Event centrality prospectively predicts PTSD symptoms

Background: Recent evidence suggests that event centrality has a prominent association with post-traumatic stress disorder (PTSD) symptoms. However, evidence for this notion thus far has been mostly correlational. We report two studies that prospectively examined the relationship between event centrality and PTSD symptoms. Study 1 Methods: Participants (N?=?1438) reported their most stressful event (“prior event”), along with event centrality, PTSD symptoms, and neuroticism. At Time 2 participants reported their most stressful event since Time 1 (“critical event”), along with measures of event centrality and PTSD symptoms. Study 1 Results: Event centrality for the critical event predicted PTSD symptoms, after controlling for event centrality and PTSD symptoms of the prior event and neuroticism. Study 2 Methods: In the second study (N?=?161) we examined changes in event centrality and PTSD symptoms over a month. Study 2 Results: Using a cross-lagged panel design, results revealed event centrality at Time 1 significantly predicted PTSD symptoms at Time 2, but the reverse was not significant. Conclusions: In two studies, a prospective association between event centrality and PTSD symptoms, but not the reverse, emerged. This evidence implicates event centrality in the pathogenesis and/or maintenance of PTSD symptoms.     

Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?

Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination partially mediating this association. Finally, based on factor analysis, expressive suppression and cognitive reappraisal appear to be independent constructs. Overall, expressive suppression, much more so than cognitive reappraisal, may play an important role in the experience of stress-related symptoms. Further, given their independence, there are potentially relevant clinical implications, as interventions that shift one of these emotion regulation strategies may not lead to changes in the other.     

青少年依恋对创伤后应激障碍和创伤后成长的影响:认知重评和表达抑制的中介作用

本研究采用创伤暴露程度问卷、父母与同伴依恋问卷、情绪调节策略问卷、DSM-5的PTSD症状核查表、创伤后成长问卷,以汶川地震8.5年后极重灾区的1153名青少年为被试,考察青少年的依恋、认知重评、表达抑制、PTSD和PTG之间的关系。结果发现：青少年的依恋可以直接负向预测PTSD、直接正向预测PTG;青少年的依恋可以通过认知重评负向预测PTSD、正向预测PTG,也可以通过表达抑制负向预测PTSD,却不能通过表达抑制预测PTG。     

Roles of Religious Commitment,Emotion Regulation and Social Support in Preoperative Anxiety

Surgery is a relatively commonplace medical procedure in healthcare settings. The mental health status of the person undergoing surgery is vital, but there is dearth of empirical studies on the mental health status of surgery patients, particularly with regard to the factors associated with anxiety in surgical conditions. This study investigated the roles of religious commitment, emotion regulation (cognitive reappraisal and expressive suppression) and social support in preoperative anxiety in a sample of 210 surgical inpatients from a Nigerian tertiary healthcare institution. A cross-sectional design was adopted. Before the surgery, respondents completed the state anxiety subscale of State-Trait Anxiety Inventory, Religious Commitment Inventory, Emotion Regulation Questionnaire and Multidimensional Scale of Perceived Social Support. After controlling for relevant demographic factors, regression results showed that cognitive reappraisal, social support and interpersonal religious commitment were negatively associated with preoperative anxiety, while expressive suppression was positively associated with preoperative anxiety. The emotion regulation strategies made robust and significant explanation of variance in preoperative anxiety. Appropriate interventions to promote interpersonal religious commitment, encourage cognitive reappraisal and enhance social support quality may improve mental health outcomes in surgery.

     

A Preliminary Examination of Thought Suppression,Emotion Regulation,and Coping in a Trauma-Exposed Sample

Attempts to modulate negative emotional and cognitive symptoms of posttraumatic stress disorder (PTSD) may be related to psychopathology. Trauma-exposed undergraduates, 31 reporting severe PTSD symptoms (PTSD group) and 34 without PTSD symptoms (non-PTSD group), completed measures of PTSD, depression, anxiety, thought control, emotion regulation, and coping. The PTSD group had greater psychopathology and overall modulation strategy use than the non-PTSD group. Thought suppression, emotion suppression, and avoidant coping strategies were positively related to psychopathology, whereas emotion reappraisal and approach coping strategies were either not related or weakly negatively related. Hierarchical multiple regressions with psychopathologic variables as criteria and modulation strategies as predictors indicated significant models in all cases. Generally, thought suppression was the only significant independent predictor of psychopathology.     

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors

Background and objectives: Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type.

Methods: A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N?=?62; HSA) and low (N?=?52; LSA) on social anxiety.

Results: Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity.

Conclusions: Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.     

Emotion Regulation: Antecedents and Well-Being Outcomes of Cognitive Reappraisal and Expressive Suppression in Cross-Cultural Samples

Habitual emotional state is a predictor of long-term health and life expectancy and successful emotion regulation is necessary for adaptive functioning. However, people are often unsuccessful in regulating their emotions. We investigated the use of cognitive reappraisal and expressive suppression in 489 university students in Norway, Australia, and the United States and how these strategies related to measures of well-being (affect, life satisfaction, and depressed mood). Data was collected by means of selfadministered questionnaires. The major aims of the study were to begin to explore the prevalence of use of cognitive reappraisal and expressive suppression across gender, age and culture, possible antecedents of emotion regulation strategies, and the influence of emotion regulation upon well-being. Results showed that the use of emotion regulation strategies varied across age, gender and culture. Private self-consciousness (self-reflection and insight) was found to be a central antecedent for the use of cognitive reappraisal. Use of emotion regulation strategies predicted well-being outcomes, also after the effect of extraversion and neuroticism had been controlled for. Generally, increased use of cognitive reappraisal predicted increased levels of positive well-being outcomes, while increased use of expressive suppression predicted increased levels of negative well-being outcomes.

Emotion regulation and risk taking: Predicting risky choice in deliberative decision making

Only very recently has research demonstrated that experimentally induced emotion regulation strategies (cognitive reappraisal and expressive suppression) affect risky choice (e.g., Heilman et al., 2010). However, it is unknown whether this effect also operates via habitual use of emotion regulation strategies in risky choice involving deliberative decision making. We investigated the role of habitual use of emotion regulation strategies in risky choice using the “cold” deliberative version of the Columbia Card Task (CCT; Figner et al., 2009). Fifty-three participants completed the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) and—one month later—the CCT and the PANAS. Greater habitual cognitive reappraisal use was related to increased risk taking, accompanied by decreased sensitivity to changes in probability and loss amount. Greater habitual expressive suppression use was related to decreased risk taking. The results show that habitual use of reappraisal and suppression strategies predict risk taking when decisions involve predominantly cognitive-deliberative processes.     

Should we suppress or reappraise our stress?: the moderating role of reappraisal on cortisol reactivity and recovery in healthy adults

Background: People differ in their ability to regulate their physiological stress response. Individual differences in emotion regulation strategies such as suppression and reappraisal may explain this differential response to stress.

Objective: The aim of the current study was to assess whether daily use of suppression and reappraisal as well as their interaction predicted physiological stress reactivity and/or recovery, as assessed by variations in cortisol levels.

Method: Thirty-eight healthy young adults (13 men) completed the Emotion Regulation Questionnaire and were exposed to a psychosocial stressor, throughout which salivary cortisol was measured.

Results: Linear regressions showed main effects of reappraisal and suppression on cortisol reactivity and a main effect of suppression on cortisol recovery, where both strategies were positively associated with stress phases. Moreover, results showed a significant interaction of suppression by reappraisal in predicting both cortisol reactivity and recovery. Simple slope tests revealed that reappraisal moderated the association between suppression and both phases of cortisol responsivity.

Conclusion: Our results suggest that reappraisal represents a protective factor against the deleterious effects of suppression on stress responsivity. This study underlines the importance of investigating emotion regulation strategies as a means to understand individual differences in vulnerability to stress-related psychopathologies such as anxiety and depression.     

An examination of the roles of trauma exposure and posttraumatic stress disorder on emotion regulation strategies of Operation Iraqi Freedom,Operation Enduring Freedom,and Operation New Dawn veterans

Theories of posttraumatic stress disorder (PTSD) implicate emotional processes, including difficulties utilizing adaptive emotion regulation strategies, as critical to the etiology and maintenance of PTSD. Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (OIF/OEF/OND) veterans report high levels of combat exposure and PTSD. We aimed to extend findings suggesting that emotion regulation difficulties are a function of PTSD, rather than combat trauma exposure or common comorbidities, to OIF/OEF/OND veterans, in order to inform models of PTSD risk and recovery that can be applied to returning veterans. We tested differences in emotion regulation, measured with the Difficulties in Emotion Regulation Scale and Emotion Regulation Questionnaire, among trauma-exposed veterans with (n = 24) or without PTSD (n = 22) and healthy civilian comparison participants (n = 27) using multivariate analyses of covariance, adjusting for major depressive disorder, anxiety disorders, and demographic variables (age, sex, and ethnicity). Veterans with PTSD reported more use of expressive suppression and more difficulties with emotion regulation than veterans without PTSD and healthy comparison participants. Groups did not differ on cognitive reappraisal. Findings suggest the key role of PTSD above and beyond trauma exposure, depression, and anxiety in specific aspects of emotion dysregulation among OIF/OEF/OND veterans. Interventions that help veterans expand and diversify their emotion regulation skills may serve as helpful adjunctive treatments for PTSD among OIF/OEF/OND veterans.     

Regulating emotions under exposure to negative out-group-related news material results in increased acceptance of out-groups

ABSTRACT

Negative emotions affect the acceptance of out-groups. Here, we investigated whether modifying negative emotions would affect perceptions of out-groups. We experimentally manipulated the use of two emotion regulation strategies: suppression of emotional expression and cognitive reappraisal, the latter involving reframing a situation to mitigate its emotional impact. Using a population-based sample (N = 317), we conducted an online randomized controlled trial. Participants regulated their emotions while reading threatening news about out-groups. Not only reappraisal, but also suppression increased immediate acceptance of out-groups. The effect of reappraisal was partly mediated by decreased disgust, suggesting unique effects of reappraisal on this emotion. In the suppression condition acceptance decreased at high levels of habitual emotion regulation, whereas reappraisal showed an opposite tendency. Previous research may have underestimated the importance of different emotion regulation strategies on prejudice, and that relatively simple interventions can affect prejudice. The findings are of interest to prejudice prevention programs.     

Is emotion regulation associated with cancer-related psychological symptoms?

Objectives: This study examined the cross-sectional and prospective relationships between subjective (cognitive reappraisal, expressive suppression and experiential avoidance) and objective (high-frequency heart rate variability [HF-HRV]) measures of emotion regulation (ER) and a set of psychological symptoms (anxiety, depression, fear of cancer recurrence [FCR], insomnia, fatigue, pain, and cognitive impairments) among women receiving radiation therapy for non-metastatic breast cancer.

Design: Eighty-one participants completed a battery of self-report scales within 10 days before the start of radiotherapy (T1) and within 10 days after its end (T2; approximately 6 weeks after T1). HF-HRV at rest was measured at T1.

Results: Canonical correlation analyses revealed that higher levels of experiential avoidance and expressive suppression were cross-sectionally associated with higher levels of all symptoms, except pain, at T1 and at T2 (both p’s?<?0.0001). Higher levels of suppression and reappraisal at T1 were marginally associated with reduced FCR and with increased depression and fatigue between T1 and T2 (p?=?0.07). HF-HRV was not associated with symptoms cross-sectionally or prospectively.

Conclusions: Although preliminary, these results are consistent with the hypothesis that maladaptive ER strategies, assessed subjectively, may cross-sectionally act as a transdiagnostic mechanism underlying several cancer-related psychological symptoms.     

不同民族文化对负性情绪调节的影响:来自ERPs的证据

采用认知重评和表达抑制策略考察不同民族文化对负性情绪调节主观体验和事件相关电位活动的影响。结果发现,汉族和少数民族文化个体在两种策略下均呈现负性情绪感受显著降低,并且汉族表达抑制的情绪体验得分低于少数民族。此外,负性情绪图片相比中性图片诱发了更大的P2成分,表达抑制相比认知重评在额-中区诱发了更大的P3成分。更重要的是,900~1200ms时间窗内,汉族个体认知重评和表达抑制后LPP波幅均降低,但少数民族文化个体仅在认知重评条件表现出LPP波幅的显著下降。以上结果表明不同民族文化背景下负性情绪调节的效果不同。     

Emotion Regulation as a Moderator of Outcomes of Transdiagnostic Group Cognitive-Behavioral Therapy for Emotional Disorders

The aim of this study was to examine the potential moderating effect of baseline emotion regulation skills—cognitive reappraisal and expressive suppression—on the relationship between treatment allocation and treatment outcomes in primary care patients with emotional symptoms. A total of 631 participants completed scales to evaluate emotion regulation, anxiety, depression, functioning, and quality of life (QOL). The moderation analysis was carried out using the SPSS PROCESS macro, version 3.5. Expressive suppression was a significant moderator in the relationship between treatment allocation and treatment outcomes in terms of symptoms of anxiety (b = −0.530, p = .026), depression (b = −0.812, p = .004), and QOL (b = 0.156, p = .048). Cognitive reappraisal acted as a moderator only in terms of QOL (b = 0.217, p = .028). The findings of this study show that participants with higher scores of expressive suppression benefited more from the addition of transdiagnostic cognitive-behavioral therapy to treatment as usual (TAU) in terms of anxiety and depressive symptoms, and QOL. Individuals with higher levels of cognitive reappraisal obtained a greater benefit in terms of QOL from the addition of psychological treatment to TAU. These results underscore the relevant role that emotion regulation skills play in the outcomes of psychological therapy for emotional symptoms.     

对恐怖情绪的调节：认知重评优于表达抑制 ——一样ERP研究

摘要 本研究采用事件相关电位（ERP）技术,通过测量由视觉诱发的脑电成分晚正波（LPP）来比较情绪调节策略在生理电特征上的差异,进一步探讨认知重评和表达抑制的优劣。实验结果表明：（1）从波幅的角度来比较：在400-600ms时间窗口内,认知重评条件下恐怖图片诱发的LPP波幅显著小于在自由观看条件下的波幅,而表达抑制和自由观看组所诱发的LPP波幅差异较小。（2）从时间进程的角度来比较：认知重评与自由观看组的差异发生在400ms并持续到600ms,甚至以后;而表达抑制和自由观看之间的差异发生在450ms但是只持续到550ms。这表明认知重评相较于表达抑制,对负性情绪起调节作用开始较早,并且持续时间较长。这为认知重评优于表达抑制策略提供了神经生理学上的证据。     

Internalizing Symptoms in Female Adolescents: Associations with Emotional Awareness and Emotion Regulation

The transition into adolescence involves a number of changes that for many adolescents result in increased negative affect and internalizing symptoms, especially for females. In the current study we examined the direct and indirect effects of emotional awareness on internalizing symptoms by exploring the extent to which certain emotion regulation strategies influence this relationship. Participants were 123 female adolescents aged 13–16 years (M = 14.51 years) who completed measures of emotional awareness, emotion regulation (emotional reappraisal and expressive suppression), and symptoms of depression and social anxiety. Two multiple indirect effect models were conducted including both reappraisal and suppression (one for each of the dependent variables, depression and social anxiety) via the bootstrapping method. Results found that reappraisal accounted for the effect of emotional awareness on depressive symptoms but suppression accounted for the effect of emotional awareness on social anxiety symptoms. Results suggest that emotion regulation strategies play an important role in determining depressive and social anxiety symptoms and are associated with an adolescent’s level of emotional awareness.     

Interactions of emotion regulation and perceived stress in predicting emerging adults’ subsequent internalizing symptoms

Emotion regulation is consistently linked to subsequent wellbeing, but little research has examined the moderating role of emotion regulation in longitudinal associations between mental health and other relevant factors. This study examines two specific emotion regulation strategies interacting with perceived stress to predict subsequent internalizing symptoms among emerging adults transitioning to college, a population for whom emotion regulation may be particularly important. A sample of 1130 college students provided data at three time points. Results indicated that cognitive reappraisal buffered against negative effects of stress, whereas expressive suppression was an independent risk factor for internalizing symptoms. Findings underscore the importance of emotion regulation, highlighting cognitive reappraisal as a protective factor against stress and further demonstrating the direct negative impacts of expressive suppression.     

Emotion Regulation Strategies,Secondary Traumatic Stress,and Compassion Satisfaction in Healthcare Providers

The aim of the present study is to examine the relationships between two emotion regulation strategies (cognitive reappraisal and expressive suppression), secondary traumatic stress, and compassion satisfaction in a sample of 190 healthcare providers. Another aim of this study is to examine if the relations between emotion regulation strategies and traumatic stress symptoms are moderated by compassion satisfaction. The respondents volunteered to take part in the research and completed self-reporting measures describing the use of emotional regulation strategies, the symptoms of secondary traumatic stress, and the compassion satisfaction. The results revealed negative associations between cognitive reappraisal and secondary traumatic stress, while expressive suppression is positively associated with arousal. Moreover, cognitive reappraisal is positively related to compassion satisfaction, while secondary traumatic stress symptoms are negatively correlated with compassion satisfaction. Furthermore, the relationship between expressive suppression and intrusions is moderated by compassion satisfaction. The implications of these results for enhancing professional quality of life in the context of secondary exposure to traumatic life events are discussed.     

Emotion regulation and memory: the cognitive costs of keeping one's cool

An emerging literature has begun to document the affective consequences of emotion regulation. Little is known, however, about whether emotion regulation also has cognitive consequences. A process model of emotion suggests that expressive suppression should reduce memory for emotional events but that reappraisal should not. Three studies tested this hypothesis. Study 1 experimentally manipulated expressive suppression during film viewing, showing that suppression led to poorer memory for the details of the film. Study 2 manipulated expressive suppression and reappraisal during slide viewing. Only suppression led to poorer slide memory. Study 3 examined individual differences in typical expressive suppression and reappraisal and found that suppression was associated with poorer self-reported and objective memory but that reappraisal was not. Together, these studies suggest that the cognitive costs of keeping one's cool may vary according to how this is done.     

Healthy and unhealthy emotion regulation: personality processes, individual differences, and life span development

Abstract Individuals regulate their emotions in a wide variety of ways. Are some forms of emotion regulation healthier than others? We focus on two commonly used emotion regulation strategies: reappraisal (changing the way one thinks about a potentially emotion‐eliciting event) and suppression (changing the way one responds behaviorally to an emotion‐eliciting event). In the first section, we review experimental findings showing that reappraisal has a healthier profile of short‐term affective, cognitive, and social consequences than suppression. In the second section, we review individual‐difference findings, which show that using reappraisal to regulate emotions is associated with healthier patterns of affect, social functioning, and well‐being than is using suppression. In the third section, we consider issues in the development of reappraisal and suppression and provide new evidence for a normative shift toward an increasingly healthy emotion regulation profile during adulthood (i.e., increases in the use of reappraisal and decreases in the use of suppression).