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Hatfield O, Bresin K, Mekawi Y, Michopoulos V, Fani N, Bradley B, Powers A. Predicting aggressive behaviors: Examining unique and interactive roles of PTSD and emotion dysregulation in a minority sample. Aggress Behav 2024; 50:e22149. [PMID: 38757986 DOI: 10.1002/ab.22149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
Aggression is a costly public health problem with severe and multi-faceted negative consequences and thus, identifying factors that contribute to aggression, particularly in understudied populations, is necessary to develop more effective interventions to reduce the public health cost of aggression. The goal this study was to test whether difficulties regulating emotions moderated the association between posttraumatic stress disorder (PTSD) symptoms and aggression in a community sample of predominantly Black females with high levels of trauma exposure. Furthermore, we explored unique relations between PTSD symptom clusters and distinct subscales of difficulties regulating emotions and aggression. The sample included 601 community participants recruited from an urban public hospital. Symptoms were assessed using self-report measures including the Difficulties in Emotion Regulation Scale (DERS) and Behavioral Questionnaire-Short. Regression analyses were conducted using PTSD symptoms and total DERS to test their interaction as predictors for aggression (using BQ-Short). We found that higher levels of PTSD arousal symptoms and difficulty controlling impulses when upset were positively related to aggression. We also conducted an exploratory analysis to examine the association between PTSD symptom clusters using the Alternative Symptom Clusters hybrid model. The results suggest that some PTSD symptoms (externalizing behavior) and some emotion dysregulation processes (difficulties controlling impulses when upset), relate to aggression in independent, rather than multiplicative ways. These results offer insights for new directions of research that focuses on the independent association between specific emotion dysregulation processes and PTSD symptoms on aggression.
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Affiliation(s)
- Olivia Hatfield
- Department of Counseling and Human Development, University of Louisville, Louisville, Kentucky, USA
| | - Konrad Bresin
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
- Atlanta VA Health Care System, Decatur, Georgia, USA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Biçaker E, Trolio V, Miller AE, Zhu LY, White C, Racine SE. Affective processes underlying restrictive eating in atypical anorexia nervosa: Comparisons to anorexia nervosa and bulimia nervosa using ecological momentary assessment. Int J Eat Disord 2024; 57:879-891. [PMID: 38192012 DOI: 10.1002/eat.24134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Certain symptom and risk/maintenance factor similarities between individuals with atypical anorexia nervosa (AN) and 'typical' AN have been documented, but few studies have investigated how atypical AN compares to bulimia nervosa (BN). Further, the role of affective mechanisms in maintaining restrictive eating in atypical AN has not been examined. The current study investigated whether atypical AN resembles AN and/or BN on affect-related processes using questionnaires and ecological momentary assessment (EMA). METHOD Women with atypical AN (n = 24), AN-restrictive subtype, (n = 27), AN-binge eating/purging subtype (n = 34), and BN (n = 58) completed questionnaires measuring depressive symptoms and emotion regulation difficulties. They also completed a 14-day EMA protocol during which they reported negative and positive affect and skipped meals five times/day (signal-contingent surveys) and restrictive eating after meals/snacks (event-contingent surveys). RESULTS Diagnostic groups generally did not differ on questionnaire measures nor affective patterns surrounding restrictive eating behaviors. Momentary changes in affect did not predict or follow restriction at meals/snacks, though higher momentary negative affect ratings predicted skipped meals, and higher positive affect was reported after skipped meals. Greater average negative affect and lower average positive affect predicted both restrictive eating behaviors. DISCUSSION Across diagnoses, reductions in food intake do not appear to be influenced by momentary changes in affect, though skipping meals may serve an emotion regulation function. Atypical AN seems to resemble AN and BN on affective processes underlying restrictive eating, raising further questions regarding the unique diagnosis of atypical AN. PUBLIC SIGNIFICANCE Though atypical anorexia appears to strongly resemble anorexia nervosa, it is less clear how this disorder relates to bulimia nervosa. It is further unknown whether affective-related processes underlie restrictive eating in atypical anorexia nervosa, and how these processes compare to those in anorexia nervosa and bulimia nervosa. Results suggest that atypical anorexia does not differ from anorexia nervosa or bulimia nervosa on emotion-related measures, nor in affective patterns surrounding restrictive eating behaviors.
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Affiliation(s)
- Ege Biçaker
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Vittoria Trolio
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Alexia E Miller
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Lisa Y Zhu
- Department of Psychology, University of Western Ontario, Social Science Centre, London, Ontario, Canada
| | - Chloe White
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Raugh IM, Strauss GP. Integrating mindfulness into the extended process model of emotion regulation: The dual-mode model of mindful emotion regulation. Emotion 2024; 24:847-866. [PMID: 37843512 PMCID: PMC11009092 DOI: 10.1037/emo0001308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Extensive research has been conducted regarding how people manage their emotions. Within this research, there has been growing attention toward the role of mindfulness in emotion regulation. While prior reviews have discussed mindfulness in the context of emotion regulation, they have not provided a thorough integration using the prevailing models of emotion regulation or mindfulness. The present review discusses the Extended Process Model of Emotion Regulation and Monitoring and Acceptance Theory of mindfulness in order to propose a novel integrated framework, the Dual-mode Model of Mindful Emotion Regulation (D-MER). This model proposes two "modes" of mindfulness: Implementation and facilitation. Implementation posits that mindfulness skills can be used as emotion regulation strategies through attentional deployment and cognitive change. Facilitation posits that mindfulness as a state or trait affects emotion generation and regulation through effects on cognitive processes and positive or negative valence systems. Further, the D-MER posits that mindfulness experience can improve the efficiency of mindfulness-based emotion regulation strategies (implementation) while effects of mindfulness on emotion regulation processes become increasingly trait-like and automatic over time (facilitation). Empirical and theoretical support for this model are discussed, specific hypotheses to guide further research are provided, and clinical implications are presented. Use of this model may identify mechanisms underlying the interaction between mindfulness and emotion regulation which can be used in ongoing affective and clinical research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Agin-Liebes G, Nielson EM, Zingman M, Kim K, Haas A, Owens LT, Rogers U, Bogenschutz M. Reports of self-compassion and affect regulation in psilocybin-assisted therapy for alcohol use disorder: An interpretive phenomenological analysis. Psychol Addict Behav 2024; 38:101-113. [PMID: 37276086 PMCID: PMC10696130 DOI: 10.1037/adb0000935] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The primary aim of this qualitative study was to delineate psychological mechanisms of change in the first randomized controlled trial of psilocybin-assisted psychotherapy to treat alcohol use disorder (AUD). Theories regarding psychological processes involved in psychedelic therapy remain underdeveloped. METHOD Participants (N = 13) mostly identified as non-Hispanic and White, with approximately equal proportions of cisgender men and women. Participants engaged in semistructured interviews about their subjective experiences in the study. Questions probed the nature of participants' drinking before and after the study as well as coping patterns in response to strong emotions, stress, and cravings for alcohol. Verbatim transcripts were coded using Dedoose software, and content was analyzed with interpretive phenomenological analysis. RESULTS Participants reported that the psilocybin treatment helped them process emotions related to painful past events and helped promote states of self-compassion, self-awareness, and feelings of interconnectedness. The acute states during the psilocybin sessions were described as laying the foundation for developing more self-compassionate regulation of negative affect. Participants also described newfound feelings of belonging and an improved quality of relationships following the treatment. CONCLUSION Our results support the assertion that psilocybin increases the malleability of self-related processing, and diminishes shame-based and self-critical thought patterns while improving affect regulation and reducing alcohol cravings. These findings suggest that psychosocial treatments that integrate self-compassion training with psychedelic therapy may serve as a useful tool for enhancing psychological outcomes in the treatment of AUD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Gabrielle Agin-Liebes
- University of California, San Francisco, Department of Psychiatry, San Francisco CA, USA
- Neuroscape, Sandler Neurosciences Center, University of California, San Francisco, San Francisco CA, USA
| | | | - Michael Zingman
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Katherine Kim
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Alexandra Haas
- University of California, San Francisco, Department of Psychiatry, San Francisco CA, USA
| | - Lindsey T. Owens
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ursula Rogers
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Michael Bogenschutz
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
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Singh V. Bittersweet memories and somatic marker hypothesis: adaptive control in emotional recall facilitates long-term decision-making in the Iowa Gambling Task. Front Neurosci 2024; 17:1214271. [PMID: 38292897 PMCID: PMC10824841 DOI: 10.3389/fnins.2023.1214271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/22/2023] [Indexed: 02/01/2024] Open
Abstract
The somatic marker hypothesis states that emotional recall and its somatic influence guide long-term decision-making. However, the mechanism through which decision-making benefits from emotional recall is unclear; whether emotional recall and the induced affect increase the regulatory demand or amplify the affect state that requires inhibition. It is unclear if controlling the automatic flow of emotion in recall improves adaptive decision-making. Two studies examine the hypothesis that affect control in emotional recall facilitates inhibitory control and benefits long-term decision-making. In Experiment 1 (n = 137), affect control was assessed in emotional recall to examine if switching of affect in recall of positive and negative valence (order: positive-negative memory recall vs. negative-positive memory recall) is linked with long-term decision-making. Results for long-term decision-making showed that negative-positive recall sequence was associated with higher long-term decision-making, whereas automatic frequency-based decision-making remained unaffected by the recall sequence. In experiment 2 (n = 71, all male), emotional recall (positive vs. negative), recall specificity (i.e., specific vs. overgeneralized recall), and post-recall mood regulation (post-recall positive mood regulation vs. no regulation) was expected to facilitate long-term decision-making. Results showed that emotional recall and post-recall mood regulation (i.e., negative recall - positive mood and positive recall - negative mood) were associated with higher long-term decision-making (decks C' and D'). Results of frequency decision-making showed that positive emotional recall, and poor recall specificity led to infrequent punishment deck choices (decks B' and D'). Hierarchical regression indicated that emotional recall increased infrequent deck choices and accounted for 10% of choices made, recall specificity increased the explanatory power to 19%, and higher recall specificity was associated with fewer infrequent punishment deck choices. Affect control engaged via negative emotional recall, post-recall mood regulation, and recall specificity might be a potential mechanism through which affect control in emotional recall might facilitate long-term decision-making.
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Affiliation(s)
- Varsha Singh
- Humanities and Social Science, Indian Institute of Technology Delhi, New Delhi, India
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Figura HM, Saha FJ, Seibt S, Haller H, Bringmann HC, Kessler CS, Kugler J, Cramer H, Michalsen A, Kandil FI, Jeitler M. Effects of an Online Meditation Course on Quality of Life and Positive Emotions: A Prospective Observational Study (EXPANSION Study). J Integr Complement Med 2023. [PMID: 38011030 DOI: 10.1089/jicm.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: Several meditation interventions showed positive effects on physical and mental health. The aim of this study is a first evaluation of the (within-group) effects of a 21-day online meditation course of the "expansion method." Methods: For this exploratory observational study, parameters were assessed at baseline, at 1 month, and at a 3-month follow-up. Exploratory endpoints were health-related quality of life (PROMIS Preference Score), global health (PROMIS) with the subscales physical and mental health, stress perception (Perceived Stress Scale), positive and negative affect regulation (Positive and Negative Affect Schedule), flourishing (Flourishing Scale), self-efficacy (Short Scale for Measuring General Self-Efficacy Beliefs), gratitude and awe (Gratitude and Awe Questionnaire), resilience (Connor-Davidson Resilience Scale), spirituality (Aspects of Spirituality), and mysticism (Mysticism Scale) on validated inventories. In addition, self-constructed questions (NRS) assessed health status, lifestyle, and concept evaluation. Results: Data from 359 participants were included in this study (response rate: 68% at 1 month, 46% at 3 months). The main analysis was based on the complete cases at 1 month (n = 244 participants; 84% female; 51 ± 11 years; 89% German). Medium effect sizes were found for mental health (p < 0.0001; d = 0.6), flourishing (p < 0.0001; d = 0.63), and negative affect (p < 0.0001; d = 0.68) at 1 month. Small effect sizes were obtained for physical health, stress, positive affect, self-efficacy, spirituality, and mysticism at 3 months. In a sensitivity analysis, the strongest effects at 1 month were found in the subgroup that completed per-protocol (n = 140), followed by those with complete data at all time points (n = 159). Effects were lowest in the intention-to-treat analysis (n = 359). The content of the course was positively evaluated by the participants. Conclusions: The online meditation course based on the expansion method had potentially beneficial effects, especially on mental health parameters. Based on the feasibility results, further research using randomized controlled designs is warranted. Clinical Trial Registration: NCT04950543.
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Affiliation(s)
- Hannah Maja Figura
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Felix Joyonto Saha
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Sonja Seibt
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Heidemarie Haller
- Center for Integrative Medicine and Planetary Health, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Holger C Bringmann
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian S Kessler
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Joachim Kugler
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Holger Cramer
- Institute for General Practice and Interprofessional Care, Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
- Bosch Health Campus, Stuttgart, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Farid I Kandil
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
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Maurer K, Kimyaci M, Konyk K, Wekerle C. Building resilience through daily smartphone app use: results of a pilot study of the JoyPop app with social work students. Front Digit Health 2023; 5:1265120. [PMID: 38053917 PMCID: PMC10694474 DOI: 10.3389/fdgth.2023.1265120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 12/07/2023] Open
Abstract
Background The JoyPop™ smartphone app is a digital intervention designed to enhance day-to-day resilience in youth, particularly those exposed to traumatogenic events [adverse childhood experiences (ACEs)]. Processes of adaptation that foster resilience in response to high stress include affect, cognitive, and behavioral regulation, and social interaction. Digital interventions have application for youth and those who provide them support, including social work trainees navigating the stressors of university studies concurrent with practice internships. Research on resilience-enhancing apps is needed to understand the underlying mechanisms by which change occurs and who is most likely to benefit from these interventions. Methods Social work student participants (N = 91) were invited to use the JoyPop app two times daily for 28 days. Baseline ACE exposure and change-over-time in affect regulation, stress responsivity, and social support were evaluated after 2 and 4 weeks of app use with t-tests and generalized estimating equation (GEE) modeling. Results Participants identified predominantly as cisgender women of European descent, mean age 26 years (SD = 6.78), 70% undergraduates, and reported consistent daily app use (Mean days = 26.9, SD = 1.90). Self-reported baseline ACE exposure was high (30% ≥ 5+). We tested change-over-time with generalized estimating equation and saw improvement in affect regulation in the Abbreviated Dysregulation Inventory scale (β = -3.38, p = <.001), and subscales of behavioral (β = -1.63, p = <.001), affect (β = -3.24, p = <.001), and cognitive regulation (β = 1.50, p = .009). Perceived stress decreased with app use (β = -2.65, p = <.001) and even more so for participants with reported exposure to more than 4 ACEs (β = -3.786, p = .030). Conclusions The exploratory findings from our pilot study suggest that consistent use of the app may enhance multidimensional resilience amongst university students who self-report higher than average levels of baseline traumatogenic exposures. Our findings support an approach modeling resilience as a complex, dynamic, multicomponent process supported by resources within and between individuals. Further testing of the mechanisms of adaptation in response to high stress that enhance resilience and identification of the JoyPop™ app features that influence this change is needed to validate that daily app use could help youth with experiences of past and current high stress to better regulate their affect, reduce stress reactivity, and increase resilience.
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Affiliation(s)
- Katherine Maurer
- School of Social Work, Centre for Research on Children and Families, McGill University, Montreal, QC, Canada
| | - Mert Kimyaci
- School of Social Work, Centre for Research on Children and Families, McGill University, Montreal, QC, Canada
| | - Katy Konyk
- School of Social Work, Centre for Research on Children and Families, McGill University, Montreal, QC, Canada
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Finch EF, Hooley JM. Functional fantasies: the regulatory role of grandiose fantasizing in pathological narcissism. Front Psychiatry 2023; 14:1274545. [PMID: 37920536 PMCID: PMC10618345 DOI: 10.3389/fpsyt.2023.1274545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Pathological narcissism is characterized by maladaptive efforts to maintain a bolstered but fragile sense of self. Clinical theory suggests that grandiose fantasizing may be one form of this self-regulation. However, no empirical research has directly assessed the regulatory function of grandiose fantasizing in narcissism. Here, we examine (1) whether people scoring higher in narcissism choose to engage in grandiose fantasizing to regulate themselves when they are feeling down and (2) whether grandiose fantasizing is a more efficacious self-esteem and affect regulator for people scoring higher in narcissism than it is for those scoring lower in narcissism. Methods Adult participants (N = 189) completed a self-report measure of narcissism and were randomized to either a negative mood induction or filler task condition. Then, participants wrote about a future event to make themselves feel better, choosing between a positive affect word or a grandiose word to guide their writing. Throughout the study, participants reported their state positive and negative affect and self-esteem. A secondary sample (N = 128) of adult participants rated the future event writing of the original participants. Results Supporting the validity of the study design, grandiose future events significantly differed from positive future events (e.g., they were rated by independent raters as less plausible, more ambitious, more active, and occurring further in the future). Participants scoring higher in narcissism and participants who experienced larger increases in negative affect were more likely to choose to engage in grandiose fantasizing. Grandiose fantasizing was more effective at decreasing negative affect among participants scoring higher in narcissism than those scoring lower in narcissism, whereas positive future thinking was equally effective at decreasing negative affect across levels of narcissism. Discussion This study demonstrates that people scoring higher in narcissism are more likely to choose to engage in grandiose fantasizing to make themselves feel better. It further demonstrates that grandiose fantasizing is a more efficacious affect regulator for those scoring higher in narcissism.
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Affiliation(s)
- Ellen F. Finch
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Doodeman TWM, Schuengel C, Sterkenburg PS. Effects of the Attune & Stimulate-checklist for caregivers of people with severe and profound intellectual disabilities: A randomised controlled trial. Research Intellect Disabil 2023; 36:1136-1149. [PMID: 37365773 DOI: 10.1111/jar.13135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/23/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Sensitive responsiveness is an important aspect in affect-regulation of people with severe to profound intellectual disabilities. AIM This randomized controlled trial evaluated the Attune & Stimulate-checklist, a tool for detecting subtle and idiosyncratic communicative behaviours and responding adequately. METHODS Effects on the sensitive responsiveness of professional caregivers and the arousal and valence of adults with severe to profound intellectual disabilities were investigated. Video recordings of 102 interactions were analysed with several observation instruments. RESULTS Although no significant effect was found on the checklist-suggestions of responsive behaviours (d = 0.33, p = .052), the intervention increased caregivers' sensitive responsive and affective behaviour (d = 0.94 - 1.10, p < .001) and clients' optimal arousal (d = 0.48, p = .019) and interactive engagement (d = 0.40 - 0.48, p = .018 - .050). CONCLUSION This low-intensity intervention had a medium to large immediate effect on the interaction. Future research should investigate medium- and long-term effects.
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Affiliation(s)
- Tanja W M Doodeman
- Faculty of Behavioural and Movement Sciences, Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Carlo Schuengel
- Faculty of Behavioural and Movement Sciences, Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Paula S Sterkenburg
- Faculty of Behavioural and Movement Sciences, Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Assessment and Treatment, Bartiméus, Doorn, The Netherlands
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Feinn R, Armeli S, Tennen H. Individual Differences in Affect Dynamics and Alcohol-Related Outcomes. Subst Use Misuse 2023; 58:967-974. [PMID: 37070645 PMCID: PMC10200030 DOI: 10.1080/10826084.2023.2201829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Background: To examine whether individual differences in intensive longitudinal data-derived affective dynamics (i.e. positive and negative affect variability and inertia and positive affect-negative affect bipolarity) - posited to be indicative of emotion dysregulation - are uniquely related to drinking level and affect-regulation drinking motives after controlling for mean levels of affective states. Method: We used a large sample of college student drinkers (N = 1640, 54% women) who reported on their affective states, drinking levels and drinking motives daily for 30 days using a web-based daily diary. We then calculated from the daily data positive and negative affect variability, inertia, affect bipolarity and mean levels of affect and used these as predictors of average drinking level and affect-regulation drinking motives (assessed using both retrospective and daily reporting methods). Results: Findings from dynamic structural equation models indicated that mean levels of affect were uniquely related to drinking motives, but not drinking level. Few dynamic affect predictors were uniquely related to outcomes in the predicted direction after controlling for mean affect levels. Conclusion: Our results add to the inconsistent literature regarding the associations between affective dynamics and alcohol-related outcomes, suggesting that any effects of these indicators, after controlling for mean affect levels, might be more complex than can be detected with simple linear models.
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Affiliation(s)
- Richard Feinn
- Department of Medical Sciences, Quinnipiac University, Hamden, Connecticut, USA
| | - Stephen Armeli
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, New Jersey, USA
| | - Howard Tennen
- Department of Public Health Sciences, UConn School of Medicine, Farmington, Connecticut, USA
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Abstract
Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles,we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research.
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Affiliation(s)
- Allison S Troy
- Popular Comms Institute, Lancaster, Pennsylvania, USA; .,Department of Psychology, Franklin & Marshall College, Lancaster, Pennsylvania, USA
| | - Emily C Willroth
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA;
| | - Amanda J Shallcross
- Department of Population Health, New York University School of Medicine, New York, NY, USA;
| | | | - James J Gross
- Department of Psychology, Stanford University, Stanford, California, USA;
| | - Iris B Mauss
- Department of Psychology, University of California, Berkeley, California, USA;
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Shahidin SH, Midin M, Sidi H, Choy CL, Nik Jaafar NR, Mohd Salleh Sahimi H, Che Roos NA. The Relationship between Emotion Regulation (ER) and Problematic Smartphone Use (PSU): A Systematic Review and Meta-Analyses. Int J Environ Res Public Health 2022; 19:15848. [PMID: 36497921 PMCID: PMC9740505 DOI: 10.3390/ijerph192315848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Emotion Dysregulation (ED) and Problematic Smartphone Use (PSU) are two rising global issues requiring further understanding on how they are linked. This paper aims to summarize the evidence pertaining to this relationship. Five databases were systematically searched for published literature from inception until 29 March 2021 using appropriate search strategies. Each study was screened for eligibility based on the set criteria, assessed for its quality and its level of evidence was determined. The Comprehensive Meta-Analysis software program (CMA) was employed to run further analyses of the data. Twenty-one studies were included in the systematic review. Nine studies with extractable data for meta-analysis had high across-studies heterogeneity, hence subgroup analyses were performed that confirmed a significant moderate positive correlation between ED and PSU (pooled correlation coefficient, r = 0.416 (four studies, n = 1462) and r = 0.42 (three studies, n = 899), respectively) and a weak positive correlation between "expressive suppression" and PSU (pooled correlation coefficient, r = 0.14 (two studies, n = 608)). Meta-regression analysis showed a stronger correlation between ED and PSU (R2 = 1.0, p = 0.0006) in the younger age group. Further studies to establish and explore the mechanisms that contribute towards the positive link between ED and PSU are required to guide in the planning of targeted interventions in addressing both issues.
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Affiliation(s)
- Siti Hajar Shahidin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Bahagia Ulu Kinta, Tanjung Rambutan 31250, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Chia Lip Choy
- Department of Psychiatry and Mental Health, Hospital Keningau, Peti Surat 11 Jalan Apin-Apin, Keningau 89007, Malaysia
| | - Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Hajar Mohd Salleh Sahimi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Nur Aishah Che Roos
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur 57000, Malaysia
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Abstract
BACKGROUND AND HYPOTHESIS Heightened stress levels in individuals with psychosis (PSY) are associated with psychotic symptom occurrence and may be partially attributed to well-established deficits in resting-state heart rate variability (HRV) and emotion regulation. In healthy participants, resting-state HRV and self-reported emotion regulation skills have been linked to recovery after a stressor; however, it is unclear whether stress recovery is altered in PSY. Thus, we compared the autonomic and subjective recovery of PSY to healthy controls (HC) and investigated the predictive value of resting-state HRV and emotion regulation skills. STUDY DESIGN We assessed resting-state HRV and self-reported emotion regulation one week prior to a combined physical and cognitive stress induction. After the stress exposure, we assessed the autonomic (decrease in heart rate [HR], increase in HRV) and subjective (decrease in subjective stress and negative affect) recovery in PSY (n = 50) and HC (n = 50) over 60 min. STUDY RESULTS Repeated-measures ANOVA revealed the expected interaction of time × group for subjective stress but not negative affect or autonomic stress. Resting-state HRV predicted recovery of HR, and emotion regulation skills predicted recovery of HRV but not of the other parameters. CONCLUSIONS Although subjective stress recovery was delayed in PSY, the absence of autonomic recovery deficits suggests that a prolonged stress response may not contribute to heightened stress levels to the expected extent. Improving resting-state HRV and emotion regulation may support autonomic recovery, but further investigation is required to test the impact of such improvements on psychotic symptoms.
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Affiliation(s)
- Katrin Bahlinger
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Hamburg, Germany
| | - Annika Clamor
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Hamburg, Germany
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Ames ME, Robillard CL, Turner BJ, Garcia-Barrera M, Rush J, Craig SG. Associations between physical activity, affect regulation difficulties, and mental health among Canadian adolescents at two different points of the COVID-19 pandemic. Psychol Health 2022:1-17. [PMID: 36184947 DOI: 10.1080/08870446.2022.2127718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/09/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022]
Abstract
Objective. Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two independent adolescent samples (T1: Summer 2020; T2: Winter 2020/21).Methods and Measures. Six hundred sixty-two Canadian adolescents (T1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (T2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation difficulties, and measures of anxious and depressive symptoms.Results. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms through affect dysregulation, but only at T1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both T1 and T2 and had an indirect effect through affect dysregulation and suppression.Conclusion. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities.
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Affiliation(s)
- Megan E Ames
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Centre for Youth and Society, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | - Christina L Robillard
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
| | - Brianna J Turner
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Centre for Youth and Society, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | | | - Jonathan Rush
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | - Stephanie G Craig
- York University, LaMarsh Centre for Child and Youth Research, Toronto, Ontario, Canada
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15
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Coleman E, Rahm-Knigge RL, Danielson S, Nielsen KH, Gleason N, Jennings T, Miner MH. The Relationship between Boredom Proneness, Attachment Styles and Compulsive Sexual Behavior. J Sex Marital Ther 2022; 49:172-188. [PMID: 35695090 DOI: 10.1080/0092623x.2022.2086511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Affect regulation is associated with compulsive sexual behavior (CSB) despite ongoing debate about its inclusion in diagnostic criteria. Previous studies on two specific affect regulation constructs - boredom proneness and attachment styles - suggest that affect regulation is associated with CSB. We tested a moderation model of the effects of attachment anxiety and attachment avoidance on the relationship between boredom proneness and CSB. Results indicate that the relationship between boredom proneness and CSB is stronger at higher levels of attachment anxiety, with no interaction between boredom proneness and attachment avoidance. Overall findings support the importance of affect regulation in conceptualizing and treating CSB.
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Affiliation(s)
- Eli Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ryan L Rahm-Knigge
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Samuel Danielson
- Department of Clinical Psychology, Minnesota State University, Mankato, Minnesota, USA
| | - Katja H Nielsen
- Department of Clinical Psychology, Minnesota State University, Mankato, Minnesota, USA
| | - Neil Gleason
- Department of Clinical Psychology, University of Washington, Seattle, Washington, USA
| | - Todd Jennings
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | - Michael H Miner
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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16
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Sperlich M, Kabilamany P. The Survivor Moms' Companion Trauma-Specific Perinatal Psychoeducation Intervention in a Community Outreach Program: An Open Pilot. J Midwifery Womens Health 2022; 67:569-579. [PMID: 35689499 DOI: 10.1111/jmwh.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Posttraumatic stress disorder (PTSD) confers significant risk during the childbearing year, including for maternal substance use, inadequate prenatal care, preterm birth, and impaired maternal-infant bonding. Although several treatments are available for PTSD, few are specific to the perinatal period. The purpose of this pilot study was to evaluate outcomes of a PTSD- and pregnancy-specific psychoeducational intervention, the Survivor Moms' Companion (SMC). METHODS The SMC includes psychoeducation with tutor support to address maternal posttraumatic stress, affect regulation, and interpersonal sensitivity. This open pilot was conducted in a large city in a mid-Atlantic state within an organization that provides perinatal services via community health workers (CHWs). The majority of participants were aged 20 to 25 years and African American and had low levels of income and educational attainment. The SMC learning modules were supplied to participants by specially trained CHWs who provided weekly face-to-face support during 30-to-60-minute tutoring sessions. Pretest-to-posttest analyses using multiple imputation methodology and paired-samples t tests examined PTSD symptom counts and scores related to theorized mechanisms of affect dysregulation and interpersonal sensitivity. Nonparametric statistical tests examined clinically meaningful changes. RESULTS Of 56 women who completed pretests, 38 (67.9%) completed the core dose of a minimum of 4 of 10 learning modules. Examination of intention-to-treat (n = 56) pretest-to-posttest scores revealed statistically significant improvements in PTSD symptoms (P < .001), affect regulation (depression [P < .001] and anger expression [P < .05]), and interpersonal sensitivity (P < .001). Per-protocol analyses (n = 38) revealed significant changes from clinical to nonclinical range scores for PTSD (P < .01) and depression (P < .05). DISCUSSION These findings suggest that a psychoeducational intervention with tutor support can be influential in fostering positive mental health changes in a high-risk perinatal population. CHWs with intervention-specific training can be effective at implementing a trauma-specific intervention.
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Affiliation(s)
- Mickey Sperlich
- School of Social Work, University at Buffalo, Buffalo, New York, USA
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17
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Edalat A, Farsinezhad M, Bokharaei M, Judy F. A Pilot Study to Evaluate the Efficacy of Self-Attachment to Treat Chronic Anxiety and/or Depression in Iranian Women. Int J Environ Res Public Health 2022; 19. [PMID: 35681959 DOI: 10.3390/ijerph19116376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/14/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023]
Abstract
The aim of this pilot study was to evaluate the efficacy of the new Self-Attachment Technique (SAT) in treating resistant anxiety and depression, lasting at least three years, among Iranian women from different social backgrounds. In this self-administrable and algorithmic intervention, the participant, using their childhood photos, imaginatively creates an affectional bond with their childhood self, vows to consistently support and lovingly re-raise this child to emotional well-being. We conducted a longitudinal study with repeated measurement to evaluate the efficacy of SAT using ANOVA. Thirty-eight women satisfying the inclusion and exclusion criteria were recruited from different parts of Tehran. To describe the SAT protocols, a total of eight one-to-one sessions were offered to the recruits, the first four were weekly while the last four were fortnightly. The participants were expected to practice the protocols for twenty minutes twice a day. Two questionnaires, GAD-7 and PHQ-9, were used to measure anxiety and depression levels before and after the intervention and in a three-month follow-up. Thirty women completed the course. The change in anxiety level between the pre-test and the post-test was significant at p < 0.001 with effect size 2.5. The change in anxiety between pre-test and follow-up test was also significant at p < 0.001 with effect size 3.5. The change in anxiety between the post-test and the follow-up was significant at p < 0.05 with effect size 0.6. For depression, the changes between pre-test and post-test as well as between pre-test and follow-up were significant at p < 0.001 with effect size 2.3 and 3.1 respectively.
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18
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Hairston IS, Portal L, Carmon T. Positive rumination can (also) interfere with sleep: A study in a non-clinical sample. Front Psychiatry 2022; 13:889810. [PMID: 36016976 PMCID: PMC9396259 DOI: 10.3389/fpsyt.2022.889810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED It is postulated that negative ruminations perpetuate insomnia symptoms by increasing arousal. Less is known about the role of positive rumination. In this study, we set out to test the association between positive and negative ruminations and insomnia symptoms in a non-clinical sample, asking whether reappraisal and suppression moderate the relationship between rumination types and symptoms of insomnia. METHODS A convenience sample of 354 participants (59% women), ages 18-50, responded to online questionnaires regarding symptoms of insomnia (Insomnia Severity Index [ISI]), Emotion Regulation Questionnaire that provides separate scales for Reappraisal and Suppression, Negative Rumination (Ruminative Response Scale), Positive Rumination and Dampening (Responses to Positive Affect questionnaire), and general health and demographics. RESULTS About 30% of respondents had moderate to severe symptoms of insomnia according to the ISI. The primary hypothesis was tested using three moderation models, where rumination type, emotion regulation styles, and interaction terms were predictors, and ISI scores were the outcome variable. Negative rumination positively predicted ISI (β = 0.56, p < 0.001), while the interaction terms with Reappraisal (β = 0.02, p = 0.575) and Suppression (β = 0.07, p = 0.092) were not significant. Dampening also positively predicted ISI (β = 0.56, p < 0.001), with the interaction term with Reappraisal nearly significant (β = -0.09, p = 0.060), but not with Suppression (β = 0.08, p =0.098). Positive rumination negatively predicted ISI (β = -0.12, p = 0.021), this relationship was reversed with emotion regulation factors in the model (β = 0.11, p = 0.094), where the interaction with Reappraisal (β = 0.13, p = 0.020) and Suppression (β = -0.13, p = 0.024) were both significant. DISCUSSION Positive Rumination weakly and negatively correlated with ISI, but the combination with Reappraisal was associated with more insomnia symptoms. By contrast, Dampening was associated with more insomnia symptoms, with minimal to no moderating effects. These observations are interpreted in the context of the role of emotion regulation strategies and sleep, and their potential clinical implications.
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Affiliation(s)
- Ilana S Hairston
- Psychology Department, Tel Hai Academic College, Kiryat Shmona, Israel.,The Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Haifa, Israel
| | - Lilach Portal
- Psychology Department, Tel Hai Academic College, Kiryat Shmona, Israel.,Psychology Department, The Max Stern Yezreel Valley College, Kiryat Shmona, Israel
| | - Tal Carmon
- Psychology Department, Tel Hai Academic College, Kiryat Shmona, Israel
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19
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Turton H, Berry K, Danquah A, Green J, Pratt D. An investigation of whether emotion regulation mediates the relationship between attachment insecurity and suicidal ideation and behaviour. Clin Psychol Psychother 2022; 29:1587-1598. [PMID: 35297124 PMCID: PMC9790629 DOI: 10.1002/cpp.2735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this research was to examine relationships between attachment insecurity and suicidal ideation and behaviour. Secondary aims were to explore the mediating role of emotion dysregulation and the moderating role of betrayal trauma in explaining hypothesised relationships. METHOD Sixty-five participants with experience of suicidal ideation completed questionnaire measures assessing attachment security, suicide ideation, emotion regulation, betrayal trauma, depressive symptoms and hopelessness. RESULTS A direct relationship was found between avoidant attachment and suicide ideation after controlling for age and gender. Multiple suicide attempters had higher anxious attachment. Anxious and avoidant attachment, suicide ideation and betrayal trauma were associated with emotion dysregulation. The relationship between attachment insecurity and suicide ideation was not mediated by emotion dysregulation. In the mediation model, only anxious attachment remained a significant predictor of emotion regulation and there was no significant effect of emotion regulation nor betrayal trauma, on suicide ideation. CONCLUSION Suicidal individuals may benefit from therapeutic intervention that explores attachment-related difficulties and therapies such as dialectical behavioural therapy, which support skills in emotional regulation. Future longitudinal research should identify other important mediators of the association between attachment and suicidality to develop more targeted psychological interventions for suicidality.
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Affiliation(s)
- Holly Turton
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK,Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
| | - Adam Danquah
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK,Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
| | - Jessica Green
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK,Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
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Abstract
In this article, we introduce a theory on the dynamic development of affective processes, affect regulation, and the relationship between emotions and sport performance. The theory focusses on how affective processes emerge and develop during competitive sport involvement. Based on Scherer's component process model, we postulate six components of emotion that interact with each other in a circular fashion: (I) triggering processes, (II) physiological reactions, (III) action tendencies, (IV) expressive behaviors, (V) subjective experience, and (VI) higher cognitive processes. The theory stresses the dynamics of affective processes and describes the consequences for performance in competitive sports. It assumes that the peculiarities of different sports must be taken into account in order to understand the affective processes, and offers starting points on which strategies can be used to effectively regulate affective states. Consequences for research and practice are derived and discussed. To study the development of affective processes, future research should test the assumptions in ecologically valid contexts, such as real competitions or competition-like situations, using multi-component measures of emotions.
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Affiliation(s)
- Darko Jekauc
- Department for Health Education and Sport Psychology, Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Julian Fritsch
- Department for Health Education and Sport Psychology, Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander T. Latinjak
- Department for Psychology and Education, School of Social Sciences and Humanities, University of Suffolk, Ipswich, United Kingdom
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21
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Jahnke-Majorkovits AC, Gander M, Taferner C, Sevecke K. [Attachment-Related Affect Regulation of Mothers in a Psychiatric Parent-Child Ward - A Case Study]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:662-78. [PMID: 34898407 DOI: 10.13109/prkk.2021.70.8.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Attachment researchers propose that the term affect regulation is associated with attachment-related defensive processes resulting from attachment experiences with primary caregivers. They serve to regulate attachment-related inner states. The Adult Attachment Projective Picture System (AAP) is a reliable and valid tool to classify attachment patterns and it allows to assess these attachment-related defensive processes. It provides information about the defensive processes that help clinicians to understand complex symptoms and interaction patterns in the parent-child relationship that can be integrated into psychiatric treatment. The present case study deals with a mother of a child with a feeding disorder. We will illustrate how information on attachment-related affect regulation can successfully be integrated into psychotherapeutic intervention in a psychiatric parent-child ward.
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22
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Jahn C, Wieacker E, Bender S, Krischer M. [Reduction of Non-Suicidal Self-Injury (NSSI) in Adolescents with Borderline Personality Organization Treated with TFP-A]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:728-47. [PMID: 34898409 DOI: 10.13109/prkk.2021.70.8.728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study examines whether transference-focused psychotherapy for adolescents (TFP-A) in a dayclinic setting increases the capability to regulate affects and decreases self-destructive behavior in adolescents with borderline personality organization in comparison to treatment as usual (TAU). A total of 120 adolescents consecutively presenting to the dayclinic were allocated to either TFP-A or TAU. They were assessed for aggression, irritability, depression, self-harm, internalizing behavior and pathological personality traits at baseline and after twelve weeks. TFP-A was more effective than TAU in reducing self-harm. Aggression and irritability was improved within the treatment group. These results can be explained by an improvement in affect regulation through a treatment with TFP-A in a dayclinic setting. Further research is necessary in order to assess whether TFP-A reduces self-harm, aggressive behavior and irritability from a long-term perspective and whether these exploratory results can be replicated in independent samples.
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23
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Stacy SE, Pepper CM, Clapp JD, Reyna AH. The effects of blood in self-injurious cutting: Positive and negative affect regulation. J Clin Psychol 2021; 78:926-937. [PMID: 34671976 DOI: 10.1002/jclp.23267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Seeing one's own blood may be a factor in affect regulation in nonsuicidal self-injury (NSSI). This study examined changes in a negative (NA) and positive affect (PA) in response to a finger prick eliciting a small drop of participants' blood. METHODS Two groups (NSSI; N = 56 and Control; N = 70) of undergraduate students were randomly assigned to receive a finger prick and look at blood, receive a finger prick and not look at blood, or receive a sham finger prick. Following a mood induction, participants completed the PANAS three times: Time 1 (pre mood-induction, baseline), Time 2 (post-mood induction), and Time 3 (post-finger prick condition), and a Pain Severity Scale. RESULTS A significant three-way interaction revealed that the NSSI: Blood Group had an increased positive effect between Time 2 and Time 3. CONCLUSION Blood serves an important function in NSSI and requires additional research to fully understand the relationship.
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Affiliation(s)
- Stephanie E Stacy
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Carolyn M Pepper
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Joshua D Clapp
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Alejandra H Reyna
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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Altimir C, Jiménez JP. The Clinical Relevance of Interdisciplinary Research on Affect Regulation in the Analytic Relationship. Front Psychol 2021; 12:718490. [PMID: 34721168 PMCID: PMC8555414 DOI: 10.3389/fpsyg.2021.718490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
After more than a century of existence, theoretical development, research, and clinical practice within the psychoanalytic movement have consistently demonstrated that psychoanalysis is not a unitary and autonomous discipline. This has been evidenced by the various ways in which psychoanalytic thought and practice have been informed by and have established a dialogue-more or less fruitful-with related disciplines (neurosciences, developmental psychology, psychotherapy research, attachment theory and research, feminism, philosophy). This dialogue has contributed to a better understanding of the functioning of the human psyche, and therefore of the analytic process, informing clinical interventions. In turn, it has enriched research on psychoanalytic practice and process, underlining the fact that research in psychoanalysis is fundamentally about clinical practice. Since its origins, psychoanalysis has made explicit the work on the patient-analyst relationship as the terrain in which the analytic process unfolds. For its part, research in psychotherapy has demonstrated the relevance of the therapeutic relationship for the good development and outcome of any psychotherapeutic process. This supports the argument that research in clinical psychoanalysis should be research on the impact of the analyst interventions on the analyst-patient relationship. In this context, a central element of what happens in the analytic relationship refers to affect communication and therefore, affect regulation, which is manifested in the transferential and counter-transferential processes, as well as in the therapeutic bond. On the other hand, affective regulation is found at the crossroads of etiopathogenesis, complex personality models and psychopathology, allowing the understanding of human functioning and the staging of these configurations in the patient-analyst relationship. In this way, research on affective regulation in the analytic process is proposed as a path that exemplifies interdisciplinary research and scientific pluralism from which psychoanalysis enriches and progresses as a discipline. The case of a line of research on affective regulation in psychoanalytic psychotherapy is illustrated. The need to resort to other disciplines, as well as the translational value of our research and its clinical usefulness, is discussed.
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Affiliation(s)
- Carolina Altimir
- Faculty of Psychology, Universidad Alberto Hurtado, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Juan Pablo Jiménez
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
- Psychiatry Department, Universidad de Chile, Santiago, Chile
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Nowak U, Wittkamp MF, Clamor A, Lincoln TM. Using the Ball-in-Bowl Metaphor to Outline an Integrative Framework for Understanding Dysregulated Emotion. Front Psychiatry 2021; 12:626698. [PMID: 34434124 PMCID: PMC8380846 DOI: 10.3389/fpsyt.2021.626698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/22/2021] [Indexed: 01/10/2023] Open
Abstract
Dysregulated emotion plays an important role for mental health problems. To elucidate the underlying mechanisms, researchers have focused on the domains of strategy-based emotion regulation, psychophysiological self-regulation, emotion evaluations, and resulting emotion dynamics. So far, these four domains have been looked at in relative isolation from each other, and their reciprocal influences and interactive effects have seldom been considered. This domain-specific focus constrains the progress the field is able to make. Here, we aim to pave the way towards more cross-domain, integrative research focused on understanding the raised reciprocal influences and interactive effects of strategy-based emotion-regulation, psychophysiological self-regulation, emotion evaluations, and emotion dynamics. To this aim, we first summarize for each of these domains the most influential theoretical models, the research questions they have stimulated, and their strengths and weaknesses for research and clinical practice. We then introduce the metaphor of a ball in a bowl that we use as a basis for outlining an integrative framework of dysregulated emotion. We illustrate how such a framework can inspire new research on the reciprocal influences and interactions between the different domains of dysregulated emotion and how it can help to theoretically explain a broader array of findings, such as the high levels of negative affect in clinical populations that have not been fully accounted for by deficits in strategy-based emotion regulation and the positive long-term consequences of accepting and tolerating emotions. Finally, we show how it can facilitate individualized emotion regulation interventions that are tailored to the specific regulatory impairments of the individual patient.
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Nordmann MA, Schäfer R, Müller T, Franz M. Alexithymia and Facial Mimicry in Response to Infant and Adult Affect-Expressive Faces. Front Psychol 2021; 12:635648. [PMID: 34421703 PMCID: PMC8371753 DOI: 10.3389/fpsyg.2021.635648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Facial mimicry is the automatic tendency to imitate facial expressions of emotions. Alexithymia is associated with a reduced facial mimicry ability to affect expressions of adults. There is evidence that the baby schema may influence this process. In this study it was tested experimentally whether facial mimicry of the alexithymic group (AG) is different from the control group (CG) in response to dynamic facial affect expressions of children and adults. A multi-method approach (20-point Toronto Alexithymia Scale and Toronto Structured Interview for Alexithymia) was used for assessing levels of alexithymia. From 3503 initial data sets, two groups of 38 high and low alexithymic individuals without relevant mental or physical diseases were matched regarding age, gender, and education. Facial mimicry was induced by presentation of naturalistic affect-expressive video sequences (fear, sadness, disgust, anger, and joy) taken from validated sets of faces from adults (Averaged Karolinska Directed Emotional Faces) and children (Picture-Set of Young Children's Affective Facial Expressions). The videos started with a neutral face and reached maximum affect expression within 2 s. The responses of the groups were measured by facial electromyographic activity (fEMG) of corrugator supercilii and zygomaticus major muscles. Differences in fEMG response (4000 ms) were tested in a variance analytical model. There was one significant main effect for the factor emotion and four interaction effects for the factors group × age, muscle × age, muscle × emotion, and for the triple interaction muscle × age × emotion. The participants of AG showed a decreased fEMG activity in response to the presented faces of adults compared to the CG but not for the faces of children. The affect-expressive faces of children induced enhanced zygomatic and reduced corrugator muscle activity in both groups. Despite existing deficits in the facial mimicry of alexithymic persons, affect-expressive faces of children seem to trigger a stronger positive emotional involvement even in the AG.
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Affiliation(s)
- Marc A. Nordmann
- Medical Faculty, Clinical Institute for Psychosomatic Medicine and Psychotherapy, University Hospital of the Heinrich-Heine-University, Düsseldorf, Germany
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Modrzejewska A, Czepczor-Bernat K, Modrzejewska J, Matusik P. Eating Motives and Other Factors Predicting Emotional Overeating during COVID-19 in a Sample of Polish Adults. Nutrients 2021; 13:1658. [PMID: 34068446 PMCID: PMC8153582 DOI: 10.3390/nu13051658] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/06/2023] Open
Abstract
We hypothesised that the higher levels of emotion-related predictors (eating motive in the form of affect regulation and COVID-19-related stress) would be associated with higher emotional overeating, after accounting for the effects of demographic variables (gender and BMI) and other eating motives (visual- and attitude-related predictors: liking, pleasure, visual appeal; body- and health-related predictors: need and hunger, health, weight control). Participants (N = 868; Mage = 33.53 years, SD = 11.98) completed: the Eating Motivation Survey, the Emotional Overeating Questionnaire, a COVID-19-related stress measure and a socio-demographic survey. The final step of the regression with emotional overeating was significant; affect regulation and COVID-19-related stress were significantly related to emotional overeating (ΔF p < 0.001, Adj. ΔR2 = 0.13). During the COVID-19 pandemic, eating can, on the one hand, help to cope with the current difficult situation and the negative emotions associated with it; on the other hand, frequent use of this tendency can lead to rigid regulation of affect and use of this mechanism as the dominant mechanism. Therefore, limited social contact, related disruptions in daily activities and stress resulting from COVID-19 should generate appropriate interventions, not necessarily focusing only on emotional eating, but also on the resources of the individual. It is worth encouraging specialists to implement alternative methods of contact with their patients, e.g., online.
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Affiliation(s)
| | | | - Justyna Modrzejewska
- Institute of Pedagogy, University of Bielsko-Biala, 43-309 Bielsko-Biala, Poland;
| | - Paweł Matusik
- Department of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
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Hoge EA, Acabchuk RL, Kimmel H, Moitra E, Britton WB, Dumais T, Ferrer RA, Lazar SW, Vago D, Lipsky J, Schuman-Olivier Z, Cheaito A, Sager L, Peters S, Rahrig H, Acero P, Scharf J, Loucks EB, Fulwiler C. Emotion-related constructs engaged by mindfulness-based interventions: A systematic review and meta-analysis. Mindfulness (N Y) 2021; 12:1041-1062. [PMID: 34149957 PMCID: PMC8210838 DOI: 10.1007/s12671-020-01561-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined. METHODS Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. RESULTS Seventy-two studies (N=7,378) were included (MBSR k=47, MBCT k = 21, Modified k=4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d=0.58; k =36), and in all constructs assessed: depression (d=0.66; k=26), anxiety (d =0.63; k=19), combined mental health (d =0.75; k=7 ) and stress (d =0.44; k=11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population-type did not moderate results, but MBI-type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. CONCLUSIONS This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.
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Affiliation(s)
- Elizabeth A. Hoge
- Department of Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Ave NW Suite 200, Washington, DC 20007, USA
| | - Rebecca L. Acabchuk
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, 06269, USA
| | - Hannah Kimmel
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Willoughby B. Britton
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Travis Dumais
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Rebecca A. Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - David Vago
- Osher Center for Integrative Medicine, Vanderbilt University, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA
| | - Jonah Lipsky
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Zev Schuman-Olivier
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
| | - Aya Cheaito
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Lauren Sager
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Sarah Peters
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Hadley Rahrig
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Pamela Acero
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Jodi Scharf
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Eric B. Loucks
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Carl Fulwiler
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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Martínez-Castilla P, Gutiérrez-Blasco IM, Spitz DH, Granot R. The Efficacy of Music for Emotional Wellbeing During the COVID-19 Lockdown in Spain: An Analysis of Personal and Context-Related Variables. Front Psychol 2021; 12:647837. [PMID: 33897554 PMCID: PMC8062927 DOI: 10.3389/fpsyg.2021.647837] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/17/2021] [Indexed: 12/13/2022] Open
Abstract
The strict lockdown experienced in Spain during March-June 2020 as a consequence of the COVID-19 crisis has led to strong negative emotions. Music can contribute to enhancing wellbeing, but the extent of this effect may be modulated by both personal and context-related variables. This study aimed to analyze the impact of the two types of variables on the perceived efficacy of musical behaviors to fulfill adults' emotional wellbeing-related goals during the lockdown established in Spain. Personal variables included age, gender, musical training, personality, resilience, and perception of music's importance. Contextual variables referred to living in a region with a high COVID-19 impact, perception of belonging to a risk group, being alone, having caring responsibilities during confinement, and amount of time of music listening as compared to prior to the crisis. The study was conducted retrospectively during August-December 2020, when the strict lockdown was over in Spain. An online survey was disseminated among the general population and groups of musicians, and the answers of 507 adults (from 18 years on, 73.9% females, 51.3% musically trained adults) were analyzed. Only personal, but not COVID-19 context-related variables, showed an impact on music's efficacy. The youngest age group of adults and those with musical training reported the highest efficacy of music for wellbeing enhancement, and music's importance was found to be the main significant predictor of music's perceived efficacy. Our findings suggest that the people who have been reported to be emotionally more vulnerable during the lockdown, due to either a strong impact on their daily lives or their lower resilience, perceive a higher benefit from musical behaviors. Being musically trained, even for a small number of years, also leads to a perception of higher efficacy of music for the achievement of emotional wellbeing goals. However, this effect is explained by the musically trained individuals' higher perception of music's importance. Although musical behaviors can be generally considered as important for wellbeing enhancement, our study highlights who are the potential individuals who could benefit the most from music-related activities for obtaining better levels of wellbeing, at least within the current context of the COVID-19 crisis.
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Affiliation(s)
- Pastora Martínez-Castilla
- Department of Developmental and Educational Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | | | - Daniel H. Spitz
- Department of Psychology and The Jerusalem School of Business Administration, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roni Granot
- Department of Musicology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Carpenter DS. The terror of the good: working the edge of experience. J Anal Psychol 2021; 66:112-131. [PMID: 33464592 DOI: 10.1111/1468-5922.12658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper considers the topic of the 'good' within the literature and in clinical work. Milder forms of the good which arise on the personal level generate defences against personal vulnerability. More powerful forms of the good, which the author calls the 'truly good', arise on an archetypal level and overwhelm the ego, generating fear, even terror. The 'truly good' invokes defences against the dissolution of an intact sense of self. In both mild and intense forms, the good will arise in every analysis, will challenge boundaries of both client and analyst, and touch the core of the analytic relationship. It demands acknowledgement. Within these two categories, the author identifies five forms of the good that may arise in containable and uncontainable intensities: beauty, intimacy, becoming, love, and encounters with the divine. Exploring encounters with the good in its various forms expands the range of tolerable human experience - one of the fundamental goals of analysis. Living the good, or at times suffering the truly good, furthers individuation as it enlarges access to experiences of profound meaning, including the divine or the numinous.
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Key Words
- Dissoziation
- Gegenübertragung
- Jung
- Jungianisch
- Kinderarchetypus
- Psyche
- Selbstzustand
- Umfeld
- Vielfalt
- affect regulation
- archetipo
- archetypal
- archétypal
- arquetípico
- bien authentique
- bien verdadero
- boundaries
- confini
- defences
- difese
- divin
- divine
- divino
- défenses
- espiritual
- fear of the good
- individuación
- individuation
- individuazione
- limites
- límites
- miedo del bien
- numineux
- numinoso
- numinous
- paura del bene
- peur du bien
- regolazione degli affetti
- regulación afectiva
- relacional
- relational
- relationnel
- relazionale
- régulation des affects
- spiritual
- spirituale
- spirituel
- truly good
- vero bene
- Юнг
- божественное
- границы
- духовное
- индивидуация
- нуминозное
- подлинное доброе
- регуляция аффекта
- реляционное
- страх добра
- 情绪调节, 防御, 原型, 对好的担忧, 真的好, 自性化, 荣格, 关系, 神圣, 神性, 精神, 边界
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Weerkamp-Bartholomeus P, Marazziti D, van Amelsvoort T. Remote W.A.R.A. Compared With Face-to-Face W.A.R.A.: A Pilot Study. Front Psychol 2021; 11:620027. [PMID: 33519645 PMCID: PMC7844207 DOI: 10.3389/fpsyg.2020.620027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/21/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic and its social restriction measures, online therapy is a life-saving possibility for patients with acute stress. Wiring Affect with ReAttach (W.A.R.A.) is a brief psychological intervention aiming to decrease negative affect, that can be offered online. METHODS We assessed the effect of remote W.A.R.A. on negative affect in 37 patients. Consequently, we compared the effect of remote W.A.R.A. versus face-to-face W.A.R.A on negative affect in a cross-sectional design. RESULTS W.A.R.A. remote therapy provoked a significant reduction of negative affect with a large effect size (d = 3.08, p < 0.001). However, the reduction on negative affect was smaller than with W.A.R.A. face-to-face. We found a substantial difference between W.A.R.A. remote therapy and W.A.R.A. face-to-face in decrease of negative affect (d = 1.36, p < 0.001). LIMITATIONS The major limitation of the pilot-study is the sample size of 37 patients. Besides, we designed a numeric rating scale for evaluating negative affect. We investigated the impact on negative affect by assessing "unpleasant feelings." This conceptualization of negative affect might still be a point of discussion. CONCLUSION The study's findings indicated that W.A.R.A. remote therapy significantly reduced negative affect, but to a lesser extent than W.A.R.A. face-to-face. Nevertheless, W.A.R.A. remote therapy might offer a fast relief, especially when personal contact is difficult.
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Affiliation(s)
- Paula Weerkamp-Bartholomeus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- ReAttach Therapy International Foundation, Voerendaal, Netherlands
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
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Eisma MC, Stroebe MS. Emotion Regulatory Strategies in Complicated Grief: A Systematic Review. Behav Ther 2021; 52:234-49. [PMID: 33483120 DOI: 10.1016/j.beth.2020.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 01/13/2023]
Abstract
Prolonged grief disorder, characterized by severe, persistent, and disabling grief, has recently been included in the International Classification of Diseases-11 (ICD-11). Emotional disturbances are central to such complicated grief responses. Accordingly, emotion regulation is assumed critical in the development, persistence, and treatment of complicated grief. Yet, a comprehensive review on this topic is lacking. We conducted a systematic review (PROSPERO: CRD42017076061) searching PsycInfo, Web of Science, and PubMed to identify quantitative research examining relationships between emotion regulation and complicated grief. Sixty-four studies on 7,715 bereaved people were identified, focusing on a variety of emotion regulation strategies (i.e., experiential avoidance, behavioral avoidance, expressive suppression, rumination, worry, problem solving, cognitive reappraisal, positive thought, and mindfulness). Our synthesis showed strong evidence that experiential avoidance and rumination play a role in the persistence of complicated grief. More generally, surveys support positive associations between putative maladaptive emotion regulation strategies and complicated grief, and negative associations between putative adaptive emotion regulation strategies and complicated grief. Laboratory research yielded mixed results. Emotion regulation is critical in complicated grief, and in particular experiential avoidance and rumination form important targets in complicated grief treatments. We advise expanding current knowledge, by employing more advanced, intensive data collection methods and experiments across diverse samples. Increasing knowledge in this domain will improve clinical practice.
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Moccia L, Janiri D, Giuseppin G, Agrifoglio B, Monti L, Mazza M, Caroppo E, Fiorillo A, Sani G, Di Nicola M, Janiri L. Reduced Hedonic Tone and Emotion Dysregulation Predict Depressive Symptoms Severity during the COVID-19 Outbreak: An Observational Study on the Italian General Population. Int J Environ Res Public Health 2020; 18:E255. [PMID: 33396363 PMCID: PMC7795888 DOI: 10.3390/ijerph18010255] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/26/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic has spiked stress-related symptoms worldwide. This study aims to assess depressive symptoms related to the early phase of the COVID-19 outbreak among the Italian general population and to analyze anhedonia and emotion dysregulation as potential predictors of depression severity. Through an online questionnaire, we collected sociodemographic and lockdown-related information; depressive symptoms, hedonic tone, and emotion dysregulation were assessed through the Beck Depression Inventory II, the Snaith-Hamilton Pleasure Scale, and the Difficulties in Emotion Regulation Scale, respectively. In our sample (n = 500), 122 individuals (24.4%) reported depressive symptoms during the COVID-19 outbreak. Individuals with and without depression differed in gender (X2 = 4.77, df = 1, p = 0.02) and age (X2 = 15.7, df = 4, p = 0.003). Among individuals presenting with depressive symptoms, those reporting close contact with confirmed cases of COVID-19 were at higher risk for severe depression (p = 0.026). Reduced hedonic tone (p = 0.014) and emotion dysregulation (p < 0.001) also predicted depression severity. To the best of our knowledge, these are among the earliest data that focus on the risk for depression among a sizeable sample of the Italian general population during the COVID-19 outbreak. Our results indicate emotion dysregulation and reduced hedonic tone as potential factors predicting COVID-19-related depression severity and provide insight into developing targeted intervention policies.
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Affiliation(s)
- Lorenzo Moccia
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
| | - Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
| | - Giulia Giuseppin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
| | - Benedetta Agrifoglio
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
| | - Laura Monti
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
| | - Marianna Mazza
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
| | - Emanuele Caroppo
- Mental Health Department, Local Health Unit ROMA 2, 00173 Rome, Italy;
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy;
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
| | - Luigi Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.M.); (G.G.); (B.A.); (M.M.); (M.D.N.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (L.M.)
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Abstract
A large and growing body of evidence suggests that physical activity (PA) may hold therapeutic promise in the management of mental health disorders. Most evidence linking PA to mental health outcomes has focused on the effects of aerobic exercise training on depression, although a growing body of work supports the efficacy of both aerobic and resistance exercise paradigms in the treatment of anxiety and post-traumatic stress disorder. Despite abundant evidence linking PA and mental health, use of exercise training as a mental health treatment remains limited due to three important sources of uncertainty: (a) large individual differences in response to exercise treatment within multiple mental health domains; (b) the critical importance of sustained PA engagement, not always achieved, for therapeutic benefit; and (c) disagreement regarding the relative importance of putative therapeutic mechanisms. Our review of treatment data on exercise interventions and mental health outcomes focuses primarily on depression and anxiety within a health neuroscience framework. Within this conceptual framework, neurobiological and behavioral mechanisms may have additiveor synergistic influences on key cognitive and behavioral processes that influence mental health outcomes. We therefore highlight sources of treatment heterogeneity by integrating the critical influences of (a) neurobiological mechanisms enhancing neuroplasticity and (b) behavioral learning of self-regulatory skills. Understanding the interrelationships between dynamic neurobiological and behavioral mechanisms may help inform personalized mental health treatments and clarify why, and for whom, exercise improves mental health outcomes. The review concludes with recommendations for future studies leveraging individual differences to refine treatment approaches to optimize mental health benefits.
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Affiliation(s)
- Patrick J Smith
- Department of Psychiatry and Behavioral Sciences.,Department of Medicine, and.,Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina 27708, USA;
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Masiero M, Keyworth H, Pravettoni G, Cropley M, Bailey A. Short Bouts of Physical Activity Are Associated with Reduced Smoking Withdrawal Symptoms, but Perceptions of Intensity May Be the Key. Healthcare (Basel) 2020; 8:E425. [PMID: 33114145 PMCID: PMC7712184 DOI: 10.3390/healthcare8040425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 12/23/2022] Open
Abstract
The primary aim of this study was to assess the effectiveness of a short bout (10 min) of moderate-intensity exercise to reduce withdrawal symptomatology, craving and negative affect; while the secondary aim was to assess how the effectiveness of a short bout of moderate exercise can be modulated by the perception of intensity in physically active and low-activity smokers. Fifty low-activity and physically active smokers were recruited (24 male and 26 female) and randomized in three different conditions. Prescribed (objective) moderate intensity (OBJ) and perceived moderate intensity (PER), and passive waiting (PW). After the intervention (T3), smokers reported less desire to smoke in the PER (p < 0.001) and OBJ (p < 0.001) conditions, relative to the PW condition. At T3 smokers in the PER condition reported less negative affect than smokers in the PW condition relative to the baseline (T1) (p < 0.007). Further, smokers in the PER condition reported less negative affect than smokers in the PW condition (p < 0.048). Physically active (PA) smokers perceived less exertion than low-activity (LA) smokers, and the effects were stronger in the PER condition relative to OBJ. Generally, our results suggest that a short bout of moderate exercise helps both LA and PA smokers. These findings provided a novel insight into the psychological mechanisms that affect the efficacy of the exercise in smoking cessation and suggest that exercise should be tailored according to individual perception of intensity.
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Affiliation(s)
- Marianna Masiero
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20141 Milan, Italy;
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Helen Keyworth
- School of Biosciences & Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey GU2 7XH, UK;
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20141 Milan, Italy;
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Mark Cropley
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Surrey GU2 7YH, UK;
| | - Alexis Bailey
- School of Biosciences & Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey GU2 7XH, UK;
- Institute of Medical and Biomedical Education, St George’s University of London, London SW17 0RE, UK
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Fuchshuber J, Unterrainer HF. Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model. Front Psychiatry 2020; 11:531. [PMID: 32581894 PMCID: PMC7296119 DOI: 10.3389/fpsyt.2020.00531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse. AIM AND SCOPE The present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment. CONCLUSIONS The results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.
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Affiliation(s)
- Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
- University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Human Friedrich Unterrainer
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
- University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
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Smith KE, Mason TB, Juarascio A, Weinbach N, Dvorak R, Crosby RD, Wonderlich SA. The momentary interplay of affect, attention bias, and expectancies as predictors of binge eating in the natural environment. Int J Eat Disord 2020; 53:586-594. [PMID: 32083337 PMCID: PMC8118158 DOI: 10.1002/eat.23235] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Affect regulation, eating expectancies, and attention toward food-related cues are interrelated constructs that have been implicated in the maintenance of binge eating. While these processes show considerable temporal variability, the momentary associations between these domains have not been elucidated. This study examined a model that posited momentary fluctuations in affect, eating expectancies, and attention bias (AB) would interact to predict subsequent binge eating. METHOD Forty women who endorsed recurrent binge eating completed a 10-day ecological momentary assessment protocol with ambulatory measures of AB (i.e., dot-probe task with palatable food and neutral cues) and self-report assessments of positive and negative affect, eating expectancies (i.e., the belief that eating would improve one's mood), and binge-eating symptoms. RESULTS Generalized linear mixed models indicated higher momentary AB toward palatable food was associated with increased risk of subsequent binge eating, and a two-way interaction showed that moments of higher eating expectancies and negative affect were associated with increased likelihood of subsequent binge eating. Also, a three-way interaction emerged, in that the association between eating expectancies and subsequent binge eating was strongest at lower levels of positive affect and higher AB. DISCUSSION Together, findings partially supported hypotheses and demonstrate meaningful within-person fluctuations in AB that precede binge eating. Further, results demonstrate that the momentary influence of eating expectancies on binge eating depends on both affective state and attentional processes.
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Affiliation(s)
- Kathryn E. Smith
- Department of Psychiatry and Behavioral Science, University of Southern California, Los Angeles, California
| | - Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | | | - Noam Weinbach
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Robert Dvorak
- Department of Psychology, University of Central Florida, Orlando, Florida
| | - Ross D. Crosby
- Department of Psychiatry and Behavioral Science, University of Southern California, Los Angeles, California
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Stephen A. Wonderlich
- Department of Psychiatry and Behavioral Science, University of Southern California, Los Angeles, California
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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Mathisen TF, Rosenvinge JH, Friborg O, Vrabel K, Bratland‐Sanda S, Pettersen G, Sundgot‐Borgen J. Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies. Int J Eat Disord 2020; 53:574-585. [PMID: 31944339 PMCID: PMC7187559 DOI: 10.1002/eat.23228] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare effects of physical exercise and dietary therapy (PED-t) to cognitive behavioral therapy (CBT) in treatment of bulimia nervosa (BN) and binge-eating disorder (BED). METHOD The active sample (18-40 years of age) consisted of 76 women in the PED-t condition and 73 in the CBT condition. Participants who chose not to initiate treatment immediately (n = 23) were put on a waiting list. Outcome measures were the eating disorder examination questionnaire (EDE-Q), Clinical Impairment Assessment (CIA), Satisfaction with Life Scale (SWLS), Beck Depression Inventory (BDI), and numbers in remission at posttreatment, and at 6-, 12-, and 24-months follow-up. RESULTS Both treatment conditions produced medium to strong significant improvements on all outcomes with long-term effect. The PED-t produced a faster improvement in EDE-Q and CIA, but these differences vanished at follow-ups. Only PED-t provided improvements in BDI, still with no between-group difference. Totally, 30-50% of participants responded favorable to treatments, with no statistical between-group difference. DISCUSSION Both treatments shared a focus on normalizing eating patterns, correcting basic self-regulatory processes and reducing idealized aesthetic evaluations of self-worth. The results point to the PED-t as an alternative to CBT for BN and BED, although results are limited due to compliance and dropout rates. Replications are needed by independent research groups as well as in more clinical settings.
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Affiliation(s)
| | - Jan H. Rosenvinge
- UiT—The Arctic University of Norway, Department of PsychologyFaculty of Health SciencesTromsøNorway
| | - Oddgeir Friborg
- UiT—The Arctic University of Norway, Department of PsychologyFaculty of Health SciencesTromsøNorway
| | | | - Solfrid Bratland‐Sanda
- Department of Outdoor Studies, Sports and Physical EducationUniversity College of Southeast NorwayBøNorway
| | - Gunn Pettersen
- Department of Health and Caring Sciences, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
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Abstract
Humans transform their environment in order to regulate their own affect. One way to do so is to avoid situations that come with negative rather than positive affect. This selection might not solely bear on expectations of full-blown emotions, but may also be invoked by anticipating the aversiveness of cognitive conflict, when a situation suggests competing behavioural responses. If cognitive conflict is indeed aversive, it may trigger affect regulation goals, which in turn influence choices of situations depending on the magnitude of conflict they contain. People should prefer actions that produce conflict-free situations to actions that produce conflicting situations. In three experiments, participants had to solve a Stroop task by freely choosing between response keys that were either associated with low-conflict or high-conflict in the subsequent trial. We find that people do not automatically prefer actions associated with conflict-free situations to actions that are associated with conflicting situations. They only do so, when they are explicitly informed about the contingency between action and congruency of an upcoming situation. This suggests that cognitive conflict, at least at the level of a standard conflict task as used here, is insufficient to invoke affect regulation processes.
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Affiliation(s)
| | - Anna Foerster
- Department of Psychology III, University of Würzburg Würzburg, Germany
| | - Wilfried Kunde
- Department of Psychology III, University of Würzburg Würzburg, Germany
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Temple VK, Cook JL, Unsworth K, Rajani H, Mela M. Mental Health and Affect Regulation Impairment in Fetal Alcohol Spectrum Disorder (FASD): Results from the Canadian National FASD Database. Alcohol Alcohol 2020; 54:545-550. [PMID: 31216355 DOI: 10.1093/alcalc/agz049] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/10/2019] [Accepted: 05/26/2019] [Indexed: 01/23/2023] Open
Abstract
AIMS Individuals with fetal alcohol spectrum disorder (FASD) frequently have challenges with regulating emotional arousal, or affect regulation (AR), and experience high rates of mental health disorders. This study examined children and adults with FASD to investigate the relationship between AR impairment and several mental health problems and diagnoses. METHODS Data from the Canadian national FASD database was used for analysis. Seven mental health diagnoses, including attention-deficit/hyperactivity disorder, post-traumatic stress disorder, conduct disorder, attachment disorder, intellectual disability, and language disorder were examined. A history of suicidality was also examined. The prevalence of these mental health problems in individuals with and without AR impairment was compared. RESULTS Individuals with FASD and AR impairment were significantly more likely to be diagnosed with conduct disorder (OR 4.8), attachment disorder (OR 6.1), or post-traumatic stress disorder (OR 8.1) when compared to those without AR impairment. They were also more likely to have a history of suicidality (OR 8.6). AR impairment was most commonly found in those with greater overall neurodevelopmental impairment. Having AR impairment was associated with receiving a diagnosis of FASD at a later age, but was not related to gender, intellectual disability, or language disorder. CONCLUSION AR impairment is strongly related to several mental health diagnoses in those with FASD and presents some promising possibilities for targeted early intervention.
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Affiliation(s)
- Valerie K Temple
- Clinical Psychologist, Surrey Place, 2 Surrey Place, Toronto, Ontario
| | - Jocelynn L Cook
- Scientific Director, The Society of Obstetricians and Gynaecologists of Canada, 2781 Lancaster Road, Ottawa, Ontario K1B 1A7 and Adjunct Professor, Department of Obstetrics and Gynaecology, University of Ottawa, 75 Laurier Ave E, Ottawa, Ontario
| | - Kathy Unsworth
- Managing Director, The Canada FASD Research Network, PO Box 11364 Wessex PO, Vancouver, British Columbia
| | - Hasu Rajani
- Professor Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Mansfield Mela
- Professor Department of Psychiatry, University of Saskatchewan, 103 Hospital Dr., Saskatoon, Saskatchewan
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Kobayashi R, Shigematsu J, Miyatani M, Nakao T. Cognitive Reappraisal Facilitates Decentering: A Longitudinal Cross-Lagged Analysis Study. Front Psychol 2020; 11:103. [PMID: 32082231 PMCID: PMC7005213 DOI: 10.3389/fpsyg.2020.00103] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/15/2020] [Indexed: 11/14/2022] Open
Abstract
Previous studies have suggested that cognitive reappraisal, which is an effective emotion regulation strategy, enhances decentering. On the other hand, other studies have implied the reverse in regard to this relationship: that decentering supports cognitive reappraisal. However, these possibilities have not yet been examined empirically. In the present study, we investigated the causal relationship between decentering and cognitive reappraisal by conducting two wave cross-lagged analysis. One hundred and thirty-eight Japanese university students responded to a questionnaire comprising measures of decentering and cognitive reappraisal tendency; the questionnaire was administered on two occasions, with an interval of 1 month. Cross-lagged analysis indicated the positive effect of cognitive reappraisal on decentering; however, the reverse possibility, that decentering influences cognitive reappraisal, was not significant. These results suggested that habitual use of cognitive reappraisal fosters decentering.
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Affiliation(s)
- Ryota Kobayashi
- Department of Psychology, Graduate School of Education, Hiroshima University, Hiroshima, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Jun Shigematsu
- Department of Psychology, Graduate School of Education, Hiroshima University, Hiroshima, Japan
| | - Makoto Miyatani
- Department of Psychology, Graduate School of Education, Hiroshima University, Hiroshima, Japan
| | - Takashi Nakao
- Department of Psychology, Graduate School of Education, Hiroshima University, Hiroshima, Japan
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Abstract
This paper begins with the understanding that early trauma leads to powerful dissociative defenses which injure the capacity to feel. It further explores ways to restore this capacity through body-centred attention to affect-in-the-moment in the psychoanalytic situation. Using the author's personal experience while in analysis as well as a case of severe early trauma, he demonstrates the consciousness-killing effect of primitive defenses and shows how body-sensitive techniques hold the promise of restoring the patient's sense of aliveness and hence, opening the unconscious to those affect-images that are the building blocks of the human imagination. A final section focuses on the neglect of feeling in Jungian psychology and suggests that the "creation of consciousness" which Jung described as his personal myth, is quintessentially a process of emotional transformation - of bringing unconscious suffering into consciousness - as feelings.
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Key Words
- Affektbilder
- Affektregulation
- Fähigkeit zu fühlen
- Grenzen von Jungs Komplextheorie
- Jungs Gefühlstypen
- Jung’s feeling-types
- Lebens- und Anti-Lebenskräfte
- Opus contra conscientiam
- Selbstfürsorgesystem
- Wiederholungszwang
- affect images
- affect regulation
- bambino interiore
- capacidad de sentir
- capacity to feel
- capacità di sentire
- capacité à ressentir
- compulsion de répétition
- compulsión a la repetición
- corazón informado
- cuore consapevole
- defensas disociativas
- difese dissociative
- dissociative defenses
- dissoziative Abwehr
- défenses dissociatives
- enfant intérieur
- forces de vie et forces anti-vie
- forze vitali e anti-vitali
- fuerzas vida y anti-vida
- images chargées d’affect
- immagini affettive
- implicit self
- implizites Selbst
- imágenes afectivas
- inconscient somatique
- inconsciente somático
- inconscio somatico
- informed heart
- informiertes Herz
- inner child
- inneres Kind
- le cœur éclairé
- les types sentiments chez Jung
- life and anti-life forces
- limitaciones de la teoría de los complejos de Jung
- limitations of Jung’s complex theory
- limitazioni della complessa teoria di Jung
- limites de la théorie des complexes de Jung
- niño interno
- opus contra conscientia
- opus contra conscientiam
- regolazione affettiva
- regulación afectiva
- repetition compulsion
- ripetizione compulsiva
- régulation de l’affect
- self implícito
- self-care system
- sistema de autocuidado
- sistema di auto-cura
- soi implicite
- somatic unconscious
- somatisches Unbewußtes
- système d’auto-soin
- sè implicito
- tipo-sentimiento en Jung
- tipologie di Jung
- аффект - образы
- внутренний ребенок
- диссоциативные защиты
- имплицитное я
- информированное сердце
- навязчивое повторение
- ограничения теории комплексов Юнга
- регуляция аффекта
- силы жизни и анти-жизни
- система защиты самости
- соматическое бессознательное
- способность чувствовать
- чувствующие типы Юнга
- 情绪调节, 自我照料系统, 隔离防御, 感受的能力, 隐含的自我, 重复的冲动, 躯体无意识, 情绪意象, 荣格的感受类型, 荣格情结理论的局限, 内在孩子, 有悖良心的作品, 生命与反生命力量, 了然的心
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Gaggero G, Bonassi A, Dellantonio S, Pastore L, Aryadoust V, Esposito G. A Scientometric Review of Alexithymia: Mapping Thematic and Disciplinary Shifts in Half a Century of Research. Front Psychiatry 2020; 11:611489. [PMID: 33362614 PMCID: PMC7758403 DOI: 10.3389/fpsyt.2020.611489] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
The term "alexithymia" was introduced in the lexicon of psychiatry in the early '70s by Sifneos to outline the difficulties manifested by some patients in identifying and describing their own emotions. Since then, the construct has been broadened and partially modified. Today this describes a condition characterized by an altered emotional awareness which leads to difficulties in recognizing your own and others' emotions. In half a century, the volume of scientific products focusing on alexithymia has exceeded 5,000. Such an expansive knowledge domain poses a difficulty for those willing to understand how alexithymia research has developed. Scientometrics embodies a solution to this issue, employing computational, and visual analytic methods to uncover meaningful patterns within large bibliographical corpora. In this study, we used the CiteSpace software to examine a corpus of 4,930 publications on alexithymia ranging from 1980 to 2020 and their 100,251 references included in Web of Science. Document co-citation analysis was performed to highlight pivotal publications and major research areas on alexithymia, whereas journal co-citation analysis was conducted to find the related editorial venues and disciplinary communities. The analyses suggest that the construct of alexithymia experienced a gradual thematic and disciplinary shift. Although the first conceptualization of alexithymia came from psychoanalysis and psychosomatics, empirical research was pushed by the operationalization of the construct formulated at the end of the '80s. Specifically, the development of the Toronto Alexithymia Scale, currently the most used self-report instrument, seems to have encouraged both the entrance of new disciplines in the study of alexithymia (i.e., cognitive science and neuroscience) and an implicit redefinition of its conceptual nucleus. Overall, we discuss opportunities and limitations in the application of this bottom-up approach, which highlights trends in alexithymia research that were previously identified only through a qualitative, theory-driven approach.
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Affiliation(s)
- Giulia Gaggero
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Andrea Bonassi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Sara Dellantonio
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Luigi Pastore
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Vahid Aryadoust
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Gunst E, Watson J, Willemsen J, Desmet M, Loeys T, Vanhooren S. A quest for self-soothing: A systematic case study into emotion-focused therapy with an emotionally avoidant client who committed sexual offenses. J Clin Psychol 2019; 76:676-687. [PMID: 31777086 DOI: 10.1002/jclp.22906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study is part of a multiple case study that investigated the emotional change in individuals who have committed sexual offenses (ISOs). This case study highlights how one client used sex as a maladaptive coping strategy to suppress negative emotions. METHOD A mixed-methods design was used to track changes in the client's affect regulation (AR) during four phases, including a baseline (Phase A), treatment as usual (Phase B), treatment with an emotion-focused therapy (EFT) component added (Phase C), and follow up (Phase A). RESULTS The qualitative description with verbatim clinical vignettes, revealed deeper insight into some important steps and hindrances and the impact of specific EFT-interventions. Quantitative analysis of self-report and observational measures showed a significant improvement in the client's AR across different phases of treatment. CONCLUSIONS The study improves our knowledge of the emotional change in ISOs during treatment and illustrates some key interventions, steps, and hindrances.
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Affiliation(s)
- Ellen Gunst
- FIDES, Psychiatric Center Sint-Amandus, Beernem, and University of Ghent, Ghent, Belgium
| | - Jeanne Watson
- Applied Psychology and Human Development, OISE, University of Toronto, Toronto, Canada
| | - Jochem Willemsen
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain, Belgium
| | - Mattias Desmet
- Department of Psychoanalysis and Clinical Consulting, University of Ghent, Ghent, Belgium
| | - Tom Loeys
- Department of Data-Analysis, University of Ghent, Ghent, Belgium
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Gunst E, Willemsen J, Desmet M, Watson JC, Loeys T, Vanhooren S. Into the Wild, Out of the Woods: A Systematic Case Study on Facilitating Emotional Change. Int J Offender Ther Comp Criminol 2019; 63:2586-2610. [PMID: 31387425 DOI: 10.1177/0306624x19866977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cognitive and behavioral treatment programs for individuals who have committed sexual offenses (ISOs) have shown significant but small effect sizes. A growing body of research points toward the importance of difficulties in affect regulation (AR) as a risk factor for sexual recidivism. On this basis, it seems important to target difficulties in AR in treatment. The current systematic case study investigates the potential contribution of emotion-focused therapy (EFT) to changing problematic AR in ISOs. Kevin was a high-risk offender with a traumatic history who met the diagnostic criteria of pedophilic and borderline disorders, with serious AR difficulties. Self-report outcome measures, observation measures, and a biomarker were used to track changes in AR, psychological symptoms, and distress during baseline (Phase A); treatment as usual (Phase B); treatment with an EFT component added (Phase C); and follow-up (Phase A). Statistically significant change was found in AR, psychological symptoms, and distress during treatment (Phase B + C); however, it is not possible to attribute these changes causally to EFT. An examination of the qualitative process data provides deeper insights into how the client reacted to specific EFT interventions. Verbatim clinical vignettes are included to clarify key interventions, hindrances, and mechanisms of change. This study provides preliminary support for the role of therapy to facilitate emotional change in ISOs.
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Affiliation(s)
- E Gunst
- Psychiatrisch Centrum Sint-Amandus, Beernem, Belgium
- Ghent University, Belgium
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Rothschild-Yakar L, Stein D, Goshen D, Shoval G, Yacobi A, Eger G, Kartin B, Gur E. Mentalizing Self and Other and Affect Regulation Patterns in Anorexia and Depression. Front Psychol 2019; 10:2223. [PMID: 31681070 PMCID: PMC6803447 DOI: 10.3389/fpsyg.2019.02223] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/17/2019] [Indexed: 11/13/2022] Open
Abstract
The study aimed to examine two constructs: general mentalizing processes and the specific component of affective mentalizing regarding self and others alongside the construct of affect regulation patterns in female adolescent and young adult inpatients with anorexia nervosa (AN; n = 41), depression (n = 20) and controls (n = 53). We further examined the predictive ability of affect regulation to eating-disorder (ED) symptoms beyond that of the mentalizing variables, and their potential role in mediating between mentalizing, depression and ED symptoms. We used tools assessing reflective functioning (RF), complex emotion recognition and theory of mind (ToM), alexithymia, affect regulation, depression, and ED symptoms. The AN and depression groups exhibited lower general mentalizing and higher alexithymia, emotional reactivity, and emotional cutoff patterns than controls, but showed no greater disturbance in ToM. The two clinical groups did not differ on any of these variables. Elevated mentalizing and adequate affect regulation patterns separately predicted lower severity of ED symptoms. Nonetheless, affect regulation did not add to the predictive value of mentalizing variables. Specifically, elevated alexithymia, and depressive symptomatology, but not RF, predicted greater ED symptomatology. Moreover, alexithymia directly accounted for elevated ED symptoms and also indirectly connected with ED symptoms via emotional hyperactivation and elevated depressive symptoms. These findings suggest that deficiencies in mentalization and affect regulation are not unique to AN, but may rather associated with psychopathology in general. Nonetheless, alexithymia and depression may increase ED-related symptomatology. Affect regulation deficiencies are mainly related with depressive symptoms and emotional hyperactivation is indirectly related with AN via the depressive symptoms.
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Affiliation(s)
- Lily Rothschild-Yakar
- School of Psychology, The Herta and Paul Amir Faculty of Social Sciences, University of Haifa, Haifa, Israel
| | - Daniel Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Dor Goshen
- School of Psychology, The Herta and Paul Amir Faculty of Social Sciences, University of Haifa, Haifa, Israel
| | - Gal Shoval
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Geha Mental Health Center, Petah Tikva, Israel
| | - Assaf Yacobi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv-Yafo, Israel
| | - Gilad Eger
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Geha Mental Health Center, Petah Tikva, Israel
| | - Bar Kartin
- School of Psychology, The Herta and Paul Amir Faculty of Social Sciences, University of Haifa, Haifa, Israel
| | - Eitan Gur
- Sheba Medical Center, Ramat Gan, Israel
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Watson JC, McMullen EJ, Rodrigues A, Prosser MC. Examining the role of therapists' empathy and clients' attachment styles on changes in clients' affect regulation and outcome in the treatment of depression. Psychother Res 2019; 30:693-705. [PMID: 31519140 DOI: 10.1080/10503307.2019.1658912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: The purpose of this study was to test whether changes in clients' affect regulation capacity (AR) mediated the impact of therapists' empathy on outcome and whether this relationship was stronger for more insecurely than securely attached clients. Method: The data set included 66 clients, who had participated in 16 weeks of either CBT or EFT for depression. Clients' AR was assessed using an observer and a self-report measure. Results: Changes in AR significantly mediated the relationship between therapists' empathy and outcome for depression, dysfunctional attitudes and self-esteem but not interpersonal problems, and changes in AR were moderated by clients' insecure attachment styles. Conclusions: The findings provide support for therapists' empathy as an active ingredient of change contributing to changes in clients' affect regulation capacities and emphasize the importance of assessing clients' attachment styles so that therapists can be more responsive and effectively tailor their treatments to fit the needs of individual clients.
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Affiliation(s)
- Jeanne C Watson
- Department of Applied Psychology and Human Development, OISE, University of Toronto, Toronto, ON, Canada
| | - Evelyn J McMullen
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada
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Abstract
Mental health crucially depends upon affective states such as emotions, stress responses, impulses and moods. These states shape how we think, feel and behave. Often, they support adaptive functioning. At other times, however, they can become detrimental to mental health via maladaptive affect generation processes and/or maladaptive affect regulation processes. Here, we present an integrative framework for considering the role of affect generation and regulation in mental illness and well-being. Our model views affect generation as an iterative cycle of attending to, appraising and responding to situations. It views affect regulation as an iterative series of decisions aimed at altering affect generation. Affect regulation decisions include identifying what, if anything, should be changed about affect, selecting where to intervene in the affect generation cycle, choosing how to implement this intervention, and monitoring the regulation attempt to decide whether to maintain, switch or stop it. Difficulties with these decisions, often arising from biased inputs to them, can contribute to manifestations of mental illness such as clinical symptoms, syndromes and disorders. The model has a number of implications for clinical assessment and treatment. Specifically, it offers a common set of concepts for characterizing different affective states; it highlights interactions between affect generation and affect regulation; it identifies assessment and treatment targets among the component processes of affect regulation; and it is applicable to prevention and treatment of mental illness as well as to promotion and restoration of psychological well-being.
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Affiliation(s)
- James J. Gross
- Department of PsychologyStanford UniversityStanfordCAUSA
| | - Helen Uusberg
- Institute of PsychologyUniversity of TartuTartuEstonia
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Fuchshuber J, Hiebler-Ragger M, Kresse A, Kapfhammer HP, Unterrainer HF. The Influence of Attachment Styles and Personality Organization on Emotional Functioning After Childhood Trauma. Front Psychiatry 2019; 10:643. [PMID: 31543844 PMCID: PMC6739441 DOI: 10.3389/fpsyt.2019.00643] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 08/08/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Current literature suggests a tenuous link among childhood trauma, personality organization, adult attachment, and emotional functioning in various psychiatric disorders. However, empirical research focusing on the interaction of these concepts is sparse. Therefore, this study intends to investigate the influence of personality organization and attachment dimensions on the relationship between childhood maltreatment and emotional functioning in adult life. To assess emotional functioning, we adopted the Affective Neuroscience model of primary emotions, comprising SEEKING, FEAR, ANGER, SADNESS, CARE, and PLAY. Methods: The total sample consisted of 616 nonclinical adults (Age: M = 30; SD = 9.53; 61.9% female). Path analysis was applied to investigate interactions among childhood trauma, personality organization, adult attachment, and primary emotion dispositions. Results: The findings suggest that childhood trauma significantly predicted deficits in personality organization and insecure attachment (all p < 0.001). Furthermore, a reduced level of personality organization was significantly associated with increased ANGER (p < 0.001), whereas adult attachment substantially predicted primary emotion dispositions in general. Moreover, the results indicate significant mediational effects of personality organization and attachment dimensions on the relationship between childhood trauma and primary emotions (p < 0.01). The final model was able to explain 48% of the variance in SADNESS, 38% in PLAY, 35% in FEAR, 28% in CARE, 14% in ANGER, and 13% in SEEKING. Discussion: The findings contribute to the understanding of the relationship between childhood maltreatment and impaired emotional functioning in adult life. Furthermore, the importance of personality organization and attachment dimensions for emotion regulation is underlined. Consequently, the treatment of patients with childhood trauma should focus on facilitating the development of more secure attachment patterns and increased personality functioning to improve overall emotional functioning.
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Affiliation(s)
- Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), GrünerKreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Michaela Hiebler-Ragger
- Center for Integrative Addiction Research (CIAR), GrünerKreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Adelheid Kresse
- Institute for Pathophysiology und Immunology, Medical University Graz, Graz, Austria
| | - Hans-Peter Kapfhammer
- University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Human Friedrich Unterrainer
- Center for Integrative Addiction Research (CIAR), GrünerKreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria.,Department of Religious Studies, University of Vienna, Vienna, Austria
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50
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Schulze L, Bürkner PC, Bohländer J, Zetsche U. Cognitive control and daily affect regulation in major depression and borderline personality disorder: protocol for an experimental ambulatory assessment study in Berlin, Germany. BMJ Open 2018; 8:e022694. [PMID: 30282684 PMCID: PMC6169760 DOI: 10.1136/bmjopen-2018-022694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Affective disturbances and difficulty in affect regulation are core features of major depressive disorder (MDD) as well as borderline personality disorder (BPD). Whereas depressed individuals are characterised by affective inertia, individuals with BPD are characterised by affective instability. Both groups have been found to use more maladaptive affect regulation strategies than healthy controls. Surprisingly, however, there have been hardly any studies directly comparing these two disorders to disentangle shared and disorder-specific deficits in affective dynamics and affect regulation.Furthermore, theoretical models link deficits in affect regulation to deficits in cognitive control functions. Given that individuals with MDD or BPD are both characterised by impairments in cognitive control, the present study will further examine the link between individual differences in cognitive control and disturbances in affect dynamics and regulation in the daily life of individuals with MDD or BPD. METHODS AND ANALYSES We will use a smartphone application to assess negative and positive affect as well as affect regulation strategies at eight times a day for 7 days. We will further employ four computerised tasks to assess two cognitive control functions, namely interference control and discarding irrelevant information from working memory. Our hypotheses will be tested using a multimethod approach. Power analyses determined a sample size of 159 (53 MDD, 53 BPD, 53 controls) to detect medium effect sizes. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Freie Universität Berlin. Data collection started in January 2017 and will last until the end of 2018. Results will be disseminated to relevant psychotherapeutic and patient communities in peer-reviewed journals, and at scientific conferences.
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Affiliation(s)
- Lars Schulze
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | | | - Julian Bohländer
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Ulrike Zetsche
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
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