Mixed emotions and coping: the benefits of secondary emotions

The existing empirical literature suggests that during difficult situations, the concurrent experience of positive and negative affects may be ideal for ensuring successful adaptation and well-being. However, different patterns of mixed emotions may have different adaptive consequences. The present research tested the proposition that experiencing a pattern of secondary mixed emotion (i.e., secondary emotion that embrace both positive and negative affects) more greatly promotes adaptive coping than experiencing two other patterns of mixed emotional experiences: simultaneous (i.e., two emotions of opposing affects taking place at the same time) and sequential (i.e., two emotions of opposing affects switching back and forth). Support for this hypothesis was obtained from two experiments (Studies 1 and 2) and a longitudinal survey (Study 3). The results revealed that secondary mixed emotions predominate over sequential and simultaneous mixed emotional experiences in promoting adaptive coping through fostering the motivational and informative functions of emotions; this is done by providing solution-oriented actions rather than avoidance, faster decisions regarding coping strategies (Study 1), easier access to self-knowledge, and better narrative organization (Study 2). Furthermore, individuals characterized as being prone to feeling secondary mixed emotions were more resilient to stress caused by transitions than those who were characterized as being prone to feeling opposing emotions separately (Study 3). Taken together, the preliminary results indicate that the pattern of secondary mixed emotion provides individuals with a higher capacity to handle adversity than the other two patterns of mixed emotional experience.

Is it worth turning a trigger into a joke? Humor as an emotion regulation strategy in remitted depression

AIM

Humor has long been considered as an effective emotion regulation strategy for people vulnerable to depression, but empirical evidence in this area is scarce. To address this issue, we investigated the emotional consequences of humor in remitted depressed patients and compared them with the effects of positive reappraisal and spontaneous emotion regulation.

METHODS

Fifty-five patients with remitted major depression took part in a laboratory computer experiment in which they were shown negative pictures twice. First, the patients simply viewed the pictures and rated their reactions. Second, they viewed each of the pictures according to instructions, which are to (a) use humor, (b) use positive reappraisal, or (c) simply view the pictures, and then, they again rated their reactions.

RESULTS

Humor was found to decrease negative emotions, increase positive emotions, and enhance the distance from adversity; it was more effective than spontaneous emotion regulation and similarly as effective as positive reappraisal. Humor was the most effortful form of emotion regulation. Patients were able to successfully produce humorous comments, and their failure to do so did not lead to worse emotional outcomes than regulating emotions spontaneously. The analyses also indicated that distancing mediates between using humor and the intensity of positive and negative emotions.

CONCLUSIONS

Our findings provide preliminary empirical support for the idea that for individuals vulnerable to depression, humor can be an adaptive tool in dealing with negative responses to aversive events, and, thus, it may impair their potential of these events to trigger depressive episodes. Further studies in this area are warranted to determine the most adaptive forms of humor and analyze their effects in various depressogenic contexts.

Analysis of the efficacy and safety of electroconvulsive therapy in elderly patients: a retrospective study in the Polish population

OBJECTIVES

The aim of the study was to assess the efficacy and safety of electroconvulsive therapy in a population ≥ 65 years old.

METHODS

The study was naturalistic, retrospective. The study group included 65 patients, women and men, hospitalized in the departments of the Institute of Psychiatry and Neurology and undergoing ECT treatment. The authors analyzed the course of 615 ECT procedures performed in 2015-2019. The effectiveness of ECT was assessed using the CGI-S scale. Safety was assessed by analyzing side effects of the therapy, taking into account the somatic diseases in the study group.

RESULTS

As many as 94% of patients initially met the drug resistance criteria. In the study group, no serious complications such as death, life-threatening condition, necessity to be hospitalized in another ward or permanent health impairment were reported. In total, in the whole group, adverse effects were reported in 47. 7% of older patients, in the majority of cases (88%) they were of slight intensity and resolved without any particular intervention. The most frequently observed side effect of ECT was an increase in blood pressure (55. 4% of patients). Four patients did not complete ECT therapy due to side effects. In the majority of patients (86. 2%) at least 8 ECT treatments were performed. ECT turned out to be an effective method of treatment in the population of patients over 65 years of age - response to treatment was found in 76. 92% and remission in 49. 23% of the study group. The severity of the disease according to the CGI-S scale was on average 5. 54 before and 2. 67 after the ECT treatment.

CONCLUSIONS

Tolerance of ECT is worse after 65 years than in younger age groups. Most of the side effects are associated with underlying somatic diseases, mainly cardiovascular problems. This does not change the fact that ECT therapy is highly effective in this population and can be a very good alternative to pharmacotherapy, which, in this age group, is often ineffective or causes side-effects.

Differential effects of stress-related and stress-unrelated humor in remitted depression

Enhancing emotion regulation among previously depressed people is crucial for improving their resilience and reducing relapse. Therefore, emphasis is placed on determining effective regulation strategies, particularly those that, besides down-regulating negative emotions, also up-regulate positive emotions. One promising strategy, with great potential in both these respects, is humor. It is unclear, however, what type of humor is most adaptive in remitted depression. This study compared two distinct humor-based strategies: stress-related humor and stress-unrelated humor. Outpatients with remitted depression (N = 94) participated in a randomized experiment evoking personal stress and the subsequent application of stress-related humor, stress-unrelated humor, or a non-humorous regulation. They repeatedly reported positive and negative emotions (at four time points) and experienced distress (at three time points). There were also assessments of selective attention, subsequent performance, effort, and intrusive thoughts. Unlike non-humorous regulation, humor-based strategies had adaptive consequences, both immediately and after a delay; however, stress-unrelated humor was most beneficial and was the only effective strategy when attention deficits were present. Humor, especially if unrelated to stressors, might broaden the repertoire of powerful emotion regulation strategies in remitted depression. Humorous focusing on distress can be detrimental for patients with attention impairment.Clinical trial registration: The study was registered under the number ISRCTN86314628 (20/09/2021).

[Sense of humour in patients with depression--review]

In recent years there has been increasingly emphasised the importance of developing a sense of humour in patients with depression, which is considered an important competence promoting recovery processes and preventing relapse. Research on the sense of humour in depression focuses on two main areas. The first one concerns the answer to the question whether depressed patients are able to make use of their sense of humour. Results of current studies in this field lead to ambiguous conclusions. Some of them point to the deficits held by these patients in terms of perception, understanding and appreciation of humour, while others demonstrate the presence of the general susceptibility to humorous stimuli and the readiness to use the sense of humour. The second area of research focuses on the effectiveness of therapeutic programmes aimed at developing a sense of humour in depression. The results showed that they have limited efficacy--short-term, observed only in some aspects or determined to a greater extent by pharmacological treatment than by implemented programmes. The reasons for their limited effectiveness seem to be largely due to an excessively wide range of impacts, not focused on the most desirable styles of humour, as well as specific needs, preferences and attitudes for patients with depression.

[Sense of humour in schizophrenia--ability of humour reception and possibilities of its application in therapeutic interventions]

The existing research on sense of humour in schizophrenia is focused on two main areas, mainly, assessment of patients' abilities to understand and appreciate humour and denoting the possibilities of its application in therapeutic programs concentrating on the improvement of patients' functionality and preventing illness relapses. The vast majority of the conclusions from the above mentioned research corroborate the opinion on the usefulness of developing and reinforcing sense of humour in schizophrenia, emphasizing its beneficial effect on the patients' quality of life, above all, in terms of reducing aggression, anxiety and depression as well as improving general life satisfaction and social functioning. At the same time numerous research indicate low reception of humour in schizophrenia which can negatively influence its effective usage in therapeutic interventions. Further constraint with regard to the therapy can constitute an intensified fear for being laughed at, which has been confirmed in numerous empirical reports. Therefore, it seems that addressing humorous therapeutic interventions to the above mentioned group of patients requires especially careful planning taking into consideration its cognitive and affective limitations in the perception of humour and intensified fear for being laughed at.