La gestion des émotions et ses déficits,chez les personnes atteintes de douleur chronique : une revue systématisée des études relatives à l’alexithymie, à l’intelligence émotionnelle, à la régulation émotionnelle et au coping

The goal of this review is to synthesize the data of scientific literature on emotional management and its deficits in chronic pain. We used terms referenced in databases and MesH terms (of the United States National Library of Medicine) to perform a literature search in a powerful online search engine (EBSCOhost research databases). Four hundred and forty-nine papers, taken from international reviews and published of 1994 (because it is in the middle of the 1990s that this theme begins to be handle) to the end of January, 2015, are identified by a total 5 electronic databases with predefined keywords about emotions and chronic pain. Forty-six of which met the inclusion criteria, according to their title, their summary and their complete text. The findings suggest that some emotional management strategies and its deficits can maintain a vicious circle of negative emotional states with physiological and psychopathological consequences. Several studies show that alexithymia, emotional ambivalence and emotional suppression have a deleterious impact on pain, emotional distress (depression, anxiety) and disability. In spite of some contradictions concerning the nature of this effect (sensory or affective pain intensity or even duration of pain), it seems that alexithymia is a major variable implied in chronic pain. Inversely, experiential acceptance has a beneficial effect on psychological distress (depression, anxiety and stress). Emotional disclosure (of stressful or traumatic events) can decrease pain intensity but not disability and mental health. Likewise, emotional expression in daily life seems beneficial, but when the expression of the positive and negative feelings are distinguished, emotional expression of negative feelings increases pain, disability and distress. The whole of these findings emphasize the need to further research about emotional management in chronic non-cancer pain. It is necessary to identify and control the source of potential bias. Some hypotheses have been proposed to explain these findings. In the future, it would be interesting to use a multifactorial approach to investigate the interactions between various processes of emotional management in chronic pain patients.     

EMPLOYMENT AT-WILL AND EMPLOYEE DISCHARGE: A JUSTICE PERSPECTIVE ON LEGAL ACTION FOLLOWING TERMINATION

In contrast to statutory constraints on employment-related discrimination, the primary legal context for employee discharge is the common law doctrine of employment at-will. Although some attention has been given to legal issues surrounding employee discharge, there has been little systematic effort to identify the psychological antecedents of the decision to bring suit against organizations for discharge-related reasons. This paper provides an overview of employment at-will and its history in the U.S. and reviews legal developments related to at-will since the late 1980s. We then offer a preliminary model addressing the decision by a discharged employee to bring suit against an organization and the factors influencing the likelihood of liability. We end with a number of practical suggestions that follow from the literature review and model.     

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.     

Do readers mentally represent characters' emotional states?

Abstract

Subjects read stories that described concrete actions, such as a main character stealing money from a store where his best friend worked and later learning that his friend had been fired. Following each story, subjects read a target sentence that contained an emotion word that either matched the emotional state implied by the story (e.g. guilt) or mismatched that emotional state. In Experiment 1, target sentences were read more slowly when the mismatched emotion words were the perceived opposites of the emotional states implied by the stories (e.g. pride). In Experiment 2, target sentences were read more slowly when the mismatched emotion words shared the affective valence of the implied emotional state; therefore, readers must represent more than simply the affective valence of the emotional states. Instead of reading target sentences that contained matching versus mismatching emotion words, subjects in Experiment 3 simply pronounced matching versus mismatching emotion words. Mismatching emotion words were pronounced more slowly. These experiments suggest that readers form explicit, lifelike, mental representations of fictional characters' emotional states, and readers form these representations as a normal part of reading comprehension.     

Factor structure and initial validation of a brief measure of perceived emotional and physical distress tolerance in post-9/11 US Veterans

Distress tolerance (i.e., perceived or actual capacity to tolerate aversive internal states) has received considerable research attention as a transdiagnostic risk-factor underlying the development and maintenance of psychopathology. Lower levels of emotional distress tolerance have been linked to psychopathology (e.g. Posttraumatic Stress Disorder) within Military populations; however, the association of physical distress tolerance to psychopathology in this population has been under-researched. This research gap may be due in part to a paucity of comprehensive, temporally stable and brief measures of distress tolerance that have been validated within Military populations, which may hinder further examination and refinement of the construct. Addressing this problem, the current study evaluates the psychometric properties of a novel and brief measure of emotional and physical distress tolerance in a sample of United States post-9/11 Veterans. Participants were 307 Veterans (M_age = 38.9, 67.7% male) who completed the 10-item Distress Tolerance Inventory at baseline and annual follow-up. Exploratory structural equation modeling was used to examine the optimal latent factor structure and longitudinal invariance of the DTI measurement model, along with correlational analyses to examine the convergent properties of the DTI subscales. The DTI reflected a longitudinally invariant two-factor structure (emotional and physical distress tolerance), with excellent internal consistency and preliminary evidence of convergent validity. Thus, the DTI represents a brief, reliable and temporally stable measure of physical and emotional distress tolerance.     

‘Needed not wanted’: An interdisciplinary examination of the work-related challenges faced by irregular migrants

Using an integrative perspective drawn from vocational psychology and migration studies, this article explores the lives of irregular migrants, which represents a unique aspect of work-based migration. Irregular migrants are those individuals who travel from regions without much work to states that offer some means of employment, without formal immigration documentation. The relational and social contexts of migration of working people to states that offer employment (albeit limited and with many attendant risks) are presented. Using the broad framework provided by the psychology of working coupled with the relational perspectives of working, prominent resources and barriers in the working lives of irregular migrants are described, including social capital, social support, culture as a source of support, and social oppression. Future directions for research that can inform public policy are provided at the conclusion of the article.     

Emotional inhibition in essential hypertension: obstacle to communication during medical visits?

A substantial literature on the "hypertensive personality" links essential hypertension (EH) with the suppression of negative emotions, implying that suppression may elevate blood pressure. Yet affective inhibition might also impair communication with health care providers and exacerbate EH by limiting therapeutic collaboration. We studied 542 patient-physician interviews from a national sample to see if patients with EH (n = 203) were less likely to exhibit negative emotions than normotensive patients (n = 339) as rated by their physicians and independent observers. EH patients did not differ from others on self-rated emotional or physical health. However, physicians were less accurate in characterizing the emotional states of EH patients than those of normotensive patients, and they rated EH patients as exhibiting fewer signs of distress during the visit. Independent observers also judged the EH patients as less distressed than normotensives, thereby validating the physicians' appraisals. Content analysis disclosed that physicians paid less attention to psychosocial concerns and concentrated on biomedical matters to a greater degree with hypertensive patients than with their normotensive patients. EH patients, particularly those experiencing emotional distress, appear to have patterns of self-presentation that could present an obstacle to effective communication with their physicians, and this difficulty may be amplified by physicians' disinclination to probe for emotional difficulty.     

Counselling in Medical Settings

The slow development of counselling as an alternative to traditional treatment within the medical model is described. Counselling in medical settings has its roots in the work of the Marriage Guidance Council and the influence of Balint towards psychotherapy. 10-30% of all consultations in general practitioners' surgeries are related to emotional distress, yet the adoption and rise of counselling is more patchy than widespread. The factors which have hindered its expansion in the past are discussed, and it is concluded that its development in the future will depend largely upon pronounced changes in public health policy.     

The Comprehensive Resource Model®: Overview of basic affects in adversity & effective treatment for complex reactions to trauma

Much of the theoretical focus in post‐traumatic stress disorder has been on the role of the amygdala, the hippocampus and the prefrontal cortex. Crucially, in unresolved traumatic experiences that underlie clinical presentations, this focus misses the brain areas key to the defence responses of fight, flight and freeze—and the associated affects of anger, fear and grief. The periaqueductal gray in the midbrain, with the hypothalamus, is essential for these somatic and emotional responses to traumatic experiences. We argue that when treatment approaches thought to work at the higher brain levels have been ineffective, it is because they have failed to engage the midbrain and hypothalamic sources of the affective responses to the trauma and to the memory of it. Basic affects have been so overwhelming that dissociation, or a similarly protective neurochemical capping mechanism, has prevented full resolution of the affective content of the adversity. Treatment with the Comprehensive Resource Model^® (CRM) aims to clear the clinically relevant residues of adverse experiences by resolving the emotional responses accessed through the body memories. When the trauma has led to overwhelming distress, and/or dissociation, there is a necessity for robust resourcing to be in place before the emotional intensity of that distress is accessed. Resourcing needs to be as proximal to the re‐experience as possible to promote complete resolution and in some psychotherapy modalities, the supports provided are somewhat remote from the crucial moments of processing. Therefore, we describe how the CRM seeks to have robustly resourced states present concurrently with traumatised states to avoid overwhelming emotional distress. This allows safe entry into the deepest pain residual from the traumatic event so that it is not overwhelming during processing of the memory, and does not lead to further dissociation, allowing the individual to remain fully present throughout. This “stepping into the affect” can then be so rapidly effective that we also argue that CRM is not an exposure treatment; re‐orientation to the deepest content of the experience resolves the residual distress quickly and permanently through memory reconsolidation. Re‐learning at upper brain levels will then follow from the revoking of the affective power, which has previously driven stimulus/context and response learning in the amygdala, hippocampus and prefrontal cortex.     

Coping with COVID-19: The sociomaterial dimensions of living with pre-existing mental illness during the early stages of the coronavirus crisis

In this article, we use the case study method to detail the experiences of five participants who reported living with pre-existing mental illness during COVID-19. We adopted a sociomaterial analytical approach, seeking to identify how human and nonhuman agents came together to generate states of wellbeing or distress during this challenging period. As the case studies show, feelings of anxiety, fear and risk were generated from the following sociomaterial conditions: loss of face-to-face contact with friends and family members; concerns about hygiene and infecting others; financial stress; loss of regular paid employment or volunteering work; public spaces; and the behaviour of unknown others in public spaces. The agents and practices that emerged as most important for opening capacities for coping and maintaining wellness during lockdown included: the space of the home; contact with a small number of intimate others; online therapeutic care; practising self-care skills learnt from previous difficult times; helping and supporting others; engaging in leisure activities; and the companionship of pets. Contributing to an affirmative approach to more-than-human assemblages of health, distress and recovery, these findings demonstrate what bodies can do in times of crisis and the agents and practices that can generate capacities for coping.     

When the social self is threatened: shame, physiology, and health

Our program of research focuses on shame as a key emotional response to "social self" threats (i.e., social evaluation or rejection). We propose that shame may orchestrate specific patterns of psychobiological changes under these conditions. A series of studies demonstrates that acute threats to the social self increase proinflammatory cytokine activity and cortisol and that these changes occur in concert with shame. Chronic social self threats and persistent experience of shame-related cognitive and affective states predict disease-relevant immunological and health outcomes in HIV. Across our laboratory and longitudinal studies, general or composite affective states (e.g., distress) are unrelated to these physiological and health outcomes. These findings support a stressor- and emotional response-specificity model for psychobiological and health research.     

Life Satisfaction and Symptoms of Mental Disorder Among Older African American Public Housing Residents

This study examines life satisfaction and symptoms of mental disorder in a sample of 831 older African American residents of urban public housing developments. Symptoms of mental disorder included measures of emotional distress, alcohol-related problems, and cognitive impairment. Subjects reporting less life satisfaction had significantly greater emotional distress. Neither lifetime alcohol-related problems nor cognitive impairment were significantly related to life satisfaction. Stepwise multiple regression analyses indicated that emotional distress subscales accounted for most of the explained variance in life satisfaction. Social dysfunction was the strongest predictor of life satisfaction, accounting for 17% of the variance. Having a confidant, instrumental social support, religious support, or being female also contributed to the explained variance in life satisfaction.     

Can we measure out a life in coffee spoons?

Public policy decisions in medicine and other fields necessitate careful weighing of choices and consequences. Cost-benefit analyses have been offered as one way to facilitate such decisions. In "Quantifying the value of human life," L. Eugene Arnold asserts that mathematical models such as his offer greater clarity in making public policy decisions than is possible with the "intuitive" or "emotional" approach. In our opinion, problems associated with this quantitative analysis demonstrate a need for caution in applying such mathematical models to public policy decisions....     

Prediction of symptoms of emotional distress by mood regulation expectancies and affective traits

Three studies examined negative mood regulation expectancies (NMRE) and affective traits as independent predictors of self‐reported symptoms of emotional distress. NMRE represent individuals' beliefs that they can alleviate unpleasant emotional states. Stronger NMRE are associated with more adaptive coping, more positive cognition during negative moods, more effective responses under stress and less emotional distress. Affective traits represent long‐term tendencies toward particular affective experiences; they confer risk for specific symptoms of emotional distress. In Study 1, NMRE, trait negative affect (TNA) and trait positive affect (TPA) were all independently associated with depression among students and staff of a German university. In Study 2, in prospective analyses among U.S. college students traits exhibited hypothesised relationships with anxiety and depressive symptoms, and NMRE uniquely predicted anhedonic depression. Study 3 revealed independent prediction of change in symptoms over time by NMRE among U.S. college students, whereas traits were not associated with change in distress, anxiety and depression symptoms. Results suggest independent roles for NMRE and traits in the development of depression and anxiety symptoms and highlight the importance of NMRE as a potential target of therapeutic intervention in the process of symptom change.     

Childhood maltreatment, emotional distress, and early adolescent sexual intercourse: multi-informant perspectives on parental monitoring

This prospective investigation used multi-informant models to examine whether parental monitoring moderated associations between child maltreatment and either emotional distress or sexual intercourse. Data included 637 youth in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Child maltreatment was determined by lifetime Child Protective Service records and youth self-report and included sexual, physical, psychological abuse, and neglect (age 12). The moderating variable was youth- and caregiver-reported parental monitoring (age 12). Outcome variables were emotional distress (age 12) and sexual intercourse (age 14). Analyses included multi- and individual-informant models, adjusting for age, ethnicity/race, family income, and study site. Rates of parental monitoring did not differ by gender, but gender-specific analyses found that among girls, but not boys, youth-reported parental monitoring buffered the effect of maltreatment on emotional distress. Subtype analyses found that the buffering effects of monitoring on emotional distress were strongest for sexual and physical abuse and when youth experienced multiple subtypes of maltreatment. Caregiver-reported monitoring was not associated with reduced emotional distress. Youth and caregiver reports of parental monitoring were inversely associated with sexual intercourse, regardless of maltreatment history. Findings suggest that promoting parental monitoring among caregivers, and perceptions of monitoring among youth, may prevent early sexual intercourse regardless of maltreatment history. Promoting parental monitoring among youth with a history of maltreatment, especially girls or those who have experienced sexual or physical abuse or multiple subtypes of abuse, may reduce the likelihood of emotional distress.     

RESOURCE LOSS, RESOURCE GAIN, AND COMMUNAL COPING DURING PREGNANCY AMONG WOMEN WITH MULTIPLE ROLES

We investigated stress, coping, and employment status in 92, mostly European American pregnant women. Conservation of Resources (COR) theory (Hobfoll, 1988, 1989) was applied as a specification of role-quality theory to examine the stressful influences of women's multiple roles. Women's resource loss predicted psychological distress better than either their resource gains or their employment status (i.e., multiple versus single roles). Full-time employed women were significantly more distressed under high loss conditions than were part-time or nonemployed women. Examining women's coping strategies based on a communal model of coping, we found that active, prosocial coping was associated with better emotional outcomes. A significant interaction was found for the effects of loss × cautious action such that loss was related to greater depression, but only among women who did not employ cautious action.     

Reducing Psychological Distress in a Genetic Counseling Consultation for Breast Cancer

High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care.     

Parent and child adjustment dual trajectories at the beginning of the COVID-19 syndemic

Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual-trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3- to 8-year-old children (M_Age = 5.04, SD_Age = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle- and high-socioeconomic status families) demonstrated family resilience amid COVID-19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at-risk families and modifiable factors for post-disaster public health interventions.     

Emotional Reactions to Observing Misogyny: Examining the Roles of Gender, Forecasting, Political Orientation, and Religiosity

The purpose of this study was to examine the reactions of women and men who observe misogyny. The authors examined the emotional distress associated with observing misogyny, and the degree to which this varied based on (a) reading about or actually observing the incivility, (b) political orientation, and (c) religiosity. Participants (n?=?205 US college students) took part in a between subjects experiment where they either heard or read about one of two scenarios: two men making a disparaging comment about a woman while she was out of the room, or a situation in which no comment was made. Results indicate that women, but not men, overestimated their emotional distress to observing misogyny. For women, but not men, whether or not the misogynistic comment was heard also interacted with religiosity to predict emotional distress. Political orientation did not have an effect on women and men’s reactions. The authors discuss contributions and implications.     

Family,public and private religiousness and psychological well-being over time in at-risk adolescents

Positive effects of different dimensions of religiousness (including private, public and familial) on well-being as well as the stress buffering effects of religiousness have been documented. However, relatively little research has explored how these different facets of religiousness are related to psychological well-being in at-risk adolescents. This study examined family, public and private religiousness and their protective influence on psychological adjustment in adolescents at risk for poor psychological and behavioural outcomes. Participants include 186 urban teens divided between African Americans and European Americans. Structured interviews assessed religiousness, stress, as well as change in emotional distress and substance abuse problems over a one-year period. Greater private religiousness protects adolescents exposed to higher levels of stress from emotional and behavioural problems. In contrast, higher levels of family religiousness exacerbate emotional problems over time in adolescents exposed to greater stress. Findings demonstrate the complex influence of religiousness on psychological well-being in adolescence.