Ventromedial prefrontal cortex activation and neurofeedback modulation during episodic future thinking for individuals with suicidal thoughts and behaviors

Individuals experiencing suicidal thoughts and behaviors (STBs) show less specificity and positivity during episodic future thinking (EFT). Here, we present findings from two studies aiming to (1) further our understanding of how STBs may relate to neural responsivity during EFT and (2) examine the feasibility of modulating EFT-related activation using real-time fMRI neurofeedback (rtfMRI-nf). Study 1 involved 30 individuals with major depressive disorder (MDD; half with STBs) who performed an EFT task during fMRI, for which they imagined personally-relevant future positive, negative, or neutral events. Positive EFT elicited greater ventromedial prefrontal cortex (vmPFC) activation compared to negative EFT. Importantly, the MDD + STB group exhibited reduced vmPFC activation across all EFT conditions compared to MDD-STB; although EFT fluency and subjective experience remained consistent across groups. Study 2 included rtfMRI-nf focused on vmPFC modulation during positive EFT for six participants with MDD + STBs. Results support the feasibility and acceptability of the rtfMRI-nf protocol and quantitative and qualitative observations are provided to help inform future, larger studies aiming to examine similar neurofeedback protocols. Results implicate vmPFC blunting as a promising treatment target for MDD + STBs and suggest rtfMRI-nf as one potential technique to explore for enhancing vmPFC engagement.

Impulsive Decision-Making, Affective Experiences, and Parental History of Self-Injurious Thoughts and Behaviors within Parent-Adolescent Dyads

Impulsive decision-making, particularly during states of affective intensity, is associated with greater risk of engagement in self-injurious thoughts and behaviors (SITBs) during adolescence. The proximal (dyadic parent-adolescent affect and impulsivity) and distal (family history of SITBs) risk factors that occur within the family system could be relevant processes at stake in the intergenerational transmission of risk. The current study tests the interdependence of parent-adolescent factors associated with risk for SITBs and probes the extent to which parent-adolescent affective states influence their own (actor-effects) and each other's (partner-effects) impulsive decision-making, and further whether these relationships are moderated by a parent's history of SITBs. Participants included 212 (106 dyads) community parents and their adolescents who completed self-report and behavioral tasks related to positive and negative affective states, impulsive decision-making, and lifetime history of SITBs. Application of the Actor-Partner Interdependence Model (APIM) revealed a partner-effect where greater parent negative affect in the past week was associated with elevated adolescent impulsive decision-making among families with a history of SITBs (Estimate = 0.66, Standard Error = 0.13, p < 0.001). In addition, a significant actor-effect was observed where greater positive affect was associated with decreased impulsive decision-making among adolescents (Estimate = -0.21, Standard Error = 0.10, p = 0.03), however, moderating effects of parent history of SITBs were not detected. Findings from the present study shed light on the interdependence of affect and impulsivity within parent-adolescent dyads, and the extent to which these interactions may be particularly salient for families with known vulnerabilities for SITBs.

Identifying the top predictors of student well-being across cultures using machine learning and conventional statistics

Alongside academic learning, there is increasing recognition that educational systems must also cater to students' well-being. This study examines the key factors that predict adolescent students' subjective well-being, indexed by life satisfaction, positive affect, and negative affect. Data from 522,836 secondary school students from 71 countries/regions across eight different cultural contexts were analyzed. Underpinned by Bronfenbrenner's bioecological theory, both machine learning (i.e., light gradient-boosting machine) and conventional statistics (i.e., hierarchical linear modeling) were used to examine the roles of person, process, and context factors. Among the multiple predictors examined, school belonging and sense of meaning emerged as the common predictors of the various well-being dimensions. Different well-being dimensions also had distinct predictors. Life satisfaction was best predicted by a sense of meaning, school belonging, parental support, fear of failure, and GDP per capita. Positive affect was most strongly predicted by resilience, sense of meaning, school belonging, parental support, and GDP per capita. Negative affect was most strongly predicted by fear of failure, gender, being bullied, school belonging, and sense of meaning. There was a remarkable level of cross-cultural similarity in terms of the top predictors of well-being across the globe. Theoretical and practical implications are discussed.

An attachment-based pilot program to promote adolescent adjustment to parental divorce

The study aimed to assess the impact of an attachment-based intervention on adolescent adaptation to parental divorce. The Adolescent Adjustment Pilot Program to Parental Divorce (AAPPD) employed an experimental group format, targeting improvements in various adaptation indicators (life satisfaction, positive affect, and negative affect). The sample comprised 30 Chilean adolescents aged 12 to 16 (M = 13.6, SD = 1.35), with 60% females and 40% males. After the intervention, the adolescents showed a decrease in negative affect at 6 and 12 months. However, no differences were identified in other dimensions of subjective well-being considered as indicators of divorce adaptation. The findings prompt discussion on theoretical and clinical implications.

Randomized controlled trial of a positive emotion regulation intervention to reduce stress in family caregivers of individuals with Alzheimer's disease: protocol and design for the LEAF 2.0 study

BACKGROUND

Caring for a loved one with Alzheimer's disease can be stressful, resulting in poorer emotional and physical health among family caregivers. Although supportive resources for caregivers are available, distance, caregiver health, and the daily demands of caregiving are barriers to access. Based on research demonstrating the importance of positive emotions in coping with stress, our previous trial showed that dementia caregivers who participated in facilitated, web-based delivery of a positive emotion regulation intervention called LEAF (Life Enhancing Activities for Family caregivers) experienced increased positive emotion and decreased depression and anxiety. Building on this evidence, the LEAF 2.0 study aims to test whether web-based, self-guided delivery can confer similar benefits for caregivers of individuals with Alzheimer's disease.

METHODS

This paper presents the design and methods for LEAF 2.0, a 3-arm web-based randomized controlled trial (N = 500) in which family caregivers of patients with Alzheimer's disease (AD) are randomized to (1) the LEAF intervention facilitated remotely via the web (N = 200), (2) the LEAF intervention self-guided online (N = 200), or (3) an emotion reporting control (N = 100), which then crosses over to the intervention after approximately 6 months, half to the facilitated arm and half to the self-guided arm. We aim to (1) compare the effect of the facilitated and self-guided LEAF positive emotion interventions to an emotion reporting control condition on AD caregiver well-being (positive emotion, depression, anxiety, and perceived stress) and secondary outcomes (caregiving burden, caregiving self-efficacy, positive aspects of caregiving, quality of care, and AD patient quality of life); (2) assess whether effects are mediated by improvements in positive emotion or other aspects of caregiver well-being; and (3) test whether caregiver age or gender or the care recipient's dementia severity moderates the effects of the intervention.

DISCUSSION

If demonstrated to be effective, LEAF can be widely disseminated and ultimately have a significant impact on the stress experienced by AD caregivers and the well-being of people living with Alzheimer's disease.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03610698.

Positive affect and heart rate variability: a dynamic analysis

Traditional survey methods can provide noisy data arising from recall, memory and other biases. Technological advances (particularly in neuroscience) are opening new ways of monitoring physiological processes through non-intrusive means. Such dense continuous data provide new and fruitful avenues for complementing self-reported data with a better understanding of human dynamics and human interactions. In this study, we use a survey to collect positive affect (feelings) data from more than 300 individuals over a period of 24 h, and at the same time, map their core activities (5000 recorded activities in total) with measurements of their heart rate variability (HRV). Our results indicate a robust correlation between the HRV measurements and self-reported affect. By drawing on the neuroscience and wellbeing literature we show that dynamic HRV results are what we expect for positive affect, particularly when performing activities like sleep, travel, work, exercise and eating. This research provides new insights into how to collect HRV data, model and interpret it.

A randomized controlled trial of brief behavioral activation plus savoring for positive affect dysregulation in university students

Rising rates of depression on university campuses accentuate the need for specific intervention. Interventions targeting disturbances in positive affect, in particular, remain sparse, yet such deficits interfere substantially with functioning and further exacerbate or maintain negative symptoms. The current study aimed to evaluate the impact of a virtual, two-session Behavioral Activation augmented with Savoring (BA + S) intervention compared to an Emotional Awareness (EA) control group in increasing positive affect. Sixty university students with low positive affect were randomized to BA + S or EA and completed 21 days of experience-sampling of positive affect. Weekly measures of positive and negative valence symptoms were assessed at baseline, sessions one and two, and at one-week follow-up. Through a prori analyses utilizing multilevel and multivariate multilevel models, our results demonstrate that daily positive affect measured via experience-sampling significantly improved in BA + S, whereas positive affect did not change for those receiving EA, though the interaction of condition and time was not significant. Furthermore, interactions in weekly variables were significant. Increases in positive valence symptoms (affect, anhedonia, etc.) were only reported for students receiving BA + S but not EA. Negative valence symptoms (affect, depression, general distress) improved in both conditions but with superior improvements in BA + S compared to EA. BA + S shows promise for a scalable and accessible intervention to university students with clinical levels of positive and negative affect. ClinicalTrials ID: NCT05234476.

Positive and negative affect change following psychotherapeutic treatment for anxiety-related disorders: A systematic review and meta-analysis

BACKGROUND

Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA.

METHODS

We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses.

RESULTS

Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = -0.90; 95%CI [-1.19, -0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = -5.26, p < .001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms.

LIMITATIONS

Results should be considered with caution given the small number and heterogeneity of included studies.

CONCLUSIONS

Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels.

Imagery rescripting: The value of an added positive emotion component

BACKGROUND AND OBJECTIVES

Imagery Rescripting (ImRs) aims to reduce trauma-related negative emotions and intrusions. Positive emotions during ImRs may aid coping with the consequences of trauma, but protocols vary in the extent to which they explicitly target such positive emotions. We used a multiple-day design with a trauma film paradigm to investigate whether adding an explicit positive emotion component to ImRs improved intervention effects in a non-clinical sample. In addition, we explored potentially differential effects on high, medium, and low arousal positive affect.

METHODS

Participants (n = 105) were randomly assigned to either a standard ImRs condition, to an ImRs condition with an added explicit positive emotion component targeting joy (ImRs+), or to a non-intervention control (NIC) condition. Participants watched a trauma film on day 1, received the condition-specific intervention on day 2, and completed additional post-assessments of positive and negative affect on day 3. In addition, participants recorded intrusions from the trauma film from day 1 until day 3.

RESULTS

Compared to standard ImRs and NIC, ImRs + significantly increased positive affect. Exploratory analyses showed that this increase concerned medium and high, but not low arousal positive affect. No significant between-group differences were found for negative affect and intrusion-related outcomes.

LIMITATIONS

Floor effects for intrusions and negative affect limited our ability to fully investigate the potential benefits of targeting positive affect.

CONCLUSIONS

Adding a positive emotion component to ImRs reliably improved positive affect. More research is needed to determine whether explicitly targeting positive affect improves efficacy of ImRs for intrusion-related outcomes.

Alcohol does not influence trust in others or oxytocin, but increases positive affect and risk-taking: a randomized, controlled, within-subject trial

BACKGROUND

Alcohol consumption to facilitate social interaction is an important drinking motive. Here, we tested whether alcohol influences trust in others via modulation of oxytocin and/or androgens. We also aimed at confirming previously shown alcohol effects on positive affect and risk-taking, because of their role in facilitating social interaction.

METHODS

This randomized, controlled, within-subject, parallel group, alcohol-challenge experiment investigated the effects of alcohol (versus water, both mixed with orange juice) on perceived trustworthiness via salivary oxytocin (primary and secondary endpoint) as well as testosterone, dihydrotestosterone, positive affect, and risk-taking (additional endpoints). We compared 56 male participants in the alcohol condition (1.07 ± 0.18 per mille blood alcohol concentration) with 20 in the control condition.

RESULTS

The group (alcohol versus control condition) × time (before [versus during] versus after drinking) interactions were not significantly associated with perceived trustworthiness (η2 < 0.001) or oxytocin (η2 = 0.003). Bayes factors provided also substantial evidence for the absence of these effects (BF01 = 3.65; BF01 = 7.53). The group × time interactions were related to dihydrotestosterone (η2 = 0.018 with an increase in the control condition) as well as positive affect and risk-taking (η2 = 0.027 and 0.007 with increases in the alcohol condition), but not significantly to testosterone.

DISCUSSION

The results do not verify alcohol effects on perceived trustworthiness or oxytocin in male individuals. However, they indicate that alcohol (versus control) might inhibit an increase in dihydrotestosterone and confirm that alcohol amplifies positive affect and risk-taking. This provides novel mechanistic insight into social facilitation as an alcohol-drinking motive.

Age-related patterns in high-risk alcohol and cannabis use and their associations with positive and negative affect in young adulthood

OBJECTIVE

We examined age-varying associations between young adult simultaneous alcohol and marijuana/cannabis use (SAM) and heavy episodic drinking (HED) and positive and negative affect to inform harm reduction efforts.

METHODS

Young adults reporting past-year alcohol use (n = 556; ages 19-25) were recruited in a state where alcohol and nonmedical cannabis use was legal for those 21 +. Participants provided 24 repeated monthly assessments. Among those reporting past-month cannabis use on at least one survey, logistic time-varying effect models estimated (1) the age-varying prevalence of and associations between past-month SAM and HED and (2) age-varying unique associations of affect with SAM and HED.

RESULTS

There was a positive age-varying association between HED and SAM over time that was highest at age 19 (OR = 7.56), decreased until age 20.7 (OR = 3.39), increased until age 23.0 (OR = 4.85), and decreased until the association became non-significant by age 25. Negative affect was positively associated with SAM from ages 20.7 to 23.0, peaking at age 21.8 (OR = 1.36). Positive affect was positively associated with HED from ages 19.4 to 20.4 (peak OR = 1.25) and ages 22.5 to 24.5 (peak OR = 1.38). In contrast, positive affect was not uniquely associated with SAM nor negative affect with HED across ages 19-25.

CONCLUSIONS

While HED and SAM were positively associated throughout young adulthood and interventions could target them in tandem, their associations with affect suggest differential etiologic processes. Preventive intervention and harm reduction efforts should attend to psychological context in which these behaviors occur.

Compassion Dynamics in Medical Students: An Ecological Momentary Assessment Study

Effective interventions to support compassionate patient- and self-care requires an understanding of how to best assess compassion. Micro-ecological momentary assessment (micro-EMA), a method in which participants provide brief responses in real-time within their own environments, can capture changes in compassion across time and contexts. This study examined a micro-EMA approach for measuring the temporal dynamics of compassion in medical students during the COVID-19 pandemic. Medical students (N = 47) completed demographic information and self-report questionnaires assessing empathy and compassion for self and others. Participants then completed six bursts of micro-EMA smartphone-delivered surveys. Each burst was 14 days, with 28 days between bursts. During each burst, participants received four daily micro-EMA surveys assessing compassion, stress, positive affect, and negative affect. Dynamic structural equation modeling was used to examine micro-EMA responses. The overall micro-EMA response rate was 83.75%. On average, daily compassion did not significantly change across the academic year. However, there was significant within-person variability in medical students' compassion trajectories over the training year (b = 0.027, p < .01). At concurrent timepoints, micro-EMA assessed compassion was associated with greater happiness (b = 0.142, p < .001) and lower stress (b = -0.052, p < .05) but was not associated with sadness. In lagged analyses, higher micro-EMA assessed compassion predicted higher next day happiness (b = 0.116, p < .01) and vice versa (b = 0.185, p < .01). Results suggest it is feasible to use micro-EMA to assess daily levels of compassion among medical students. Additionally, there is wide variability in day-to-day fluctuations in compassion levels among medical students, with some students showing substantial increases in daily compassion across the training year and others showing decreases. Positive affect as opposed to negative affect may have particularly strong associations with compassion. Further examination of antecedents and consequences of fluctuations in daily compassion could inform potent intervention targets.

Social Media Use as a Predictor of Positive and Negative Affect: An Ecological Momentary Assessment Study of Adolescents with and without Clinical Depression

Social media use is common in adolescents, with implications for psychosocial development and the emergence of depression. Yet, little is known about the time-linked connections between social media use and adolescents' affective experiences and how they may differ between depressed and non-depressed youth. We leveraged ecological momentary assessment in adolescents oversampled for current depression to examine (1) associations between social media use and concurrent and later positive and negative affect and (2) sex and presence of a depressive disorder as moderators of these associations. Adolescents aged 14-17 with (n = 48) and without (n = 97) clinical depression, as indicated via clinical interview, reported momentary social media use and positive and negative affect seven times per day for one week. Multilevel modeling indicated that social media use was associated with reduced positive affect both concurrently and at the next assessment. Further, among clinically depressed youth only, social media use was associated with reduced negative affect at the next assessment. Results suggest that social media use may reduce both positive and negative affect, highlighting the nuanced relation between adolescent social media use and emotional health and laying the groundwork for future research to address several open questions.

An integrative analysis of potential mechanisms of reduced positive affect in daily life in depression: an ESM study

Decreased levels of positive affect (PA) are a hallmark of depression. Current models propose as potential main mechanisms a dysfunctional use of emotion regulation (ER) strategies (i.e. dampening, positive rumination), and a maladaptive activation of pro-hedonic goals. However, the role of these mechanisms in PA in daily life remains understudied. We used a 10-day ESM design to assess how these mechanisms influence each other and contribute to depressive symptomatology-related low momentary PA in 139 individuals. Higher depressive symptoms were associated with lower PA, pro-hedonic goals, more frequent use of positive rumination, and higher use of dampening. Further, experiencing higher levels of PA predicted lower following time point use of dampening in individuals with higher symptoms. Finally, using positive rumination was more beneficial (i.e. predicted higher PA increases one moment later) for individuals with higher symptomatology. Our findings suggest that moment-to-moment changes in PA daily life are affected by, and have an effect on, both pro-hedonic goals and the use of dampening and positive rumination, highlighting specific cognitive-affective mechanisms that should be considered when designing interventions aimed at improving low PA characterising depression symptomatology.

Effects of positive and negative affect inductions on interpretive and response bias

Affective states and interpretations of ambiguous stimuli are inherently related constructs, although effects of induced affective states on interpretive and response biases have not been comprehensively explored. The present study examined the relationship between induced affective states and interpretive and response bias in a sample of 189 undergraduates. Participants completed an online study in which they were randomized into one of two mood induction conditions and subsequently completed an interpretive bias task. Results demonstrated significant condition differences in affect after the mood induction; the positive induction condition demonstrated significantly more positive mood and the negative condition demonstrated more negative mood. A significant difference between conditions emerged with respect to positive interpretive bias for non-social scenarios, with the positive mood induction condition demonstrating more positive interpretive bias to non-social situations than the negative induction condition (p = .04). The negative induction condition demonstrated significantly greater negative response bias for social scenarios (p = .03) and, unexpectedly, a significantly higher positive response bias for non-social scenarios (p = .05). Findings offer some support for the notion that inducing positive affect may promote more positive interpretations of ambiguous scenarios.

Divergent Acute and Enduring Changes in 50-kHz Ultrasonic Vocalizations in Rats Repeatedly Treated With Amphetamine and Dopaminergic Antagonists: New Insights on the Role of Dopamine in Calling Behavior

BACKGROUND

Rats emit 50-kHz ultrasonic vocalizations (USVs) in response to nonpharmacological and pharmacological stimuli, with addictive psychostimulants being the most effective drugs that elicit calling behavior in rats. Earlier investigations found that dopamine D1-like and D2-like receptors modulate the emission of 50-kHz USVs stimulated in rats by the acute administration of addictive psychostimulants. Conversely, information is lacking on how dopamine D1-like and D2-like receptors modulate calling behavior in rats that are repeatedly treated with addictive psychostimulants.

METHODS

We evaluated the emission of 50-kHz USVs in rats repeatedly treated (×5 on alternate days) with amphetamine (1 mg/kg, i.p.) either alone or together with (1) SCH 23390 (0.1-1 mg/kg, s.c.), a dopamine D1 receptor antagonist; (2) raclopride (0.3-1 mg/kg, s.c.), a selective dopamine D2 receptor antagonist; or (3) a combination of SCH 23390 and raclopride (0.1 + 0.3 mg/kg, s.c.). Calling behavior of rats was recorded following pharmacological treatment, as well as in response to the presentation of amphetamine-paired cues and to amphetamine challenge (both performed 7 days after treatment discontinuation).

RESULTS

Amphetamine-treated rats displayed a sensitized 50-kHz USV emission during repeated treatment, as well as marked calling behavior in response to amphetamine-paired cues and to amphetamine challenge. Antagonism of D1 or D2 receptors either significantly suppressed or attenuated the emission of 50-kHz USVs in amphetamine-treated rats, with a maximal effect after synergistic antagonism of both receptors.

CONCLUSIONS

These results shed further light on how dopamine transmission modulates the emission of 50-kHz USVs in rats treated with psychoactive drugs.

The ABC of happiness: Validation of the tridimensional model of subjective well-being (affect, cognition, and behavior) using Bifactor Polytomous Multidimensional Item Response Theory

Background

Happiness is often conceptualized as subjective well-being, which comprises people's evaluations of emotional experiences (i.e., the affective dimension: positive and negative feelings and emotions) and judgements of a self-imposed ideal (i.e., the cognitive dimension: life satisfaction). Recent research has established these two dimensions as primary parts of a higher order factor. However, theoretical, conceptual, and empirical work suggest that people's evaluations of harmony in their life (i.e., the sense of balance and capacity to behave and adapt with both acceptance and flexibility to inter- and intrapersonal circumstances) constitutes a third dimension (i.e., the behavioral dimension). This tridemensional conceptualization of subjective well-being has recently been verified using Unidimensional Item Response Theory (UIRT) and Classical Test Theory (CTT). Here, we use a recently developed and more robust approach that combines these two methods (i.e., Multidimensional Item Response Theory, MIRT) to simultaneously address the complex interactions and multidimensionality behind how people feel, think, and behave in relation to happiness in their life.

Method

A total of 435 participants (197 males and 238 females) with an age mean of 44.84 (sd = 13.36) responded to the Positive Affect Negative Affect Schedule (10 positive affect items, 10 negative affect items), the Satisfaction with Life Scale (five items), and the Harmony in life Scale (five items). We used Bifactor-Graded Response MIRT for the main analyses.

Result

At the general level, each of the 30 items had a strong capacity to discriminate between respondents across all three dimensions of subjective well-being. The investigation of different parameters (e.g., marginal slopes, ECV, IECV) strongly reflected the multidimensionality of subjective well-being at the item, the scale, and the model level. Indeed, subjective well-being could explain 64 % of the common variance in the whole model. Moreover, most of the items measuring positive affect (8/10) and life satisfaction (4/5) and all the items measuring harmony in life (5/5) accounted for a larger amount of variance of subjective well-being compared to that of their respective individual dimensions. The negative affect items, however, measured its own individual concept to a lager extent rather than subjective well-being. Thus, suggesting that the experience of negative affect is a more independent dimension within the whole subjective well-being model. We also found that specific items (e.g., "Alert", "Distressed", "Irritable", "I am satisfied with my life") were the recurrent exceptions in our results. Last but not the least, experiencing high levels in one dimension seems to compensate for low levels in the others and vice versa.

Conclusion

As expected, the three subjective well-being dimensions do not work separately. Interestingly, the order and magnitude of the effect by each dimension on subjective well-being mirror how people define happiness in their life: first as harmony, second as satisfaction, third as positive emotions, and fourth, albeit to a much lesser degree, as negative emotions. Ergo, we argue that subjective well-being functions as a complex biopsychosocial adaptive system mirroring our attitude towards life in these three dimensions (A: affective dimension; B: behavioral dimension; C: cognitive dimension). Ergo, researchers and practitioners need to take in to account all three to fully understand, measure, and promote people's experience of the happy life. Moreover, our results also suggest that negative affect, especially regarding high activation unpleasant emotions, need considerable changes and further analyses if it is going to be included as a construct within the affective dimension of a general subjective well-being factor.

Sleep Disruption Moderates the Daily Dynamics of Affect and Pain in Sickle Cell Disease

Persons with sickle cell disease (SCD) often experience pain that can interfere with quality of life and daily activities. Pain can modulated by affect and sleep continuity; however, few studies have explored how these factors complementarily influence pain in adults with SCD. The study aims were to investigate 1) whether pain levels were heightened on days characterized by low positive affect and high negative affect, and 2) whether the relationship between affect and pain was intensified following nights of disrupted sleep. Adults with SCD (N = 25) completed ecological momentary assessments and daily sleep diaries. Mixed models were used to analyze the main and interactive effects of daily affect (positive affect and negative affect) and sleep disruption (wake after sleep onset and frequency of awakenings) on both daily average pain and daily maximum pain. Results suggested that daily average pain and maximum pain tended to be higher on days of low positive affect and high negative affect. Furthermore, the frequency of nocturnal awakenings moderated the relationship between positive affect and pain. On days where there were higher frequencies of nocturnal awakenings, low positive affect was associated with both average and maximum pain; however, this association was not observed with lower frequencies of nocturnal awakenings. The association between negative affect and maximum pain was also stronger at higher levels of awakenings. Results highlight the relevance of adjunctive interventions that target affect among populations with SCD and further suggest that sleep continuity may further facilitate these interventions, highlighting the importance of multimodal treatments. PERSPECTIVE: This study examined the effects of affect and sleep on pain among adults with sickle cell disease (SCD). Higher pain occurred on days of low positive affect and high negative affect, particularly following nights of more frequent awakenings. These findings emphasize the importance of addressing affect and sleep in SCD treatment.

Aberrant positive affect dynamics in individuals with subthreshold depression: Evidence from laboratory and real-world assessments

Background/Objective

Reduced positive affect (PA) is a core feature of major depressive disorder (MDD). However, the precursor of MDD, subthreshold depression (StD), has received less attention in this regard. Therefore, we examined PA dynamics in StD, integrating laboratory-based and ecological momentary assessment (EMA) approaches.

Method

Participants were college students recruited from Chinese universities (31 with StD, and 39 healthy controls (HC)). Positive mood was induced in the laboratory by an eight-minute comedy clip used to assess PA reactivity and maintenance. To extend findings to the real world and explore mechanisms of PA maintenance, 53 participants with StD and 64 HC reported their emotional states 14 times daily for one week via EMA. Multilevel models were used to test for predictors of PA inertia.

Results

In the laboratory, participants with StD achieved the same PA reactivity as HC when facing positive stimuli, yet the curve-fitting revealed difficulties for the StD group in maintaining PA over time. Such reduced capacity was further observed in real-world settings, manifesting in significantly greater PA inertia.

Conclusions

High PA inertia in daily life may reflect resistance to mood change in StD, explaining anhedonia and difficulties with emotional maintenance, and highlighting the need for early identification.

Golf skill learning: An external focus of attention enhances performance and motivation

An external focus of attention has been shown to enhance the performance and learning of motor skills, relative to an internal focus (see Chua, Jimenez-Diaz, Lewthwaite, Kim, & Wulf, 2021). In the present study, we examined possible motivational consequences of learners' experience of greater movement success with an external focus. Participants were asked to learn a golf pitch shot. In addition to measuring learning, we assessed self-efficacy, as well as positive and negative affect in groups that received external versus internal focus instructions. Furthermore, we examined the feasibility of providing several focus instructions in the same practice session as the learning of complex skills typically requires more than one instructional cue. The results showed that skill learning was enhanced by instructions that promoted external foci, as measured by golf shot accuracy on delayed retention and transfer tests. The external focus group also showed higher positive affect and reduced negative affect at the end of practice, and higher self-efficacy before retention testing, compared with the internal focus group. These findings provide support for several assumptions of the OPTIMAL theory (Wulf & Lewthwaite, 2016). From a practical perspective, they highlight the attentional and motivational benefits of an external focus.

Neural reward responsiveness and daily positive affect functioning in adolescent girls

Deficits in reward processing have been implicated in the development of many forms of psychopathology, especially major depressive disorder (MDD). One facet of reward processing, known as reward responsivity, has been associated with the development and maintenance of depression across development. The reward positivity (RewP) is an event-related potential derived from electroencephalogram (EEG), which is thought to reflect reward responsivity. An attenuated RewP has been observed in both currently depressed individuals and youth at risk for depression, suggesting it may represent a biomarker of depression. Despite this, little is known about how the RewP translates to behavior and affect in the real world. In the current study, we examined how the RewP relates to real world emotional functioning, measured using ecological momentary assessment (EMA). Thirty-eight female adolescents (ages 11-16, Mage = 13.9 years) participated in the study; approximately half of the sample were considered high risk due to maternal lifetime history of MDD. Adolescents completed a monetary reward task while EEG was recorded, followed by a 10-day period of EMA assessing daily affect and emotion regulation strategy use following positive events. Results revealed that the RewP was positively associated with subjective reports of positive, but not negative, daily affect. Results also revealed that the RewP was positively associated with focusing on positive feelings following a positive event (e.g., savoring). Findings from this preliminary study highlight how neural responses to reward in the lab relate to daily life emotional functioning, supporting the RewP as an ecologically valid marker of positive affect functioning among youth.

Mu Opioid Receptor-Expressing Neurons in the Dorsal Raphe Nucleus Are Involved in Reward Processing and Affective Behaviors

BACKGROUND

Mu opioid receptors (MORs) are key for reward processing, mostly studied in dopaminergic pathways. MORs are also expressed in the dorsal raphe nucleus (DRN), which is central for the modulation of reward and mood, but MOR function in the DRN remains underexplored. Here, we investigated whether MOR-expressing neurons of the DRN (DRN-MOR neurons) participate in reward and emotional responses.

METHODS

We characterized DRN-MOR neurons anatomically using immunohistochemistry and functionally using fiber photometry in responses to morphine and rewarding/aversive stimuli. We tested the effect of opioid uncaging on the DRN on place conditioning. We examined the effect of DRN-MOR neuron optostimulation on positive reinforcement and mood-related behaviors. We mapped their projections and selected DRN-MOR neurons projecting to the lateral hypothalamus for a similar optogenetic experimentation.

RESULTS

DRN-MOR neurons form a heterogeneous neuronal population essentially composed of GABAergic (gamma-aminobutyric acidergic) and glutamatergic neurons. Calcium activity of DRN-MOR neurons was inhibited by rewarding stimuli and morphine. Local photo-uncaging of oxymorphone in the DRN produced conditioned place preference. DRN-MOR neuron optostimulation triggered real-time place preference and was self-administered, promoted social preference, and reduced anxiety and passive coping. Finally, specific optostimulation of DRN-MOR neurons projecting to the lateral hypothalamus recapitulated the reinforcing effects of total DRN-MOR neuron stimulation.

CONCLUSIONS

Our data show that DRN-MOR neurons respond to rewarding stimuli and that their optoactivation has reinforcing effects and promotes positive emotional responses, an activity which is partially mediated by their projections to the lateral hypothalamus. Our study also suggests a complex regulation of DRN activity by MOR opioids, involving mixed inhibition/activation mechanisms that fine-tune DRN function.

Functional Ability, Psychological Factors, and Rehabilitation Outcomes After Elective Total Hip Replacement

Background. The role of positive psychological factors in acute rehabilitation after total hip replacement (THR) is unclear. Purpose. (a) Examine the trajectory of functional ability among older adults after THR from presurgery to discharge from acute rehabilitation and (b) determine which physical and psychological factors at admission would predict functional ability at discharge and length of stay in rehabilitation. Methods. This prospective cohort study included 30 participants (age M = 76.20 years) from an inpatient geriatric rehabilitation center. They completed the Geriatric Depression Scale and Positive Affect questionnaire. The FIM® Motor domain of Functional Independent Measure (mFIM) was recorded presurgery, at admission, and upon discharge. Findings. Functional ability improved at discharge; however, the presurgery functional ability was not regained. Positive affect explained the length of stay in rehabilitation above and beyond the presurgery mFIM. Implications. Occupational therapists should improve ways to enhance self-care and positive affect in acute rehabilitation.

Self-compassion, Positive and Negative Affect and Social Avoidance among Adolescence: Mediating Role of Mindfulness

Objective

Mindfulness is an attribute of consciousness to manage social fear avoidance and promote well-being. Social anxiety is a common psychological experience noted among the general population. Social anxiety develops during adolescence and is prevalent among college students. This study investigates the factors contributing to social anxiety - fear and avoidance of social situations of female first-year undergraduates.

Methods

The study used a survey research design. A sample of 821 first-year female undergraduate students aged between 17 and 19. Data were collected using the Liebowitz Social anxiety scale, the Five-Facet mindfulness questionnaire, A short form of the Self-compassion scale, and the Positive and Negative affect scale.

Results

Mindfulness weakens social fear and reduces the tendency to avoid social situations. Mindfulness effectively mediates the impact of self-compassion's positive affect and negative effects on social fear. Mindfulness and social fear jointly mediate the impact of self-compassion, positive affect, and negative affect on social avoidance.

Conclusion

Mindfulness is the awareness and acceptance of the feelings, thoughts and sensations attached to self and its possible reciprocity with social surroundings to mitigate fear-self-compassion and positive emotional affect augment, and negative emotional affect attenuate mindfulness. Results analysis highlights the mediation of mindfulness on social anxiety, self-compassion, positive affect, and negative affect.

Attenuated maladaptive emotion processing as a potential mediator of the relationship between dispositional mindfulness and mental health

The emotion processing and regulation mechanisms by which dispositional (personality trait) mindfulness exerts its positive effects on mental health remain unclear. Here, we tested, using structural equation modeling, whether the relationship between higher dispositional mindfulness and better mental health is mediated by reduced maladaptive processing of emotional information (e.g., expressive suppression, impoverished emotional experiences, unprocessed emotions, avoidance, externalizing strategies) and associated lower negative affect, enhanced adaptive processing of emotional information (e.g., cognitive reappraisal) and associated higher positive affect, or a combination of these two emotion processing styles. Dispositional mindfulness, mental health, diverse emotional constructs with adaptive and maladaptive dimensions (including range and differentiation of emotional experiences, use of specific emotion regulation strategies, emotion processing deficits, negative affect repair strategies, negative mood regulation expectancies), and positive and negative affect were assessed using self-report measures in a non-clinical sample of 256 adults. The relationship between higher dispositional mindfulness and better mental health was found to be best explained by reduced maladaptive emotion processing styles and associated lower negative affect, rather than by enhanced adaptive emotion processing and higher positive affect. Further research should investigate whether the same mechanisms explain psychological benefits of cultivated mindfulness in people with low dispositional mindfulness and/or with mental health disorders following mindfulness skills training.

Chinese calligraphic handwriting practice promotes positive affect in adolescents: Converging evidence from correlational and experimental designs

Chinese calligraphic handwriting (CCH) practice has proven to be beneficial to several aspects of psychological health and has been considered a complementary therapy for mental disorders. However, less is known about whether CCH practice benefits an individual's positive affect, a core component of affective well-being. Therefore, we examined this question in Chinese adolescents by combining correlational and experimental methods. In Study 1 (N = 1460), we found that high school students who practiced CCH had higher positive affect in their daily lives than those who did not practice CCH. In Study 2, a training experiment was conducted with college students, who were randomly assigned to receive either CCH training or no treatment. A six-day short-term CCH training led to a significant benefit in positive affect in the training group (N = 23) relative to the control group (N = 27). Together, our study provides converging evidence that CCH practice can promote positive affect in adolescents, further supporting the promotion of CCH in mental health practice.

Positive Psychology Interventions for Improving Self-management Behaviors in Patients with Type 1 and Type 2 Diabetes: a Narrative Review of Current Evidence

PURPOSE OF REVIEW

Interests have been emerging in using positive psychology interventions (PPIs) to improve diabetes self-management (DSM) behaviors (e.g., blood glucose monitoring, physical activity). To explore the impact of those interventions on DSM behaviors, we summarized the evidence of PPIs on self-management behaviors among both type 1 diabetes (T1D) and type 2 diabetes (T2D) patients between 2012 and 2022.

RECENT FINDINGS

Among the eight studies identified, different study designs and types of PPIs were apparent. Typical PPIs (e.g., activities enhancing positive affect/gratitude/self-affirmation/optimism) were usually applied to T1D patients (N = 5); PPIs were usually combined with motivational interviewing for T2D patients (N = 3). Contrary to expectations, PPIs did not consistently demonstrate positive effects on self-management behaviors' change regardless of the types of diabetes patients, compared to the control groups. Improvements in diabetes patients' self-management behaviors from PPIs are still unclear. Future studies should more rigorously evaluate and identify the active ingredients of PPIs for behavioral changes among diabetes patients.

Associations of DHEA(S) with negative and positive affect in people who smoke daily with elevated and low depression symptoms: A pilot laboratory study

BACKGROUND

Individuals with depression symptoms have a harder time quitting smoking. High negative affect and low positive affect are core depression symptoms and arise following cigarette abstinence. Investigating associations of biological markers with negative and positive affect may provide valuable information about factors relevant to smoking cessation in individuals with elevated depression symptoms.

METHODS

Depression symptoms were measured at a baseline session. Participants then completed two counterbalanced experimental sessions (non-abstinent, abstinent) and completed measures of positive and negative affect, and provided saliva samples. Saliva samples were assayed at the Salimetrics' SalivaLab (Carlsbad, CA) using the Salimetrics Salivary Dehydroepiandrosterone (DHEA) Assay Kit (Cat. No. 1-1202) and Dehydroepiandrosterone-sulfate (DHEA-S) Assay Kit (Cat. No. 1-1252).

RESULTS

There were no main or interactive associations of DHEA with negative affect. However, there were significant DHEAS × experimental session and DHEAS × experimental session × depression symptom level interactions with negative affect. In the high depression symptom group, DHEAS positively associated with negative affect during the non-abstinent experimental session, but DHEAS negatively associated with negative affect during the abstinent experimental session. There were no associations of DHEA or DHEAS with positive affect.

CONCLUSION

This study found that DHEAS negatively associated with negative affect during cigarette abstinence in individuals with elevated depression symptoms. This is important as high negative affect during cigarette abstinence may result in a return to smoking.

A prefrontal cortex alpha/delta switch controls the transition from positive to negative affective states

Positive and negative emotional states in rats can be studied by investigating ultrasonic vocalizations (USVs). Positive affect in rats is indexed by 50 kHz hedonic USVs, and negative affect is indexed by 22 kHz aversive calls. We examined the relationship of emotional states in rats using medial prefrontal cortex (MPFC) quantitative electroencephalograms (qEEG) and found that hedonic USVs were associated with active wake qEEG (high alpha/low delta power), and aversive USVs occurred with groggy wake qEEG (low alpha/high delta). Further, alpha frequency electrical stimulation of the MPFC induces hedonic calls and reward-seeking behavior, whereas delta frequency stimulation produces aversive calls and avoidance behavior. The brain region responsible for generating motor output for USVs, the periaqueductal gray (PAG), shows a motor-evoked potential that is temporally locked to the alpha (hedonic) and delta (aversive) motor-evoked potential. Closed-loop alpha frequency electrical stimulation could prevent delta qEEG and aversive USVs. At the neuronal circuit level, the alpha rhythm was associated with synaptic long-term potentiation (LTP) in the cortex, whereas the delta rhythm was associated with synaptic depotentiation (LTD) in the cortex. At the pharmacological level, NMDAR and growth factor modulation regulated these forms of neuroplasticity. At the single neuron level, excitatory neurons show increased activity in response to alpha frequencies and decreased activity during delta frequencies. In humans, the feeling of joy increased alpha and decreased delta power in frontal scalp qEEG, and the opposite response was seen for sadness. Thus, the synchronization of alpha/delta oscillations through the neuronal circuit responsible for emotional expression coordinates emotional behavior, and the switch between active wake/positive affect and groggy wake/negative affect is under the control of an LTP- LTD synaptic plasticity mechanism.

Positive life experiences and mortality: Examination of psychobiological pathways

INTRODUCTION AND RATIONALE

Positive life experiences are potentially-rewarding events and behaviors, such as social and romantic interactions, experiences of relaxation and physical comfort, time spent in nature, and other leisure activities. To date, there is limited evidence linking positive life experiences to long-term health outcomes.

OBJECTIVE AND METHODS

The current study used data from N = 1243 participants in the Midlife Development in the US Study Biomarker Project to examine whether greater frequency of a range of different positive experiences and greater level of enjoyment of these experiences was linked to survival over a 12- to-16-year period in Cox proportional hazards models. The potential mediating roles of positive affect, depression, perceived stress, and an allostatic load index of physiological dysregulation in these associations were also examined.

RESULTS

Greater frequency of positive experiences and greater enjoyment of positive experiences were both associated with a reduced hazard of mortality over the 12- to 16-year period. Models assessing a single mediator showed that both associations were mediated by decreased depression and decreased perceived stress, but not by positive affect or allostatic load. In supplementary multi-mediation models, depression was the only significant mediator of the frequency-survival and enjoyment-survival associations.

CONCLUSIONS

Positive life experiences may confer long-term survival benefits, partially through lessening depressive symptomatology.

Links of positive affect and stress to HbA1c: a prospective longitudinal study

While affect is linked to a number of diabetes outcomes, the specific role of positive affect (PA) in HbA1c remains unclear. The present study examined whether PA prospectively predicted lower HbA1c among adults with type 2 diabetes and whether this relation was moderated by stress. Participants were 123 adults (44.7% female; 60.2% White, 39.8% Black) recently diagnosed with type 2 diabetes. Perceived stress, diabetes-specific distress, and PA were assessed at baseline; HbA1c was assessed at baseline (T1), six months (T2), and five years (T3). PA was cross-sectionally associated with lower HbA1c at T1 and prospectively predicted lower HbA1c at T3. PA interacted with both measures of T1 stress to predict T1 HbA1c, and PA interacted with T3 perceived stress to predict T3 HbA1c. Interactions were consistent with stress buffering. Sensitivity analyses attentuated findings, but robust evidence remained for PA as a protective factor for blood glucose five years later and for a stress-buffering effect of PA on diabetes-specific distress. Findings suggest PA may be a clinically useful indicator among adults with type 2 diabetes and may be particularly important for those experiencing the greatest stress from their disease.

Children's emotional intelligence and aggressive behavior: The mediating roles of positive affect and negative affect

Objective

Although previous studies have noted that emotional intelligence (EI) might be a significant protective factor for aggressive behavior, the specific mechanisms involved is largely unknown. Based on the General Aggressive Model, this cross-sectional study aims to investigate whether EI will influence aggressive behavior through the mediating roles of positive affect (PA) and negative affect (NA).

Methods

A total of 410 primary school students (45.4% females; Mage = 10.35, SD = 0.48, range from 10 to 11 years) from Shenzhen, China, completed questionnaires on EI, aggressive behavior, PA, and NA. SPSS 22.0 was used for reliability test and correlation analysis, and (Hayes, 2013) [1] PROCESS macro (Model 6) was used to examine the multiple mediation model.

Results

The results show that (a) EI was negatively associated with children's aggressive behavior; (b) NA partially mediated the link between EI and aggressive behavior in children, and (c) PA and NA sequentially mediated the above link.

Conclusion

This study would not only deepen our understanding of how EI is associated with aggressive behavior but also provide valuable suggestions for teachers and parents to more effectively prevent and intervene children's aggressive behavior.

Positive affect improves a transdiagnostic model of perinatal depression symptoms

INTRODUCTION

Accurate measurement of perinatal depression is vital. We aimed to 1) test whether a factor that measured positive affect (PA) bettered a transdiagnostic model of depression symptoms and 2) replicate the model in a second sample.

METHODS

We conducted secondary analyses from two samples (n's = 657 and 142) of women in treatment at perinatal psychiatric clinics. Data were derived from items from seven commonly used measures. We compared fit indices from our original factor model-one general and six specific factors derived from the Research Domain Criteria (Loss, Potential Threat, Frustrative Nonreward, and Sleep-Wakefulness) and depression literatures (Somatic and Coping)-to our novel factor model with a PA factor. The PA factor was created by recategorizing items that measured affective states with a positive valence into a new factor. Sample 1 data were split into six perinatal periods.

RESULTS

In both samples, the addition of a PA factor improved model fit. At least partial metric invariance was found between perinatal periods, with the exception of trimester 3 - postpartum period 1.

LIMITATIONS

Our measures did not operationalize PA in the same way as in the positive valence system in RDoC and we were unable to perform longitudinal analyses on our cross-validation sample.

CONCLUSIONS

Clinicians and researchers are encouraged to consider these findings as a template for understanding symptoms of depression in perinatal patients, which can be used to guide treatment planning and the development of more effective screening, prevention, and intervention tools to prevent deleterious outcomes.

Influence of social support on cognitive reappraisal in young adults elevated on neuroticism

Social support offers protection from depression and anxiety, possibly through its beneficial effects upon cognitive reappraisal. The present study evaluates potential mechanisms of social support, utilizing a reappraisal task in 121 undergraduates elevated on neuroticism. Participants were instructed to reinterpret stressful images with (Social Condition) and without (Solo Condition) the reminder of a social support figure. Aversiveness, negative affect, and positive affect ratings, as well as written reappraisal responses, were collected trial-by-trial. Results indicated that participants reported lower aversiveness and negative affect and higher positive affect when reinterpreting images in the Social Condition compared to the Solo Condition. Analyses of adherence ratings of written reappraisals revealed that participants generated reinterpretations more in the Social Condition than in the Solo Condition. Exploratory mediation analyses indicated that Condition was indirectly associated with reappraisal efficacy as measured by aversiveness and affect ratings through reappraisal adherence. Results suggest that cognitive reappraisal with the influence of social support may be more effective than cognitive reappraisal without such social influence, and thus may be a suitable target for interventions for depression and anxiety.

Discrete emotions and global affect: Applying empirically driven approaches to experience sampling data to model state and trait affective structure and affect-alcohol use associations in a heavy drinking young-adult sample

Affective functioning is central to most contemporary models of alcohol use. However, the affective structure at the within- and between-person levels is rarely investigated nor is the differential predictive value of specific affect dimensions assessed across state and trait formats. We examined a) the structure of state and trait affect using experience sampling methodology (ESM) and b) predictive associations between the empirically derived affect facets and alcohol use. Participants were 92 heavy drinking college students aged 18-25 who completed 8 momentary assessments of their affect and drinking a day for 28-days. We found evidence for a single positive affect factor at both the within- (i.e., state) and between-person (i.e., trait) levels. We found a hierarchical factor structure for negative affect, represented by a general, superordinate dimension as well as facet-level sadness, anxiety, and anger dimensions. Associations between affect and alcohol use differed across trait and state levels and across specific types of negative affect. Lagged state positive affect and sadness as well as trait positive affect and sadness were inversely associated with drinking. Lagged state anxiety and trait general negative affect were positively associated with drinking. Thus, our study demonstrates how associations between drinking and affect can be studied in relation to general (e.g., general negative affect) and more specific aspects of affective experiences (e.g., sadness versus anxiety) concurrently within the same study and across trait and state levels of assessment.

Happy people live longer because they are healthy people

OBJECTIVES

Higher levels of happiness are associated with longer life expectancy. Our study assessed the extent to which various factors explain the protective effect of happiness on all-cause mortality risk, and whether the association differs between older men and women.

METHODS

Using data from the Singapore Longitudinal Aging Studies (N = 6073) of community-dwelling older adults aged ≥ 55 years, we analyzed the association of baseline Likert score of happiness (1 = very sad to 5 = very happy) and mortality from mean 11.7 years of follow up. Cox regression models were used to assess the extent to which confounding risk factors attenuated the hazard ratio of association in the whole sample and sex-stratified analyses.

RESULTS

Happiness was significantly associated with lower mortality (p < .001) adjusted for age, sex and ethnicity: HR = 0.85 per integer score and HR = 0.57 for fairly-or-very happy versus fairly-or-very sad. The HR estimate (0.90 per integer score) was modestly attenuated (33.3%) in models that included socio-demographic and support, lifestyle or physical health and functioning factor, but remained statistically significant. The HR estimate (0.94 per integer score) was substantially attenuated (60%) and was insignificant in the model that included psychological health and functioning. Including all co-varying factors in the model resulted in statistically insignificant HR estimate (1.04 per integer score). Similar results were obtained for HR estimates for fairly-to-very happy versus fairly-to- very sad).

DISCUSSION

Much of the association between happiness and increased life expectancy could be explained by socio-demographic, lifestyle, health and functioning factors, and especially psychological health and functioning factors.

Feasibility, Acceptability, and Preliminary Efficacy of a Positive Affect Skills Intervention for Adults With Fibromyalgia

Background and Objectives

To examine the feasibility, acceptability, and preliminary efficacy of a positive affect skills intervention for middle-aged and older adults with fibromyalgia syndrome (FMS).

Research Design and Methods

Ninety-five participants with FMS aged 50 and older (94% female) were randomized to 1 of 2 conditions: (a) Lessons in Affect Regulation to Keep Stress and Pain UndeR control (LARKSPUR; n = 49) or (b) emotion reporting/control (n = 46). LARKSPUR included 5 weeks of skill training that targeted 8 skills to help foster positive affect, including (a) noticing positive events, (b) savoring positive events, (c) identifying personal strengths, (d) behavioral activation to set and work toward attainable goals, (e) mindfulness, (f) positive reappraisal, (g) gratitude, and (h) acts of kindness. Outcome data were collected via online surveys at baseline, postintervention, and 1-month follow-up.

Results

Completion rates (88%) and satisfaction ratings (10-point scale) were high (LARKSPUR: M = 9.14, standard deviation (SD) = 1.49; control: M = 8.59, SD = 1.97). Improvements were greater in LARKSPUR participants compared with control participants on measures of positive affect (Cohen's d = 0.19 [0.15, 0.24]), negative affect (Cohen's d = -0.07 [-0.11, -0.02]), and pain catastrophizing (Cohen's d = -0.14 [-0.23, -0.05]). Improvements in positive affect (Cohen's d = 0.17 [0.13, 0.22]) and negative affect (Cohen's d = -0.11 [-0.15, -0.06]) were maintained at 1-month follow-up. Dose-response analyses indicated that intervention engagement significantly predicted pre-to-post and post-to-follow-up reductions in pain catastrophizing.

Discussion and Implications

The current preliminary findings add to existing literature and highlight the specific potential of internet-delivered positive affect skills programs for adults with FMS.

Clinical Trial Registration

NCT04869345.

A randomized, placebo-controlled, double-blinded mechanistic clinical trial using endotoxin to evaluate the relationship between insomnia, inflammation, and affective disturbance on pain in older adults: A protocol for the sleep and Healthy Aging Research for pain (SHARE-P) study

Chronic pain is prevalent in older adults. Treatment, especially with opioids, is often ineffective and poses considerable negative consequences in this population. To improve treatment, it is important to understand why older adults are at a heightened risk for developing chronic pain. Insomnia is a major modifiable risk factor for chronic pain that is ubiquitous among older adults. Insomnia can also lead to heightened systemic inflammation and affective disturbance, both of which may further exacerbate pain conditions in older adults. Endotoxin exposure can be used as an experimental model of systemic inflammation and affective disturbance. The current study aims to understand how insomnia status and endotoxin-induced changes in inflammation and affect (increased negative affect and decreased positive affect) may interact to impact pain facilitatory and inhibitory processes in older adults. Longitudinal data will also assess how pain processing, affective, and inflammatory responses to endotoxin may predict the development of pain and/or depressive symptoms. The current study is a randomized, double-blinded, placebo-controlled, mechanistic clinical trial in men and women, with and without insomnia, aged 50 years and older. Participants were randomized to either 0.8ng/kg endotoxin injection or saline placebo injection. Daily diaries were used to collect variables related to sleep, mood, and pain at two-week intervals during baseline and 3-, 6-, 9-, and 12-months post-injection. Primary outcomes during the experimental phase include conditioned pain modulation, temporal summation, and affective pain modulation ∼5.5 hours after injection. Primary outcomes for longitudinal assessments are self-reported pain intensity and depressive symptoms. The current study uses endotoxin as an experimental model for pain. In doing so, it aims to extend the current literature by: (1) including older adults, (2) investigating insomnia as a potential risk factor for chronic pain, (3) evaluating the role of endotoxin-induced affective disturbances on pain sensitivity, and (4) assessing sex differences in endotoxin-induced hyperalgesia.

Clinicaltrialsgov

NCT03256760.

Trial sponsor

NIH R01AG057750-01.

Autobiographical memory specificity and restrained eating: examining the influence of priming with images of healthy and unhealthy foods

BACKGROUND

Dietary restraint has been linked to deficits in the ability to recall detailed memories of personally experienced events (referred to as autobiographical memory specificity). As priming with healthy foods increases the salience of restraint it would be expected to lead to greater deficits in memory specificity.

OBJECTIVE

To determine if priming word cues with images of healthy or unhealthy foods would influence the specificity of memory retrieval, and if deficits in memory specificity would be more evident in those reporting higher levels of dietary restraint, or currently dieting.

METHODS

Sixty female undergraduates self-reported if they were currently dieting and completed measures of mood, restraint, and disinhibition, and a modified version of the autobiographical memory task. Participants were presented with positive and negative words (unrelated to eating concerns) and asked to retrieve a specific memory in response to each cue. A food image was shown prior to each word cue; half of the participants were primed with images of healthy foods and half with images of unhealthy foods.

RESULTS

As expected, participants primed with healthy foods retrieved fewer specific memories than did those primed with unhealthy foods. However, neither restraint nor current dieting behaviour was associated with memory specificity.

CONCLUSIONS

Differences in memory specificity between the priming conditions cannot be explained in terms of increased salience of restraint. However, it is plausible that unhealthy images led to an increase in positive affect, which in turn improved memory specificity.

LEVEL OF EVIDENCE

Level I: Evidence obtained from: at least one properly designed experimental study.

The effectiveness and equivalence of different versions of a brief online Best Possible Self (BPS) manipulation to temporary increase optimism and affect

BACKGROUND AND OBJECTIVES

The Best Possible Self (BPS) has been found to be an effective manipulation to temporarily improve optimism and affect. The BPS has been used in different formats. In some versions, participants just write about their best possible future, while in others this is combined with imagery. An imagery only version has not been tested yet. The aim of the current study was to examine the effectiveness of three different versions of the BPS and their equivalence in improving optimism and affect.

METHODS

In an online study format, participants (N = 141) were randomly assigned to one of four conditions: (1) writing and imagery BPS; (2) writing BPS; (3) imagery BPS; and (4) a typical day (TD) control condition.

RESULTS

Results showed that each BPS condition significantly improved optimism (i.e. increased positive future expectancies and decreased negative future expectancies) and affect (i.e. increased positive affect and decreased negative affect). Equivalence testing showed that all online BPS conditions were equivalent in increasing optimism and affect, thereby confirming that both the writing and imagery elements of the BPS can independently from each other increase optimism and positive affect in a healthy population.

LIMITATIONS

Only the immediate effects of the BPS formats on increasing optimism and affect were measured.

CONCLUSIONS

The BPS manipulation can be employed in different ways for potential future exploration, depending on the research question, design and context and/or E-mental health applications for the treatment of individuals suffering from psychological complaints.

Delving into the role of creativity on meaning in life: A multiple mediation model

How to enhance the sense of meaning in life is a topic deserving of extensive research. The impact of creativity on finding meaning in life, however, has not been thoroughly explored in empirical research. This paper studies the relationship between creativity and meaning in life, and the cognitive and emotional factors underlying this relationship. The participants of this study were 359 Chinese college students (38 males and 321 females; aged from 17 to 41 years) in learning English as a foreign language (EFL). Four instruments were utilized in the survey, namely, the Kaufman Domains of Creativity Scale (K-DOCS), the Positive Affect Scale, the General Self-Efficacy Scale (GSES), and the Meaning in Life Questionnaire (MLQ). The correlation analysis shows that creativity, positive affect, general self-efficacy, and meaning in life are all positively correlated. According to a bootstrap method to assess the significance of the indirect effect, general self-efficacy and positive affect play multiple mediating roles in the relationship between creativity and meaning in life via three mediating pathways: general self-efficacy alone, positive affect alone, and the effect of general self-efficacy on positive affect. The mediating effect accounts for nearly half (44.18%) of the total effect. This study examines the theoretical connection between creativity and meaning in life, and uncovers the psychological process that underlies this connection. On a practical level, these results indicate that stimulating Chinese college students to engage in creative activities in various fields can enhance their sense of meaning in life.

Pilot study of facial and bodily feedback

BACKGROUND

The modulation hypothesis of facial feedback has not adequately examined how combining facial expressions and bodily postures might influence our experience of emotional stimuli. This pilot study examined a new method for manipulating both face and body together, which is important in furthering our understanding of how face and body interact to influence emotional experiences in the real world.

METHODS

Using a within-subjects design, 30 participants viewed positive film clips under four conditions: (1) positive face with positive body (PP), (2) positive face with neutral body (PN), (3) neutral face with positive body (NP) and (4) neutral face with neutral body (NN). Measures of positive and negative affect were taken before and after each clip, to assess the subjective emotional experience.

RESULTS

Repeated-measures analysis of variance (ANOVA) was conducted to examine differences in the emotional experience under each condition. Post hoc pairwise comparisons demonstrated that positive affect in the PP condition was significantly higher than in the NP and NN conditions. There was no significant difference between the PP and NN conditions.

CONCLUSION

Whilst the study findings are difficult to interpret, this pilot study generated a number of important methodological learnings that are relevant to future research of this kind.

The effect of experimentally induced positive affect on the generalization of pain-related avoidance and relief

Avoiding pain-associated activities can prevent tissue damage. However, when avoidance spreads excessively (or overgeneralizes) to safe activities, it may culminate into chronic pain disability. Gaining insight into ways to reduce overgeneralization is therefore crucial. An important factor to consider in this is relief, as it reinforces avoidance behavior and therefore may be pivotal in making avoidance persist. The current study investigated whether experimentally induced positive affect can reduce generalization of pain-related avoidance and relief. We used a conditioning task in which participants (N = 50) learned that certain stimuli were followed by pain, while another was not. Subsequently, they learned an avoidance response that effectively omitted pain with one stimulus, but was ineffective with another. Next, one group of participants performed an exercise to induce positive affect, while another group performed a control exercise. During the critical generalization test, novel stimuli that were perceptually similar to the original stimuli were presented. Results showed that both avoidance and relief generalized to novel stimuli, thus replicating previous work. However, increasing positive affect did not reduce generalization of avoidance, nor relief.

Coping strategies predict daily emotional reactivity to stress: An ecological momentary assessment study

BACKGROUND

Emotional reactivity predicts poor health and psychopathology. Despite its theoretical importance, little research has tested whether coping predicts emotional reactivity to stressors. We analyse three studies to test this hypothesis for negative (NA) and positive affect (PA) reactivity to daily stressors.

METHODS

422 Participants (72.5 % females, M_age = 22.79 ± 5.36) came from three longitudinal, ecological momentary assessment (EMA) studies across 7-15 days (ACES N = 190; DESTRESS N = 134; SHS N = 98). Coping was measured at baseline. NA, PA, and daily stressors were assessed via EMA. Mixed effects linear models tested whether coping predicted NA and PA reactivity, defined as their slope on within- and between-person daily stressors.

RESULTS

Behavioural disengagement and mental disengagement coping predicted greater within-person NA reactivity across all studies (all p < .01, all f² = 0.01). Denial coping predicted greater within-person NA reactivity in ACES and DESTRESS (both p < .01, f² from 0.02 to 0.03) and between-person in ACES and SHS (both p < .01, f² from 0.02 to 0.03). For approach-oriented coping, only active planning coping predicted lower within-person NA reactivity and only in DESTRESS (p < .01, f² = 0.02). Coping did not predict PA reactivity (all p > .05).

LIMITATIONS

Our findings cannot be generalised to children or older adults. Emotional reactivity to daily stressors may differ from severe or traumatic stressors. Although data were longitudinal, the observational design precludes establishing causality.

CONCLUSIONS

Avoidance-oriented coping strategies predicted greater NA reactivity to daily stressors with small effect sizes. Few and inconsistent results emerged for approach-oriented coping and PA reactivity. Clinically, our results suggest that reducing reliance on avoidance-oriented coping may reduce NA reactivity to daily stressors.

Evaluating a Comprehensive Model of Euthymia

INTRODUCTION

In research and treatment of mood disorders, "euthymia" traditionally denotes the absence of clinically significant mood disturbance. A newer, expanded definition of euthymia also includes positive affect and psychological well-being.

OBJECTIVE

We aimed to test this comprehensive model of euthymia and estimate the coherence and predictive power of each factor in the model.

METHODS

Community-dwelling adults (N = 601), including both mental health outpatients and non-patients at high risk for personality pathology, completed a battery of interviews and questionnaires at time 1. Most (n = 497) were reassessed on average 8 months later (time 2). We modeled euthymia using standard mood, personality, and psychosocial functioning assessments rather than measures designed specifically for euthymia.

RESULTS

The hypothesized model of euthymia was supported by confirmatory factor analysis: specific measures loaded on three lower order factors (mood disturbance, positive affect, and psychological well-being) that reflected general euthymia at time 1. Each factor (general euthymia plus lower order factors) demonstrated moderately strong concurrent (time 1) and predictive (time 1-2) correlations with outcomes, including employment status, income, mental health treatment consumption, and disability. Compared to positive affect and psychological well-being, mood disturbance had stronger incremental (i.e., nonoverlapping) relations with these outcomes.

CONCLUSIONS

Support for a comprehensive model of euthymia reinforces efforts to improve assessment and treatment of mood and other disorders. Beyond dampening of psychological distress, euthymia-informed treatment goals encompass full recovery, including enjoyment and meaning in life.

Social anxiety inhibits needs repair following exclusion in both relational and non-relational reward contexts: The mediating role of positive affect

The pain of social exclusion can motivate people to capitalize on opportunities to reconnect with others and repair their self-esteem and feelings of belongingness. This effect is often diminished for those with high social anxiety (HSA). Prior research suggests this may be due to their diminished capacity for recognizing and emotionally responding to relational reward cues. We investigated whether non-relational success experiences in the aftermath of exclusion may be an alternative means of repairing threatened self-esteem and belongingness in HSA individuals. In a preregistered, online study, we threatened belongingness and self-esteem in 422 participants by excluding them in a Cyberball game and then assigned them to one of three conditions: Relational Repair, Non-Relational Repair, or a No-Repair control condition. Results showed that both repair contexts facilitated needs repair relative to the no-repair control condition, and mediation analyses suggested this effect was driven by increased positive affect (PA). HSA individuals were less likely to restore needs regardless of condition and this effect appeared to be driven by low PA. Findings emphasize the critical role of PA for restoring threatened needs in the aftermath of exclusion and suggest that HSA inhibits needs repair processes across both relational and non-relational reward contexts.

Does an Online Positive Psychological Intervention Improve Positive Affect in Young Adults During the COVID-19 Pandemic?

Meta-analyses indicate that positive psychological interventions are effective at increasing positive affect, as well as reducing anxiety and depression; however, it is unclear how well these effects generalize during periods of high stress. Therefore, the current study tested whether a 2-week online positive psychological intervention delivered during the COVID-19 pandemic, a naturalistic stressor, (1) increased positive affect; (2) improved psychological well-being, optimism, life satisfaction, perceived social support, and loneliness; (3) and reduced negative affect in college students, a group known to have high pandemic distress. Participants (N = 250; 76.9% female) ages 18-45 were recruited from the University of Pittsburgh undergraduate subject pool between September and November of 2020. Participants were randomized to the online positive psychological intervention or active control condition and stratified by trait positive affect, sex, and year in college. Participants in both conditions completed one writing activity every other day for two consecutive weeks. Control participants documented their activities for that day (e.g., meals, going to gym). Intervention participants chose from six positive psychology activities. All outcome variables were assessed pre- and post-intervention by validated questionnaires. Across both conditions, positive and negative affect decreased from pre- to post-intervention. No other psychological factor differed by condition, time, or their interaction. The current null findings are in line with a more recent meta-analysis indicating that positive psychological interventions may have smaller effects on psychological well-being and depressive symptoms than was reported pre-pandemic. Study findings may suggest reduced efficacy of virtual positive psychological interventions under highly stressful circumstances.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-022-00148-z.

Emotion regulation strategies and aggression in youngsters: The mediating role of negative affect

Aggression in youngsters is a highly prevalent problem worldwide. Given that this problem has negative consequences for society, aggressors, and victims, the present study aims to understand the processes underlying the acts of aggression in this population. Specifically, we analyze the role of two emotional regulation strategies (cognitive reappraisal and expressive suppression) and the positive and negative affect variables in aggressive behavior. For this purpose, 654 primary and high school students aged between 9 and 18 years (47.6% boys) were assessed on emotion regulation, positive and negative affect, and aggression through the Emotion Regulation Questionnaire, the Positive and Negative Affect Schedule, and the Buss-Perry Aggression Questionnaire, respectively. The results revealed that higher use of the cognitive reappraisal strategy was correlated with lower levels of aggression (for total, physical, and anger). In contrast, the opposite was observed with expressive suppression (for total aggression and hostility). More important for the purposes of this study was the finding that the negative affect variable mediated the relationship between expressive suppression and aggressive behavior. Specifically, those individuals who made greater use of the expressive suppression strategy had higher levels of negative affect, which, in turn, was associated with higher levels of aggression. Cognitive reappraisal appeared to be only directly related with a reduction in total aggression. Thus, higher levels of cognitive reappraisal were related to a reduction in aggressive behavior. However, when focusing on the four dimensions of aggression, the relationship between cognitive reappraisal and aggression appears to be mediated by negative affect and, in the case of anger, by positive affect. The limitations and implications of these findings are discussed.

Positive Psychology Interventions in Medical Populations: Critical Issues in Intervention Development, Testing, and Implementation

Positive psychological well-being is prospectively associated with superior health outcomes. Positive psychology interventions have promise as a potentially feasible and effective means of increasing well-being and health in those with medical illness, and several initial studies have shown the potential of such programs in medical populations. At the same time, numerous key issues in the existing positive psychology literature must be addressed to ensure that these interventions are optimally effective. These include (1) assessing the nature and scope of PPWB as part of intervention development and application; (2) identifying and utilizing theoretical models that can clearly outline potential mechanisms by which positive psychology interventions may affect health outcomes; (3) determining consistent, realistic targets for positive psychology interventions; (4) developing consistent approaches to the promotion of positive psychological well-being; (5) emphasizing the inclusion of diverse samples in treatment development and testing; and (6) considering implementation and scalability from the start of intervention development to ensure effective real-world application. Attention to these six domains could greatly facilitate the generation of effective, replicable, and easily adopted positive psychology programs for medical populations with the potential to have an important impact on public health.

Considerations for Advancing the Conceptualization of Well-being

In this commentary, we raise several points regarding Park and colleagues' emotional well-being framework. First, we question whether the term emotional well-being is appropriate and whether a new framework is necessary, and we argue that the field may be better served through other efforts, such as clarifying the distinctions between different well-being constructs and providing guidance on best practices for measurement and intervention. In addition, we note that by placing well-being on the opposite end of the spectrum from despair and depression, Park and colleagues have overlooked the influences of stress, distress, and life challenges on shaping positive aspects of well-being, and vice versa. Furthermore, we challenge the conceptualization of well-being as encompassing how positive an individual feels generally and about life overall. In its current form, this definition of well-being is overly static and trait-like, whereas a process-oriented conceptualization would more closely align with how well-being unfolds in real-life contexts and would be more suitable for identifying mechanistic targets for intervention. Finally, we raise the concern that the process for developing this definition of well-being did not actively involve input from diverse communities that have historically been disserved and underrepresented in research, practice, and policy. The cultural differences in constituents of well-being as well as evidence demonstrating that key positive psychological constructs (e.g., positive affect, sense of control) are less health-protective in racial/ethnic minorities than in whites necessitate greater integration of perspectives from underrepresented communities to build a more inclusive and accurate understanding of well-being.