Profiles of emotion regulation: Understanding regulatory patterns and the implications for posttraumatic stress

Trauma survivors often experience posttraumatic stress (PTS) and report concurrent difficulties with emotion regulation (ER). Although individuals typically use multiple regulatory strategies to manage emotion, no studies yet examine the influence of a constellation of strategies on PTS in a community sample. We assessed six ER strategies and investigated whether specific profiles of ER (i.e. the typical pattern of regulation, determined by how often each strategy is used) were related to PTS. A hierarchical cluster analysis indicated that four distinct profiles were present: Adaptive Regulation, Active Regulation, Detached Regulation, and Maladaptive Regulation. Further analyses revealed that an individual's profile was not related to frequency of past trauma, but had the power to differentiate symptom severity for overall PTS and each symptom cluster of posttraumatic stress disorder. These findings highlight how profiles characterising multiple regulatory strategies offer a more complete understanding of the ways ER can account for PTS.     

Difficulties in emotion regulation differentiate depressive and obsessive–compulsive symptoms and their co-occurrence

Background and Objectives: Depressive and obsessive–compulsive (OC) symptoms are frequently comorbid, and the combination of these may result in additional impairment compared to the difficulties of experiencing one of these symptom groups. Emotion regulation difficulties underlie many forms of psychopathology symptoms, and this study examined whether aspects of emotion regulation could differentiate clinical levels of depressive and OC symptoms, and their co-occurrence. Design and Method: College students (N?=?199; M_age?=?19.47 years; 59.8% female) were grouped based on the presence of clinical levels of OC and depressive symptoms. Using a multinomial logistic regression approach, differences in odds ratios for emotion regulation difficulties were examined. Results: The co-occurring clinical-symptom group was differentiated from the single clinical-symptom groups on several aspects of emotion regulation. Impulse-control difficulties and limited access to emotion regulation strategies differentiated clinical levels of depressive from OC symptoms. Conclusions: This study highlights the importance of conducting a nuanced emotion assessment to best inform prevention and treatment of depressive and OC symptoms, and their comorbidity.     

Beliefs about emotion: implications for avoidance-based emotion regulation and psychological health

People’s beliefs about their ability to control their emotions predict a range of important psychological outcomes. It is not clear, however, whether these beliefs are playing a causal role, and if so, why this might be. In the current research, we tested whether avoidance-based emotion regulation explains the link between beliefs and psychological outcomes. In Study 1 (N?=?112), a perceived lack of control over emotions predicted poorer psychological health outcomes (increased self-reported avoidance, lower well-being, and higher levels of clinical symptoms), and avoidance strategies indirectly explained these links between emotion beliefs and psychological health. In Study 2 (N?=?101), we experimentally manipulated participants’ emotion beliefs by leading participants to believe that they struggled (low regulatory self-efficacy) or did not struggle (high regulatory self-efficacy) with controlling their emotions. Participants in the low regulatory self-efficacy condition reported increased intentions to engage in avoidance strategies over the next month and were more likely to avoid seeking psychological help. When asked if they would participate in follow-up studies, these participants were also more likely to display avoidance-based emotion regulation. These findings provide initial evidence for the causal role of emotion beliefs in avoidance-based emotion regulation, and document their impact on psychological health-related outcomes.     

Emotion regulation mediates the effects of temperament traits and posttraumatic stress disorder symptoms on affect in motor vehicle accident survivors

ObjectivesThe aim of the present study was to investigate the associations among temperament traits postulated by the Regulative Theory of Temperament (RTT), posttraumatic stress disorder symptoms (PTSD symptoms), emotion regulation strategies, and affect in the 280 motor vehicle survivors (MVA).MethodsTemperament was measured with the Formal Characteristics of Behaviour–Temperament Inventory (FCB-TI), the level of posttraumatic stress disorder symptoms was assessed by the PTSD Clinical Inventory (PTSD-C), emotion regulation was tested with the Polish adaptation of the Inventory of Cognitive Affect Regulation Strategies (ICARUS), and affect was evaluated by the Polish version of the Positive and Negative Affect Scale (PANAS).ResultsGreater emotional reactivity was associated with grater negative affect (also by maladaptive regulation) and lower positive affect whereas greater activity was linked to grater positive affect (also via adaptive regulation). Furthermore, greater PTSD symptoms were related to greater negative affect (also through maladaptive regulation) and lower positive affect. However, PTSD symptoms were not linked to adaptive regulation strategies.ConclusionThe findings significantly extends our current knowledge on the associations among temperament traits, PTSD symptoms, emotion regulation strategies, and affect in the motor vehicle survivors.     

Role of event centrality and emotion regulation in posttraumatic stress disorder symptoms among internally displaced persons

Background: Event centrality and emotion regulation in relation to posttraumatic stress disorder (PTSD) have been documented in various global samples especially in Western cultures; but internally displaced persons (IDPs) still constitute an underrepresented population in psychotraumatology literature. This study tested the roles of event centrality and emotion regulation strategies (cognitive reappraisal and expressive suppression) in PTSD symptoms among IDPs in Nigeria.

Design: The multi-group cross-sectional design was adopted.

Methods: Tiv language versions of the Centrality of Events Scale, Emotion Regulation Questionnaire, and Harvard Trauma Questionnaire were completed by 859 IDPs in two camps located in Benue State, North-central region of Nigeria.

Results: Hierarchical multiple linear regression results indicated that event centrality positively predicted PTSD symptoms. Cognitive reappraisal was a negative predictor of PTSD symptoms while expressive suppression was a positive predictor of PTSD symptoms. Bonferroni corrections indicated that expressive suppression was the strongest predictor of total PTSD symptoms, avoidance/numbing symptoms, and hyper-arousal symptoms; but event centrality was the most robust predictor of PTSD intrusion/re-experiencing symptoms.

Conclusion: The findings underscore recent developments in psychotraumatology indicating that the extent to which individual differences impact the development of PTSD is essential in clinical psychology research and practice.     

Ruminative Inertia,Emotion Regulation,and Depression: A Daily-Diary Study

Emotional suppression and cognitive reappraisal are emotion regulation strategies that have been linked to the severity of depression. Recent research has shown that greater ruminative inertia (i.e., rumination that is more resistant to change across time) is also associated with higher levels of depressive symptoms in clinical samples. However, it is unknown how tendencies to use suppression or reappraisal might be related to the inertia of rumination from day to day. After completing a baseline assessment of depressive symptoms and trait emotional suppression and cognitive reappraisal use, undergraduates (n = 94) completed daily-diary questionnaires assessing rumination for two weeks. Both higher depressive symptoms and greater tendencies to use suppression predicted stronger ruminative inertia, while tendencies to use reappraisal were unrelated to ruminative inertia. These results suggest that maladaptive emotion regulation strategies may contribute to a pattern of rumination that is more resistant to change over time. They also provide the first evidence that ruminative inertia is positively associated with depressive symptoms in a nonclinical sample.     

Difficulties in emotion regulation are associated with panic symptom severity following a quit attempt among cannabis dependent veterans

Background and Objectives: Prior research suggests that difficulties in emotion regulation are associated with elevations in panic symptoms. The present study aimed to extend this work by prospectively examining the relation between difficulties in emotion regulation and panic symptoms over the course of a self-guided cannabis cessation attempt. Design and Method: One hundred and four cannabis-dependent military veterans participated in the study. Difficulties in emotion regulation and panic symptoms were assessed at baseline and at each week during a four-week cessation attempt for a total of five time-points. Results: Fewer difficulties in emotion regulation were associated with a greater reduction in panic symptoms during the self-guided cannabis cessation period. Results remained significant after statistically adjusting for mean substance use (i.e., cannabis, alcohol, and tobacco) during the study period. Conclusions: Results are discussed in terms of integrating adaptive emotion regulation skills training into existing evidence-based treatments for cannabis dependence.     

Infant Emotion Regulation Strategy Moderates Relations between Self‐Reported Maternal Depressive Symptoms and Infant HPA Activity

Children of mothers with depressive symptoms often have high cortisol levels. Research shows that various child characteristics (e.g., attachment pattern, internalizing behaviours, and temperament) moderate this association. We suggest that these characteristics share common variance with emotion regulation strategy. Therefore, we examine infant emotion regulation strategy as a moderator of the association between maternal depressive symptoms and infant hypothalamic–pituitary–adrenal (HPA) function. We hypothesize that infants who utilize more independent emotion regulation strategies and have mothers who report higher depressive symptoms will exhibit elevated cortisol levels. Participants were 193 mothers and infants (15 months old) recruited from the community. Self‐reported maternal depressive symptoms were assessed. Infant independent regulatory behaviours (withdrawal, wandering away, distraction, scanning, orienting to another object) were coded in the context of a Toy Frustration Task. Infant cortisol was collected via saliva samples at baseline, +20, and +40 minutes. Results indicate that infant emotion regulation strategy moderates the relation between mothers' self‐reported depressive symptoms and infant total cortisol output (AUC_G) and cortisol reactivity (AUC_I). Infants who employed more independent regulatory behaviours and have mothers with higher depressive symptoms experience greater cortisol secretion. We discuss the findings in relation to parent‐infant interactions and the adaptive nature of emotion regulation strategies, as they relate to HPA regulatory capacities. Copyright © 2015 John Wiley & Sons, Ltd.     

Assessment of stress and self-efficacy for the NIH Toolbox for Neurological and Behavioral Function

Background and Objectives: The NIH Toolbox for Neurological and Behavioral Function assessment battery contains measures in the domains of cognitive function, motor function, sensory function, and emotional health. It was designed for use in epidemiological and clinical trials health-related research. Design: This paper describes the first phase of instrument development for the stress and self-efficacy subdomain of emotional health. Based on an extensive literature review and expert consultation, 127 measures were initially considered for inclusion in this subdomain, including measures of stress, self-efficacy, emotion regulation, and coping. Results: Several measures, including emotion regulation and measures of coping strategies, did not meet criteria that were a priori established for inclusion. Psychometric properties of the remaining candidate measures were evaluated using data from five independent samples (combined N = 3175). Confirmatory and exploratory factor analyses indicated the Perceived Stress Scale and the General Self-Efficacy Scale each assessed single dimensions. Conclusions: Based on their psychometric performance, these two instruments were selected for inclusion and subsequent national norming for the NIH Toolbox.     

Doing Despite Disliking: Self‐regulatory Strategies in Everyday Aversive Activities

We investigated the self‐regulatory strategies people spontaneously use in their everyday lives to regulate their persistence during aversive activities. In pilot studies (pooled N = 794), we identified self‐regulatory strategies from self‐reports and generated hypotheses about individual differences in trait self‐control predicting their use. Next, deploying ambulatory assessment (N = 264, 1940 reports of aversive/challenging activities), we investigated predictors of the strategies' self‐reported use and effectiveness (trait self‐control and demand types). The popularity of strategies varied across demands. In addition, people higher in trait self‐control were more likely to focus on the positive consequences of a given activity, set goals, and use emotion regulation. Focusing on positive consequences, focusing on negative consequences (of not performing the activity), thinking of the near finish, and emotion regulation increased perceived self‐regulatory success across demands, whereas distracting oneself from the aversive activity decreased it. None of these strategies, however, accounted for the beneficial effects of trait self‐control on perceived self‐regulatory success. Hence, trait self‐control and strategy use appear to represent separate routes to good self‐regulation. By considering trait‐ and process‐approaches these findings promote a more comprehensive understanding of self‐regulatory success and failure during people's daily attempts to regulate their persistence. © 2018 European Association of Personality Psychology     

Performance and learning goals for emotion regulation

Goal orientation theory is concerned with performance and learning goals in academic, athletic, and other ability areas. Here we examine performance and learning goals for emotion regulation. We define performance goals for emotion regulation as seeking to prove one’s ability to manage emotions; learning goals for emotion regulation are defined as seeking to improve one’s ability to manage emotions. In two studies, we tested the hypothesis that performance goals for emotion regulation would be associated with greater use of defensive emotion regulation strategies and depressive symptoms. Results from both studies showed that individuals with greater performance goals for emotion regulation reported higher levels of rumination and thought suppression and greater depressive symptoms, while individuals with greater learning goals reported greater use of cognitive reappraisal. The findings suggest that goals for emotion regulation may help explain individual differences in use of defensive versus constructive emotion regulation strategies.     

Gender and age differences in emotion regulation strategies and their relationship to depressive symptoms

We examined differences between men and women, and between young, middle and older age adults in emotion regulation strategies (rumination, suppression, reappraisal, problem-solving, acceptance, social support) and the relationships between these strategies and depressive symptoms. Women were more likely than men to report using several different emotion regulation strategies, and these gender differences were significant even after statistically controlling for gender differences in depressive symptoms. Use of most strategies decreased with age, with two exceptions: (1) use of suppression increased with age for women but not for men and (2) use of acceptance did not decrease with age for women. Use of maladaptive strategies was associated with more depressive symptoms in all age groups and both genders, yet, the use of adaptive strategies generally was not related to lower levels depressive symptoms across groups.     

Role of maternal affect and regulatory strategies in toddlers’ emotion and behavior regulation

Using a moment-to-moment multilevel approach, we examined the relative effectiveness of (a) toddlers’ lagged (i.e., previous-interval) regulatory strategies and toddlers’ lagged expression of negative emotion, as moderated by maternal affect, and (b) maternal lagged regulatory strategies, on toddlers’ current-interval (1) expression of negative emotion, and, (2) ability to delay gratification during a wait task. Two-level random coefficient models, with twelve repeated-measurement occasions (10 s-intervals) of observed behaviors (N = 1571) nested within 134 mother-toddler dyads from low-income families (67 girls; M_age = 25.77 months, SD_age = 1.60) were examined. Cross-level interactions revealed that maternal positive affect buffered severity of toddlers’ expression of negative emotion between lagged and current-intervals, while maternal negative affect disrupted toddlers’ effective utilization of lagged regulatory strategies on current-interval expression of negative emotion. However, regardless of maternal affect, toddlers who displayed higher expression of negative emotion and utilized more regulatory strategies in lagged-intervals displayed greater delay of gratification in current-intervals. Also, as mothers displayed greater minimization of toddlers' emotional distress, higher physical restraint, and used fewer distractions, toddlers displayed more intense expression of negative emotion in subsequent intervals. Similarly, as mothers used higher physical restraint and fewer distractions, toddlers were less able to wait in subsequent intervals. Results illustrate the disruptive roles of maternal negative affect and unsupportive regulatory strategies on toddlers' emotion and behavior regulation. Together, these findings point to targeting maternal positive affect in combination with supportive regulatory strategies to promote toddlers’ transition from external- to internal-regulation.     

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.

Are emotion regulation difficulties a moderator in the relationship between dating abuse and body investment in eating disorders?

IntroductionIt is well known that eating disorders (EDs) are related to intimacy difficulties and to previous adverse experiences; however, little is known about dating abuse and how this kind of abuse is related to the different facets of body investment and emotion regulation difficulties in EDs. This study aimed to evaluate the presence of dating abuse in ED outpatients and to evaluate the moderating role of difficulties in emotion regulation in the relationship between dating abuse and the different facets of body investment.MethodSixty-four ED outpatients (95.3% females; aged from 15 to 30 years) completed self-report measures regarding dating abuse, body investment, difficulties in emotion regulation, and ED symptoms.ResultsApproximately 89% of ED outpatients identified a current or past dating relationship. Of those, 51 (89.5%) reported at least one episode of dating abuse perpetration, and 52 (91.2%) reported at least one episode of dating abuse victimization. Emotional abuse was the most reported type of dating abuse. High levels of dating abuse were related to elevated body care in participants with more difficulties in emotion regulation. The remaining models, incorporating the other facets of body investment, did not show significant moderating effects.DiscussionA substantial number of ED outpatients reported dating abuse. Pending longitudinal replication, body care may be used as a strategy to deal with dating abuse in the absence of more adaptive emotion regulation strategies.     

Cyberbullying victimization and somatic complaints: A prospective examination of cognitive emotion regulation strategies as mediators

Background/Objective: The main purpose of this study was to examine the relationships among cybervictimization, maladaptive cognitive emotion regulation strategies and somatic complaints in a 4-month follow-up study. Method: A total of 1,024 high school students (456 male and 568 female, M (SD) = 13.69 years (1.3 years), range 12–18 years, voluntarily participated in this study. Measures of cybervictimization and cognitive strategies were obtained at Time 1. Four months later (Time 2), measures of somatic complaints were obtained. Results: Multiple mediation analyses were conducted to determine the mediating roles of maladaptive strategies in the link between cybervictimization and somatic complaints. As expected, path-analytic results showed that cybervictimization predicted somatic symptoms. Furthermore, some maladaptive regulation strategies, namely self-blame and rumination, partially mediated the link between cybervictimization and somatic symptoms evaluated 4-months later. Conclusions: The findings are discussed in terms of the role that maladaptive cognitive emotion regulation strategies might play with regards to physical health in cyberbullying episodes. In general, these findings have important implications for developing an understanding about the affective determinants of somatic health problem initiation and maintenance after a victimization and for developing intervention programs specifically for cybervictimized adolescents.     

Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety

ABSTRACT

The aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame (only girls), positive reappraisal, and positive refocusing (the latter two inversely) were uniquely (and significantly) associated with depression symptoms; and after controlling for comorbid depression symptoms, catastrophising and other-blame were uniquely related to anxiety symptoms. The results supported the cognitive content-specificity model, in which anxiety is supposed to be uniquely characterised by thoughts concerning the overestimation of threats and harm, and depression is supposed to be uniquely characterised by negative evaluations of self, and of past and future events.     

Direct and indirect associations of cognitive reappraisal and suppression with disease biomarkers

Objective: Habitual use of emotion regulation strategies may influence physical health. We examined whether the tendencies to employ cognitive reappraisal and suppression were associated with health biomarkers, and whether stress and sleep quality mediated these associations. Design & main outcome measures: Using data from the Biomarkers substudy (n?=?1255) of the national Midlife in the U.S. Study, we tested the hypothesis that there would be indirect, but not direct, associations of cognitive reappraisal and suppression to biomarker indicators of multisystem physiological dysregulation, that is, allostatic load (AL). We computed the proportion of biomarkers in the highest risk quartile within seven biological systems, and summed these scores to compute AL. Associations with the biological systems were also examined separately.Results: Neither reappraisal nor suppression was directly associated with AL or biomarker function in the seven biological systems. Suppression was indirectly associated with higher AL and greater dysregulation in the inflammatory, metabolic, and hypothalamic-pituitary-adrenal systems via its relations to stress and sleep, p?<?0.05. Reappraisal was indirectly associated with lower AL and less metabolic and inflammatory dysregulation, ps<0.05.Conclusions: Suppression and reappraisal may have different downstream health effects via stress, sleep, and biomarker expression, suggesting malleable emotion regulation strategies may be an important intervention target.     

Interoceptive attention facilitates emotion regulation strategy use

BackgroundPerception of bodily signals—or interoception—has been suggested to facilitate individuals’ habitual use of emotion regulation (ER) strategies and to guide the flexible deployment of specific ER strategies. Previous research has shown that the emotional intensity of stimuli modulates regulatory choice between disengagement (i.e., distraction) and engagement strategies (i.e., reappraisal).MethodThis study used experience-sampling methods to investigate the role of interoceptive attention in dynamic changes in ER strategies. Healthy participants first completed one-time measurements of ER strategies, emotional awareness and interoceptive attention in the lab and then reported on negative events and use of strategies including reappraisal and distraction, throughout daily life.ResultsResults showed that interoceptive attention was positively associated with habitual use of several ER strategies, and emotional awareness mediated the relations between interoceptive attention and these ER strategies. Results also suggested an interaction between interoceptive attention and intensity of negative events; individuals with higher interoceptive attention used distraction rather than reappraisal only during high intensity negative life events, but those with lower interoceptive attention used more distraction than reappraisal, regardless of event intensity.ConclusionsOverall, these findings suggest interoceptive attention may increase emotional awareness, which in turn facilitates application of certain ER strategies but also the flexible deployment of appropriate strategies tailored to a given situation. Training interoceptive attention may provide a promising way to improve ER and promote mental health.