom-up and the dorsolateral prefrontal cortex (DLPFC)-centric top-down regulations are recruited for self-regulation on negative emotions. The DLPFC will exert modulatory influence on the VS only when the VS fails to suppress the induced emotions by self-inhibition.

The Mediating Role of Cognitive Emotion Regulation in BIS/BAS Sensitivities, Depression, and Anxiety Among Community-Dwelling Older Adults in China

Background

The behavioral inhibition system (BIS) and behavioral activation system (BAS), which primarily underlie emotions and behaviors, are associated with depression and anxiety. However, the reasons behind these associations require further exploration.

Objective

This study aims to examine the mediating effects of cognitive emotion regulation between BIS/BAS and depression/anxiety among community-dwelling elderly Chinese.

Methods

A cross-sectional survey was conducted with a sample of 836 elderly individuals. Structural equation modeling was used to determine relationships among BIS/BAS, cognitive emotion regulation, and depression/anxiety.

Results

Participants reporting higher BIS sensitivity were more likely to use maladaptive cognitive emotion regulation strategies, which were in turn associated with higher rates of depression and anxiety. BAS sensitivity was more likely to lead to adaptive cognitive emotion regulation strategies, which resulted in lower levels of depression and anxiety.

Conclusion

Our findings suggest that incorporating emotional regulation in interventions targeting BIS/BAS sensitivities may enhance the accuracy and efficiency of these treatments for depression and anxiety.

Childhood Trauma, Cognitive Emotion Regulation and Motivation for Behavior Change Among Clients of Opioid Substitution Treatment With and Without Past Year Synthetic Cathinone Use During Therapy

Background

With a decrease in heroin's purity and availability in the European drug market, Hungarian opioid dependent patients started to substitute heroin with novel psychoactive substances (NPS) and especially with synthetic cathinones.

Goal

This study aims to assess whether clients of opioid substitution treatment (OST) with and without a history of synthetic cathinone use during therapy differ in (1) the rate and type of experienced childhood trauma, (2) the way they cope with negative life events, (3) their motivation to change substance use behavior, (4) the rate of treatment retention.

Methods

A total of 198 clients of an outpatient centers (Nyírõ Gyula National Institute of Psychiatry and Addictions, Budapest) OST were asked to provide information about their general substance use experiences, including the consumption of NPS during treatment, their childhood traumatic experiences (Childhood Trauma Questionnaire), cognitive emotion regulation strategies (Cognitive Emotion Regulation Questionnaire), their motivation to change substance use behavior (University of Rhode Island Change Assessment Scale) and current psychiatric symptoms (Brief Symptom Inventory). Baseline data was collected in the summer of 2015, while 4 years follow-up data on treatment retention was obtained in the summer of 2019.

Results

The majority of the clients were male (N = 141, 71.2%), receiving methadone as a substitute for opioids (N = 178, 89.9%), while mean age of the full sample was 39.7 (SD = 6.8). Based on a logistic regression model, the odds for past year synthetic cathinone use was higher among clients with more severe psychiatric symptoms (B = 0.8, OR = 2.2, p < 0.01) and among clients who were in treatment for a shorter period of time (B = 0.1, OR = 0.9, p < 0.05). Synthetic cathinone use during treatment was further associated with less adaptive strategies to cope with negative life events. Synthetic cathinone use was also a risk factor for reduced treatment retention (B = -0.8, OR = 0.4, p < 0.05) and was associated with lower odds of being member of a latent class with less severe psychopathological profile (B = -0.9, OR = 0.4, p < 0.05).

Conclusion

Synthetic cathinone use during treatment is associated with poorer treatment outcomes and might be characterized by more severe psychiatric symptoms and amotivation to change substance use among opioid dependent clients.

Emotional regulation training for intensive and critical care nurses

Professional quality of life is related to psychological well-being for nurses with implications for quality patient care. This study evaluated the effectiveness of emotional regulation training on depression, anxiety and stress, and professional quality of life for intensive and critical care nurses. In this experimental comparison trial, 60 intensive and critical care nurses were randomly assigned to treatment and wait-list control groups. The treatment group received six sessions of emotional regulation training, while the wait-list control group received no treatment. Outcome measures were: the Cognitive Emotion Regulation Questionnaire; the Depression, Anxiety and Stress Scale; and the Professional Quality of Life Scale in a pre-post design. The treatment group demonstrated greater improvements in burnout and compassion satisfaction compared with the wait-list control group. No significant reduction in compassion fatigue was found compared with controls. Some cognitive coping strategies improved in the treatment group compared with controls, with greater reductions in depression, anxiety, and stress. This study indicates the benefits of implementing emotional regulation training programs to improve psychological well-being and professional quality of life for intensive and critical care nurses.

The relationship between posttraumatic growth and cognitive emotion regulation strategies in hemodialysis patients

BACKGROUND AND AIM

Posttraumatic growth following traumas such as chronic illnesses can occur in some people. The psychological factors, such as cognitive emotion regulation (CER), can influence its formation. CER is a type of coping strategy that helps to efficiently deal with trauma. Due to the importance of the topic and the lack of sufficient studies on posttraumatic growth and CER in hemodialysis patients, this study aims to investigate the relationship between posttraumatic growth and CER in hemodialysis patients.

METHODS

This is a descriptive study performed on hemodialysis patients in Bou Ali and Velayat hospitals in Qazvin. One hundred and sixty-two patients were selected by the convenience sampling method, and Garnefski Cognitive Emotion Regulation Questionnaire (α =0.92) and Tedeschi Posttraumatic Growth Questionnaire (α =0.96) were used. Data were analyzed using Pearson correlation and ANOVA tests.

RESULTS

The results showed that the majority of the hemodialysis patients experienced some degree of posttraumatic growth. The participants achieved high scores in the domains of spiritual development and communication with others. Moreover, posttraumatic growth was positively and significantly correlated with CER (r = 0.67, P < 0.001).

CONCLUSIONS

Hemodialysis provides the basis for the positive mental reactions known as posttraumatic growth in hemodialysis patients. Nurses and other authorities can use this phenomenon to adapt to illness and care planning.

Structure of Affect in Types of Anxiety and Depression

Abstract. Although anxiety and depression are treated as separate conditions, the literature concerning their affective functioning is inconclusive. To address this issue, we analyzed types of anxiety (arousal and apprehension) and depression (valence and anhedonic). We hypothesized that the similarities and differences in the structure of affect would be related to the specific structural components and functions (reactive or regulative) of the types. We assessed the valence (negative and positive affect) and content (specific emotions) of affect by the Positive and Negative Affect Schedule – Expanded Form (PANAS-X) in 1,632 participants from a general population. Regression analyses showed that the anxiety and depression types (measured by Anxiety and Depression Questionnaire) can be differentiated by the content of affect, but not its valence: Fear was characteristic for anxiety, especially the arousal anxiety. Valence depression was primarily related to hostility, while anhedonic depression was predicted by sadness, guilt, and lowered joviality. Moreover, as expected, regulative emotions (e.g., joviality) were stronger predictors of the regulative apprehension anxiety and anhedonic depression, while the more reactive fear was more strongly related to the reactive arousal anxiety than to regulative apprehension anxiety. These results confirm that the structure of affect is related to the structure and functions of anxiety and depression types.